The perspective on care for people with chronic diseases, such as Alzheimer's disease and other types of dementia, has changed profoundly over the last decades. From a mainly medical focus, including medical-hygienic care issues and developing treatments to stabilize the disease, over the course of de last decades interest has broadened to include the chronic consequences of dementia and psychosocial aspects, such as guiding the person in accepting the disease and dealing with it in daily life, and ultimately to also include the quality of life of persons living with dementia.
This broadened perspective led to new goals in care and the development of a range of new care and treatment methods, which are summarized by terms as 'psychosocial', 'emotion-oriented' and 'non-pharmacological treatments'. They have in common that they are offered to assist people with dementia and their carers in dealing with the practical, emotional and social consequences of dementia, with the aim to reduce or prevent behavioural, psychological and mood disruptions, and to maintain an acceptable quality of life.
To categorise the information on psychosocial care and treatment methods on this website we used a theoretical framework: the Adaptation-coping model (Dröes et al., 2011; Finnema et al., 2000). This model, which is based on the stress-coping model of Lazarus en Folkman (1984) and the crisis model of Moos and Tsu (1977), distinguishes seven general adaptive tasks that people with dementia encounter as a consequence of their illness:
- coping with one's own disabilities
- preserving an emotional balance
- maintaining a positive self-image
- preparing for an uncertain future
- dealing with the day care, care home or nursing home environment and treatment procedures
- developing an adequate care relationship with healthcare professionals
- developing and maintaining social relationships
According to the Adaptation-coping model, many of the behaviour and mood disruptions in people with dementia, such as depressed, anxious, aggressive and rebellious behaviour, agitation, wandering, suspicious behaviour, delusions and hallucinations, can be explained by the difficulties people experience in coping with these adaptive tasks. As a consequence, supporting people in dealing with the adaptive tasks will help them regain a balance.
On the website you can find out which care and treatment methods in scientific research have demonstrated to be effective in supporting people to deal with the different adaptive tasks.
- Dröes RM. Insight in coping with dementia: listening to the voice of those who suffer from it. Aging Ment Health 2007;11(2):115-8.
- Dröes R, van der Roest H, van Mierlo L, Meiland F. Memory problems in dementia: adaptation and coping strategies and psychosocial treatments. Expert Rev. Neurother. 2011;11 (12):1769-1782.
- Dröes RM, Van Mierlo LD, Van der Roest HG, Meiland FJM. Focus and effectiveness of psychosocial inter-ventions for people with dementia in institutional care settings from the perspective of coping with the dis-ease. Non-pharmacological Therapies in Dementia 2010;1(2):139-161.
- Finnema E, Droes RM, Ribbe M, van Tilburg W. A review of psychosocial models in psychogeriatrics: impli-cations for care and research. Alzheimer Dis Assoc Disord 2000;14(2):68-80.
- Lazarus, R.S. & Folkman, S. Stress, appraisal, and coping. Springer Publ. Comp., New York, 1984.
- Moos, R.H. & Tsu, V.D. The crisis of physical illness: An overview. In: Coping with physical illness. R.H. Moos (ed.), Plenum Medical Book Company, New York/London, 1977.
- Moniz-Cook E, Manthorpe (eds). Psychosocial interventions in early stage dementia; a European evidence-based text (INTERDEM-network), Jessica Kingsley Publishers, London, UK, Dec, 2008. ISBN: 978-1-84310-683-8.