アルツハイマー病患者に対する作業療法の一経験
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概要
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A weekly one-day occupational therapy program has been carried out for a 49-year-old male patient with moderate memory disturbance and disorientation. The main goal of the program was to improve the level of activity performance and to establish a commuting pattern between his house and the OT clinic within 45 minutes by bus and train. The patient became well motivated to complete simple constructive projects which were all new to him, and showed remarkable increase in conversation with his family, friends and members of the OT clinic. He has moderately improved in orientation of space with less getting-lost episode within the hospital. The commuting pattern seemed to show a little improvement. He somehow managed to find a way to the clinic and/or home by himself, though he still takes wrong train and bus once in a while. Following principles were suggested for an implementation of occupational therapy : 1. Activities should be presented in a very clear cut step-by-step manner with simple one verbal instruction, So that the patient could be free from over-loaded distracting information. This may help the activity performance through procedural memory. 2. The interpersonal relationship should be geared to support patient's positive performance at any time. Each process and achievement of occupational therapy provides the patient with opportunities for positive feedback from the clinic and family situation. The experience in OT becomes meaningful through emotional episodic memory. 3. Any change of familiar environments will cause a marked confusion in orientation of space which may aggravate the functional maladjustment due to negative emotional episodic memory.
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