Home-Based Occupational Therapy Intervention for the Improvement of Quality of Life in Individuals With Moderate to Severe Dementia and Their Caregivers.

Abstract

Background and purpose: The quality of life (QoL) of individuals with dementia is influenced by their ability to perform activities of daily living (ADLs), social engagement, and emotional well-being. Instrumental ADLs (IADLs) decline even in early stages, while basic ADLs (BADLs) are significantly affected in advanced stages. This study examined whether a home-based occupational therapy intervention improves QoL in people with dementia, reduces caregiver burden, depression, and anxiety, and enhances BADL performance.

Methods: Forty-nine participants with moderate to severe dementia were assigned to an intervention group (n=26, mean age 83.5±5.0 years, t=2.63, p=0.011) or a control group (n=23, mean age 80.0±4.2 years). QoL was assessed using the QoL in Alzheimer's disease (QoL-AD) and QoL in late-stage dementia (QUALID) scales. The intervention group received a 3-month standardized home-based occupational therapy program (12 individualized sessions) focused on BADL training, in addition to ongoing support from the Greek Alzheimer's Disease Association. The control group received only standard support. Caregivers in both groups participated in counseling or standard support sessions, respectively.

Results: Significant improvements were observed in patients' QoL (QoL-AD, p=0.008; QUALID, p=0.009) and in caregivers' anxiety and depression (p<0.001). No significant effects were found for BADL performance (p=0.857) or caregiver burden (p=0.773).

Conclusions: Home-based standardized occupational therapy interventions enhance the quality of life and emotional well-being of individuals with moderate to severe dementia and improve caregiver mental health, highlighting their crucial role in community dementia care.