Neuro Navigators Episode 15: How Can We Think Differently About Dementia Care in Therapy?

May 15, 2025

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Episode notes

Julie D. Ries, PT, PhD, a professor of physical therapy and an international educator on dementia care, joins host J.J. Mowder-Tinney for an honest conversation about elevating therapy for older adults living with dementia. Together we dive into the biases that often shape clinical decisions and explore how shifting your approach can enhance engagement, occupational participation, and outcomes. You’ll walk away with practical strategies that can help boost your confidence and make every interaction count through relationship building, positive communication, environmental awareness, and leveraging motor learning strategies. Whether you’re new to dementia care or looking to refine your skills, this episode offers a fresh lens—and a few simple mindset shifts—to maximize your impact.

Learning Objectives

Analyze the evidence around therapists’ perceptions of working with older adults with dementia and strategies to maximize therapeutic engagement and occupational participation of these individuals
Apply evidence-based, practical strategies to actionably address therapists’ confidence and competence in working with individuals with dementia
Examine pragmatic suggestions for engagement and best therapeutic outcome in working with individuals with dementia

Timestamps

(00:00:00) Welcome
(00:01:19) Julie Ries, PT, PhD, shares her background and what drew her to dementia care
(00:03:11) Therapeutic nihilism and shifting clinician mindsets
(00:06:45) Introducing Ries’s framework and its use in educational settings
(00:08:45) Origins and evidence for the four-part framework
(00:10:14) Component 1: Relationship building—personalization, respecting reality, and reminiscence
(00:14:40) The value of validation and emotional safety in dementia care
(00:18:45) Component 2: Communication strategies—tone, simplicity, elderspeak, and nonverbal cues
(00:23:58) Intentional smiling and reading body language
(00:25:07) Behavior as communication and decoding “inappropriate” actions
(00:28:53) Ensuring basic needs are met before sessions
(00:29:15) Component 3: Environmental awareness—consistency, routine, and visual cues
(00:33:32) Environmental enrichment with music and personalization
(00:34:54) Component 4: Motor learning optimization—functional salience, errorless learning, and blocked practice
(00:42:58) Applying errorless learning in clinical scenarios
(00:46:29) Repetition and safe intensity in therapeutic interventions
(00:48:35) Adjusting approaches for various levels of dementia
(00:50:32) Fostering self-efficacy and honoring cognitive capabilities
(00:52:54) Educating families to prevent “excess disability”
(00:57:08) Top three actionable takeaways
(00:58:15) Episode close and Medbridge resources reminder

Resources Mentioned in Episode

Neuro Navigators is brought to you by Medbridge. If you’d like to earn continuing education credit for listening to this episode and access bonus takeaway handouts, log in to your Medbridge account and navigate to the course where you’ll find accreditation details. If applicable, complete the post-course assessment and survey to be eligible for credit. The takeaway handout on Medbridge gives you the key points mentioned in this episode, along with additional resources you can implement into your practice right away.

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