Laura Gitlin, PhD, Director of the Jefferson Center for Applied Research on Aging and Health (CARAH) at Thomas Jefferson University's Jefferson School of Health Professions, testified before the Senate Special Committee on Aging on December 8, 2010. She shared some of the outcomes of research she has done regarding nonpharmacologic treatment, specifically occupational therapy, on the functional dependence of individuals with dementia and their caregivers.
Gitlin shared the story of Millie, a patient in the Care of Persons with Dementia in their Environment (COPE) trial. COPE aims to support patient capabilities by reducing environmental stress and to enhance caregiver skills. Treatment provided through COPE involved such strategies as personal counseling, education, hands-on skills-training of family members, home modifications to enhance safety; or simplifying activities to engage people with dementia. In the story, both Millie and the daughter with whom she lived benefited from the nonpharmacologic interventions. Benefits included better sleep habits, less stress and anxiety, and fewer basic health issues.
In her testimony, Gitlin noted that improving quality of life for individuals with dementia and their families is a fundamental treatment goal endorsed by health professionals, and it is also a new goal in the 2020 version of Healthy People 2020, which prioritizes public health activities. However, she said, “improving quality of life consistently receives far less attention and funding than drug research.”
Gitlin mentioned a Johns Hopkins University study of families of individuals with dementia that showed a variety of needs including home safety, medical care, legal concerns and lack of meaningful activities. The same study showed that many of the caregivers needed a referral for a resource, lacked education about the disease and had unaddressed mental and physical health issues. “The research by myself and my team and that of numerous other scientists suggest that non-pharmacologic approaches can address all of these unmet critical needs,” she said.
As she concluded her testimony, Gitlin suggested that nonpharmacologic therapies may save more than they cost. In fact, in studies she conducted, there was a savings of more than 50 percent. She went on to say that there must be a national strategy for developing a new standard of care for those with dementia and their families in order to make nonpharmacologic strategies part of the standard of care. She said this is necessary “in order to address one of the most devastating diseases of our time and which soon will be an epidemic.”