TY - JOUR
T1 - Feasibility of Telehealth Occupational Therapy for Behavioral Symptoms of Adults With Dementia
T2 - Randomized Controlled Trial
AU - Rhodus, Elizabeth K.
AU - Baum, Carolyn
AU - Kryscio, Richard
AU - Liu, Changrui
AU - George, Rosmy
AU - Thompson, Mary Ellen
AU - Lowry, Kimberly
AU - Coy, Beth
AU - Barber, Justin
AU - Nichols, Heather
AU - Curtis, Alexandra
AU - Holloman, Angela
AU - Jicha, Gregory A.
N1 - Publisher Copyright:
© 2023 American Occupational Therapy Association, Inc. All rights reserved.
PY - 2023/7
Y1 - 2023/7
N2 - Importance: Supporting community residency of adults with Alzheimer's disease (AD) is a critical public health initiative. Occupational therapy can contribute to this goal. Objective: To assess the feasibility of a novel telehealth intervention to support occupational engagement in community-residing people with AD. Design: Single-blind, three-arm, parallel, randomized controlled trial. Setting: Occupational therapy delivered through telehealth in participants' homes. Participants: People with AD who reside in the community with behavioral symptoms and their care partners (dyads). Interventions: (1) HARMONY (Helping older Adults cReate & Manage OccupatioNs successfully), a telehealth intervention that applies principles of individualized guided discovery with environmental cueing for caregivers of persons with AD to promote activity participation and manage behavioral symptoms; (2) standardized training regarding the use of a sensory-based approach in dementia care; and (3) a control, including home safety education and weekly monitoring of behaviors. Outcomes and Measures: Feasibility was assessed as the primary outcome measured by completion of at least 75% of the telehealth sessions. Secondary outcomes included change in functional activity performance and neuropsychiatric behavioral symptoms. Results: Twenty-eight dyads participated. The intervention was feasible, with high adherence to weekly visits (M number of visits 55.4 for HARMONY, 4.9 for standardized training, and 4.6 for control), with high participant retention in the intervention arms. HARMONY demonstrated promise in improving patient performance and behavioral symptoms. Conclusions and Relevance: HARMONY is feasibly delivered through telehealth service and has a positive effect on occupational performance and behavioral symptoms of AD. Additional studies are needed to explore effectiveness in a broader population. What This Article Adds: Use of HARMONY for community-residing adults with AD is feasible and has promise for improving functional activity performance and behavioral symptoms, as well as caregiver satisfaction.
AB - Importance: Supporting community residency of adults with Alzheimer's disease (AD) is a critical public health initiative. Occupational therapy can contribute to this goal. Objective: To assess the feasibility of a novel telehealth intervention to support occupational engagement in community-residing people with AD. Design: Single-blind, three-arm, parallel, randomized controlled trial. Setting: Occupational therapy delivered through telehealth in participants' homes. Participants: People with AD who reside in the community with behavioral symptoms and their care partners (dyads). Interventions: (1) HARMONY (Helping older Adults cReate & Manage OccupatioNs successfully), a telehealth intervention that applies principles of individualized guided discovery with environmental cueing for caregivers of persons with AD to promote activity participation and manage behavioral symptoms; (2) standardized training regarding the use of a sensory-based approach in dementia care; and (3) a control, including home safety education and weekly monitoring of behaviors. Outcomes and Measures: Feasibility was assessed as the primary outcome measured by completion of at least 75% of the telehealth sessions. Secondary outcomes included change in functional activity performance and neuropsychiatric behavioral symptoms. Results: Twenty-eight dyads participated. The intervention was feasible, with high adherence to weekly visits (M number of visits 55.4 for HARMONY, 4.9 for standardized training, and 4.6 for control), with high participant retention in the intervention arms. HARMONY demonstrated promise in improving patient performance and behavioral symptoms. Conclusions and Relevance: HARMONY is feasibly delivered through telehealth service and has a positive effect on occupational performance and behavioral symptoms of AD. Additional studies are needed to explore effectiveness in a broader population. What This Article Adds: Use of HARMONY for community-residing adults with AD is feasible and has promise for improving functional activity performance and behavioral symptoms, as well as caregiver satisfaction.
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U2 - 10.5014/AJOT.2023.050124
DO - 10.5014/AJOT.2023.050124
M3 - Article
C2 - 37624998
AN - SCOPUS:85168715821
SN - 0272-9490
VL - 77
JO - American Journal of Occupational Therapy
JF - American Journal of Occupational Therapy
IS - 4
M1 - 7704205010
ER -
