The Cult ure of Homework Homework is a long-standing education tradition that, until recently, has seldom been questioned. The concept of homework has become so ingrained in U. Simple tasks of memorization and practice were easy for children to do at home, and the belief was that such mental exercise disciplined the mind.
In this and the following chapter, the main grouping is by the therapeutic goal, with three major domains highlighted: Each of these three areas has the aim of improving the quality of life and well-being of the person with dementia, which may in turn impact on the well-being of those providing care.
In this chapter, we look at the evidence for the effectiveness of interventions designed to enhance and increase functioning; in the following chapter, the Spiritual needs and occupational therapy essay of therapy is to reduce depression or agitation or to modify other distressing symptoms of dementia — although potentially this may also be achieved by improving function in other areas.
This chapter focuses specifically on outcomes for the person with dementia, whilst in Chapter 9 interventions directed at carers, whose experience of the effects of dementia is often equally important, are discussed in detail.
However, with regard to the intervention reviewed in this chapter, where relevant effects on carers have been documented, these will be highlighted here. Cognitive symptoms are, of course, recognised as the core of any definition of dementia, and interventions targeting them have been the subject of much research and interest.
However, the link between improving cognitive symptoms and maintaining day-to-day function is also key. In considering the efficacy of interventions in this chapter, it is this broader effect that must be the eventual goal. This chapter includes discussion of both pharmacological and non-pharmacological approaches.
Evaluating the effects of such different types of interventions alongside each other is a relatively new endeavour and some caution is required, especially when the double-blind RCT is taken as the gold standard Woods, While the pharmacological intervention can be conveniently packaged and standardised, with a measured dose, non-pharmacological interventions can be more difficult to evaluate.
The same label may be used for an intervention in different studies, but it may comprise quite different components. Non-pharmacological interventions have rarely used a standardised treatment manual; any such manual would, in any case, need to take on board the range of individual differences between people with dementia if it were to be seen as a credible approach.
Double-blind studies are seldom possible, as the person with dementia or carer will be perfectly aware of which intervention he or she is receiving, although it is feasible to ensure that assessors are unaware of group allocation.
While it is sometimes possible to design placebo interventions, assuring that those delivering them do so with the same enthusiasm as for the intervention being evaluated is problematic. Although some interventions can be offered for a discrete period of time, such as half an hour per day, many others involve intervention at the level of the care setting or in the general approach or interactive style of those providing care.
Cluster randomised designs would be appropriate for evaluating interventions at care-setting level, but require considerable resources.
Where the intervention is designed to be delivered through carer interaction, a key step is to ensure that any training provided is effective in producing the required type and quality of interactions.
Introduction Promoting independence is important at all stages of dementia and is used in this guideline to mean facilitating performance of or engagement in as much activity as is reasonable and tolerable for the individual. Though the level of independence will change with the stage of dementia and other illnesses, a balance across personal care and productive, leisure, social and spiritual activities is important for quality of life and well-being.
As function deteriorates, it is not uncommon for people with dementia to withdraw from more complex activity and social environments and for others to want to perform tasks for them.
However, the literature suggests that functioning in activities of daily living often deteriorates below what would be expected by the illness alone Tappen, ; Beck et al.Goldsmiths, University of London is in South East London.
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Spiritual Needs and Occupational Therapy - The importance of considering an individual's spirituality and the confusion over definition have been emphasised by the . The importance of considering an individual's spirituality and the confusion over definition have been emphasised by the interest shown in this subject over the past decade.
A working definition to help to reduce confusion was presented at the College of Occupational Therapists' annual conference in.
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Testimonials from listeners who have used Joudry Sound Therapy / Sound Therapy International programs. The thunder-and-lightning example seems like a bad comparison for this kind of situation, in that the false claim is (1) easily observable to be untrue, and (2) utterly useless to the society that propagates it.