Feasibility of the occupational therapy protocol TAP (Tailored Activity Program) for the management of behaviors in a dementia hospital unit: Preliminary results from a pilot study

Abstract

Background: BPSD may have a significant impact on the quality of life of people with dementia (PWD), cause significant burden in their caregivers (CG) and rise probability of hospitalization .The Tailored Activity Program (TAP) is an evidence-based OT program based on meaningful activities of PWD. The primary goal of the program is to prevent and reduce BPSD. The intervention is delivered also toward professional and non professional CG to help them with the implementation of the identified strategies, delivered as tailored non-pharmacological "prescriptions". OBJECTIVE: verify the applicability in Italy of the TAP OT program. Methods:The program was adapted for the Italian cultural context in agreement with the main author. It consisted of 6 sessions to be carried out at the SCU-B after being selected by the Geriatrician. Inclusion criteria for PWDs: MMSE <24, CDR <5, absence of psychiatric comorbidities.In addition to the applicability of the program, other parameters were also detected, specifically BPSD (UCLA-NPI), autonomy (Barthel), quality of life (QUALID), the use of psychotropic drugs, the confidence of the CG in use of strategies.Results: A total of 10 patients (age 80.7 ± 5.12) and their primary caregivers were recruited. The TAP program proved to be feasible in all its parts as required by the protocol within a specialist hospital dementia unit. There was also a reduction in BPSDs at NPI (median IN = 42; OUT = 12.5), an improvement in autonomy (Barthel median IN = 52.5; OUT = 57.5) and quality of life (Median QUALID IN = 31; OUT = 26). Caregivers reported greater confidence in using activities (M ± SD IN = 2.60 ± 1.96; OUT = 6.75 ± 2.31), communication (M ± SD IN = 4.40 ± 2.64; OUT = 7.63 ± 1.06) and environmental strategies (M ± DS IN = 3.30 ± 2.836; OUT = 7.25 ± 1.69) for the management of BPSDs at the end of the program.Conclusions: TAP was overall feasible and applicable in all its parts and has shown to be useful for both PWD and CG in different outcomes. It is necessary to enlarge the sample to confirm these preliminary positive results.