Cognitive rehabilitation: An enablement approach

This is an extract from an article published by Bahar-Fuchs et al. 2016

Helping people with dementia learn

Evidence from experimental studies shows that, when provided with appropriate support, people with early stage or mild dementia can learn or relearn relevant information, as well as adapt their behaviour, and develop new routines, skills and habits. Cognitive rehabilitation (CR) builds on this evidence, and exploits this knowledge to identify the most relevant methods of helping the person with dementia better manage everyday

activities.

For example, when people with dementia learn new information while limiting their opportunity to make memory errors, they sometimes recall information better than they do through trial and error – an approach known as errorless learning (Haslam et al 2011).

Another technique that has been successfully used to support learning in people with dementia is known as spaced retrieval. The simple principle underlying this technique is that when the time interval between the learning and subsequent recalling of information is very short (eg 30 seconds), and increases systematically in fixed increments of time, there is a greater chance that information will create a stronger trace in the person’s long-term memory store. Using spaced retrieval, we and others have demonstrated that people with mild dementia recalled face-name associations for up to nine months (Clare et al 1999; Clare et al 2003b).

Importantly, individuals with dementia respond differently to various evidence-based techniques, and a CR therapist will assist the person with dementia and their family identify the technique(s) that are most helpful for the individual in question.

Although much of the work on CR to date has been carried out on people with mild Alzheimer’s disease (AD) dementia or mixed AD and vascular-type dementia, principles of CR have also been applied in intervention studies targeting people with other forms of dementia, including semantic dementia (e.g., Savage et al 2013), and work is currently under way with people with Parkinson’s disease (Hindle et al 2016).

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