Relearning of activities of daily living: A comparison of the effectiveness of three learning methods in patients with dementia of the Alzheimer type

Abstract

This study examined the effectiveness of three different learning methods: trial and error learning (TE), errorless learning (EL) and learning by modeling with spaced retrieval (MR) on the relearning process of IADL in mild-to-moderately severe Alzheimer's Dementia (AD) patients (n=52), using a 6-weeks randomized controlled trial design. The participants had to relearn three IADLs. Repeated-measure analyses during pre-intervention, post-intervention and 1-month delayed sessions were performed. All three learning methods were found to have similar efficiency. However, the intervention produced greater improvements in the actual performance of the IADL tasks than on their explicit knowledge. This study confirms that the relearning of IADL is possible with AD patients through individualized interventions, and that the improvements can be maintained even after the intervention.

Structured relearning of activities of daily living in dementia: the randomized controlled REDALI-DEM trial on errorless learning

“…Recent studies that have used procedural tasks or skills to examine the effects of EL in patients with dementia showed mixed results [5, 17]. One explanation for these mixed findings may lie in the nature of the tasks.…”

<p>Spaced Retrieval and Episodic Memory Training in Alzheimer’s Disease</p>

“…), 25,32,33,19,35,34,36,37,18,21 common personal and household objects, 38,39,40 names of medication, 41,42 and word lists. 43 SR has also been effective in supporting procedural memory in AD, including activities of daily living (ADL) and independent activities of daily living (IADL) such as how to eat safely, 6,22,44,45 everyday multi-step activities, such as using the oven, preparing tea, setting an alarm clock, 46 using mobile devices and managing voicemail, 47 putting things back where they belong, and following a sequence of instructions to guide behaviours. 47,48 In addition to semantic and procedural memory, SR has been used to support prospective memory in order to decrease problematic behaviours, 49,50,51 manage medications, prevent wandering and support wayfinding, use mobility aids, 52,53 and increase social interaction and participation in recreational activities in residential care settings ).…”

A situation-driven framework for relearning of activities of daily living in smart home environments

“…Finally, relearning is a clinical approach used for supporting older adults in correctly executing an intended goal to avert errors [74]. In this study, a situ-learning agent (SLA) was proposed to support decision making with respect to goal of the resident in risky situation.…”

“…Due to deterioration in cognitive functions and loss of autonomy experienced by older adults with cognitive disorders and with no curative measures available, non-pharmacological intervention known as relearning that targets the learning to recover useful IADL skills have been employed in clinical settings to help improve their QoL [73,74]. Generally, there are three methods of relearning, namely: ▪ Trial and Error (TE): This type of learning method requires the patient to guess the correct answer to a task while he/she learns from any errors or mistakes made [74].…”

“…Since ED causes decline in cognitive functioning of seniors, the temporal position of an action in a goal sequence may miss or might be out of order and this deviation may constitute a risk or hazardous state [74,119].…”