A case of Alzheimer's disease with improved activities of daily living and psychological symptoms after photo assessment for activities of daily living and online management

Background Impairment of the activities of daily living (ADL) due to dementia can reduce the quality of life of patients and increase the burden on caregivers, necessitating appropriate interventions. Recently, the effectiveness of telerehabilitation for patients with dementia has been demonstrated, but its effect on ADL is uncertain. Objective We report on a 76-year-old female patient with Alzheimer's disease who underwent photo assessment for activities of daily living (PA-ADL) in the home environment and online management (O-MGT) at home. Methods The PA-ADL and O-MGT were implemented because of the progressive impairment of instrumental ADL and increased caregiver burden. In the PA-ADL, occupational therapists used photos of her home environment taken by her caregivers to check off environments that might pose a risk for life disability and set rehabilitation goals. Using a videoconferencing system, O-MGT had a therapist provide goal-directed ADL interventions remotely while she and her caregivers were at home. Results She improved in behavioral psychological symptoms and instrumental ADL after our PA-ADL and O-MGT intervention package, despite no improvement in cognitive function. In addition, caregiver burden was also found to be reduced after these interventions. Conclusions The PA-ADL and O-MGT intervention packages improved some of her behavioral and psychological symptoms, ADL abilities, and caregiver burden. Physical environment assessment using home photos and remote ADL rehabilitation may be considered options for Alzheimer's disease patients with ADL impairment.