Developing Personally Relevant Goals for People with Moderate to Severe Dementia

Many speech-language pathologists work in the skilled nursing facility setting and have a growing number of patients with moderate to severe dementia on their caseloads. Traditional rehabilitation interventions are often not appropriate for people with dementia due to the severity of their cognitive impairment and the progressive nature of dementia. Whereas a rehabilitation approach focuses on deficits (so they can be improved), a habilitation approach focuses on what strengths remain and who the patient is as a person. Through a habilitation approach, the goal is not to improve the patient's skills; the goal is to improve the environment (and the people in it), so the person with dementia can function at their highest possible level. This case study is a thorough example of how the habilitation approach can be used to provide intervention for a person with moderate to severe dementia. The case study will explain indication for treatment, assessment, goal selection, and research to support the treatment plan.