Rehabilitation of Elderly People with Dementia

Rehabilitation of Elderly People with Dementia

Hitoshi Okamura
DOI: 10.4018/978-1-4666-2113-8.ch024
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Abstract

Numerous rehabilitation approaches have been attempted to improve the cognitive functions and quality of life (QOL) of elderly people with dementia. This chapter provides an outline of three major approaches that have been previously reported (music therapy, physical activity, and reminiscence therapy) and reviews their effectiveness. These approaches are typically used in clinical settings. However, the results of this review show that there is limited evidence to support the use of these approaches to improve cognition in older people with dementia. In addition, effective rehabilitation approaches for dementia still need to be established, and further high-quality research is needed. Finally, the author introduces a new approach for improving the cognitive functions of elderly people with dementia.
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Rehabilitation Approaches For Dementia

Music Therapy

The purpose of music therapy is to relax the mind and body, reduce anxiety and stress, reduce non-adaptive behavior, improve spontaneity, enhance cooperativeness, develop the long- and short-term memory by retrieving memories, improve the discernment of reality, enhance interactions with others, strengthen physical fitness, and improve exercise capacity. Music therapy includes passive music therapy, in which participants passively listen to music, and active music therapy, in which participants actively participate in musical activities by singing songs and playing instruments. In other words, in passive music therapy, the participants listen to classical music and old time favorite songs as background music during meals or during their daily life activities with assistance. In contrast, in active music therapy, the participants themselves sing children’s songs, school songs, folk songs and military songs; they also play instruments, such as bells and tambourines while singing and stretching their bodies, performing singing exercises and dancing to the music.

The effects of music therapy in the treatment of behavioral, social, cognitive and emotional problems in older people with dementia were assessed by a Cochrane review (Vink, Birks, Bruinsma & Sholten, 2004). Randomized controlled trials that reported clinically relevant outcomes associated with music therapy in the treatment of behavioral, social, cognitive and emotional problems in older people with dementia were selected. Five studies met the inclusion criteria. The methodological quality of the studies was generally poor, and the study results could not be validated or pooled for further analyses. Therefore, it was concluded that the methodological quality and reporting methods of the studies were too poor to draw any useful conclusions.

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