As an occupational therapist deeply committed to enhancing the quality of life for individuals living with dementia and their families, I would like to introduce you to my favorite program: Skills₂Care^®! This innovative program is designed specifically to support family caregivers/care partners of people living with dementia.

Why is the Skills₂Care^® Program Important?

The program aims to reduce caregivers’ level of upset and increase their confidence in handling some of the most challenging aspects of day-to-day care. Understanding what Skills₂Care^® is and the importance of certification can significantly impact the care and well-being of your loved ones.

Understanding Skills₂Care^®

Skills₂Care^® is an evidence-based occupational therapy program developed to support family caregivers of individuals living with dementia. The program focuses on equipping caregivers with practical skills and strategies to manage the daily challenges that come with dementia care. Developed by Dr. Laura N. Gitlin and her team at Thomas Jefferson University, Skills₂Care^® integrates research and best practices to offer a comprehensive approach to dementia care.

The program is structured to address several key areas:

1. Environmental Modifications: Making the home environment safer and more supportive for individuals with dementia.
2. Activity Participation: Engaging individuals in meaningful activities to maintain their cognitive and physical functions.
3. Behavioral Strategies: Managing challenging behaviors associated with dementia, such as agitation, aggression, and wandering.
4. Caregiver Support: Providing support and practical strategies to reduce caregiver stress and burnout

By focusing on these areas, Skills₂Care^® aims to enhance the quality of life for both caregivers and individuals living with dementia.

Benefits for Caregivers

For caregivers, working with a certified Skills₂Care^® practitioner can lead to numerous benefits:

• Improved Care Strategies: Learn practical and effective techniques to manage daily challenges, reduce stress, and enhance the well-being of your family member with dementia.
• Personalized Support: Receive tailored advice and support that addresses your specific needs and circumstances.
• Enhanced Confidence: Gain confidence in your caregiving abilities, knowing that you are using strategies backed by research and expert knowledge.
• Reduced Burden: Experience a reduction in caregiver burden and burnout through better management of behaviors, strategies to improve activity engagement, and environmental modifications to enhance safety and participation.

Why Work with a Skills₂Care^® Certified Occupational Therapy Practitioner?

• Expertise and Knowledge: Certification ensures that professionals have undergone rigorous training and possess a deep understanding of the program’s principles and techniques. This knowledge is essential for tailoring interventions to meet the unique needs of each individual and their caregiver. Occupational therapists complete an in-depth 30-hour continuing education course. The course consists of online modules and activities, multiple live training days, and 5 coaching calls during their initial implementation phase. Coaching calls offer guidance and support as clinicians begin using the Skills₂Care^® program. Clinicians also provide a written case report and present it to their colleagues and instructor.
• Consistency and Quality: Certified practitioners adhere to standardized protocols. This ensures interventions are delivered consistently and effectively to maintain program fidelity. This consistency is vital for achieving the best possible outcomes for caregivers and individuals living with dementia.
• Evidence-Based Practice: Certification in Skills₂Care^® means that practitioners are equipped with evidence-based, research-tested strategies. This ensures that caregivers are receiving advice and support grounded in scientific research and proven to be effective.
• Professional Credibility: Certification enhances the credibility and professional standing of therapists. It signals to caregivers and other stakeholders that the practitioner is committed to providing the highest standard of care.
• Support and Resources: Certified professionals have access to ongoing support and resources from the Skills₂Care^® team. This network provides opportunities for continuous learning and collaboration, which can be incredibly valuable in staying updated with the latest developments in dementia care.

Real-Life Impact – A Case Study

This is one example of how your Skills₂Care^® OT may support you.

Mary was caring for her mother, Susan, who had an unspecified type of dementia. Before the onset of dementia, Susan was a professional artist, raised 3 children, and managed many of the household tasks such as dishes and laundry.

​Session 1

During her first Skills₂Care^® session with the occupational therapist (OT), Mary provided important background and context for the occupational therapist including Susan’s work and social history, the home layout, and any past activities enjoyed by Susan. Mary also identified the following challenges in caring for her mother:

• Susan was waking up about 3-4 times in the middle of the night most nights, often pacing through the home
• Susan was often resisting taking medications
• Susan was often bored or inactive during the day

​The occupational therapist also worked with Mary to ensure she had her own stress reduction strategies and that she was adequately caring for herself in this process.

​Session 2

Mary confirmed that her mom’s waking at night and pacing in the home upon waking were the top priority for this session. The OT worked with Mary to identify why this challenge/behavior was occurring. The OT did this by engaging Mary in the Skills₂Care^® program’s problem-solving process and used their knowledge of dementia care models and recent research. In this case, it was determined that Susan was likely waking at night due to:

• Limited activity engagement during the day, often leading to naps
• Drinking caffeinated tea before bed
• Mirrors in the bedroom made Susan think someone was in the room with her

​With this information in mind, the OT and Mary developed strategies for how to reduce Susan’s waking at night and pacing, and they developed strategies for how to respond to and handle Susan’s behaviors when they did occur.

​Session 3

The OT provided Mary with a Skills₂Care^® Action Plan for her mom’s waking and pacing at night, incorporating all of the strategies identified in Session 2 along with any additional strategies from available research.

These strategies included items such as:​

• Removing/covering the mirrors in Susan’s bedroom​
• Enhancing Susan’s activity engagement during the day
  • Communication strategies for how to engage her inactivity​
  • Recommendations for specific, meaningful activities and how to adapt them to enhance Susan’s participation including
    • Painting, including how to set up the necessary items
    • Washing dishes, including how to adapt the task
    • Folding laundry, including how to adapt the task
    • Activities to do with her grandchildren
  • Limiting opportunities for Susan to nap during the day​
  • Providing Susan with her preferred tea at lunchtime or considering another hot beverage for the evening such as hot water with lemon

​The OT reviewed this action plan with Mary to ensure she felt comfortable and confident using the recommended strategies and made any necessary adaptations to the action plan. Mary and the OT practiced/role-played these strategies, as appropriate.

​Once Mary reported that she felt confident in her implementation of the recommended strategies for handling Susan’s waking/pacing at night, the OT and Mary then began to address Mary’s second priority, which was Susan’s resistance to taking medication. Future sessions followed the same general structure.

How Much Does Skills₂Care^® Cost?

The short answer: it depends.

Skills₂Care^® can be integrated into a patient’s plan of care, in which case it may be covered by health insurance for the person living with dementia. This may be offered under home health (Medicare Part A), or outpatient insurance (Medicare Part B). Some occupational therapists are credentialed with private insurance companies and Medicare Advantage plans. Other occupational therapists offer Skills₂Care^® as a consultative service to the caregiver only, and this would likely be offered through private pay. There are also some grants awarded across the US that support implementation of Skills₂Care^®. Please contact a Skills₂Care^® OT near you to learn more.

​Finding a Skills₂Care^® OT

To find a Skills2Care^® certified occupational therapist near you, please visit the Skills₂Care^® Provider Directory.

If you are unable to locate a Skills₂Care^® occupational therapist near you, reach out to any Skills₂Care^® OT in your state, as they may be able to offer telehealth sessions. If there are no Skills₂Care^® OTs in your state at this time, you can also use resources like the Best Practice Caregiving Database, to identify other evidence-based programs that may be available in your area.

Finding Other Evidence-Based Dementia Care Programs

For a comprehensive resource on dementia caregiving interventions, including Skills₂Care^®, you can explore the Best Practice Caregiving Database. This database provides detailed information on evidence-based programs designed to support caregivers.

In addition to Skills₂Care^®, Dr. Laura Gitlin and her colleagues have developed other evidence-based programs to enhance dementia care:

• Tailored Activity Program (TAP): TAP is designed to engage individuals with dementia in customized activities that match their interests and abilities. The goal is to improve their quality of life and reduce behavioral symptoms. TAP focuses on enhancing the person’s functional abilities and providing caregivers with effective activity strategies. Find more information about TAP.
• Care of Older Persons in the Environment (COPE): COPE aims to improve the quality of life and functional performance of older adults with dementia by making home environment modifications and providing caregiver training. The program addresses safety, mobility, and daily living activities, ensuring that the living environment supports the individual’s needs and abilities. Learn more about COPE.

Learn More about Skills₂Care^® Certification

Skills₂Care^® is a powerful tool in the realm of dementia care. It offers practical, evidence-based strategies to support caregivers in their journey. Occupational therapists who offer this program ensure that these strategies are delivered with expertise and consistency, and are grounded in research. As an occupational therapist, I have witnessed the impact that Skills₂Care^® can have on the lives of individuals living with dementia and their families. And I hope to continue to expand access to this valuable program.

Feel free to reach out if you have any questions, need further information about Skills₂Care^®, or would like help connecting with a Skills2Care occupational therapist near you. info@dementiacollaborative.com

Jefferson Elder Care

The Dementia Collaborative

Skills₂Care^® is a trademark of Thomas Jefferson University.  All rights reserved.

Contributed by:

Rachel Wiley, MS, OTR/L, CDP

Rachel Wiley, MS, OTR/L, CDP is an occupational therapist and the founder and owner of Day By Day Dementia Consulting, through which she provides virtual consultations to family care partners of people living with dementia throughout Pennsylvania, New Jersey, and Vermont. In addition, she is the founder and owner of the Dementia Collaborative LLC. Rachel is certified in Skills2Care® for caregivers of individuals living with dementia, and she is a Certified Dementia Practitioner.

Also, Rachel is a certified master trainer of Skills2Care® through Jefferson Elder Care. She trains occupational therapists from around the world in the Skills2Care® program. She is also currently a volunteer advisory council member for Dementia Society of America.

Previously, Rachel was an adjunct faculty member in the occupational therapy departments at Thomas Jefferson University and Temple University. She also worked as the occupational therapist and Dementia Service Coordinator for the Pew Charitable Trust Grant with Jefferson Elder Care.

Rachel attended Penn State University for her Bachelor’s in Rehabilitation and Human Services and minor in Psychology. And she attended Thomas Jefferson University for her Master’s of Science in Occupational Therapy.

 

We appreciate the information written and shared by professionals. So Friends Life Care maintains the eMeetinghouse blog to share information older adults may find useful.  Friends Life Care is a nonprofit organization with a foundation of Quaker values.  It is committed to helping members and friends to live independently at home as they age.