Date Presented 04/03/2025
Dementia-related behaviors are distressing. The Tailored Activity Program was beneficial for people with dementia and their caregivers when implemented by OTs in a clinical context in Australia.
Primary Author and Speaker: Sally Bennett
Contributing Authors: Lindy Clemson, Brenda Gannon, Trevor Russell, Maria O’Reilly, Kate Laver, Elizabeth Beattie, Lee-Fay Low, Alison Pighills, Jacki Liddle, Claire O’Connor, Asad Khan, Sandra Smith, Catherine Travers, Monique Smets, Gerard Byrne, Tammy Aplin, Laura Gitlin
PURPOSE: Behavior change is a distressing feature of dementia. The Tailored Activity Program (TAP), an evidence-based occupational therapy intervention, addresses such changes by coaching carers to tailor activities, providing education about dementia and stress management (Gitlin et al., 2008). This study explored the effect of TAP for people with dementia and their carers (client dyads) in Australia when provided by occupational therapists in the clinical context, and carers’ experiences.
DESIGN: This mixed methods pilot study used pre-post design and qualitative description of carers’ experiences. Embedded in an implementation study, 39 Australian therapists given implementation support, offered TAP to client dyads in the community and recruited them to the research.
METHOD: Baseline and post-TAP measures included: the Neuropsychiatric Inventory; Perceived Well-Being Index; Activity Engagement scale; and a measure of carer confidence - analyzed with descriptive statistics and t-tests for pre-post change. Carers experiences of TAP were explored through interviews and data analyzed using thematic analysis.
RESULTS: Of the 24 client dyads who commenced, 16 (66%) provided pre-post data. Significant improvements were found for: severity of behaviors (p = .003); carer distress (p = .012); perceived well-being (p=.031); and carer confidence (p = .007). Preliminary themes from interviews (n = 7) included: 1) ‘Gaining clarity’ – carers feel heard and gain perspective despite being overwhelmed; 2) ‘Timing of TAP’ – needing TAP earlier in realize greater benefit; and 3) ‘New ways’ – trialing new strategies.
CONCLUSIONS: Importantly, beneficial effects of TAP when provided by clinicians having received implementation support, echo results from research trials (Gitlin et al., 2008; Gitlin et al., 2018). Interview findings suggest the need for therapists to consider carers’ capacity and optimum time to deliver such programs, which should also be considered in future research.
References
Gitlin, L. N., Winter, L., Burke, J., Chernett, N., Dennis, M. P., & Hauck, W. W. (2008). Tailored activities to manage neuropsychiatric behaviors in persons with dementia and reduce caregiver burden: A randomized pilot study. American Journal of Geriatric Psychiatry, 16(3), 229–239. https://doi.org/10.1097/jgp.0b013e318160da72
Gitlin, L. N., Arthur, P., Piersol, C., Hessels, V., Wu, S. S., Dai,Y., & Mann W. C. (2018). Targeting behavioral symptoms and functional decline in dementia: A randomized clinical trial. Journal of the American Geriatrics Society, 66(2), 339–345. https://doi.org/10.1111/jgs.15194
