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Dementia Part One: A Physical Treatment of Individuals with Dementia

Jan van de Rakt and Steve McCarthy-Grunwald

A very difficult item because physical treatment for elderly is still a “lesser” form of physical therapy and a treatment for elderly with dementia is almost “not done”. But out investigation all over the world, it is clear, that movement and especially aerobe exercises have a better effect on slowing down this disease than other approaches including medical treatment. This part about dementia will discussed these investigations and their conclusion and the translation to the practice. And the first problem is very fast present, because most investigation is only done with mobile individuals with dementia and not with individuals that are not so mobile anymore. That means: “That the greatest problem isn’t properly investigated and that makes things complicated”. People with dementia have a restriction in the capacity, what their brain can copy with. Is that problem “Movement”, than are there an lot of possibilities, but exercising/ training ask for an activity close to the border of the possibilities and that can be difficult by this group. The fear for failing is very strong and has a great negative effect, where this people are very sensitive for and can make exercising almost impossible. Another problem is environment, the care givers/family but also other professionals. They often react from their own perspective and search for an solution, that make it work for themselves easier but the independency of the individual with dementia will often fast decrease. The environment can also be an inhibition for movement and that we see often in residences/nursing home and even in their own home, that the possibilities are not optimal to move independent with their own speed. In this part the emphasis lies on what we know about the sciences and how to translate this for the individual with dementia to hold his own possibilities. Further one we start with an assessment, to get an picture, where the difficulties lies and that is often still possible at the beginning of the disease. When the disease is progressing this will far more difficult but with the knowledge of the start, we have a cardinal point. To have a “railway guide” in developmental of this degenerative disease we start with the introduction of the “Rakt-scheme” to focus on the main problems of the people with dementia in the diver’s moments of this disease.