Enhancing caregivers’ understanding of dementia and tailoring activities in frontotemporal dementia: two case studies

Abstract

Purpose: The purpose of this study is to describe the intervention process and results of the Tailored Activities Program (TAP) in two people diagnosed with Frontotemporal Dementia (FTD). Method: TAP is an occupational therapy (OT) community-based intervention program that prescribes personalised activities to reduce difficult behaviours of dementia. The OT works with carers over a 4-month period (assessment, activity prescription and generalisation of strategies). Study measures were collected (blind researcher) pre- and post-intervention: cognition, functional disability, behavioural symptoms and Caregiver Confidence and Vigilance. Results: A 51-year-old woman with behavioural-variant FTD could consistently engage in more activities post-intervention, with scores indicating improvements to behaviour, function and caregiver confidence. A 63-year-old man with semantic variant FTD engaged well in the prescribed activities, with scores reflecting reduced carer distress regarding challenging behaviours and improved caregiver vigilance. Conclusions: TAP is efficacious in FTD, allowing for differences in approach for FTD subtype, where behavioural symptoms are very severe and pervasive.

Implications for Rehabilitation

• The Tailored Activities Program is an intervention which can be tailored to account for unique behavioural and language profiles inherent across frontotemporal dementia (FTD) subtypes.

• Maintaining a flexible approach when applying an intervention in FTD allows for tailoring to individual case variability within FTD subtypes.

• Caregivers
• dementia
• frontotemporal dementia
• non-pharmacological intervention
• occupational therapy
• Tailored Activities Program

Acknowledgements

The authors thank the people diagnosed with FTD and their caregivers for their participation.

Declaration of interest

C. O. C. is supported by an Alzheimer’s Australia Dementia Research Foundation PhD Scholarship. L. C. is supported by an NHMRC Career Development Fellowship (APP1036639). O. P. is supported by an NHMRC Clinical Career Development Fellowship (APP1022684). E. M. is a recipient of an Alzheimer Association USA New Investigator Research Gran (NIRP-12-258380).