Motivating Apathetic, Depressed, and Cognitively Impaired Individuals to Maximally Benefit from Therapy

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1 Motivating Apathetic, Depressed, and Cognitively Impaired Individuals to Maximally Benefit from Therapy Course Outline Mike Studer, PT, MHS, NCS, CEEAA, CWT, CSST Northwest Rehabilitation Associates Robert Winningham, Ph.D Professor, Behavioral Sciences Western Oregon University 8:00-8:45 How memory (and the brain) changes with cognitive impairment and dementia. 8:45-9:30 Maximizing cognition through improved attention and taking advantage of existing cognitive abilities. 9:30-9:40 Break 9:40-10:15 More approaches to maximize attention and awareness. Cognitive rehabilitation interventions and possibilities. 11:00-12:00 Psychology applied in the rehabilitation clinic: Part 1.Maximizing learning and treatment outcomes in your unmotivated, depressed, apathetic, neurotic, fearful and/or anxious patients. 12:00-1:00 Lunch 1:00-1:45 Psychology applied in the clinic: Part 2. Maximizing functional independence and carryover in patients with affect, cognition, or psychological impairment. Functioning better in a variety of settings, and with different caregivers. 1:45-2:50 Evidenced-based cognitive and psychological rehabilitation approaches: beyond the couch. 3:00-3:45 Videotape applications of evidenced-based cognitive rehabilitation approaches.

2 Course Objectives Participants will be ready to implement effective strategies that enhance functional independence in clients with cognitive impairment. Participants will be able to identify strategies to remove common barriers to learning. Participants will identify optimal caregiver training strategies for the cognitively impaired. Identify several ways to motivate depressed, apathetic, and anxious patients to participate in therapy and activities to improve memory ability and quality of life. Learn how to recognize and employ at least 5 real time strategies to enhance attention and executive functioning in people with mild to moderate cognitive impairment. Participants will be able to identify and apply effective cognitive rehabilitation strategies, especially for their geriatric and brain injured patients. Participants will know how encoding, storage and retrieval changes throughout older adulthood. Course Description Patients with cognitive impairment often have difficulty with functional activities as well as learning or relearning behaviors in the clinic. Attendees will learn what aspects of cognition are most often affected by mild to moderate cognitive impairment and how to overcome some of those deficits with either long term cognitive rehabilitation or short term executive functioning enhancing interventions. Many clients are functioning below their potential, because of fear or other psychological barriers. In addition, depressed, unmotivated, apathetic and/or anxious clients often do not benefit from treatment as much as others. As you know, these patients often pose difficult challenges for therapists. In this exciting and unique course we will learn and discuss how to increase the efficacy of our treatment with patients who have cognitive impairment, depression, or difficult personality disorders. Therapists will learn how to

3 individualize their treatment interventions for difficult populations in this intermediate course. Therapists will also get practical ideas, tools, and strategies they will be able to immediately put into practice. If you treat patients with the following conditions then this course is for you: Alzheimer s Disease Parkinson s Disease Brain injury from stroke or trauma No awareness of their impairments Depression Apathy Extreme lack of motivation Multiple Sclerosis Older adults with memory problems Patients that fall or are fearful of falling The approaches presented will be evidence-based, supported by research and will focus on improving functional independence, mobility, ADLs, and even memory ability. Videotaped clinical case studies and examples will be used to illustrate and reinforce the ideas and techniques. Bio: Mike Studer Mike Studer is a full-time treating clinician at and president of Northwest Rehabilitation Associates in Salem, OR. He is has been recognized as a board certified neurologic clinical specialist by the American Physical Therapy Association (APTA) since 1995 and is a nationally and internationally-recognized physical therapist in the areas of neurology and healthy aging. Mike is active in the APTA, with national-level board positions, clinical research, continuing education, and authoring publications. In 2011, Mike received the Neurology Section Clinician of the Year a national award from the American Physical Therapy Association. In 2014, he received the same award from the Geriatric Section of the APTA making him the only clinician to have received these awards from two different sections on a national level.

4 Bio: Dr. Robert Winningham Dr. Rob Winningham has 20 years of experience researching applied memory issues and for the past 16 years has conducted research on older adults and ways to enhance their mental functioning and quality of life. He has developed novel approaches to maximize the efficacy of physical, occupational, and speech therapy. Most recently, he has been helping LinkedSenior.com create video games and interactive activities specifically designed to enhance older adult s cognition. Thousands of subscribers get his monthly brain stimulation activities called Dr. Rob s Cranium Crunches. He is a full Professor and Past Chair of the Behavioral Sciences Division at Western Oregon University (WOU) where he managed both the Psychological Sciences and Gerontology Departments. Dr. Winningham received his Ph.D. in Neuroscience from Baylor University. In addition to publishing many peer-reviewed articles in the area of human memory, Dr. Winningham makes frequent television and radio appearances and has given well over 600 invited presentations about memory and aging at various conferences and workshops. His book Train Your Brain: How to Maximize Memory Ability in Older Adulthood was published by Baywood Publishing. Learn more at: Bibliography Karr, J., Alexander, J., & Winningham, R. (2011). Omega-3 polyunsaturated fatty acids and cognition throughout the lifespan: a review. Nutritional Neuroscience, 14(5), doi: / y Matthews F, Arthur A, Brayne C, et al. A two-decade comparison of prevalence of dementia in individuals aged 65 years and older from three geographical areas of England: results of the Cognitive Function and Ageing Study I and II. Lancet [serial online]. July 17, 2013;Available from: MEDLINE, Ipswich, MA. Accessed August 27, Nagamatsu, L., Handy, T., Hsu, C., Voss, M., & Liu-Ambrose, T. (2012). Resistance training promotes cognitive and functional brain plasticity in seniors with probable mild cognitive impairment. Archives Of Internal Medicine, 172(8), doi: /archinternmed

5 Wilson, R., Boyle, P., Yu, L., Barnes, L., Schneider, J., & Bennett, D. (2013). Life-span cognitive activity, neuropathologic burden, and cognitive aging. Neurology, 81(4), doi: /wnl.0b013e31829c5e8a Woods, B., Aguirre, E., Spector, A., & Orrell, M. (2012). Cognitive stimulation to improve cognitive functioning in people with dementia. The Cochrane Database Of Systematic Reviews, 2CD doi: / cd pub2 Campbell, S. S., Murphy, P. J., & Stauble, T. N. (2005). Effects of a nap on nighttime sleep and waking function in older subjects. Journal of the American Geriatrics Society, 53(1), Colcombe, S., & Kramer, A. F. (2003). Fitness effects on the cognitive function of older adults: A meta-analytic study. Psychological Science, 14(2), Ross, B. M. (2007). Omega-3 fatty acid deficiency in major depressive disorder is caused by the interaction between diet and a genetically determined abnormality in phospholipid metabolism. Medical Hypotheses, 68(3), Rundek, T., & Bennett, D. A. (2006). Cognitive leisure activities, but not watching TV, for future benefits. Neurology, 66(6), Small, G. W., Silverman, D. H., Siddarth, P., Ercoli, L. M., Miller, K. J., Lavretsky, H., et al. (2006). Effects of a 14-Day healthy longevity lifestyle program on cognition and brain function. American Journal of Geriatric Psychiatry, 14(6), Stawski, R., Sliwinski, M. J., & Smyth, J. M. (2006). Stress-related cognitive interference predicts cognitive function in old age. Psychology and Aging, 21(3), Stroud, J. M., Steiner, V., & Iwuagwu, C. (2008). Predictors of depression among older adults with dementia. Dementia: The International Journal of Social Research and Practice, 7(1), Stern, Y. (2006). Cognitive reserve and Alzheimer Disease. Alzheimer Disease & Associated Disorders, 20(3), S69-S75. Vink, D., Aartsen, M. J., & Schoevers, R. A. (2008). Risk factors for anxiety and depression in the elderly: A review. Journal of Affective Disorders, 106(1-2), Wilson, S., & Nutt, D. (2007). Management of insomnia: Treatments and mechanisms. The British Journal Of Psychiatry, 191, Winningham, R. G., & Pike, N. L. (2007). A cognitive intervention to enhance institutionalized older adults social support networks and decrease loneliness. Aging & Mental Health, 11(6),

6 Oren S, Willerton C, Small J. Effects of spaced retrieval training on semantic memory in Alzheimer's disease: A systematic review. Journal Of Speech, Language, And Hearing Research [serial online]. February 2014;57(1): Available from: PsycINFO, Ipswich, MA. Accessed September 12, Connolly F, Aitken L, Tower M. An integrative review of self-efficacy and patient recovery post acute injury. Journal Of Advanced Nursing [serial online]. April 2014;70(4): Available from: MEDLINE, Ipswich, MA. Accessed September 12, Borella E, Carretti B, Cantarella A, Riboldi F, Zavagnin M, De Beni R. Benefits of training visuospatial working memory in young old and old old. Developmental Psychology [serial online]. March 2014;50(3): Available from: PsycINFO, Ipswich, MA. Accessed September 12, 2014.

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