Cognitive Rehabilitation for Alzheimer’s: What It Is and Why You Should Try It

Being diagnosed with Alzheimer’s disease can bring new challenges, but it doesn’t mean you have to stop doing the things that give your life meaning. Cognitive rehabilitation is one intervention that can help you adjust to changes and find new ways to navigate daily life.

Cognitive rehabilitation is a personalized therapy that helps people with Alzheimer’s disease develop strategies and use tools to manage specific challenges. Rather than restoring lost memory or stopping disease progression, cognitive rehabilitation helps you make the most of your current abilities by focusing on practical goals that matter to you, such as:

• Managing medications
• Preparing meals
• Remembering appointments
• Staying socially connected

Unlike brain-training games or memory exercises, cognitive rehabilitation focuses on solving real-life challenges.

The goal of cognitive rehabilitation is “to limit the disability associated with a cognitive deficit and increase daily, common, and practical functions,” says Paul Mattis, PhD, chief of neuropsychology at North Shore University Hospital in Manhasset, New York.

In practice, that often means creating routines and using simple tools to make everyday tasks easier. For example, instead of relying on memory, you might write down your grocery list and learn to organize it by the order you’ll walk through the store. If the produce section is first, fruits and vegetables go at the top of the list. The list then becomes both a memory aid and an organizational tool, helping you shop with greater confidence and fewer mistakes, says Dr. Mattis.

Potential benefits include:

• Greater Confidence You’ll work with a therapist to develop strategies for making everyday tasks feel more doable, managing memory lapses, and reducing frustration.
• More Independence Together, you’ll develop calendars, reminder systems, routines, and other organizational tools to help you stay on track with daily activities.
• Better Problem-Solving Skills Your therapist can also help you work on ways to stay organized, recognize when it’s time to take a break, follow conversations, and adapt to memory challenges.

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Cognitive rehabilitation is most helpful in the earlier stages of Alzheimer’s disease, Mattis says. This is when you’re more likely to be able to learn, practice, and retain strategies that support daily life.

Mattis describes cognitive rehabilitation as a form of “prehabilitation” — a way to build habits before they become necessary. “The idea is to maintain function earlier on, rather than improve functioning in the later stages of the disease,” he says.

Cognitive rehabilitation is typically done one-on-one with a trained therapist. Sessions may be led by a neuropsychologist or a specialist, such as a speech-language pathologist or occupational therapist, says Mattis.

During each session, you’ll work with your therapist to identify goals that are meaningful to you and develop strategies to address them. This may include:

• Creating routines
• Finding new ways to approach activities that have become more challenging
• Organizing your day
• Using reminders 
  

• Feel more present and in control
• Manage stress
• Recognize when you need a break
• Stay focused during conversations

You’ll get the most out of cognitive rehabilitation by actively participating in sessions and then practicing what you’ve learned outside of therapy. “These treatments do take effort, and without appropriate motivation, significant gains are unlikely,” says Mattis.

At the same time, support can be an important part of implementing new strategies from cognitive rehabilitation in your daily life. Because memory and thinking changes can make it harder to recognize when a new tool is needed or remember to use it consistently, “It’s often difficult to set up these strategies alone,” says Mattis.

A therapist can help you develop strategies that fit your daily life, while caregivers or family members can provide encouragement, support, and reminders as you practice using the strategies.