The role of therapy in dementia care

Hear the words “dementia care” and you’re likely to think of nurses and nurses’ aides. Therapists can play a role in caring for those with Alzheimer’s disease and other forms of dementia, however, says Carmen Vitton, MS, CCC-SLP.

Vitton is chief operating officer of Rehab Synergies. “We provide occupational, physical and speech therapy services to our parent company [Advanced Healthcare Solutions] at more than 47 locations all over the state of Texas,” including outpatient therapy at 27 locations, she explains, “and we also provide services to external organizations that are not owned by our parent company, as well as through home health organizations.”

Because therapists work closely with a varied resident/patient population, Vitton says, they can recognize the differences in the disease processes associated with dementia versus stroke or Parkinson’s disease—perhaps more so than others working in a skilled nursing setting. And those who receive additional training related to Alzheimer’s disease and other dementias can make an important contribution to long-term care (LTC) efforts, she adds.

“We establish what's called a restorative nursing program, and we teach and train and educate the restorative nursing aide and other CNAs,” Vitton says. “Once we’re comfortable and confident with their ability to follow through with the program, we’ll turn it over to them.”

Working with a patient or resident who has dementia is different than working with what might be considered a typical person undergoing therapy, Vitton says. “We’re not attempting to reverse a disease process. We’re not going to change anything,” she adds. “But we are going to identify the functional skills that these patients have remaining, and we are going to provide them with their best ability to function to what they can do, will do and what they are able to do and give them something functional and meaningful to do.”

Rehab Synergies has been working diligently to enhance the dementia programming that it provides, Vitton says.

After Vitton met National Certification Board for Alzheimer Care (NCBAC) Chief Operating Officer Dayne DuVall at the 2014 LeadingAge annual meeting, Rehab Synergies invited him to speak at the company’s directors’ meeting. Now, 10 employees have taken or are planning to take the NCBAC test to become certified Alzheimer’s educators.

Also, two Rehab Synergies regional directors who are speech pathologists, Melissa Collier and Lindsey Roberts, received training through the Crisis Prevention Institute and wrote a course that now is available for credit online. Many of Rehab Synergies’ senior directors and speech pathologists are required to take it. Collier and Roberts also recently presented the course to more than 200 of their peers at the Texas Speech-Language-Hearing Association conference.

“We even partnered with our pharmacy consultant so that they are now referring to occupational therapy and speech therapy as they attempt to reduce the use of antipsychotic medications” for those with dementia, Vitton says, noting the prominence of the issue in the LTC industry.

Vitton encourages providers to remember the role that therapists can play in dementia care. “The speech pathology community at large differs in our level of understanding in what we can do with patients with dementia,” she says, adding that others are starting to notice. “A lot of research, social media, the Glen Campbell movie and the more recent Julianne Moore movie, “Still Alice,” increase the public’s understanding of the frustration on family members’ side. Someone has to step in, and it’s perfectly appropriate within our scope of practice. A speech pathologist can provide that level of service.”

Vitton successfully nominated Dayne Duvall, LMT, CAEd, CRTS, for consideration for a 2015 Long-Term Living Leaders of Tomorrow award. To read more about him, see his profile.

Lois Bowers

Lois A. Bowers was senior editor of I Advance Senior Care / Long-Term Living from 2013-2015.