Cathryn Schaffer and Sonia Nurkse, occupational therapists in an inpatient rehabilitation unit at Good Samaritan of Multicare in Puyallup, WA, proposed a research question: Can occupation-based activities be used to improve quality of life and/or reduce problem behaviors in adults with dementia-related cognitive impairment? Five databases were searched for articles published from 2007 to 2017, resulting in 23 articles that met search criteria. Interventions that did not take extensive time, training, or resources were included with the intention that they would be easily incorporated into a caregiver or health professional’s routine. Multiple interventions were found that address problem behaviors and/or quality of life including social interaction, activity individualization, object interaction, and general occupations. Each of these interventions had moderate to strong evidence that they reduced the occurrence of problem behaviors and limited to mixed evidence supporting their efficacy on improving quality of life, though individualization of activities seemed to have the most evidence as effectively reducing problem behavior occurrences.

Results of the critically appraised topic review were summarized into an in-service presentation for inpatient rehabilitation staff of a Multicare hospital. This in-service informed staff regarding the potential to implement these interventions and strategies to educate caregivers of people with dementia about what they can do to reduce occurrence of problem behaviors and increase quality of life of care recipients. A caregiver pamphlet was created with activity ideas and tips to communicate with and engage a person with dementia in activity. The impact of the in-service and pamphlet was assessed with a survey completed by in-service attendees, which yielded positive results: 86% stated they would probably or definitely use the caregiver handout, and 71% said they were somewhat to very comfortable individualizing activities. We recommend future in-services regarding this research in other settings such as long-term care facilities, adult family homes, or to be available as caregiver information sessions.

Publication Place

Tacoma, Washington


University of Puget Sound

Project Chairperson

Tatiana Kaminsky, PhD, OTR/L


Publication Date



Capstone Project





Degree Program

Occupational Therapy

Degree Level

Master of Science


Occupational Therapy


University of Puget Sound

Souza.Utt.pdf (35 kB)