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So what is Habilitation Therapy, and why is JCHE staff learning about it?

Posted: July 8, 2013

Habilitation Therapy, developed by Dr. Paul Raia and Joanne Koenig-Coste, is a way of understanding, communicating with, and working with people who have dementia. Why is it called “Habilitation Therapy”? Imagine that a resident has a hip replacement and goes to a nursing home for short-term rehabilitation therapy. The goal is to get better. Since Alzheimer's is a progressive disease, those who suffer from it do not get better - so instead of rehabilitation, this method is habilitation. Simply put, the goal is to promote positive emotion, maximize the skills and abilities that remain, and reduce problem behaviors of people with dementia.

Not only do many residents with memory loss live at JCHE now, but there is a national movement to keep people living in the community longer (either in their own houses or in housing like JCHE) because of the cost to the Medicare and Medicaid systems when those folks go into nursing homes. Many residents do not need the higher level of supervision and care, and can do just fine in independent housing with the right formal (home and health care aides, adult day health…) and informal supports (family, friends and neighbors).

As it should be, Habilitation Therapy centers around the person with dementia and teaches us a few critical concepts. Since people with dementia hang on to emotion (i.e. feeling emotion, reacting to others’ emotions) longer than their other skills as the disease progresses, each concept of the model has to do with promoting positive emotion. With the resident as the centerpiece of the model, the five key concepts are:

  1. The most effective ways to communicate with people who have dementia;
  2. How the physical environment can affect someone with dementia;
  3. The way we interact in order to get our jobs done;
  4. Purposeful engagement not only makes a person with dementia feel involved and valuable, but it also “exercises” the skills and abilities that are still intact;
  5. Understanding that behavior is often the way someone with dementia communicates with us.

LeadingAge (the national association of homes and services for the aged) through an inaugural Innovation Fund grant, has entrusted the thoughtful and competent staff at JCHE to learn about the Alzheimer’s Association Habilitation Therapy model, which has been used successfully in nursing homes and assisted living communities, and adjust it to make it more applicable to independent housing.

By Caren Silverlieb, Director of Strategic Planning and Partnerships

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