Occupational therapy

Occupational therapists are allied health professionals who specialise in assessing and promoting a person’s ability to complete day-to-day tasks. Occupational therapy for people living with dementia is usually designed to improve or maintain function. Occupational therapy approaches include:

• Education about dementia and the potential risk to functional independence
• Assessment of the current strengths and abilities of the person living with dementia
• Training in practical skills, coping, and adaptive and compensatory strategies [1]
• Prescription of equipment and aids to assist with day-to-day activities
• Home safety assessment
• Integration into community
• Energy conservation.

Many home-based occupational therapy interventions are delivered to both the person living with dementia and the carer (also known as the dyad). [2]

This evidence theme on occupational therapy is a summary of one of the key topics identified by a scoping review of dementia research. If you need more information on this topic, try using the PubMed search below.

We found six systematic reviews that examined the impact of occupational therapy on people living with dementia. These reviews found that occupational therapy interventions have a positive influence on:

• People’s ability to manage their self-care (also known as activities of daily living) [2, 3]
• Daily functioning [4]
• Carer quality of life. [2]

These also include reductions in:

• Responsive behaviours [2, 5]
• Carer distress [2]
• Carer hours assisting the person living with dementia. [2]

There is inconclusive evidence that occupational therapy improves the abilities or quality of life for the person living with dementia. This is because some studies reported benefits while others did not. [1, 2, 5, 6]

There was no clear evidence of benefit in depression for the person living with dementia. [5] In other words, studies that have assessed the relationship between occupational therapy and depression reported no benefit.

The reviews highlighted concerns about the methods used by some of the studies. This reduces the degree of certainty we might have about the benefits of occupational therapy. For example:

• Studies did not compare the effectiveness of occupational therapy interventions across the varying stages of dementia. [3]
• It is unclear how long benefits last. [2]
• Potentially important outcomes were not assessed (e.g., functional dependency, carer wellbeing). [1]
• The types of responsive behaviours that were reduced by occupational therapy were not always made clear by the researchers. [2]

• Be familiar with what occupational therapy is and how it may assist someone living with dementia (see some resources below).
• Refer or escalate any occupational or safety concerns (e.g., ability to manage self-care).
• Check the case notes of the individual living with dementia for any programs that may have previously been supplied by an occupational therapist.

• Referral to occupational therapy should be considered to support and optimise the ability to carry out day-to-day activities and improve the wellbeing of people living with dementia. [2]
• Put practices in place (e.g., staff training, organisational changes) to increase adherence to any programs which may have been provided by an occupational therapist for the person living with dementia.

1. Ojagbemi A, Owolabi M. Do occupational therapy interventions improve quality of life in persons with dementia? A meta-analysis with implications for future directions. Psychogeriatrics. 2017;17(2):133-41.
2. Bennett S, Laver K, Voigt-Radloff S, Letts L, Clemson L, Graff M, et al. Occupational therapy for people with dementia and their family carers provided at home: A systematic review and meta-analysis. BMJ Open. 2019;9(11).
3. Raj SE, Mackintosh S, Fryer C, Stanley M. Home-based occupational therapy for adults with dementia and their informal caregivers: A systematic review. Am J Occup Ther. 2021;75(1):1-27.
4. Sampath P, Forbes DA, Barton S, Blake C. A systematic review of the effectiveness of interventions for persons living with dementia based in the home or community. Perspectives. 2015;38(2):6-19.
5. Kim SY, Yoo EY, Jung MY, Park SH, Park JH. A systematic review of the effects of occupational therapy for persons with dementia: A meta-analysis of randomized controlled trials. NeuroRehabilitation. 2012;31(2):107-15.
6. McLaren AN, Lamantia MA, Callahan CM. Systematic review of non-pharmacologic interventions to delay functional decline in community-dwelling patients with dementia. Aging Ment Health. 2013;17(6):655-66.