Errorless learning of everyday tasks in people with dementia

Maartje ME de Werd,^1,2,5 Daniëlle Boelen,^1–3 Marcel GM Olde Rikkert,^2,4 Roy PC Kessels<sup>1,2,4

1</sup>Radboud University Nijmegen Medical Centre, Department of Medical Psychology, ²Radboud University Nijmegen Medical Centre, Department of Geriatric Medicine and Radboud Alzheimer Centre, Nijmegen, ³Rehabilitation Medical Centre, Groot Klimmendaal, Arnhem, ⁴Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, ⁵VieCuri Hospital, Department of Medical Psychology, Venlo, the Netherlands

Abstract: Errorless learning (EL) is a principle used to teach new information or skills to people with cognitive impairment. In people with dementia, EL principles have mostly been studied in laboratory tasks that have little practical relevance for the participants concerned, yet show positive effects. This is the first paper to exclusively review the literature concerning the effects of EL on the performance of useful everyday tasks in people with dementia. The role of factors such as type of dementia, type of task, training intensity, EL elements, outcome measures, quality of experimental design, and follow-up are discussed. The results indicate that, compared with errorful learning (EF) or no treatment, EL is more effective in teaching adults with dementia a variety of meaningful daily tasks or skills, with gains being generally maintained at follow-up. The effectiveness of EL is highly relevant for clinical practice because it shows that individuals with dementia are still able to acquire meaningful skills and engage in worthwhile activities, which may potentially increase their autonomy and independence, and ultimately their quality of life, as well as reduce caregiver burden and professional dependency. Suggestions for future research are given, along with recommendations for effective EL-based training programs, with the aim of developing a clinical manual for professionals working in dementia care.

Keywords: dementia, implicit learning, occupational therapy, errorless learning, review, everyday activities