General

The Alzheimer’s Society reported in 2013 that 1 in 4 people living with dementia had used complementary or alternative therapies in the past year. With the possible side effects of conventional medicines well documented, and people anxious to find any effective way to treat the effects of dementia, it is easy to why complementary therapies are gaining in popularity so fast.

But are they safe? And just how effective are they?

What role can complementary therapy play in the treatment of dementia?

While the terms “complimentary” and “alternative” are often used interchangeably, they technically have quite different meanings.

“Complimentary” refers to an approach or treatment used alongside conventional medicine.

“Alternative” refers to an approach or treatment adopted in place of conventional medicine.

Current interest in complimentary forms of therapy has outpaced scientific research into the effectiveness of the differing forms of therapy, and at present there is simply not enough high quality evidence to justify abandoning proven successful drug treatments in favour of unproven and possibly ineffective therapies.

However, as an aid to conventional medicine, the potential of natural, non-invasive, complementary therapies to boost a feeling of wellbeing and enhance quality of life among people living with dementia is becoming increasingly recognised.

 Potential benefits

The aims for complementary treatments can be wide ranging.

Massage photosSome can be geared towards stimulation with such aims as:

  • Encouraging social interaction
  • Boosting cognitive function
  • Stimulating memory
  • Encouraging physical activity

Others have relaxation as their main function, with such potential benefits as:

  • Reducing disturbed and agitated behaviours
  • Promoting sleep
  • Easing physical discomfort

All therapies aim to boost mood and instil a feeling of wellbeing. The power of this should not be under-estimated. As one man in the early stages of Alzheimer’s commented, “I don’t remember what people told me but I remember how they made me feel”.

 What types of complementary therapy are available?

Complementary therapies are numerous and wide ranging in nature, but can be divided into the following areas:

  • Art, Music and Dance

Art and Music both provide useful tools in dementia care by evoking powerful responses and freeing people up from the need to find the right words. Both provide enjoyable and meaningful activities that have the ability to boost mood, increase attention span, expand social interaction and decrease feelings of anxiety and depression.

  • Botanicals, Herbal supplements and Extracts

The most common of these is Aromatherapy using essential oils extracted from plants and herbs which are either applied to the skin through massage, or inhaled by steam inhalation to stimulate the limbic system in the brain. Each essential oil has unique effects (anti-bacterial, diuretic, tranquilising…) and the effect can be hugely relaxing, aiding sleep, calming disturbed behaviours etc.

  • Exercise
  • Pets and Dolls
  • Therapeutic Multi-sensory experiences

These include therapies as wide ranging as group therapies such as Reminiscence and Validation therapies to improve cognitive function, Bright Light therapy (which benefits the circadian rhythm to improve sleep patterns, decrease wandering and agitation etc) and Acupuncture.

 How effective are these therapies?

The grandmother with a cat on a sofa The majority of medical professionals, care home staff and dementia charities, now widely support the use of complementary therapies when used alongside conventional medicine. Despite plenty of anecdotal stories of individual successes however, scientific research has not managed to keep pace with the ever-growing public interest. High quality scientific research is lacking so there is little solid evidence as yet about the effectiveness of any particular therapy.

Words of Caution

  • Everyone experiences dementia in a slightly different way so it is important to bear in mind that what works for one person, may well not work for another. A therapy that promotes happiness and increased motivation in one person can, just as easily, confuse and frustrate another.

Any therapy should be targeted at an individual’s distinct needs, and its effectiveness  based on his/her unique response.

  • Current regulation remains patchy for the different forms of complementary therapies, so be wary of possibly exaggerated benefits and successes.
  • Just because a therapy is touted as “natural” does not necessarily mean it’s safe for everyone. Some herbal and vitamin supplements or essential oils used in aromatherapy and massage can react significantly – and sometimes negatively – with medication.

Always talk to your Doctor before embarking on any form of therapy to check there are no safety concerns for you personally.

 Before embarking on any form of complimentary therapy…..bear in mind the following points:

  • Talk first to your doctor –he/she will be able to check there are no safety concerns and that any proposed therapy will not react harmfully against any other treatment you are undertaking. Most doctors are now sympathetic to the use of complementary therapies, and may be able to offer advice about good practitioners in the area or even refer you through the NHS.
  • Be prepared- before starting any therapy, find out exactly what the treatment will involve, how many visits will be required, what are the likely results  you can expect, and importantly, how much it will cost.
  • Be realistic- therapy cannot magically erase the symptoms, but may help with a particular targeted problem or simply help you relax and boost your mood.

Give it a go and keep an open mind!

 Further Reading:

When faced with a diagnosis of dementia, one of the most immediate concerns people have is that confusion and memory loss will prevent them from continuing to live safely in their own home. Yet, with the right support, and some basic design and lay-out alterations, much can be done to transform the physical space in the home into an environment that is both safety conscious AND fosters independence.

Where to start?

Knowing where to start is probably the hardest part. When assessing your home, the 2 key questions to ask are:

What hazards exist that can easily be removed?

What adaptations can be made that will foster independence?

Using research conducted by the University of Stirling, and the national housing charity, Care & Repair England, we’ve collected together some useful suggestions for considering possible changes.  We’ve arranged them under 3 headings to get you started:

o   General design and layout

o   Lighting and heating

o   Safety and security

Look at each room in turn and don’t get overwhelmed – remember even 1 or 2 small changes can have a significant impact. 

The Design and Layout of your home:

Hazards:

Consider the layout of each room. Simply eliminating clutter and unneeded furniture can make route-ways to and from the door, or across the room, more readily recognisable, and ensure movement is easier and safer.

Mirrors can cause confusion, particularly as the dementia progresses, so covering or moving them may help.

Closed doors, particularly in a confined space such as a hallway or landing, may be disorientating. Although it may seem drastic, removing them to create a more open-plan layout can reduce confusion and distress.

 Possible Adaptations:

Use of contrasting colours can assist with finding your way around the home and remembering what things are meant to be used for. For example, dark coloured bed linen against cream walls and pale carpet will really stand out, as would a dark coloured toilet seat or handrail against a white bathroom suite. Plain colours work better than patterns and you can use this idea to highlight any object you want easily noticed…light switches, cutlery on the table, door handles etc.

Rearranging chairs to make it possible to look out of the window or watch what other people in the house are doing, can provide stimulation and help maintain social contact.

Put away infrequently used items and try to keep cupboards and surfaces uncluttered so that the important, much used objects are easier to spot.

Using see-through containers, glass fronted doors or open shelves will make things easier than having to remember where something is behind a closed cupboard door.

Lighting and Heating:

Hazards:

Shadows and dark areas can increase the incidence of hallucinations so ensuring good lighting (whether natural and electric) without excessive brightness or shadow is important.

Cookers and fires can become potential fire hazards as the dementia progresses. All fires should be fitted with a fire guard, and if possible, an isolation valve should be fitted to a gas fire or cooker to ensure it can only be turned on if a carer is there to supervise use.

Possible Adaptations:

Try to maximise natural daylight as this provides important information about the time of day.

Timers and motion-sensitive sensors can be useful to ensure adequate lighting at night.

Consider installing central heating with thermostatic controls that will automatically come on if the temperature drops below a certain level rather than having to rely on manual controls.

 Safety and Security:

Hazards:

Minimize the risk of falls by installing handrails on stairs, grab rails on steps, and remove rugs or loose carpets that could prove a tripping danger.

Fitting a KeySafe on to an outside wall enables the front door to be kept locked at all times. Relatives, friends and carers who know the KeySafe code can access the keys and still enter the property when needed.

 Possible Adaptations:

Make sure a smoke alarm is fitted – preferably mains operated so you don’t need to worry about replacing batteries.

Bathrooms can become a high accident risk area and hygiene needs to be a priority.Colour coding important equipment such as grab rails, toothbrush, and even soap can help as a memory aid, and grab rails and a toilet riser can provide physical support. Many older people find using a bath difficult so it is worth considering fitting a level access shower or wet room.

Getting this done as early as possible enables you to learn how to use it, helping maintain independence as long as possible, and then makes it easier for carers later on. Sensors can be fitted to the skirting boards so that if the taps are left running and cause a flood, the system will shut off the water and raise the alarm. Specially designed plugs are also available that drain water should a tap be left running.

There is an ever growing range of equipment and gadgets, including  pressure-pad and motion sensors linked by a telephone line to a nominated person or call centre that can alert a carer to a potential problem. Useful sources of information on the latest aids available, (which can be accessed by clicking in the link below) are:

The Disabled Living Foundation’s website www.asksara.dlf.org.uk

atDementia www.atdementia.org.uk

Assist UK www.assist-uk.org