Telehealth Therapies for Dementia Management
Therapeutic Approaches for Dementia: A Telehealth Perspective
Characterized by a decline in cognitive abilities, dementia can cause significant disruptions to a person’s daily life. It is estimated that about one-third of people aged 85 and older have dementia, and the most common cause of dementia is Alzheimer’s disease, which causes a progressive decline in memory, thinking, and learning skills.
For those supporting loved ones with dementia, understanding the various therapeutic approaches available can be invaluable. This guide explores different therapeutic interventions for dementia management, with a particular focus on non-pharmacological approaches that can be effectively delivered through telehealth platforms. With a stronger understanding of available therapies, caregivers and family members can better support those living with dementia, even when in-person care options are limited.
Understanding Dementia
Dementia is a general term used to describe a group of symptoms impacting memory, thinking, and social abilities to the point of disrupting daily life. Dementia is characterized by a decline in cognitive abilities, memory loss, and difficulties with thinking, reasoning, and problem-solving. It is not itself a disease, but rather several diseases that can cause dementia.
There are several types of progressive dementias, including Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia, Parkinson’s disease dementia, and other dementias. Other disorders linked to dementia include Parkinson’s disease and Huntington’s disease.
The symptoms of dementia can vary depending on the specific type and stage of the condition, but common signs include:
- Memory loss
- Impaired communication
- Cognitive decline
- Confusion and disorientation
- Behavioral changes
- Difficulty with daily tasks
- Loss of initiative
- Poor judgment
- Changes in visual perception
It’s important to note that experiencing occasional memory lapses or difficulties with cognitive function does not necessarily indicate dementia. A diagnosis of dementia requires a comprehensive evaluation by medical healthcare professionals to determine the underlying cause and distinguish it from other conditions.
Alzheimer’s Disease: The Most Common Form of Dementia
Dementia and Alzheimer’s disease are related but distinct conditions. Dementia is an umbrella term that refers to a range of symptoms that affect cognitive abilities, memory, and behavior. Alzheimer’s disease is a specific neurological disorder that involves progressive memory loss and a loss of cognitive ability.
Mild Alzheimer’s Disease
During the early stages of Alzheimer’s, also known as mild Alzheimer’s disease, patients typically function independently but begin to experience lapses in cognitive function and memory. Individuals with Alzheimer’s disease may struggle to remember upcoming events or the name of a specific object. Care needs are typically limited at this point, making it an ideal time to establish telehealth connections and support systems.
Moderate Alzheimer’s Disease
Moderate Alzheimer’s disease is the longest stage and symptoms include confusion, severe memory loss, incontinence, trouble choosing the appropriate clothing, and behavioral changes. During this stage, virtual therapy sessions can help caregivers identify ways to simplify tasks to encourage any level of independence. Regular telehealth check-ins can also provide crucial respite and guidance for caregivers.
Severe Alzheimer’s Disease
During late-stage Alzheimer’s, patients typically require round-the-clock care, struggle to communicate, and lose much of their awareness. They may spend much of their time in bed and are more susceptible to infection. While direct patient participation in telehealth sessions may be limited at this stage, virtual consultations can help guide caregivers in providing appropriate interactions like playing soothing music or using gentle touch techniques.
Vascular Dementia
Vascular dementia is the second most common type of dementia after Alzheimer’s disease. It occurs when a lack of blood flow to the brain damages brain tissue. Symptoms include trouble with daily functioning, stroke symptoms, memory problems, and personality changes.
Dementia Treatment Approaches
Most types of dementia cannot be cured, but there are a variety of treatment options available that can help a person manage their symptoms. In cases of progressive dementia, the goals of care may change over time. As the condition advances, the emphasis may shift from actively preserving cognitive function to managing symptoms, promoting emotional well-being, and ensuring a safe and supportive environment.
Goals for dementia care may include:
- Enhancing cognitive function
- Managing behavioral and psychological symptoms
- Promoting independence and functional abilities
- Enhancing quality of life
- Providing support for caregivers
Non-pharmacological Interventions Via Telehealth
The vast majority of people with cognitive impairment—around 80%—will experience the behavioral and psychological symptoms of dementia (BPSD) at some stage. For these symptoms, in particular, non-pharmacological interventions can be a valuable strategy. These interventions may involve engaging individuals with activities that evoke memories, promote cognition, and improve mood.
Many of these approaches can be effectively adapted for telehealth delivery through secure video platforms like ReachLink. Below, we’ll explore several types of therapy and other non-pharmacological interventions that may be used for individuals with dementia in a virtual setting.
Reminiscence Therapy
This type of therapy involves encouraging individuals with dementia to recall and discuss past memories. Through video sessions, therapists can guide reminiscence activities using digital photos, music, or other sensory prompts that family members can prepare in advance. This approach is particularly well-suited to telehealth as it primarily relies on conversation and visual cues.
Reality Orientation
Reality orientation is used to reinforce a person’s awareness of time and place, with the aim of decreasing confusion and behavioral symptoms. Through regular video sessions, therapists can provide individuals with cues and reminders about their surroundings. Family members can be guided to create orientation boards, calendars, and other visual aids that enhance a person’s sense of certainty and improve their ability to navigate daily life. Studies have shown that reality orientation provided by family members resulted in slow but reliable progress.
Validation Therapy
Validation therapy is an approach to communication that aims to support the emotions and experiences of individuals with dementia through empathy and active listening. Through telehealth sessions, therapists can both demonstrate and guide caregivers in these techniques, recognizing and respecting the individual’s reality, even if it differs from the actual facts or current circumstances.
Cognitive Stimulation
Cognitive stimulation therapy (CST) involves sessions focused on stimulating cognitive functions through various activities, discussions, and exercises. While traditionally conducted in groups, CST can be adapted for telehealth delivery through one-on-one sessions or small virtual group therapy sessions. These sessions typically cover various topics, including memory, attention, language, and problem-solving, and encourage active participation and engagement. A recent clinical trial found that CST was effective in decreasing behavioral and psychological symptoms of dementia and reducing caregiver burden.
Bright Light Therapy
Bright light therapy is a non-pharmacological intervention that involves regular exposure to outdoor and intense artificial light, typically in the morning or early part of the day. Through telehealth consultations, therapists can assess the home environment and provide guidance on implementing light therapy to help control sleep patterns, improve mood, and alleviate symptoms of depression and agitation.
Music Therapy
Music therapy may help evoke emotions, stimulate memories, improve mood, and facilitate social interaction. Virtual sessions can guide caregivers in selecting appropriate music, creating personalized playlists, creating engaging activities, and encouraging active listening to music together. This therapy can be tailored to individual preferences, making it an effective tool for improving emotional well-being and fostering connection between caregivers and those with dementia.
Conclusion
As dementia progresses, the challenges faced by individuals and their caregivers become increasingly complex. Telehealth offers a valuable platform to provide continuous therapeutic support, especially through non-pharmacological interventions that can be adapted to a virtual setting. Approaches like reminiscence therapy, reality orientation, validation therapy, cognitive stimulation, bright light therapy, and music therapy all have significant potential to improve quality of life and manage symptoms effectively.
Importantly, integrating telehealth into dementia care can empower caregivers with knowledge, guidance, and practical strategies, even when in-person support is not feasible. By embracing these technological advances and therapeutic options, family members and professionals can collaborate more closely to foster comfort, dignity, and engagement for those living with dementia.
Ultimately, a tailored combination of personalized care and innovative telehealth interventions can make a meaningful difference in managing dementia and supporting the individuals and families affected by this complex condition.
