How Occupational Therapy Helps When Living with Mid-Stage Alzheimer's

A study looked at the quality of life for people living with Alzheimer's disease and their caregivers. The researchers checked how people felt before and after using occupational therapy in mid-stage Alzheimer’s.

The study showed that following an occupational therapist’s advice made a big difference. When the advice was based on the person's specific needs, quality of life improved for the person living with Alzheimer’s in the community. It also significantly lowered the stress felt by family members caring for them.¹

What are common mid-stage Alzheimer's symptoms?

There are many symptoms unique to mid-stage Alzheimer's disease, including:²

Cognition

A person can feel confused. They might not know where they are or what day or year it is. They may forget the names of their close family members. It may be hard for them to understand others or express themselves when talking. They often struggle to find the right words. However, they can still follow simple instructions.

Behavior

The person may feel more anxious. They might act out by being physically or verbally aggressive. They might act in ways that are not typical in social situations. Walking around or wandering happens more often in the late afternoon or at night. They may become more suspicious of others or pull away from social groups. They might see things that aren't there (hallucinations) or resist help with care.

Daily living skills

Moving around and understanding physical feelings becomes harder. It is common to have difficulty recognizing items or to be unaware of safety risks. These challenges mean the person needs assistance with tasks like grooming, showering, feeding, and dressing.

Also, at this stage, it is often very hard for an individual to handle instrumental tasks. This includes shopping, driving, doing laundry, taking medication, and using the telephone. These tasks require much assistance.²

What does an occupational therapy evaluation involve?

Occupational therapy in mid-stage Alzheimer's starts with a close look at the person's needs. Occupational therapists will conduct specific evaluations to assess how well the person can perform daily tasks and move around their home. The caregiver's feedback and the level of help they provide are also important.²

How can OT help with daily activities?

Occupational therapists can help you find ideas to keep your loved one busy and active. They look for activities the person might enjoy. An occupational therapist can also help family members and loved ones find ways to continue including the person in family events, parties, and social outings.^2,3

It is also very important for the therapist to watch how the person does everyday tasks in their own home.^2,3

What home modifications can improve safety?

Occupational therapists teach family members how to change the home to fix hazards and prevent injury. Some examples of home modifications include:^2,3

• Turning off the garbage disposal
• Removing small rugs that could cause a fall
• Keeping cleaning supplies and medicines in locked cabinets
• Using electrical covers over outlets.
• Using childproof knobs on the stove
• Replacing a glass shower door.

How can OTs help with caregiver communication?

Occupational therapists can teach caregivers new ways to help their loved one function better, even with memory loss.^2,3

The therapist helps the caregiver spot things that cause stress or agitation. For instance, mirrors can cause anxiety. Sometimes people living with Alzheimer's see their reflection and don't recognize themselves. This can make them feel like they are being watched by a stranger. Removing or covering mirrors is a simple way to help.^2,3

Therapists also show caregivers how to break tasks down into small, simple steps. Breaking tasks down makes the activity easier for the person to finish.^2,3

The therapist will also teach caregivers how to use "cues." This means using words, signs, or a gentle touch to guide the person. Sometimes "hand-over-hand" help is needed. This is extremely helpful for a loved one in mid-stage Alzheimer’s disease. It helps the person stay involved in meaningful activities.^2,3

What does a home OT program look like?

The therapist can teach the patient and caregivers a home program to follow. This program uses visual and spoken cues. It is very important to keep the person moving with strength and stretching activities.^2,3

Having a set schedule is very helpful. This should include self-care, hobbies, rest, and sleep. Occupational therapists will work with the patient and caregiver to create a schedule. They will provide it in a simple written or visual form. Keeping the schedule simple will help keep the person from feeling overwhelmed.^2,3

How to incorporate OT into your care team

Occupational therapists can help in many ways during each stage of Alzheimer's disease. This treatment can benefit the person, their family, and their caregivers.

If you feel occupational therapy in mid-stage Alzheimer's could benefit your loved one and your family, talk with your doctor. If your doctor agrees, they can refer you to an occupational therapist.

Most insurance plans will cover occupational therapy. Contact your insurance company to ask about your coverage.

Have you used occupational therapy for a loved one in mid-stage Alzheimer's? Want to talk to others in the community? Tell us about your experience in the comments below, or share your story with the community.