Carrie A. Ciro, Linda A. Hershey, David Garrison; Enhanced Task-Oriented Training in a Person With Dementia With Lewy Bodies. Am J Occup Ther 2013;67(5):556-563. doi: 10.5014/ajot.2013.008227.
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© 2019 American Occupational Therapy Association
Despite the inevitable loss of function seen in people with progressive dementias, interventions for reversing or minimizing functional loss are understudied. Research supports task-oriented training, but practical gaps in how to best evaluate clients for this training and how to implement it in clinical settings may be thwarting translation to occupational therapy practice. We structured an intervention model called STOMP (Skill-building through Task-Oriented Motor Practice) using a unique blend of task-oriented training and motor-learning principles. In this article, we describe through a case study the process and outcome of using STOMP to improve functional skills in a woman with moderate dementia with Lewy bodies. Our findings suggest that STOMP has the potential to serve as a structure for the evaluation and treatment of occupational performance deficits in people with dementia and that this model warrants further investigation.
Participant attempted to use rocking momentum to stand from the chair, but the chair was a rocking recliner, so it rocked with her.
Participant attempted to use her arms to push up from the chair.
Participant did not monitor feet placement, so she stood up with her feet together and became unbalanced; she required maximal assistance to stand from the chair.
Because her unguided performance took several minutes, she forgot what she was attempting to do.
We attempted prearousal activities, including playing beloved old music or vigorously rubbing the tops of legs.
We placed a block under the recliner to prevent the chair from rocking.
We placed a “Couch Cane” under one side of the chair to provide a pull-up bar for standing.
We placed a pillow behind the participant’s back to improve her posture in the chair and to keep her in a dynamic pelvic position for standing.
Grab couch cane (this required participant to automatically scoot forward and flex at hips and minimized the motor sequence directions).
Systematic evaluation of occupational performance deficits in people with dementia and
Structured treatment planning and implementation strategies for improving occupational performance deficits.
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