Rehabilitation
The rehabilitation program implemented in this service is based on the assessment and rehabilitation programs of the Great Ormond Street Hospital (London, UK) and the work of Drs. Barbara Wilson and Jon Evans at the University of Cambridge (Cambridge, UK).
Our programme is centred on the planning of individualised short- and long-term goals, developed in collaboration with the patient and their family, aimed at improving daily life. These objectives must meet the following characteristics:
- Patient-centred (e.g., remembering to take medication).
- Realistic and achievable within the rehabilitation period.
- Clear and specific (e.g., planning weekly activities).
- Time-limited (e.g., obtaining a driving licence).
- Measurable (e.g., how many times the person has remembered to take their medication).
- Strategies and External Memory Aids Non-digital external aids are very important, and depending on the individual’s abilities, digital tools (tablet, mobile phone, computer) can be used at varying levels of complexity, ranging from simple alarms to electronic diaries and calendars. Studies by Evans et al. (2003) and Jamieson et al. (2017) compiled a list of approximately 100 external memory aids. The two most commonly used recall strategies are: placing items in noticeable locations and remembering by reconstructing steps. Regarding external aids, the most popular include diaries, lists, calendars, and reminder alarms on mobile phones, as well as alarm sounds set for specific times of the day to prompt activities (e.g., walking the dog).
- Activities such as university courses, education, sports activities, professional work, or internships in a company, with the aim of maintaining or achieving the highest possible level of independence. In cases of dementia, these activities will be adapted to the individual’s level of cognitive and brain impairment.
- Individual or group psychological sessions targeting:
- Understanding the nature and consequences of brain damage
- Compensatory strategies for memory problems: organisation and planning.
- Problem-solving and organisation in daily life
- Family members and caregivers: sharing experiences of caregiving and cohabitation with the patient
- Specialised courses: stress and anxiety management, social skills, and assertiveness. Changes in physical reactions associated with anxiety, panic, and mood, along with relaxation exercises to reduce levels of hyper- or hypoarousal.
- General health: modification/adoption of healthy habits.
- Clinical psychological therapy tailored to the needs of the patient and their family.
PSYCHOLOGICAL AND SOCIAL RESEARCH
These activities will be coordinated in collaboration with the community centre closest to the needs of the person with memory problems. Among other organisations, we collaborate with the Acquired Brain Injury Association (ADACE) of Castilla-La Mancha and the Alzheimer’s Association. Coordination of interactions will be ensured.
- Understanding the nature and consequences of brain damage.
- Compensatory strategies for memory problems: organisation and planning.
- Problem-solving and organisation in daily life
- Family members and caregivers: sharing experiences of caregiving and cohabitation with the patient
- Specialised courses: stress and anxiety management, social skills, and assertiveness. Changes in physical reactions associated with anxiety, panic, and mood, along with relaxation exercises to reduce levels of hyper- or hypoarousal.
- General health: modification/adoption of healthy habits.
- Clinical psychological therapy tailored to the needs of the patient and their family.
- School, residential care home, family and/or day centre.
- Patient associations:
- Social workers, local council. Disability assessment for potential degree of disability. Establishment of networks/groups of homogeneous patients, enabling social interaction through activities to share experiences, difficulties, problem-solving strategies, and leisure activities.
Assessment of the rehabilitation programme
Six months after the start of the assessment and rehabilitation process, patients will be contacted again to conduct an open interview and a questionnaire designed to evaluate the extent of their readjustment to social, occupational, and family life. The degree to which the objectives set at the beginning of the programme have been achieved will also be assessed.
It is estimated that the patient will receive a total of 10 hours of care. This time includes the neuropsychological assessment, the rehabilitation intervention, and the MRI scan.
