Abstract
The term “rehabilitation” refers not training to restore functions, but refers to a process aimed at enabling persons with disabilities to reach and maintain their optimal physical, sensory, intellectual, psychiatric and/or social functional levels. It includes any measures to compensate for the lost functions. Dementia is not attributable to a simple aging process, but is an acquired, persistent impairment of a broad range of once developed intellectual function produced by organic brain diseases. Each organic brain disease has specific symptomatology, pathophysiology, and prognosis, so that accurate diagnosis of the underlying illness is particularly important for any therapeutic intervention including rehabilitation.
It is almost impossible to restore cognitive functions in patients with degenerative dementing illnesses such as Alzheimer's disease. Although studies approaching the feasibility of cognitive training in patients with Alzheimer's disease are limited, cognitive training cannot be justified as a principal technique in the rehabilitation due to the low efficiency and high effort. In order to overcome the functional limitation of patients with dementia, a caregiver education program would be the most indicated. As patients themselves are supposed to have a lack of insight and/or severe memory impairment, they cannot be the main targets for the educational intervention. In the program, the caregivers should be informed about the diagnosis of the causative disease, the skills necessary to cope with behavioral problems and to maintain the activities of daily living, and social support services. The caregiver burden, which is reportedly a significant predictor for the poor outcome of patients with Alzheimer's disease, can be used as an index of the success of the caregiver education program.
