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“Occupational therapy is the therapeutic use of self-care, work and play (leisure) activities to increase independent function, enhance development and prevent disability. May include adaptation of task or environment to achieve maximum independence and quality of life” (American Occupational Association [AOTA], 1986)
Occupational Therapy uses activity with the aim of preventing or delaying a person’s functional decline using training, grading, analysis of the function or training in technical assistance or adaptations to the environment.
The functions of an occupational therapist in a cognitive psychostimulation day centre, especially Fundació ACE centres, focus on the application and implementation of occupational techniques and training and stimulation of affected physical and/or mental functions.
Specifically, a therapist runs cognitive stimulation workshops, praxis workshops (for people with diverse symptoms influencing areas that are affected, or compensating through adapting the activity, grading the difficulty, or assisting the person) and participates in the creation of new exercises. After meeting the user, the occupational therapist collaborates in creating an intervention plan, programming activities based on the person’s needs, preferences and tastes.
A therapist also reports to the family services director on the technical assistance and adaptations of the environment which need to be taken into account when assisting the person. In addition to care tasks, the occupational therapist also carries out teaching activities, both for centre staff and through the Fundació ACE website.
These online sessions offer information about how to care for a person with dementia in their home, whether in carrying out activities of daily living or instrumental activities, leisure activities or adaptation to the environment.
10.00–11.00: Welcome and breakfast. Entertainment.
11.00–12.30: Cognitive stimulation workshop (structured sessions, organised into different homogenous working groups according to cognitive level).
12.30–13.00: Preservation of basic activities of daily living.
13.00–14.00: Motor/praxis stimulation workshop (different groups).
14.00–15.30: Lunch and conversation.
15.30–16.15: Preservation of basic activities of daily living.
16.15–17.30: Occupational therapy workshop (different groups and activities).
17.30–18.00: Farewell. There are also small-group physiotherapy sessions during the day.
In Fundació ACE centres, PPI is implemented from an interdisciplinary approach which can meet the needs of the person with dementia and their family in the different phases of the disease. Continued therapeutic attention is offered in the cognitive, physical, functional, psychological and social spheres.
The range of techniques used (cognitive psychostimulation, expression workshops, physiotherapy, occupational therapy workshops, preservation of basic activities of daily living and kinesiotherapy) are alternated in such a way that the person is active, awake and stimulated throughout the day, following a pre-established timetable and a familiar routine.
Like this, the morning is used for more therapeutic activities which require more attention, such as cognitive psychostimulation workshops. In the afternoon, by contrast, activities are more playful and occupational.
PPI is a therapeutic strategy founded on the presence of neuronal plasticity and based on cognitive neuropsychology, behaviour modification therapy and the person’s physical/mental/social state. The therapy aims to improve and/or slow the evolving clinical process in the short and medium term (Boada and Tárraga, 1990).
This programme essentially consists in integrating different techniques to improve aspects of behaviour and personality. The application of rehabilitative techniques mainly influences four aspects of the person with dementia: cognitive, motor and psychosocial skills and the activities of daily living combined, this constitutes an integrated intervention.