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Introduction
The DICE approach is a patient and caregiver-centered approach to identify triggers and create solutions for everyday tasks. DICE stands for: Describe (the problem), Investigate (the cause), Create (a solution) and Evaluate (the results). This is a case study on how this approach was utilized to help a patient with dementia and the family at home.
Strategies for Success
Betty's Story:
Betty is an 86-year-old patient with a diagnosis of dementia who was referred for PT/OT therapy intervention with functional decline and a recent fall. Recently widowed, Betty lives with her daughter, Jennie, in a single-story home. Her daughter is her primary caregiver and, except for daycare services twice per week for Betty, she is at home. The therapist applied the DICE Approach to evaluate causes and create a person-centered solution.
Describe the Problem:
Betty becomes aggressive and strikes at her daughter during bath time.  Jennie is frustrated and feels that her mom as poor hygiene and the process takes too long.
Investigate
Using a task analysis approach, the OT spent some time speaking with the daughter and with Betty about bathing and evaluated the bathroom space. This is what she learned.
The Task: Bathing was done in the evening after dinner and before bed every day. After dinner, Jennie would take her Mom to the bathroom for bathing and towel dry and then to her bedroom to change and get ready for bed.
The Environment: The bathroom had a standard bathtub with a handheld shower in place. Floors were tiled and Jennie reported that the rugs had been removed for safety (a recommendation from a prior therapist for fall prevention). Standard bright overhead lights
The Caregiver: Jennie was frustrated and would often yell, "Let's just get this done!".
Betty: Betty reported that bathing "hurts".
Create a Solution
Evaluate
The strategies were implemented over the course of 1-2 weeks and were successful. Betty did not need "less" help but was no longer agitated and both she had her daughter enjoyed bathtime together.
More Info
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