94 Therapeutic activities and MLN8237 molecular weight creative arts therapies Therapeutic activities and the creative arts therapies have been recognized as beneficial, especially in persons with dementia living in long-term care facilities.

Therapeutic programming emphasizes a balance of group and individual activities that promote strengths, personal interests, and abilities, as well as accomplishments, and the opportunity for self-expression. Creative arts therapies include Inhibitors,research,lifescience,medical music, art, dance/movement, drama, and bibliotherapy (literature and poetry). A creative arts therapy is the controlled use of an art medium in the treatment, rehabilitation, education, and training of persons with physical, Inhibitors,research,lifescience,medical mental, and emotional disorders. For example, music has been recognized as a therapeutic tool with documented psychological and physiological effects for persons with

dementia.95 CohenMansfield et al reported reduced screaming in a study of nursing home residents where music was a part of the environment.96 Knopman and Sawyer-DeMaris found that music is usually preferred and enjoyed by patients with dementia in contrast to background noise from a television.97 (See section on Environment.) Music interventions can be used in conjunction with exercise, Inhibitors,research,lifescience,medical as well as reminiscence and RO. Because people naturally move rhythmically, tap their feet, and clap their hands “in time” to the music, this medium can be used to increase movement in patients with limited range of motion. However, in attempting to find the appropriate balance of stimuli for the persons Inhibitors,research,lifescience,medical with dementia, it is critical that the type of music and volume level be selected carefully. Therapeutic touch An ancient intervention that has recently gained popularity in the field of health care is the use Inhibitors,research,lifescience,medical of therapeutic touch. In a survey of nursing home management of disruptive behavior, 38% of staff listed touch as an intervention.98

While few empirical data exist, a number of long-term care settings that offer professional massage therapy and whirlpool treatments indicate how beneficial this service has become. The use of touch with infants and autistic children has been documented; however, empirical studies of this intervention with the elderly are needed. The environment The term “environment” is used here in the Astemizole most, global sense to encompass everything from physical modifications to staff attitudes, approaches, and demeanor. This is commonly referred to as the therapeutic “milieu.” A therapeutic milieu considers “problem behaviors” as meaningful expressions representing unmet, needs and responds to these needs by using supportive interventions. A central element, that can determine the effectiveness of a therapeutic milieu is the quality of all interactions that take place within the setting. This includes interpersonal interactions as well as individual actions and reactions to one’s surroundings.