Currently, there are around 65,000 people living with dementia in Ireland. It is predicted that this number could reach 157, 883 by 2046 (O’ Shea, Cahill & Pierce, 2017). Dementia remains hugely undetected and under-diagnosed in Ireland. Internationally, we know that fewer than half of people with dementia ever receive a formal diagnosis.
Receiving a diagnosis of dementia is a life-changing experience. It is widely accepted that comprehensive post-diagnostic supports are essential to assist with education, symptom management, maintaining independence, sign-posting as well as supporting individuals and families. Occupational therapists are uniquely placed to address cognitive deficits that impact on people’s daily lives due to their understanding of the relationship between the person, environment and daily occupations.
In 2019, we were very fortunate at St. James’s Hospital to be awarded a National Dementia Office grant to implement post-diagnostic support for people with dementia. This grant was the seed from which SMART – Specialised Memory and Attention Rehabilitation Therapy grew.
SMART is an occupation focussed cognitive rehabilitation programme for people with mild dementia and their families or carers. SMART is usually delivered in a group based format however, it was adapted to individual sessions during the Covid-19 pandemic.
SMART incorporates education, individual goal-setting, discussion, activity tasks and individual home programmes. Consistent with other evidence, SMART demonstrates that people with mild dementia can significantly improve;
Realising the benefits of customised cognitive rehabilitation via objective outcome measurement and clinical observations is a truly rewarding experience for any occupational therapist. However, no standardised assessment score or clinical judgement can portray the true benefit as effectively as one’s own lived experience;
“I now feel confident again. I am able to carry out a conversation with confidence – not forgetting words as much. My days are more normal. I would like to say thanks for the wonderful guidance, it has made my days so much brighter.” – SMART participant
“For my part as a husband, the program gave me guidelines on how to help. At first, I was so lost but believe me now I’ve got lots of knowledge about dementia and this can be of real help. This in turn has made life much better for my wife. We can deal with the down days and any frustrations that may occur. It was of so much value to us both.” – SMART participant’s husband
A significant development in dementia care is the establishment of a nationwide network of 25 Memory Technology Resource Rooms (MTRRs) spanning all 9 CHOs. A predominantly Occupational Therapy led programme, the MTRRs provide assessment of client needs, showcase a wide range of assistive technologies and provide advice to families and carers. The current Covid-19 context has further emphasised the vital role that MTRRs can play in supporting people with memory difficulties during what is proving to be an incredibly stressful time for us all. Check out the network at
More and more, we are hearing about the importance of brain health. Regular commentaries cover topics such as the relationship between diet, sleep, physical activity, stress and brain health or how brain health affects cognition. Strong evidence supports the thinking that lifestyle can affect brain functionality and our reaction to the ageing process. It is never too late or too early to start “minding your mind” or looking after your brain health. Start thinking of it as a pension fund.
Practising healthy brain habits now builds up your brain’s reserves, similar to making bank account deposits for later in life. Consider your brain as a muscle – if you don’t use it, you lose it. Challenge your brain to stay in shape with a “cross-training” assortment of puzzles, reading, art, learning a musical instrument, a new language or any activity that is meaningful to you.
Social interaction and connectivity is hugely significant in optimising brain health. Never has this been more relevant than now as we continue to adapt to the realities of the Covid-19 pandemic. Considering the unprecedented pressures and demands that HSCPs have faced both professionally and personally over the past year, it would stand us in good stead to consider adopting the advice we so readily impart to our clients. Don’t we always say that timely diagnosis and early intervention is key? Perhaps, it’s time for us all to start “minding our minds”.
Simple steps to get you started on your brain health journey could include;
Dementia cannot yet be prevented or cured. However, experts advise that by making small changes to the way we live, we can reduce our chances of developing dementia or at the very least, improve our overall health and well-being. Don’t delay, get brain smart and start minding your mind.
The authors would like to acknowledge the support of the National Dementia Office, Dr. David Robinson, Mercer’s Institute for Successful Ageing, Matthew Gibb, the Dementia Services Information, Development and Support Services and Dr. Tadhg Stapleton, Head of Discipline of Occupational Therapy, Trinity College Dublin.
This Blog was written by Aoife O’ Gorman, Occupational Therapist Manager in Charge III and Aislinn Griffin, Senior Occupational Therapist and SMART Programme Co-ordinator in St. James’s Hospital.