Special Issue: Dimensions of dementia

Abstract

Living well with dementia is often perceived as challenging for individuals and those who support them. Joy Watson, herself living with dementia, defines it as finding peace, contentment and having fun, but says this is hard to achieve when your ‘brain doesn’t work’ (Watson, 2016). Such comments are a challenge to occupational therapists, who have the knowledge and skills to enable individuals to participate in meaningful activity but may be constrained by practice or confidence limitations. The national and international articles in this special issue on ‘dimensions of dementia’ illustrate the potential for occupational therapists to support those living with dementia to achieve well-being. Dudzinski (2016) demonstrates in a single case study how engagement in meaningful activity resulted in an increased sense of well-being. Using the Pool Activity Level (PAL) Instrument she describes how a graded intervention can be structured to the individual’s level of ability and also recognises the importance of involving staff and other care givers in utilising this approach. Mattock and McIntyre (2016) explore how occupations might contribute to the transition from dementia care giving before and after the death of a partner. The importance of sustaining occupations and roles to maintain identity are highlighted as a focus for occupational therapists. This is an exciting emerging role for the profession both at a national and international level. In contrast, Griffiths and Bunrayong (2016) identify the challenges of care givers in Thailand when supporting people with dementia. The activity performance and difficulties experienced by care givers led the authors to develop an educational package for carers to support individuals to engage in activities of daily living. In a scoping survey in the United Kingdom, Swinson et al. (2016) investigate the role of community occupational therapists. Their review provides not only a national picture of practice but also contributes to the development of a community occupational therapy intervention as part of the NIHR-funded research programme, Valuing Active Life in Dementia (VALID) (https://www.ucl.ac.uk/valid and see also Swinson et al. (2016)). The final four papers focus on interventions. Raber et al.’s (2016) phenomenological study of occupational therapy practitioners’ use of the Remotivation Process highlights the need for therapists to be knowledgeable and confident in methods for motivating individuals with dementia to participate in therapy programmes. This is particularly relevant to the article by Unsworth and Chan (2016), who demonstrate the importance of using a reliable and valid tool to determine fitness to drive among drivers with Alzheimer’s disease. Having such a tool reinforces the importance of identifying retained skills rather than relying on diagnosis. Depending only on a diagnosis can be demotivating and become a self-fulfilling prophesy.