Can Yoga benefit people with dementia in care homes?

Alzheimer’s Research UK yoga can be a positive way to maintain health and wellbeing. She says “that we all know that keeping active is important as we age, and evidence increasingly suggests it could be beneficial for people with dementia”. She goes on to say “While there is a growing body of evidence to suggest that physical activity is beneficial for cognition, it’s still unclear what type and intensity of activity could be most important.” The Department of Health (2011) recommends that older adults spend at least two and a half hours doing moderate-intensity aerobic activity every week and muscle-strengthening activities on two or more days a week. However, many residents in residential care settings perform very little physical activity (Benjamin et al., 2014). Regular tailored yoga sessions are potentially a safe and effective way of helping elderly residents work towards these recommendations. Yoga and mindfulness based exercise has been proven to be an effective intervention for a number of common conditions that are present in residents living with dementia such as: anxiety, depression, co-ordination and balance problems (McCall, 2007). There are also a number of other studies showing initial positive results of chair-based yoga on people with Alzheimer's disease. McCaffrey et al. (2014) showed that older adults with severe Alzheimer’s disease who participated in an 8-week tailored yoga programme showed improvements across a range of physical tests (walking, gait, speed and balance). Hariprasad et al. (2014) show yoga based interventions appear beneficial to improve several domains of cognitive function in older people living in residential care homes. A recent (2016) UCLA study has shown that a three-month course of yoga and meditation was found to be even more effective than memory enhancement exercises for managing mild cognitive impairment. Yet despite this growing evidence, to date few residential care homes offer yoga as a regular activity. This may be in part due to lack of awareness of, or scepticism about, the benefits of yoga, or practical difficulties in employing and paying for a regular yoga teacher. A new project has recently seen yoga sessions introduced into care homes in Britain, with resounding success. The 18-month project was carried out by Tania Plahay, a yoga instructor, and was funded by the Foundation for Nursing Studies with the backing of independent care services body Care England. During the project, Ms Plahay taught basic movement and relaxation techniques to groups of residents in a care home. The yoga instructor had been prompted to offer the service following her experiences as a volunteer at residential care homes and after her disappointment at the lack of social and physical activity in certain residential settings she had visited while looking after her relatives. Although no scientific study was made of the results of the yoga project, both the residents and the staff involved reported positive effects. One of the home’s activities co-ordinators said that residents who had taken part were more relaxed and less agitated following the sessions, while another reported increased level of engagement and improvements in cognitive and memory skills in those with dementia. It is this positive impact on people with dementia which has been attracting most interest, adding as it does to a growing body of evidence which points to the fact physical activity can benefit cognition as well as physical well-being. Being able to reduce the levels of anxiety and agitation often experienced by those with dementia would be high on most medical professionals’ wish lists. The director of research at the Alzheimer’s Society, Dr Doug Brown, welcomed the project, saying although there was little research into the specific benefits of yoga to those with dementia, it was certainly an area worth exploring. The chief executive of Care England, Martin Green, agreed, saying there is a real need to ensure people in care homes do not live sedentary lives.

Summary There is growing evidence that physical activity can be of benefit to people who live in care homes. The question is can the benefits of physical activity be extended to improving the quality of life of people with dementia? The yoga project carried out by Tania Plahay is to be commended in that it provides some anecdotal evidence that yoga sessions resulted in an increased level of engagement and improvements in cognitive and memory skills in those with dementia. This work should be followed up by further scientific research to explore the positive effects of yoga for those with dementia who live in care homes. For more information: Yoga for People Living with Dementia in Residential Care Settings Albert Cook Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy