‘Partnering with Poise’: Alexander technique online group classes are a promising intervention to decrease loss‐of‐self and increase agency for care partners of people living with dementia

Abstract

AbstractBackgroundStudies show 1:1 in‐person Alexander technique (AT) sessions can reduce anxiety and musculoskeletal pain with long‐term benefits [1‐4]. Care partners (CP) often experience role engulfment and loss of self [5]. AT is an embodied approach to choose functional patterns that transform disruptive stress reactions to adaptive responses, increasing confidence, self‐control, and self‐awareness. Previous in‐person group course results from 71 Parkinson’s CP showed promise with benefits retained at 12 months. COVID‐19 provided an opportunity to test synchronous online AT‐based courses for CP of people living with dementia.Method Design: Controlled feasibility trial. AT group: 14 participants (12F/2M) from 9 states; mean age 68; 72% provided 41+ hrs/wk care for family member with dementia; 13 lived with care‐receiver. Control group: 9 participants (8F/1M) from 4 states; mean age 63; 67% provided 41+ hrs/wk care; 6 lived with family care‐receiver. AT groups met 90 min/week x 10wks. Intervention: Delivered in‐home via Zoom. Embodied self‐management strategies included intentional strategies to interrupt automatic reactions and affirm centrality of the self, taught via verbal and visual instruction, activities, anatomical models/images, and demonstration videos. AT principles were embedded in everyday activities (gait, sit‐to‐stand, IADLs, etc.). Outcome Measures: Self‐report, executive function, anonymous evaluations, interviews.Result70% retention, 87% attendance. AT group improved executive function (Digit Span p = .003; Stroop p = .05); control group did not. AT group reported increased self‐efficacy (caregiver scale p = .08); and reduced fear (p = .004); control group did not. On 0‐10 scale, mean rating was >9 for novelty of ideas, practical tools for physical self‐management, and would recommend to a friend; and >8 for enjoyment of group interaction, practical tools for self‐management of emotions and reactions, and prevention of pain; 7.9 for feeling better prepared for CP daily challenges. Six‐month follow‐up is underway.ConclusionAlexander technique shows promise as a long‐term self‐management approach to reduce loss‐of‐self in CP of people living with cognitive decline. Group classes can provide cost‐effective delivery with social benefits. Online classes can increase accessibility. A full‐scale study is merited.1.Little (2008) 2.MacPherson (2015) 3.Klein (2014) 4.Stallibrass (2002) 5.Skaff, Pearlin (1992)