Logo image
Back
The tailored activities program (TAP) for the management of frontotemporal dementia: A case study
Conference poster   Open access   Peer reviewed

The tailored activities program (TAP) for the management of frontotemporal dementia: A case study

Claire M. O'Connor, Lindy Clemson, Henry Brodaty, John R. Hodges, Olivier Piguet, Laura N. Gitlin and Eneida Mioshi
Alzheimer's & dementia, v 11(7S_Part_18), pp P837-P838
Jul 2015
DOI: https://doi.org/10.1016/j.jalz.2015.06.1861
url
https://doi.org/10.1016/j.jalz.2015.06.1861View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Restricted

Abstract

Background Frontotemporal dementia (FTD) is a unique condition which manifests with a range of behavioural symptoms, dysfunction in activities of daily living and greater caregiver distress when compared to caregivers of other dementias such as Alzheimer's disease. With research into pharmacological treatments yet to show any clear benefit in FTD, research into non-pharmacological management is crucial, especially in light of marked impairments in activities of daily living (ADLs) and severe behavioural changes. Aim Describe a person with FTD receiving TAP. Methods TAP is a community-based occupational therapy (OT) intervention prescribing personalised activities for persons with dementia. Visits which are conducted in-home over a 4-month period are structured around three phases: assessment, activity prescription, and generalisation of strategies. Throughout the intervention there is a close collaborative relationship between the OT and caregivers, with an educational focus on dementia and skills in activity simplification, communication, and environmental modification. For the case study, measures included: Global cognition (Montreal Cognitive Assessment), functional disability (Disability Assessment for Dementia), Behavioural changes (Neuropsychiatric Inventory – Clinician rating scale), caregiver confidence, and Vigilance items, which occurred at baseline and 4 months (post-intervention). Results A 66-year-old man (Randall*, bvFTD) participated in TAP. After intervention, Randall's cognitive score on the MoCA remained constant. Randall improved his basic ADL score (+6%), retained a constant level of instrumental ADL functioning and improved his overall ADL score on the DAD (+2%). Caregiver confidence reduced (-0.5%; of note, baseline score was at ceiling). While vigilance feelings of “being on duty” worsened (+5.5), there was no change to time the caregiver was “actually doing things” for Randall. Caregiver distress regarding behaviours increased for dysphoria (+1), apathy (+2) and appetite and eating disorders (+3); however decreased for agitation (-7) and anxiety (-5). Conclusions FTD is a unique condition with its core behavioural features often resulting in higher levels of caregiver distress than other dementias. At an individual level, this case highlighted the great benefit of TAP at improving function and reducing marked behavioural changes. An ongoing randomised controlled trial in Australia will reveal the benefits of TAP at a group level. *Name changed to preserve confidentiality.

Metrics

39 Record Views

Details

Logo image