ABSTRACT
Increasingly, rehabilitation scientists have evidence that intervention can improve the daily functional skills and decrease problem behaviors of persons with dementia. As discussed in chapters 4 and 5, we can achieve such functional outcomes for activities and participation through development of compensatory strategies that capitalize on preserved skills. The purpose of this chapter is to identify how the interdisciplinary team can implement specifi c behavioral or environmental interventions. In the previous chapter, pharmacological approaches and behavioral interventions that addressed communication and memory skills from the perspectives of speech-language pathology and psychology were reviewed. These interventions largely addressed communication and memory defi cits at the levels of impairments of cognitive functioning (e.g., pharmacological treatments) and compensatory strategies for the impairments and activity limitations of dementia (e.g., use of communication cards and spaced retrieval memory training). This chapter explores the wealth of treatments that have been developed from the traditions of other disciplines, such as recreation therapy, music and art therapy, occupational therapy, nursing, and spiritual care, among others, to reduce activity limitations and participation restrictions (e.g., use of written cue cards to promote participation in activities, and attention to furniture arrangement and lighting in residential facilities) of persons with dementia. Each rehabilitation discipline has contributed various sensory-based and activityfocused techniques to enhance positive skills and to reduce problem behaviors in persons with dementia (e.g., Arkin, 1998; Eisner, 2001; Hellen, 1998; Lawton, 1999; Tappen, 1997; Volicer & Bloom-Charette, 1999). This chapter will focus on adaptations to the physical and sensory environment, daily leisure activities, and social environments, as both environmental design and programming are important in caring for persons with dementia (Forrest & Cohen, 2004).
