Dementia is a collection of symptoms resulting from multiple areas of cognitive impairment that interfere with normal daily life functions. While memory impairment is generally the first and most commonly observed area of impairment, an individual suffering from dementia will also experience impairment in other cognitive functions, such as language, perception, judgment or reasoning. Secondary to cognitive impairment, individuals with dementia generally experience emotional, behavioral, and personality changes. As more areas of the brain become impacted by the disease process, the individual exhibits more severe and extensive cognitive impairment, with consequent loss of functional capacities.
Any approach to treating dementia and its many sequelae must be an interdisciplinary one, due to the multiple problems and needs of the person with dementia. When a dementia patient is no longer able to care for oneself at home, even with assistance, a memory/dementia care facility is often required to provide optimal care and quality of life. The person with mid-to-later stage dementia is generally in need of: nursing care to assist with activities of daily living, including feeding and basic hygiene needs; physical and occupational rehab services to assist with mobility and overall gross and fine motor skills; and supportive, cognitive, behavioral and family therapies to reduce feelings of anxiety, depression, agitation, and associated behaviors ranging from aggression to isolation.
While the traditional MTCA program is the treatment-of-choice for individuals experiencing ‘very mild’ and ‘mild’ symptoms of cognitive impairment, the specialized Dementia Treatment Program was developed in response to requests of MTCA to provide services for individuals experiencing moderate and moderately severe levels of dementia.
Just as our clinical psychologists and neuropsychologists provide cognitive testing to evaluate the degree of cognitive impairment for patients in our Memory Treatment Program, the Dementia Treatment Program has its own evaluation procedures. The battery of testing utilized in the DTP was strategically developed to identify the stage of dementia with which a patient is struggling, and to identify the remaining functional capacities that can be worked with in therapy. As a treatment team, the MTCA psychologist and treating clinician develop a plan of therapy that will augment the services already being provided on the dementia care unit. Individual therapy sessions are provided 2-3 times per week to help each individual patient achieve their best ability to function- even in the face of significant cognitive impairment.
Each individualized therapy plan involves a range of interventions, including supportive therapy, behavioral and cognitive therapy, family therapy, and consultation to facility staff. Our clinicians are provided with extensive education to strengthen their understanding of dementia and the various therapies available to help maintain quality of life for individuals struggling to function at each stage of the disease process. The skills of the mental health clinician to make contact and develop a trusting relationship with each individual are particularly valuable with this population. In addition to helping the individual to achieve their best ability to function, they are helped to communicate their needs, thoughts and feelings. This information is utilized not only to help the patient to feel understood (and thus decrease aggressive and other problematic behaviors that result from verbal communication impairment), but also to foster better understanding of family-members and facility staff that can inform the ways in which they approach the patient. Psycho-education regarding the various difficulties faced at each stage of dementia is also provided to family-members who may be struggling with unrealistic expectations, feelings of frustration, guilt, loss, and related emotional or behavioral challenges.