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The Gerontologist Advance Access originally published online on May 6, 2009
The Gerontologist 2009 49(3):428-439; doi:10.1093/geront/gnp087
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

The Tailored Activity Program to Reduce Behavioral Symptoms in Individuals With Dementia: Feasibility, Acceptability, and Replication Potential

Laura N. Gitlin, PhD1,2, Laraine Winter, PhD2, Tracey Vause Earland, MS, OTR/L2, E. Adel Herge, MS, OTR/L3, Nancy L. Chernett, MPH2, Catherine V. Piersol, MS, OTR/L2 and Janice P. Burke, PhD, OTR/L, FAOTA3

2 Jefferson Center for Applied Research on Aging and Health
3 Department of Occupational Therapy, Jefferson College of Health Professions, Thomas Jefferson University, Philadelphia, Pennsylvania

1 Address correspondence to Laura N. Gitlin, PhD, Jefferson Center for Applied Research on Aging and Health, Thomas Jefferson University, 130 South 9th Street, Suite 513, Philadelphia, PA 19107. E-mail: laura.gitlin{at}jefferson.edu


  Abstract

Purpose: The Tailored Activity Program (TAP) is a home-based occupational therapy intervention shown to reduce behavioral symptoms and caregiver burden in a randomized trial. This article describes TAP, its assessments, acceptability, and replication potential. Design and Methods: TAP involves 8 sessions for a period of 4 months. Interventionists identify preserved capabilities, previous roles, habits, and interests of individuals with dementia; develop activities customized to individual profiles; and train families in activity use. Interventionists documented time spent and ease conducting assessments, and observed receptivity of TAP. For each implemented prescribed activity, caregivers reported the amount of time their relative spent in activity and perceived benefits. Results: The TAP assessment, a combination of neuropsychological tests, standardized performance-based observations, and clinical interviewing, yielded information on capabilities from which to identify and tailor activities. Assessments were easy to administer, taking an average of two 1-hr sessions. Of 170 prescribed activities, 81.5% were used, for an average of 4 times for 23 min by families between treatment sessions for a period of months. Caregivers reported high confidence in using activities, being less upset with behavioral symptoms (86%), and enhanced skills (93%) and personal control (95%). Interventionists observed enhanced engagement (100%) and pleasure (98%) in individuals with dementia during sessions. Implications: TAP offers families knowledge of their relative's capabilities and easy-to-use activities. The program was well received by caregivers. Prescribed activities appeared to be pleasurable and engaging to individuals with dementia. TAP merits further evaluation to establish efficacy with larger more diverse populations and consideration as a nonpharmacological approach to manage behavioral symptoms.

Keywords: Activity engagement, Occupational therapy, Quality of life, Dementia care, Caregiving

Received July 26, 2008; Accepted February 23, 2009

Decision Editor: Kathleen Walsh Piercy, PhD


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