New learning in dementia: transfer and spontaneous use of learning in everyday life functioning. Two case studies.

The purpose of these two case studies was to explore the effectiveness of learning methods in dementia when applied in real-life settings and the integration of new skills in daily life functioning. The first participant, DD, learned to look at a calendar with the spaced retrieval method to answer his repeated questions about the current date and calls made to family. Progressive cuing was used by his wife to increase spontaneous use of the calendar, but DD had difficulty integrating the calendar into his routine. The second patient, MD, relearned a leisure activity (listening to music on a cassette radio) and how to participate in a social activity (saying the rosary in a group) with a combination of learning methods. Transfer of these skills in similar contexts was difficult for MD. She never integrated the cassette radio into her daily life routine but she went regularly to the rosary activity, which was cued by an alarm clock. In sum, the learning methods used were very effective with these patients but transfer and spontaneous use were difficult. Since these aspects are essential to rehabilitation, they should be further explored in order to increase the effectiveness of cognitive interventions.