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New Help for Dementia Patients, Delivered Via Games and Puzzles

New Help for Dementia Patients, Delivered Via Games and Puzzles
February 18
09:00 2020

By Andrea Petersen

Bertha Golding and Jackie Lauritzen huddled over an adult coloring book. Ms. Golding, 74, picked up a green pencil. Ms. Lauritzen, 68, chose a blue one. As the gospel song “I’ll Fly Away” played in the background, the two women colored and chatted.

“Who’s your favorite country star?” asked Ms. Lauritzen.

“Johnny Cash,” Ms. Golding replied.

During pauses in the conversation, they sang quietly together to the music: “I’ll fly away, oh glory. I’ll fly away.”

It looked like just two friends having a fun morning together at the Roy Hillside Senior Center here. But Ms. Golding has Alzheimer’s disease and Ms. Lauritzen is a volunteer who works with Ms. Golding twice a week.

The coloring exercise is part of a therapeutic approach for people with dementia run by a county-funded agency. Called the Tailored Activity Program, it uses activities, like games and puzzles, to engage patients. A version of the program has been shown to alleviate some of the most challenging symptoms of the disease, such as agitation and aggression. “It reengages people in daily life so they can feel a part of their environment and derive meaning and purpose,” says Laura Gitlin, dean of the College of Nursing and Health Professions at Drexel University, who created the program with colleagues.

Josephine Martinez, right, dances with her senior companion, Barbara Padilla, at the Golden Hours Senior Center in Ogden, Utah.PHOTO: KIM RAFF FOR THE WALL STREET JOURNAL

The Utah program, which launched in 2018, is the first of its kind to train volunteers rather than caregivers. Dr. Gitlin conceived a program to engage dementia patients with personalized activities about a decade ago. Versions of it have been adopted by organizations around the world, including in Scotland, Australia, Brazil and Italy. But the other iterations train the patients’ existing caregivers, who are often relatives.

The focus on volunteers here reflects a troubling reality as the dementia population is expected to surge: There simply aren’t enough caregivers to meet demand, says Quincy Samus, associate professor in the department of psychiatry and behavioral sciences at Johns Hopkins University. Caregivers also are often overwhelmed and juggling jobs and other family responsibilities.

Dr. Samus is launching a randomized controlled trial, funded by the National Institute on Aging, using the TAP volunteer program, along with other components. The study will involve 80 volunteers and 240 dementia patients along with their caregivers. It will look not only at the program’s effect on patients and caregivers, but on the volunteers, who are also seniors, to see if it helps with their cognition, physical function and social engagement. Clinicians at the University of Hong Kong are also planning to launch a TAP for volunteers program there by the end of this year.

Volunteer Jackie Lauritzen, left, helps Bertha Golding, who has Alzheimer’s disease, with a Bible-themed word search game. The game is one of several activities prescribed to Ms. Golding by an occupational therapist as part of the Tailored Activity Program.
Ms. Golding and Ms. Lauritzen color together. The activity is meant to spur engagement.

The program is part of a wave of nondrug treatments for dementia symptoms that also include music therapy, exercise and “reminiscence therapy,” an approach that uses photos and other prompts to jog patients’ memories. The interest is partly fueled by concerns that too many dementia patients are being treated with powerful psychiatric medications that either aren’t effective or have dangerous side effects, says Lon Schneider, professor of psychiatry, neurology and gerontology at the University of Southern California.

Karyl Chase, the director of the Senior Companion Program, says TAP techniques have made her volunteers more confident about working with people with dementia, a growing number of her clients. Before TAP, volunteers would say, “We don’t know how to deal with [people with dementia]. We don’t know what to do,” she says. Ms. Chase, who cared for her own mother with Alzheimer’s disease, found out about the TAP version using volunteers via a Facebook post and approached Dr. Gitlin about bringing it to Utah.

First, occupational therapists perform assessments of dementia patients’ mobility and cognitive abilities, evaluate the clients’ environments and identify potential activities. Then the occupational therapist works with a volunteer to introduce the activities to the client. The key is to find activities that aren’t too tough—which can be frustrating for the client—or too easy, which can be boring, says Ms. Chase.

Sometimes there are surprises. Josephine Martinez, 83, pretty much used to dance only at weddings, says her son and caregiver Richard Martinez. But on a recent Monday morning at the Golden Hours Senior Center in Ogden, Utah, Ms. Martinez, who has Alzheimer’s disease, was a constant on the dance floor, holding hands and swaying with her senior companion, Barbara Padilla. A six-piece band, complete with banjo, saxophone and ukulele, played songs including “Yes Sir, That’s My Baby.” “She’s very nice. I love her,” Ms. Martinez said of Ms. Padilla. “I love her, too,” Ms. Padilla replied.

Alice Gibbons and volunteer Jackie Lauritzen work on a puzzle in Ms. Gibbons’ home

The only time Karie Gibbons and her sister can both be out of the house they share with their 80-year-old mother Alice Gibbons are the days Ms. Lauritzen visits. “That’s been a lifesaver because you can’t leave her alone,” says the younger Ms. Gibbons. “I just do what I need to do—grocery shopping, if I want to go buy a pair of shoes,” she says. Ms. Lauritzen, who retired from a 30-year career as a server in family restaurants, volunteers with the senior companion program about 40 hours a week; she works with five different clients.

Karie Gibbons has been her mother’s full-time caregiver for the past six years, since the older woman began showing signs of dementia. The demands have steadily increased: The elder Ms. Gibbons now needs assistance with bathing, dressing, using the bathroom and getting in and out of her chair and bed.

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