Adapting Physiotherapy Techniques for Aged Care Residents with Dementia
As a Physiotherapist in Aged Care, we have crucial role in maintaining physical health and quality of life, especially for those living with dementia. Sadly, as dementia progresses, it often brings about challenges that impact not only cognitive function but also physical ability. For physiotherapists like myself who are working with this population, it’s essential to adapt techniques to meet the specific needs of residents with dementia. By tailoring my sessions, I aim to help these individuals maintain mobility, independence, and quality of life.
Understanding the challenges
Dementia can affect various cognitive functions, including memory and speech. These impairments make it difficult for residents to follow instructions, retain new information, or even recognise the purpose of certain exercises. Sometimes I find myself laughing with my resident, as we simply cannot understand each other at times! Additionally, behavioural and psychological symptoms such as agitation, anxiety and depression can further complicate therapy sessions.
Building trust, rapport and involving the family
I personally believe that the foundation of any successful interaction with a resident with dementia is trust. Establishing rapport with the patient is essential, as it helps reduce anxiety and resistance. Simple actions such as making eye contact, speaking in a calm and reassuring tone, and using physical touch can create a sense of familiarity and comfort.
It’s also important to involve family members and caregivers in the care process. They can provide valuable insight into the patient’s preferences, routines, and triggers, which can help tailor the therapy to the individual’s needs. Additionally, their presence can offer emotional support to the resident during sessions. I cannot stress how many times I have struggled with a resident with dementia, only to find that with a family member present they are able to function so much better!
Simplifying instructions and using demonstrations
Those with dementia often struggle to understand or remember complex instructions. To overcome this, we aim to simplify their communication by breaking down instructions into smaller steps. Instead of giving multiple directions at once, I like to focus on one task at a time and use short, clear sentences.
I find visual demonstrations can be particularly effective. Physically showing the resident what to do can be more beneficial than verbal instructions alone.
Incorporating familiar activities
Another way to I find helpful to increase engagement is by incorporating activities that are familiar to the resident. For example, if the resident enjoys gardening, simulating movements such as digging or planting can be both therapeutic and enjoyable. I have one resident at my facility who treats his four-wheeled-walker as a lawn mower, so we find great fun in “cutting the grass around the facility”! Familiarity can trigger positive memories, making the individual more willing to participate in exercise.
Adapting the environment
The environment in which physiotherapy sessions take place can significantly impact their success. A quiet, well-lit, and clutter-free space can help minimise distractions and limit confusion for the resident. Additionally, having consistent routines and familiar surroundings can create a sense of security. I always ask the carers to try being in the resident’s shoes. The last thing you want as somebody with dementia is a chaotic and loud environment, as it can make them confused and reduce engagement significantly.
Conclusion
These are just a few of the techniques I utilise for residents with dementia. At the end of the day, it may not always be perfect when dementia comes along as a barrier. However, by creating a supportive and engaging environment, physiotherapists can help those with dementia maintain their physical health, independence, and quality of life.
References
Dementia Australia. (2024). Family, friends and carers. https://www.dementia.org.au/living-dementia/family-friends-and-carers
Edvardsson, D., Petersson, L., Sjogren, K., Lindkvist, M., & Sandman, P. O. (2014). Everyday activities for people with dementia in residential aged care: Associations with person‐centredness and quality of life. International journal of older people nursing, 9(4), 269-276
About the author
Meet David, an early career Physiotherapist at KEO. David graduated in 2022 and jumped straight into our Aged Care team. He enjoys creating meaningful connections and provides holistic care to all of his clients.
As an early career professional, he utilises recent evidence-based approaches in his everyday practice. His main area of interest is musculoskeletal Physiotherapy. David loves his work in the Aged Care community and aims to empower every individual he works with to the best of his ability.
