The COTiD Model (Community Occupational Therapy in Dementia)
COTiD is a home-based Occupational Therapy intervention model designed for people with mild to moderate dementia and their caregivers. The programme places the person-caregiver dyad at the centre of care, with the aim of promoting autonomy, participation, and quality of life through meaningful daily activities.
The Occupational Therapist observes how the person carries out everyday activities in their own environment and, together with the caregiver, identifies practical strategies to make these activities safer, clearer, and more rewarding.
Origins and development of the model
COTiD is an evidence-based model developed in the Netherlands in 1998 in response to the lack of structured guidelines for dementia care interventions. The programme has since been adapted and validated in several European countries, including Switzerland.
What makes the COTiD model unique?
One of the distinctive features of the model is its joint and balanced approach to supporting both the person with dementia and the caregiver. The programme addresses the needs of both individuals, actively involving them throughout the therapeutic process.
Structure of the COTiD Model
The programme consists of ten home-based sessions organised into three main phases.
- Phase A: Getting to know and assessment. During the first phase, the Occupational Therapist gathers detailed information about both the person with dementia and the caregiver. Life history, daily habits, values, difficulties, and personal strengths are explored. The therapist then observes how the person performs everyday activities within their home environment, such as dressing, preparing a simple meal, organising the day, using familiar objects, or taking part in household routines. Together with the caregiver, the therapist identifies practical strategies to make these activities safer, easier to understand, and more satisfying.
- Phase B: Goal setting. The therapist identifies intervention goals based on the priorities, wishes, and remaining abilities that emerged during the previous phase. This stage becomes a collaborative discussion between therapist, patient, and caregiver, where all parties actively contribute to agreeing on shared therapeutic goals.
- Phase C: Intervention. In the final phase, the intervention plan is implemented and tailored to the specific needs and abilities of the person–caregiver dyad. The intervention aims to strengthen existing cognitive strategies while introducing practical solutions to support everyday activities. Strategies may include simplifying tasks, using visual reminders, adapting the home environment, structuring routines, selecting more suitable activities, or improving the way the caregiver communicates and provides assistance. The caregiver is supported in developing practical strategies and problem-solving skills in order to assist the person without completely taking over. Both the environment and the activity itself become therapeutic tools to promote autonomy, safety, and a sense of competence.
Conclusion
The COTiD model addresses two closely connected dimensions: the person with dementia and the caregiver. The aim is not only to compensate for difficulties, but also to encourage participation in daily life, enhance preserved abilities, and support caregivers in managing everyday challenges.
For the person with dementia, the intervention aims to promote:
- greater autonomy and independence in daily activities;
- activities adapted to remaining abilities and personal interests;
- enjoyment and satisfaction in meaningful activities;
- a sense of competence, usefulness, and appreciation.
For the caregiver, the programme supports:
- the development of practical caregiving strategies;
- more effective and respectful communication;
- improved management of everyday challenges;
- reduced caregiving burden;
- increased confidence and competence in their role.
In this way, COTiD helps the person-caregiver dyad develop practical, personalised solutions that can improve quality of life within the home environment.
If you want to know more about the COTiD model don’t hesitate to contact us here at Polispecialistico Paradiso!
