Occupational therapy in the care of an older adult with Alzheimer’s disease and their caregiver in a favela: a case study

Abstract

Introduction: Older adults with Alzheimer’s disease and their caregivers may develop limitations that affect participation in their occupations, especially in contexts of social vulnerability. Objective: To describe the main occupational therapy assessments and interventions carried out with an older adult with Alzheimer’s disease and their caregiver in a Compassionate Favela. Method: This is a single case study conducted in a Compassionate Favela located in Rocinha, Rio de Janeiro. Ten sessions were carried out with the older adult and their caregiver between December/2024 and April/2025. Data collection was conducted through the development of an interview guide, application of validated instruments, and systematic recording of interventions in a field diary. Data were analyzed qualitatively using reflexive thematic analysis. Results: The older adult presented total dependence in most Activities of Daily Living. The caregiver presented difficulties in self-care and in managing behavioral changes of the older adult’s father, as well as routine disorganization and severe physical and emotional burden. Occupational therapy interventions included optimization of the older adult’s occupational performance through caregiver training, promotion of caregiver self-care, and participation in meaningful activities. Conclusion: The study reinforces the contribution of occupational therapy in compassionate communities and the need for contextually grounded strategies for older adults with Alzheimer’s disease and their caregivers.