Telephone-Based Reality Orientation Therapy for Patients With Dementia: A Pilot Study During the COVID-19 Outbreak

Abstract

When in-person rehabilitation is not feasible, interventions delivered in remote telephone-based sessions may be an option. To determine whether telephone-based reality orientation therapy (T-ROT) can improve cognition, mood, and neuropsychiatric symptoms among patients with major neurocognitive disorders (NCDs) who are forced to isolate and also whether T-ROT can relieve the burden of distress among their caregivers. Nonrandomized interventional comparison study. Individual telephone calls between practitioners and patients and their caregivers. Twenty-seven patients (14 in the experimental group, 13 in the control group) with a major NCD and their primary caregivers. Ten T-ROT sessions and a pretest-posttest neuropsychological evaluation over 4 wk. Outcomes measured included cognitive and behavioral symptoms of patients with major NCDs and correlations between changes in patient clinical condition and caregiver stress. Primary outcome measures were two measures of depressive symptoms, the Neuropsychiatric Inventory Questionnaire and the Telephone Mini-Mental State Examination, administered at baseline and program discharge. T-ROT significantly outperformed nontreatment on all measures of depression, behavior, cognition, and caregiver burden. T-ROT combined with emotional support appears to be an effective intervention for monitoring and managing the behavioral symptoms of patients with major NCDs who are forced to isolate. Occupational therapy practitioners can use T-ROT or similar procedures not only during a pandemic but also when it is not possible to treat patients in person at a hospital or at home. Telephone-based treatment may also represent a good practice to be integrated into traditional rehabilitation programs.