Non-pharmacological interventions for patients with dementia and their caregivers
M. TSOLAKI, G. VASSILIADES

Recent years have seen a growing interest in research on both pharmacological and non-pharmacological interventions in Dementia. Our discussion is about the Cognitive, the Functional and the Behavioral side of rehabilitation of patients with dementia as well as the educational interventions for caregivers. All these approaches have the advantage of being safe and effective with demonstrated psycho-educational and cognitive-behavioral benefits, as well as being practical and flexible. Interventions to improve cognitive performance: Reactivating occupational rehabilitation (memory training, manual/creative activities, improving sensorimotor functions and self management therapy), Validation therapy, Programs of facilitating personal expression, Reminiscence, Montessori-inspired methods, Exercise therapy, Dancing therapy. Interventions to improve functional performance: Studies show that behavior modification, scheduled toileting and prompt voiding can reduce urinary incontinence. Moreover graded assistance, skills practice and positive reinforcement can increase functional independence in persons with dementia. Interventions to improve problem behaviors. Music particularly during meals and bathing, Walking or other forms of exercise, light exercise, Simulated presence therapy, Massage, Comprehensive psychosocial care programs, Pet therapy, Commands issued at the patient's comprehension level, Bright light, White noise, Cognitive remediation. Interventions for caregivers. Comprehensive, psychoeducational caregiver training, Support groups, computer networks to provide education and support to caregivers, telephone support programs. Care environment alterations: Special care units within long-term care facilities, Homelike physical setting with small groups of patients, Short term, planned hospitalization of 1-3 weeks, Provision of exterior space and changes in the bathing environment. Finally, more evidence-based studies must explore the benefits of various interventions for patients with dementia and their environment. However the best intervention to improve cognition, behavior, Activities of Daily Living of the patients with dementia and the mental Health of Caregivers is a combination of Cognitive Therapy, medical treatment and Caregiver's Counseling.