A detailed exploration of changes in everyday task performance in people with dementia
mesheuropmc: behavioral disciplines and activities
For most people, everyday tasks, such as tea making, are familiar, routine tasks that are normally performed without effort. A diagnostic feature of dementia, however, is an insidious decline in the ability to perform everyday tasks. Through a series of six studies, I examined how everyday task performance changes in people with dementia and I piloted two behavioural strategies that might enhance memory for everyday tasks in people with dementia.\ud \ud Study 1 developed a detailed error and error-monitoring taxonomy to explore the minutia of everyday task performance in healthy ageing. The study demonstrated that older adults without dementia rarely make errors in everyday tasks, even when conditions are manipulated to reduce cognitive resources.\ud \ud Study 2 documented errors and error-monitoring of everyday task performance in individuals with a developing dementia, using archive data to chart performance change over 5 years. While errors increased with dementia progression, there was no reactive increase in error-monitoring, suggesting a lack of awareness characterises the breakdown of task performance.\ud \ud Study 3a explored the impact of verbally instructing another person how to perform an everyday task on recall of an everyday task. People with dementia were able to do this surprisingly well, appearing to use both visual and motor cues to support recall.\ud \ud Study 3b piloted the impact of verbal self-explanation on everyday task performance, in four people with dementia. Self-explanation did not benefit recall and implementation of a familiar task.\ud \ud Study 4a compared observation with verbal instruction on acquisition of a novel routine. Results showed that people with mild-moderate dementia learned a new routine better under observation compared to verbal instruction.\ud \ud Study 4b tested observational learning of an everyday task over five weeks in three people with dementia. The initial benefit over verbal instruction was sustained, but did not increase over time.\ud \ud These studies constitute a detailed and meticulous exploration of everyday task performance in people with dementia and provide pilot evidence of a potential strategy that could support memory of everyday tasks in people with dementia.