OT 504 Week 3 LG 1: Treatment & Interventions for Major NCD.

What is Major Neurocognitive Disorder (Major NCD)?

A decline in mental ability severe enough to interfere with daily life (dementia).

Is dementia a specific disease?

No, it is a general term for cognitive decline.

What are the three most common irreversible dementia subtypes?

Alzheimer's disease, Vascular Dementia, and Dementia with Lewy Bodies.

What are the 3 stages of Major NCD progression?

Early (Mild), Middle (Moderate), and Late (Severe).

What characterizes early-stage dementia?

Emerging cognitive changes while physical abilities remain largely intact.

What activities may require assistance in early dementia?

IADLs, especially unfamiliar or complex tasks.

What type of problem-solving is common in early dementia?

Trial-and-error problem solving.

Common cognitive symptoms of early dementia?

Memory loss, difficulty planning, poor judgment, trouble focusing.

Common emotional symptoms of early dementia?

Anxiety and depression.

What navigation issue may begin in early dementia?

Getting lost.

What level of supervision is typically required in moderate dementia?

More intensive supervision and care.

What living arrangement change may occur during moderate dementia?

Transition to long-term care.

What happens to attention span during moderate dementia?

It shortens.

What behavioral symptoms may occur during moderate dementia?

Delusions, agitation, shouting, personality changes.

What orientation difficulties occur during moderate dementia?

Confusion about time and location.

What wandering-related phenomenon often occurs?

Sundowning.

What motor impairments may occur during moderate dementia?

gait impairment, apraxia, bradykinesia, and paratonia.

what is paratonia?

A condition characterized by increased muscle resistance and altered tone, making movements difficult.

What is magnetic apraxia?

Compulsive utilization behavior due to reduced impulse control.

What level of support is required during severe dementia?

Extensive support with daily activities.

What cognitive impairment is present during severe dementia?

Profound cognitive impairment.

What recognition difficulties occur?

May not recognize close family members or respond to their own name.

What communication difficulties occur?

Significant difficulty communicating.

What assistance level is needed for ADLs?

Moderate assistance to dependence.

What continence issue commonly occurs?

incontinence.

What executive function skills are affected in dementia?

Planning, decision-making, working memory, inhibition, flexibility

What attention skills are affected?

Sustained, divided, and selective attention; processing speed.

What language skills are affected?

Object naming, word finding, fluency, grammar, syntax, receptive language.

What memory skills are affected?

Recall, recognition memory, autobiographical memory, implicit learning.

What social cognition skills are affected?

Emotion recognition, theory of mind, insight.

What perceptual-motor skills are affected?

Visual perception, visuoconstructional reasoning, coordination.

What is OT's primary role in dementia care?

Mitigate cognitive changes' impact on occupations.

What health habits should OT promote?

Healthy diet, exercise, and physical activity.

Why is physical activity important?

It addresses modifiable risk factors.

What occupations should OT support?

Meaningful activities, leisure, social participation, and ADLs.

Who should OT train?

Care partners and caregivers.

What type of intervention is recommended for maintaining quality of life?

Multimodal interventions.

Why should social activities be tailored?

To improve engagement.

What intervention supports sleep?

Individualized activities.

What activity modification strategies improve ADLs?

Task simplification, prompting, and errorless learning.

What is backward chaining?

OT starts the task; client finishes it.

What is forward chaining?

Client starts the task; OT finishes it.

What is habit stacking?

Linking a new habit to an existing routine.

What learning strategy is appropriate in early-stage dementia?

Trial-and-error learning.

What is errorless learning?

Preventing mistakes during learning by providing assistance before errors occur.

Examples of errorless learning?

Hand-over-hand guidance, modeling, parallel performance, feed-forward instructions, mnemonics.

When is assistance faded?

Once the client can complete the difficult component independently.

Examples of compensatory interventions?

Memory aids, smartphone reminders, environmental modifications.

Why reduce visual clutter?

To improve participation and reduce cognitive demands.

What is habit anchoring?

Building routines around existing habits.

What important habilitative intervention may be needed?

Driving retirement planning.

What prevention intervention has brain benefits?

Physical activity.

What challenge level should activities have?

Reasonable challenge and intensity.

What education is important in early-stage dementia?

Disease process and future planning.

Why are routines critical?

Promote independence and may delay decline.

What cognitive strategy is emphasized?

Daily routine management.

What adaptive supports are used?

Memory devices, task simplification, environmental modifications, driving retirement planning.

What type of learning is emphasized?

Overlearning routines and habits.

What can support overlearning?

Sensory priming and music.

What driving intervention becomes important?

Driving cessation planning.

What safety intervention is emphasized?

Fall prevention.

What symptom management intervention is important?

Managing behavioral expressions and responsive symptoms.

What caregiver training topics are important?

Communication, task simplification, and environmental modifications.

What are the major goals of late-stage interventions?

Maintain quality of life, dignity, choice, and self-determination.

What occupations should be preserved?

Self-care, leisure, and social participation.

Why structure the environment?

Promote safety, independence, and sensory stimulation.

What exercises are recommended?

Gentle stretching and ROM.

What caregiver training is important?

Transfers, ADL assistance, positioning, behavior management, and support service referrals.

What is dual-task training?

Performing two tasks either simultaneously or sequentially.

What are the three types of dual-task training?

Cognitive-cognitive, motor-cognitive, motor-motor.

what is Cognitive-cognitive training?

Training that involves performing two cognitive tasks at the same time, such as solving math problems while memorizing a list.

what is motor-cognitive training?

Training that involves performing a cognitive task while engaging in a physical activity, such as counting numbers while walking.

what is motor-motor training?

Training that involves performing two physical activities simultaneously, such as jogging while tossing a ball.

What is reminiscence therapy?

Recalling pleasant personal memories using photos, music, memory boxes, etc.

What dementia intervention can be used across all stages?

Reminiscence therapy.

What activity program can be used across all stages?

Montessori activities for older adults with dementia.

What interventions have the strongest evidence for cognitive benefits?

Cognitive-oriented approaches + standard OT/meds.

What combination intervention has strong evidence?

Exercise plus music interventions or memory games.

What psychosocial intervention has strong evidence?

Reminiscence therapy.

Which movement-based intervention has moderate evidence?

Dance interventions.

Which psychological interventions have moderate evidence?

Cognitive therapy, behavioral therapy, and CBT.

Define reminiscence therapy.

Facilitating recall of past events, activities, and experiences.

Can reminiscence therapy be verbal or nonverbal?

Yes.

Can reminiscence therapy be individual or group based?

Yes.

What is Life Review?

Guided recall of memories from different life stages using weekly topics.

What is Guided Autobiography?

Discussion of major life turning points to gain insight.

Who developed the Snow Approach?

Teepa Snow.

What are the four PAC skills?

Positive Physical Approach (PPA), Hand-under-Hand (HUH), Positive Personal Connections (PPC), Positive Action Starters (PAS).

First step of PPA?

Enter visual range and pause about 6 feet away.

Second step of PPA?

Smile, greet by name, and place open hand near face.

Third step of PPA?

Offer a handshake.

Final step of PPA?

Move to the person's side in a supportive stance.

Purpose of Hand-under-Hand?

Use remaining muscle memory to provide comfort and assist participation.

What activities can HUH support?

Eating, dressing, and other ADLs.

Five PPC strategies?

Greet, Compliment, Share, Notice, Seek.

Purpose of PPC?

Build connection before initiating a task.

Five PAS strategies?

Help, Try, Choice, Short & Simple, Step-by-Step.

Why use PAS?

Reduce resistance and refusals.

What are the four activity categories?

Productive, Leisure, Self-Care, Rest & Restoration.

What is a productive activity?

Paid or unpaid activity that creates a sense of contribution