Please select the eligibility criteria that correspond to the clinical trial below.
Title: High-dose Mass Practice Intervention to Reduce ADL Disability in Dementia
Brief Summary: People with Alzheimer's disease and related dementias present with changes in how they think, move and emotionally respond to daily life situations. While type of dementia will dictate how severe certain symptoms are, all people with dementia will report a gradual change in how they function in daily life skills. Losing the ability to do daily life tasks, such as using a cell phone, balance a checkbook or get dressed in the morning signifies loss for both the person with dementia and their caregiver. Caregivers that assist with daily life tasks report more depression and anxiety, as well as a higher burden of care. People with dementia that lose the ability to perform daily tasks report more depression and decreased satisfaction with life. Despite gains in research, researchers are still missing important pieces that will improve rehabilitation interventions for improving daily life skills.

In order to address the needs of people with dementia, an intervention called Skill-building through Task-Oriented Motor Practice (STOMP) was developed by an occupational therapist. Our team proposes that improvement in daily life skills is possible under certain circumstances. First, the daily life task a person is addressing in rehabilitation should be personally-meaningful and should also be the task practiced in therapy which is called "task-oriented training". For example, a person that is having trouble making a sandwich should practice making a sandwich. Second, the investigators propose that people with dementia need a lot of "correct practice" so that the brain has time to "rewire" how to do the task correctly. Therefore, when patients practice tasks using STOMP, investigators do not allow our participants to make errors and patients practice for long periods of time. Investigators also incorporate and provide new technology into training such as medication reminder alarms and photo phones which allow you to dial a number by choosing a loved one's picture.

In this pilot study, the investigators want to look more closely at the how the amount of time you practice influences study outcomes. The investigators believe that the findings from this study will support our belief that more time in therapy is needed to enhance how someone with dementia learns.


Options:
A: Inclusion Criteria:

* aged 65 years or older
* mild to moderate dementia (MMSE 10-24)
* living in the community at maximum of 50 kilometers from the Memory Clinic
* having an informal primary caregiver who was involved in the care for the patient at least once a week

Exclusion Criteria:

* depression: score \> 12 on the Geriatric Depression Scale
* severe behavioral or psychological symptoms in dementia (BPSD) judged by a geriatrician
* severe illnesses, judged by a geriatrician
* no OT goals, determined by the researcher or research assistant
* caregivers having severe illnesses
B: Patient Inclusion Criteria:

* Currently a patient within Wishard Health Services in Central Indiana
* Diagnosed with possible or probable Alzheimer's Disease
* Age 45 or older
* English speaking
* Hear well enough to answer questions in person or by telephone
* Community-dwelling (includes senior communities, but not skilled nursing facilities)
* Caregiver willing to participate in the study
* Willing to receive home visits
* Lives in Indianapolis metro area and planning to continue care at primary care clinic

Caregiver Inclusion Criteria

* Age 18 or older
* English speaking
* Hear well enough to answer questions in person or by telephone
* Community-dwelling
* Willing to receive home visits

Exclusion Criteria:

* Not a current patient within Wishard Health Services
* Does not speak English
* Currently enrolled in another study
* Non-community dwelling, or residing in a skilled nursing facility
C: Inclusion Criteria:

* Care-recipients must have a MMSE score \< 24 and a diagnosis of dementia, live in the community, and either need help with one or more daily activities and/or have one or more behavioral occurrences. Caregivers must be a relative, at least 21 years of age, be English speaking, have a telephone, either live with the care-recipient (CR) or spend at least 48 hours per week in direct oversight or caring for him/her; plan to live in the area for 9 months, report upset with CR function dependence or behavioral occurrences.

Exclusion Criteria:

* The CG-CR dyad will be excluded if CR has had more than 3 hospitalizations within the past 12 months, are in treatment for life-threatening cancer, have schizophrenia or a bipolar disorder, have dementia secondary to head trauma, have a MMSE score = 0 and are bed-bound (defined as confinement to bed or chair for at least 22 hours a day for at least four of the previous seven days); or they are enrolled in a clinical trial of pharmacological treatment for agitation. Also, the dyad will be excluded if the CG had more than 3 hospitalizations within the past 12 months or is in treatment for life-threatening cancer; is involved in another clinical trial of psychosocial or educational interventions for caregivers; or plans to place their family member in a nursing home within the next 9-months.
D: Inclusion Criteria:

1. Lives in the community and speaks English
2. adult aged 50-90 years old
3. lives with someone who can provide consent to be in the study
4. diagnosed with some form of dementia
5. cognitive score on the Mini-Mental Status Examination score \>10 but ≤25
6. able to understand and follow one step commands
7. can move one arm sufficiently for practicing tasks
8. participant or family member can identify three goal areas related to self-care or home management
9. able to participate in 3 hours of daily therapy in their home environment for 2 consecutive weeks

Exclusion Criteria:

1. Creutzfeldt-Jakob Dementia, delirium or a progressive neurological condition such as Parkinson's disease
2. receptive or global aphasia
3. uncorrected vision/hearing

Answer: D