Rural Community-Residing Persons With Dementia & Caregivers Access Client-Centered Telehealth Services for Dual Dyadic Occupational Benefits

Caring for those with Alzheimer’s disease and related dementias creates significant caregiver burden. Occupational therapy has the opportunity to implement Person-Environment-Occupation-Performance Model (Law et al., 1996) to improve care and occupational engagement for both members of the dyad (person with dementia and care partner). The purpose of this study is to explore caregiver-identified areas of occupation which create substantial burden to facilitate client-centered goal development. This secondary analysis examines caregiver identified areas of occupation creating distress for the dyad. Data are part of a larger single-arm clinical trial assessing feasibility for telehealth occupational therapy in rural communities for persons living with dementia. Dyads living in rural communities were recruited for this study. Using the Canadian Occupational Performance Measure (Law et al., 2014) caregivers identified greatest care needs. Caregivers completed several surveys related to burden, depression, behavioral disturbance, and stress. Statistical analyses included demographic, frequencies, and regression analysis examining relationships between COPM results and caregiver burden. Thirty-four dyads were included in analyses. Of caregiver identified areas of occupation, self-care/personal care was most frequently identified as causing burden (n = 13). Other areas included functional mobility (n = 9), quiet recreation (n = 7), socialization (n = 4) and household management (n = 1). Caregiver burden mean was 32.4 with a standard deviation of 11.8. Client-centered interviewing and the PEOP model allow development of tailored goals aimed to benefit both caregiver and patient. Rural communities are chronically medically underserved, often rampant with health disparities, leading to and including Alzheimer’s disease. This study highlights the importance of equitable access to occupational therapy as a resource for both those living with dementia and those caring for them.

References

Law, M., Baptiste, S., Carswell, A., McColl, M., Polatajko, H., & Pollock, N. (2014). Canadian Occupational Performance Measure Manual. 5th ed.

Law, M., Cooper, B., Strong, S., Stewart, D., Rigby, P., & Letts, L. (1996). The Person-Environment-Occupation Model: A transactive approach to occupational performance. Canadian Journal of Occupational Therapy, 63(1), 9-23. https://doi.org/10.1177/000841749606300103