The Tailored Activity Program to reduce behavioral symptoms in individuals with dementia: feasibility, acceptability, and replication potential - PubMed (original) (raw)

Randomized Controlled Trial

The Tailored Activity Program to reduce behavioral symptoms in individuals with dementia: feasibility, acceptability, and replication potential

Laura N Gitlin et al. Gerontologist. 2009 Jun.

Abstract

Purpose: The Tailored Activity Program (TAP) is a home-based occupational therapy intervention shown to reduce behavioral symptoms and caregiver burden in a randomized trial. This article describes TAP, its assessments, acceptability, and replication potential.

Design and methods: TAP involves 8 sessions for a period of 4 months. Interventionists identify preserved capabilities, previous roles, habits, and interests of individuals with dementia; develop activities customized to individual profiles; and train families in activity use. Interventionists documented time spent and ease conducting assessments, and observed receptivity of TAP. For each implemented prescribed activity, caregivers reported the amount of time their relative spent in activity and perceived benefits.

Results: The TAP assessment, a combination of neuropsychological tests, standardized performance-based observations, and clinical interviewing, yielded information on capabilities from which to identify and tailor activities. Assessments were easy to administer, taking an average of two 1-hr sessions. Of 170 prescribed activities, 81.5% were used, for an average of 4 times for 23 min by families between treatment sessions for a period of months. Caregivers reported high confidence in using activities, being less upset with behavioral symptoms (86%), and enhanced skills (93%) and personal control (95%). Interventionists observed enhanced engagement (100%) and pleasure (98%) in individuals with dementia during sessions.

Implications: TAP offers families knowledge of their relative's capabilities and easy-to-use activities. The program was well received by caregivers. Prescribed activities appeared to be pleasurable and engaging to individuals with dementia. TAP merits further evaluation to establish efficacy with larger more diverse populations and consideration as a nonpharmacological approach to manage behavioral symptoms.

Trial registration: ClinicalTrials.gov NCT00259467.

PubMed Disclaimer

Similar articles

Cited by

References

    1. Alzheimer's Association. 2008 Alzheimer's disease facts and figures. 2008. Retrieved May 2, 2008, from http://www.alz.org/national/documents/report_alzfactsfigures2008.pdf. - PubMed
    1. American Psychiatric Association Work Group on Alzheimer's Disease and Other Dementias. American Psychiatric Association practice guideline for the treatment of patients with Alzheimer's disease and other dementias. Second edition. American Journal of Psychiatry. 2007;164(Suppl. 12):5–56. - PubMed
    1. Ballard C, Hanney ML, Theodoulou M, Douglas S, McShane R, Kossakowski K, et al. for the DART-AD investigators. The dementia antipsychotic withdrawal trial (DART-AD): Long-term follow-up of a randomized placebo-controlled trial. Lancet. 2009;8:151–157. - PubMed
    1. Ballard C, Lowery K, Powell I, O’Brien J, James I. Impact of behavioral and psychological symptoms of dementia on caregivers. International Psychogeriatrics. 2000;12(Suppl. 1):93–105.
    1. Bodenheimer T. Coordinating care—A perilous journey through the health care system. New England Journal of Medicine. 2008;358:1064–1071. - PubMed

Publication types

MeSH terms

LinkOut - more resources