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What is Problem Adaptation Therapy?

Problem Adaptation Therapy: A Breakthrough for Dementia Care Patients with Depression and Anxiety.

When someone suffers from Alzheimer’s disease or another form of dementia, their days can be filled with anxiety, sadness and depression, which can lead to suffering and family disruption. Research shows that about a third of people with dementia also have depression, and that anxiety symptoms afflict roughly a quarter to half of the patients with dementia.

Moreover, many people with dementia who suffer from depression and anxiety are prescribed antidepressant medications as a first-line defense. Although data on psychiatric drug use is mixed, current research indicates that antidepressants don’t work well in seniors with dementia. Many also come with serious side effects such as disorientation and confusion, which can lead to falls and fractures.

Fortunately, there are effective new therapies for seniors with depression and anxiety to help them cope and find solace. One such treatment is Problem Adaptation Therapy.

What is Problem Adaptation Therapy?

Problem Adaptation Therapy (also known as PATH) is a new home-delivered treatment for older adults with mild cognitive impairment to moderate dementia. Developed by researchers at Weill Cornell Medicine in New York City and White Plains, N.Y., PATH takes a personalized approach to teach patients how to solve everyday problems that lead to feelings of sadness and hopelessness.

In an article from the New York Times, Dr. Kiosses, an associate professor of psychology in clinical psychiatry at Weill Cornell Medical College, stated that the goal of PATH is to “reduce negative emotions the patient has and increase positive emotions.”

Patients are taught how to identify situations that trigger negative feelings. They’re also taught how to shift their attention away from those situations and emotions.

The therapist and patient create a plan, which includes ways to avoid situations that lead to negativity and feelings of sadness, anxiety, guilt, helplessness and hopelessness. Together, they pinpoint ways to elicit positive feelings, such as scheduling activities that are meaningful and bring them pleasure – it could be needlepoint, woodworking, or going to church. Caregivers are encouraged to participate in this therapy for dementia patients to help them use what they’ve learned.

Because patients have memory issues, the therapist may send them home with tools such as checklists, calendars, or signs to also help them recall what they’ve learned. For instance, an 84-year-old patient struggled with feelings of loneliness, so the therapist and patient put signs in her living room that read, “Going to church will make me feel better” and “Staying home makes me sad.”

Depression and anxiety can make dementia symptoms worse, and can lead to social withdrawal and the discontinuation of normal activities. That’s why Problem Adaptation Therapy advocates scheduling pleasurable activities to increase positive emotions, because it’s clear how important this is.

Dr. Laura Gitlin, dean of the College of Nursing and Health Professions at Drexel University, said that keeping the mind active with meaningful daily activities is particularly crucial for people with dementia, who often face blank calendars as their cognitive problems grow.

“Boredom and having nothing to do contributes to having an array of behavioral symptoms, agitation, aggressiveness, apathy, rejection of care,” said Dr. Gitlin. “Activity is part of what makes us human.”

While there’s work still to be done in the area of senior mental health solutions and psychosocial intervention research, the results emerging from Problem Adaptation Therapy for seniors with depression are quite encouraging. As more non medication treatments are desperately needed, studies suggest that psychosocial interventions are currently the best and lowest-risk treatments for depression and anxiety in older adults with cognitive impairment.

Life Care Services

If you have a loved one with Alzheimer’s disease or other form of dementia, you should know that Life Care Services® offers 84 trusted memory care communities across the country. As an organization and within each community, commitment to whole-person health is evident. We employ the latest in dementia care research and best practices, and each highly trained team member helps provide a person-centered, activity-focused, dignified continuum of care in a safe and secure environment. To learn more about the exceptional memory care services we provide, find an LCS community near you.