The Cope Program for Better Dementia Care at Home
Supporting your loved one who is living with dementia to live in their own home for as long as possible is always best for their wellbeing, but due to changes in their functional ability or behaviour, along with changes in your own stress levels as a carer, this can be challenging.
Dementia Lens Orange recently met with Kelly Agland, Occupational Therapist and Director of Occupational Therapy Plus in Orange, NSW, to discuss the COPE program. Kelly’s team works closely with older adults and families across the Central West, supporting people to remain as independent, safe and engaged in life as possible. A large part of that work is supporting people living with dementia, and their family members caring for them at home, through COPE.
We asked Kelly to explain more about COPE and how it can help families. People who live outside the Central West area can find a cope practitioner on the COPE website.
Kelly, can you tell us a little more about COPE? As an occupational therapist, what led you and your team to complete COPE training?
Over the years, I’ve seen how overwhelming dementia can feel for families, especially when behaviours change or daily routines become harder to manage.
Our team completed training in the COPE program because I was looking for an evidence-based, practical approach that genuinely helps both the person living with dementia and the people supporting them. What I really value about COPE is that it focuses on understanding the person, adapting the environment and building confidence in carers rather than simply “managing behaviours.”
COPE stands for Care of People with Dementia in their Environments. It’s an evidence-based occupational therapy program designed for people living with dementia at home and the family members or carers supporting them. The program was developed to help with some of the real-world challenges families face every day, things like agitation, resistance to care, wandering, boredom, loss of routine, communication difficulties, and increasing stress for carers.
Rather than focusing only on memory loss, COPE focuses on helping people function better in everyday life and reducing distress for everyone involved. COPE looks at the whole picture: the person living with dementia; their abilities and interests; the home environment; daily routines; and carer’s stress levels and support needs.
How does COPE approach behavioural changes like agitation, resistance to care, wandering or apathy?
One of the core ideas behind COPE is that behaviours are usually a form of communication, not someone “being difficult.”
The program helps families understand what might be contributing to behaviours. For example:
confusion from too much stimulation
pain, fatigue, dehydration or infection
tasks being too complex
boredom or lack of meaningful activity
communication that feels overwhelming
environmental triggers or unmet needs
Instead of trying to control the behaviour, we look at changing the environment, simplifying tasks, improving communication and helping the person feel more successful and secure. Sometimes relatively small changes can make a surprisingly big difference.
What does a typical COPE intervention look like in practice? Can you give examples of practical environmental changes that make a meaningful difference?
COPE is usually delivered over multiple sessions (up to 10) in the home and is tailored to the individual family.
We spend time understanding:
the person’s routines and abilities
what’s becoming difficult
what matters most to the family
and what situations are causing the most stress
From there, we develop practical strategies together.
Environmental changes might include:
reducing clutter or excess noise
improving lighting
using visual cues or labels
simplifying the setup of daily tasks
adjusting bathroom or bedroom layouts
creating clearer routines
positioning commonly used items where they’re easier to find
Sometimes families expect huge complicated changes, but often the most effective strategies are small, practical adjustments that reduce confusion and help the person feel more capable.
How important is meaningful activity and purpose in dementia care?
It’s incredibly important. People living with dementia still need purpose, routine, connection and a sense of identity. One of the hardest things for families is watching someone gradually stop doing the things they once enjoyed.
COPE places a strong focus on identifying past and current interests and adapting activities so the person can still participate successfully.
That might mean:
folding towels instead of managing all the laundry
helping prepare part of a meal rather than cooking independently
gardening tasks adapted for safety
listening to favourite music
looking through family photos
simple routines that still create a sense of contribution and familiarity
Meaningful activity often helps reduce distress, boredom, pacing, agitation and withdrawal because people feel more engaged and connected.
How does occupational therapy fit into dementia care in ways people may not expect?
A lot of people think occupational therapy is only about equipment or home modifications, but dementia care is actually a huge area of OT practice.
Occupational therapists look at how a person functions in everyday life. That includes routines, relationships, activities, communication, the physical environment, fatigue, safety, identity and participation in meaningful life roles.
In dementia care, OT is often about helping families understand:
why things are becoming difficult
how to adapt tasks successfully
how to reduce stress and overwhelm
how to support the person’s remaining strengths instead of focusing only on loss
We’re often translating dementia into practical everyday strategies families can actually use at home.
At what stage of dementia is COPE usually introduced? What surprises families most when they go through the program?
COPE is generally introduced when a person is still living at home and starting to experience increasing difficulties with daily function, behavioural changes or carer stress.
That might be in the earlier or moderate stages of dementia, but honestly, one of the biggest things we see is that earlier support is often better. Families are sometimes told to wait until things become “bad,” but early intervention can make a huge difference in helping someone remain independent for longer and reducing stress before families hit crisis point.
I think many families are surprised by how much of a difference small changes can make.
They’re often relieved to realise the behaviours are not intentional or personal. Once families start understanding the “why” behind behaviours, they usually feel less frustrated and more confident in how they respond.
Families are also often surprised that the focus is not just on the person living with dementia, but on supporting the carer as well. Carers are under enormous pressure and helping them feel more supported, capable, and less alone is a really important part of the program.
What costs are involved with implementing COPE, and how do people get in touch with you?
The cost depends on the individual situation and funding arrangements. In some cases, services may be funded through Support at Home Packages, Short Term Restorative Care or Transitional Aged Care packages or the NDIS if the person is eligible. If no funding is available, we may be able to offer a shorter COPE package for a lower cost or provide some free resources to work through independently at home.
We’re always happy to have a conversation with families about what supports may be available and whether COPE is likely to be a good fit.
People can contact Occupational Therapy Plus directly through our website or by calling our clinic on 1300 933 122 to discuss referrals or ask questions about dementia support services.
