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Running head: DEMENTIA

Dementia
Katherine Andert
Grand Valley State University
November 23, 2014

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DEMENTIA

Abstract
Dementia is a cognitive disorder that affects an individuals ability to recall memories and
make new memories. One of the causes of dementia is Alzheimers disease. The use of
therapeutic recreation interventions like sensory stimulation, reality orientation, validation,
reminiscence and exercise can greatly affect the individuals with Alzheimers quality of life.

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Introduction
Dementia is a cognitive disorder affecting mainly older adults. It can affect memorystorage and cause memory loss. Alzheimers is one of the greatest causes of dementia.
Therapeutic Recreation can help this disease in many ways including sensory stimulation,
reminiscence, validation, reality orientation and exercise. Through these, an individual with
dementia is able to live with a higher quality of life.
Dementia
Dementia is a cognitive disorder that has a gradual deterioration of brain function which
affects judgment, memory, language, and other advanced cognitive processes. It can be caused
from medical conditions like traumatic brain injuries, strokes, Parkinsons, or Huntingtons;
other causes include drug and alcohol abuse (Durand & Barlow, 2010). Dementia includes
memory loss and the inability to process and store new information (Silverthorn, 2013). It is
more common among older adults but can occur in people of all ages with approximately 5%
chance in people older than 65 years of age. 20 to 40% of people 85 and older have Dementia
(Durand & Barlow, 2010). Individuals with Alzheimers disease are approximately half of all
individuals with dementia (Durand & Barlow, 2010).
Alzheimers disease is one of the most common causes for dementia and was discovered
in 1902. Individuals with Alzheimers disease have a 33% decrease in life expectancy when
compared to healthy people of the same age (Austin & Crawford, 2001). Alzheimers disease
has specific stages it goes through including its early, moderate, moderately severe, and severe.
Mild Alzheimers disease lasts for about 2 years with some inability to perform relatively
complex personal tasks. At this stage, it is hard to determine if the individual has Alzheimers

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disease or just age- associated memory impairment. The moderate stage of Alzheimers usually
lasts between 18 and 24 months with decreased ability to remember significant and simple
aspects about life. Individuals at this stage tend to have time disorientation also. Moderately
severe Alzheimers lasts between 2 and 3 years with the loss in the ability for the individual to
make new memories. The final stage of Alzheimers is the most severe and can last up to 7
years. At this stage, the individual has difficulty with vocabulary, motor function, and many
times goes into a vegetative state. This stage is also very difficult on the individuals family and
caretakers (Austin & Crawford, 2001).
Alzheimers is a progressive neurodegenerative disease of cognitive impairment that
affects all aspects of cognitive functioning (Silverthorn, 2013). Some of the cognitive
disturbances include aphasia, apraxia, agnosia, or difficulty with activities like planning,
organizing, sequencing, or abstracting information (Durand & Barlow, 2010). It is an atypical
form of dementia with nearly 10 million people within the United States being affected by it in
2010 (Austin & Crawford, 2001). Alzheimers disease can only be diagnosed after an autopsy
which determines that certain characteristics types of brain damage are present in the brain.
Clinicians can now identify characteristics and conditions present in living patients and diagnose
Alzheimers disease 70 to 90% accuracy (Durand & Barlow, 2010). Alzheimers disease is
irreversible and affects memory, orientation, judgment, and reasoning with the inability to gain
any new information (Durand & Barlow, 2010).
Alzheimers not only affects cognition but will eventually lead the individual to lose
interest in activities and other people. This can result in the individual becoming isolated. Other
side effects of Alzheimers include the individual becoming agitated, confused, depressed,
anxious, or even combative as the disorder progresses (Durand & Barlow, 2010). Alzheimers

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has a symptom that can occur called sundowners syndrome which makes the individuals present
with more difficulties later in the day. Some doctors theorize this is because the individuals
become tired or fatigued which makes the other symptoms harder to suppress (Durand & Barlow,
2010).
Role of Therapeutic Recreation
Therapeutic Recreation exists to provide services based on the individuals interests and
lifestyle; this allows for functional improvement in all areas of life including physical, emotional,
cognitive and social. This is done through activities, education, and some physical exercises to
develop healthy habits, the individual can then improve their life outside of the treatment facility
and increase the likelihood of an active lifestyle (What is RT/TR, 2014). Within the population
of Dementia, therapeutic recreation works to improve individuals lifestyles but within an agency,
many individuals with dementia can no longer live on their own. Therapeutic recreation uses
treatments including exercise, reminiscence, validation, sensory stimulation, structured tasks
such as sorting crafts, cooking, gardening, music, and socialization activities (Grote & Warner,
2013). With the use of these activities, therapeutic recreation works to reduce agitation in the
individual. It helps the individual to remember the past, verbalize their needs, improve behavior,
increase focus, improve socialization with peers and improve movement (Grote & Warner,
2013).
One of the interventions therapeutic recreation uses with individuals with dementia
includes sensory stimulation. Sensory stimulation is a highly structured group that works to
increase awareness of the individuals environment, increase physical movement, attention span,
and skills of daily living (Austin & Crawford, 2001). It helps individuals with deficits in
processing information. Sensory stimulation involves a number of items or experiences for an

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individual that stimulate their senses (Stumbo & Wardlaw, 2011). These include and are not
limited to visual stimulation like contrasting text with its background, tactile stimulation like
distinguishing between hot and cold, auditory stimulation like the use of hearing aids or doing
activities in a quiet room to minimize background noise, and olfactory stimulation like tasting
both sweet and sour (Austin & Crawford, 2001). In the later stages of Alzheimers the individual
may be in a coma. You can still use sensory stimulation with these individuals but in a different
way. You could use the sense of touch by touching the individuals hand or you could use their
sense of hearing and say the individuals name and talk to them (Austin & Crawford, 2001).
Different items can be used for this intervention including brightly colored balloons or a
blowing fan (Stumbo & Wardlaw, 2011). These help improve quality of life because the human
brain is able to adapt to stimulus being presented to it. Sensory stimulation helps the brain
become active and helps to improve the individuals sense of sight, smell, taste, touch, and
hearing. Improving an individuals ability to process and improve their ability to take in
information greatly affects the individuals quality of life (Stumbo & Wardlaw,2011).
Contraindications to Intervention
Some research has been done on the use of sensory stimulation. The findings of this have
indicated that with the use of too much stimulation, individuals lose a large amount of the ability
to process information when too much information is presented. This information overload
makes the individual more dysfunctional. Also sensory stimulation has not held up to much of
the research scrutiny. There is no support that rules out or supports the use of sensory
stimulation for individuals with dementia (Stumbo & Wardlaw, 2011).
Other Treatment for Dementia

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Some of the other treatments that can be used with individuals with dementia include
reality orientation, validation, reminiscence, and exercise (Dattilo & McKenney, 2011). Reality
orientation is used to help the individual know who they are, where they are, why they are there
and when it is (Stumbo & Wardlaw, 2011). This is especially important with individuals with
dementia because they lose a lot of cognition and memory which in turn makes them confused
and forget this information. Validation is the idea that certain behaviors done by the individuals
with dementia are actually purposeful actions working towards resolving issues in their lives.
Validation explains how the individual is dealing with past issues that they now remember and
want to resolve. This intervention helps to validate the individuals feelings and issues and helps
them get through it (Stumbo & Wardlaw, 2011). Reminiscence involves eight functions
including: identity, problem solving, death preparation, teach-inform, conversation, bitterness
revival, boredom reduction, and intimacy maintenance. The reason reminiscence is useful with
individuals with dementia is that it helps them remember past times. This can be helpful in
reducing stress and improving memory (Stumbo & Wardlaw, 2011).
Exercise is considered a customary part of therapeutic recreation (Stumbo & Wardlaw,
2011). Exercise as a whole improves physical, emotional, social and cognitive functioning in
individuals. When you stimulate your body, your brain gets stimulated to (Stumbo & Wardlaw,
2011). Another form of exercise I found that can be useful for individuals with Dementia was
dance. Older adults and nursing home residents find dance to be a source of fond memories. It
can also be a source of physical activity as well as stimulates communication, and requires
concentration. For individuals with dementia, it is a way to connect with family members. It has
been shown that people with dementia retain their ability to dance even when they do not
remember other things (Kustler & Daly, 2010).

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Conclusion
Through the use of interventions like reminiscence, validation, reality orientation,
exercise and sensory stimulation, individuals with dementia can have a higher quality of life.
Dementia is a devastating condition that greatly affects an individuals cognition. But with the
use of therapeutic recreation interventions, the individual can become less agitated, more aware
of their environment and more accepting of the eventual end of life. Therapeutic recreation
interventions can stimulate an individuals memory and senses to maintain their level of memory.
It can also help them recall past events which help them deal with issues in their lives. Through
all of this, the individual have a greater quality of life in the end of their lives.

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Reference
Austin, D. R., & Crawford, M. E. (2001). Therapeutic recreation an introduction (3rdrd ed., pp.
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