By: Kathy Hubbard
When she was 78 years old, Mrs. Clark was diagnosed with Alzheimer’s disease. Her husband of 52 years had noticed that she had lost interest in what had been her favorite hobbies, she began to find daily activities more difficult, and her friends noticed that she was becoming forgetful.
Mrs. Clark’s clinical case is detailed on the American Journal of Occupational Therapy’s website. I paraphrased their description, but the reason I’m telling you about her is because her primary care provider recommended that she see an occupational therapist. She did, and both she and her husband, who understandably had beginning signs of depression, showed remarkable improvement.
To learn more, I reached out to Bonner General Health Performance Therapy Services Elizabeth Wise to ask what exactly an occupational therapist can do for those suffering from dementia. So you know, Wise holds a master’s degree in occupational therapy, she’s a registered and licensed occupational therapist (OT) and a certified hand therapist.
The following are the questions I asked and, of course, her answers:
KH: What’s the procedure for assessing a dementia patient’s need? And is it done in your office or at the patient’s home?
EW: As OTs we are often involved along the continuum of a dementia diagnosis and ongoing changes in function. For example, we often do cognitive testing as part of the original diagnostic process and work on memory strategies to retain function for as long as possible. Then, we are often a part of education and assessment with the person and their family or friends on decisions such as aging in place, amount of assistance likely needed in the home, when to transition to a higher level of care such as assisted living or memory care.
KH: Can you give me a brief description of the actual therapy?
EW: We teach planning, memory and organization strategies early on that improve people’s function. Later, we assess problems the person is having, such as telling the difference between day and night, concepts of time, dressing oneself. And then providing real solutions.
KH: I assume that some of the therapy is aimed at the caregiver and other things are aimed at the patient. Am I right on that? Or is it all focused on the patient?
EW: We work with the whole unit, whatever that unit looks like.
KH: Can you give me an example of a patient who saw improvements after going through the therapy? Sort of a “day in the life” example?
EW: We can provide solutions so that a person can perform tasks independently again; stop getting up at two a.m. and getting dressed because they think it’s morning, and reduce anxiety or confusion in the afternoon (Sundowning).
KH: What’s the time investment? Are we talking one hour sessions? Less or more? And for how long? And is it covered under insurance and Medicare? Or is there a cost to the patient?
EW: Medicare covers OT services as does private insurance. We do one hour sessions. The length of treatment varies. We usually make five or six visits over the same number of weeks to get things on track and then people come back in six months or so for a reboot as things change.
If you’re wondering how successful OT can be for dementia patients, you’re not alone. The National Institutes on Health analysis of the short-term effects of OT in patients with dementia concluded that it very well “may be an effective intervention to maintain cognition and functionality and to reduce psychiatric symptoms in dementia patents. Mild stages of dementia could gain more benefits from OT with regard to functional decline.”
Their study found that 421 dementia patients remained cognitively stable over time. “Behavioral troubles were significantly reduced over the intervention period and remained stable after. Patients’ quality of life increased over the three month intervention and the caregivers’ burdens significantly decreased over the same period.”
The journey for all dementia patients is unique to them. If you have, or if you’re a caregiver for someone with dementia. Talk to your healthcare team to see if OT is recommended. Wise said that occupational services can be accessed through outpatient care and also home health therapy.
Kathy Hubbard is a member of the Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com. This article was written for publication in the Bonner County Daily Bee on June 18, 2025.
