Chapter Update

Monday, October 3

How Social Work Interventions Can Help People with Dementia and Their Families

How Social Work Interventions Can Help People with Dementia and Their Families Live With Purpose and Meaning
Darby Morhardt, MSW, LCSW
    Older adults and their families, most specifically those living with some form of cognitive impairment in the community setting has been the focus of my work for over 25 years.    I have learned much and been enriched by what they have taught me about aging, about facing challenge and coping with loss, and most importantly about living life with purpose and meaning.   In spite of the progressive nature of dementia and although we currently lack medications to prevent, arrest or reverse its course, we can enhance the quality of life for the person with dementia and their family.
    While non-medical interventions cannot stop disease progression, there are effective ways to help individuals and families cope.  A 2010 systematic review suggests that non-pharmacological treatments initiated early in the disease, have the potential to improve outcomes related to cognitive ability, physical functioning and well-being for those with dementia and their families (Olazaran, 2010).  Multimodal therapies that incorporate emotional support, exercise and promotion of physical health, creative expression and cognitive stimulation have been shown to positively affect physical, cognitive and behavioral outcomes (Burgener et al., 2008).  With the anticipated increase in individuals diagnosed with dementia there will be a demand for programs focused on participants’ strengths, abilities, creative potential and valuable contributions, rather than for their disease.
    In this workshop, Improving Quality of Life for Persons with Dementia and Their Families, we will review the growing body of research that calls attention to the impact of dementia on the affected person and their struggle to maintain a sense of identity despite diminishing abilities.  We will then review ways to help both the person with dementia and their family live and cope with cognitive decline by exploring a number of innovative education and quality of life enrichment programs targeting their multiple and complex needs.
    For example, we will discuss one program in which persons with early stage dementia are paired with a first year medical student for an academic year, allowing for the person with dementia to experience an empowering relationship in which they are not the “patient”, but a mentor and guide to a medical student.  This interaction, in turn, has led medical students to reconsider their images and ideas of illness and aging and allowed them to witness first-hand how the person with dementia and their family cope with the changes they are experiencing.
    The arts have long been recognized as enhancing health and well-being across the lifespan and interventions tapping into creative abilities of persons with early stage dementia also show promise.   Published results from model programs will be discussed and a new program using an improvisational theatre intervention for persons with early stage dementia will be introduced.
    Finally, the need for more research on the efficacy of non-pharmacological interventions will be examined.  In essence, what are the most effective ways of helping people with dementia preserve their sense of self and live their lives as meaningfully as possible?   I hope you will please join me in exploring these issues.
References
Burgener, S., Yang, Y., Gilbert, R., Marsh-Yant, S. (2008).  The effects of a multimodal     intervention on outcomes of persons with early-stage dementia.  American     Journal of Alzheimer’s Disease & Other Dementias, 23(4), 382-394.
Olazaran, J., Reisberg, B., Clare, L., Cruz, I., Pena-Casanova, J., del Ser, T., Woods, B.,     Beck, C., Auer, S., Lai, C., Spector, A., Fazio, S., Bond, J., Kivipelto, M., Brodaty,     H., Rojo, J.M., Collins, H., Teri, L., Mittelman, M., Orrell, M., Feldman, H.H., &     Muniz, R. (2010).  Nonpharmacological therapies in Alzheimer’s disease:  A     systematic review of efficacy. Dementia and Geriatric Cognitive Disorders,     30,161-178.
 

Posted on 10/03/11 at 09:23 AM

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