How should we tailor our treatment or approach a patient with the early and middle stages of dementia during gait training?
Answer
Remember GAIT tasks are often engrained into long term memory as procedural tasks therefore abilities may be preserved into later stages. Safety awareness can be a significant concern during follow through of tasks. Incorporate gait tasks into functional and desirable routines for the residents versus simply saying “Lets go for a walk” say “Lets take a walk down to activities”. Tie purpose to the task and make routine.
For residents with high level gait abilities in early stages of dementia provide verbal review of tasks prior to initiation. For example: “Mr. Jones we are going to walk to activities with your walker. Remember in order to stay safe do not let the walker get to far ahead of you and remember to watch out for other residents and wheelchairs in the hallways so we do not risk having a fall”.
For middle stages, provide verbal instuctions at only 2-steps max.
Renee Kinder, MS, CCC-SLP, RAC-CT
Renee currently serves as Director of Clinical Education for Encore Rehabilitation where she provides education for interdisciplinary team members related to clinical programming, Medicare regulations, documentation requirements, and evidenced based practice patterns. She maintains certification as a resident assessment coordinator (RAC-CT) from the American Association of Nurse Assessment Coordination (AANAC). She is an active member of the American Speech Language Hearing Association currently serving as Editor of Perspectives on Gerontology and acting as a member of ASHA’s Healthcare and Economics Committee. Additionally, she is a member of community faculty for the University of Kentucky College of Medicine, serves as an Ambassador for the Alzheimer’s Association of America, and acts as Vice President of Healthcare for the Kentucky Speech Language Hearing Association.
Related Courses
1https://www.physicaltherapy.com/pt-ceus/course/supporting-lgbtq-senior-in-healthcare-4096Supporting the LGBTQ Senior in HealthcareThis training describes the required elements for responding to the emerging needs of long term care communities to provide sensitive and respectful services to LGBT elders. The training reviews definitions related to sexual orientation and gender identity challenges experienced by LGBT older adults, and strategies for communication and policies that honor residents' rights. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comSupporting the LGBTQ Senior in HealthcareThis training describes the required elements for responding to the emerging needs of long term care communities to provide sensitive and respectful services to LGBT elders. The training reviews definitions related to sexual orientation and gender identity challenges experienced by LGBT older adults, and strategies for communication and policies that honor residents' rights. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.4096OnlinePT120M
This training describes the required elements for responding to the emerging needs of long term care communities to provide sensitive and respectful services to LGBT elders. The training reviews definitions related to sexual orientation and gender identity challenges experienced by LGBT older adults, and strategies for communication and policies that honor residents' rights. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.
2https://www.physicaltherapy.com/pt-ceus/course/alzheimer-s-and-other-dementias-4864Alzheimer's and Other Dementias: Overview for Healthcare ProfessionalsAn overview for healthcare professionals about Alzheimer’s disease and related disorders is provided in this course. Characteristics of the dementias, such as symptoms, progression, and how they are diagnosed, are described. Care planning strategies for improving communication with patients and families, understanding and managing behavioral challenges, and promoting independence are also discussed.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comAlzheimer's and Other Dementias: Overview for Healthcare ProfessionalsAn overview for healthcare professionals about Alzheimer’s disease and related disorders is provided in this course. Characteristics of the dementias, such as symptoms, progression, and how they are diagnosed, are described. Care planning strategies for improving communication with patients and families, understanding and managing behavioral challenges, and promoting independence are also discussed.4864OnlinePT60M
An overview for healthcare professionals about Alzheimer’s disease and related disorders is provided in this course. Characteristics of the dementias, such as symptoms, progression, and how they are diagnosed, are described. Care planning strategies for improving communication with patients and families, understanding and managing behavioral challenges, and promoting independence are also discussed.
3https://www.physicaltherapy.com/pt-ceus/course/novel-ways-to-use-literature-5123Novel Ways to Use the Literature to Stimulate Treatment Ideas for the Patient with Dementia: PT and OT ApplicationsThis presentation provides therapists with creative strategies inspired by recent research to enhance the care of dementia patients. PT and OT providers will discover how to leverage the latest findings to develop innovative, effective treatment plans tailored to these patients' cognitive and physical needs. The session will offer practical insights and applications to improve therapeutic outcomes in dementia care.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comNovel Ways to Use the Literature to Stimulate Treatment Ideas for the Patient with Dementia: PT and OT ApplicationsThis presentation provides therapists with creative strategies inspired by recent research to enhance the care of dementia patients. PT and OT providers will discover how to leverage the latest findings to develop innovative, effective treatment plans tailored to these patients' cognitive and physical needs. The session will offer practical insights and applications to improve therapeutic outcomes in dementia care.5123OnlinePT120M
This presentation provides therapists with creative strategies inspired by recent research to enhance the care of dementia patients. PT and OT providers will discover how to leverage the latest findings to develop innovative, effective treatment plans tailored to these patients' cognitive and physical needs. The session will offer practical insights and applications to improve therapeutic outcomes in dementia care.
4https://www.physicaltherapy.com/pt-ceus/course/treat-them-like-athletes-performance-5379Treat Them Like Athletes: Performance-Based Rehab for Non-AthletesThis training equips physical and occupational therapy providers with tools to maximize client outcomes by blending athletic principles with innovative rehabilitation strategies. Participants will learn how to adapt techniques like plyometric training, dynamic warm-ups, motor imagery, motivational interviewing, Tabata training, and performance-based feedback for non-athlete clients.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comTreat Them Like Athletes: Performance-Based Rehab for Non-AthletesThis training equips physical and occupational therapy providers with tools to maximize client outcomes by blending athletic principles with innovative rehabilitation strategies. Participants will learn how to adapt techniques like plyometric training, dynamic warm-ups, motor imagery, motivational interviewing, Tabata training, and performance-based feedback for non-athlete clients.5379OnlinePT120M
This training equips physical and occupational therapy providers with tools to maximize client outcomes by blending athletic principles with innovative rehabilitation strategies. Participants will learn how to adapt techniques like plyometric training, dynamic warm-ups, motor imagery, motivational interviewing, Tabata training, and performance-based feedback for non-athlete clients.
5https://www.physicaltherapy.com/pt-ceus/course/salzman-matrix-combining-cognitive-motor-5381The Salzman Matrix: Combining Cognitive & Motor Tasks with PurposeCognition and movement are tightly linked in functional activity, yet integrating them in rehabilitation can be challenging. While dual-task training is commonly used, poorly matched cognitive demands can interfere with motor performance and learning. This introductory course introduces the Salzman Matrix, an evidence-aligned clinical reasoning framework designed to guide purposeful cognitive–motor integration while minimizing interference. Participants will learn how to distinguish cognitive processes that support movement from cognitive demands that commonly compete with motor goals, and how to apply this framework to functional treatment planning and documentation across rehabilitation settings.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comThe Salzman Matrix: Combining Cognitive & Motor Tasks with PurposeCognition and movement are tightly linked in functional activity, yet integrating them in rehabilitation can be challenging. While dual-task training is commonly used, poorly matched cognitive demands can interfere with motor performance and learning. This introductory course introduces the Salzman Matrix, an evidence-aligned clinical reasoning framework designed to guide purposeful cognitive–motor integration while minimizing interference. Participants will learn how to distinguish cognitive processes that support movement from cognitive demands that commonly compete with motor goals, and how to apply this framework to functional treatment planning and documentation across rehabilitation settings.5381OnlinePT120M
Cognition and movement are tightly linked in functional activity, yet integrating them in rehabilitation can be challenging. While dual-task training is commonly used, poorly matched cognitive demands can interfere with motor performance and learning. This introductory course introduces the Salzman Matrix, an evidence-aligned clinical reasoning framework designed to guide purposeful cognitive–motor integration while minimizing interference. Participants will learn how to distinguish cognitive processes that support movement from cognitive demands that commonly compete with motor goals, and how to apply this framework to functional treatment planning and documentation across rehabilitation settings.
