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Familiarity key to helping caregivers manage apraxia. (Maintaining Independence is Key).

SAN ANTONIO -- In managing the apractic patient, caregivers should be careful to maintain a sense of familiarity in tools and setting, said Dr. Josepha A. Cheong at the annual meeting of the Academy of Psychosomatic Medicine.

Apraxia is a frequent consequence of left-hemisphere damage and of degenerative dementia. Conceptual apraxia involves a difficulty in remembering which tool or object to use for a task. Ideational apraxia involves difficulty remembering all the steps, or the order needed to complete a task. Ideomotor apraxia involves difficulty in coordinating movements.

Physicians should instruct caregivers that the goal in managing the apractic patient should be to maintain as much independent functioning as possible. One way to do that is to break down every task into its component parts. Caregivers should not tell an apractic patient to get ready to go out. Instead they should first instruct them to brush their teeth, then to get dressed, then to comb their hair, and so on. Instead of putting a basket of mixed laundry in front of an apractic patient, first separate the laundry into like items.

Caregivers should also take care to give patients with apraxia simple, familiar tools. "If a coffee maker goes bust, do not buy the fanciest thing out there," advised Dr. Cheong, a psychiatrist at the University of Florida, Gainesville. Buy the exact same coffee maker they had been using for years.

It's long been noted that patients with dementia often stop eating, but Dr. Cheong believes that lack of hunger is often not the cause. These patients simply forget how to use utensils. One way around this is to give them finger foods, which they have an easier time manipulating.

In restaurants, since they often feel self-conscious about their tool problems, choose a corner or side table, and seat them so they are facing the wall.
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Author:Finn, Robert
Publication:Clinical Psychiatry News
Article Type:Brief Article
Geographic Code:1USA
Date:Jun 1, 2002
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