Psychosocial approaches for dementia:

Local stimulation groups

Annette Johannesen, MSc in OT

The Danish Knowledge Center on Ageing

Reality Orientation (RO)

A technique to improve the quality of life for confused people. It operates through the presentation of orientation information (time, place and person-related) to provide the person with greater understanding, resulting in an improved sense of control and self-esteem

Reality Orientation (RO)

• Important that the intervention is used in a sensitive, personal manner to people who want to be orientated to reality

• Constant re-learning drills may contribute to self-esteem problems if given in a rigid and insensitive way

Cognitive stimulation therapy (CST)

• CST programme is based on concepts of RO

• CST sessions: group name, theme song, warm-up activities, themed sessions, RO-board, word association, multi-sensory stimulation, flexible activities, reminiscense, strengthening relationships...

Danish Experience: Stimulation in a group-setting

• Local stimulation groups run by activity workers and home care staff

(Johannesen, Faaborg 1992)

Aim of the project

Gaining people with dementia and their families

• a better quality of life

• calmer living

• a longer stay in their customary environment

Psychosocial approach

Every person with dementia must be met as a unique person with a particular life story and profits from meeting others

Occupational approach• Health and well-

being is related to meaningful occupation

• People with dementia risk occupational imbalance and lack of stimulation

Home support

• To become familiar with the person with dementia, visits are made prior to attending the group

Assisted transport

• 3-5 times a week • 5-8 participants are

picked up at home• 3 hours meetings

Programme

• Warming up, coffee, songs, inquiry on well-being

• Date, today’s menu and deciding the schedule of the day, themed sessions, exercise, games, quiz, multi-sensory stimulation,

• Sharing memories and the experiences of having memory problems

”Cognitive fitness”

• Mental exercise: play, reading, quiz, puzzle, discussion, reminiscing, multi-sensory stimulation

Physical exercise/ activity

Sharing a meal

A qualitative evaluation

Local stimulation groups:

• increase the attention on the everyday life of the group members

• increase their social skills

• offer relief to the family

• delay admission to institution

• makes transfer to institution less stressful

Psychosocial interventions are needed

• The National Danish guidelines stress the importance of non-pharmacological treatment and coordination of efforts

• Analysis from Sweden shows, that persons with dementia stay longer in their own home

References

Samarbejdsmodel på demensområdet www.servicestyrelsen.dkSpector A et al.R eality orientation for dementia, The Cochrane Library,

Issue 4, 2000. Oxford:Update softwareSundhedsstyrelsen redegørelse: Demens - den fremtidige tilrettelæggelse

af sundhedsvæsenets indsats vedrørende diagnostik og behandling. Kan downloades på http://www.ssst.dk/publ/Publ2001/Demens/kap01.htm

Svenske Socialdepartementets rapport: På väg mod en god demensvård. Samhällets instser för personer med demenssjukdomar och deras anhörige, DS2003:47. Kan bestilles via fritzes.order@liber.se

Swane CE. Glimt i øje! - Udvikling af omsorgen for demente gamle mennesker, 1991. Socialministeriets Informations- og konsulentvirksomhed (SIKON)