Working with people with dementia and their care partners can be complicated and confusing. What does the evidence say is the best approach? Is it rehabilitative or habilitative?? In this episode, hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS interview occupational therapist and Dementia Collaborative founder Rachel Wiley, MS, OTR/L about her approach to working with people with dementia and their care partners. Rachel shares how past experiences with conflicting recommendations between professionals—and the confusion and mistrust this caused for families—motivated her to create a more advanced, evidence-based program that gets teams using the same language and approaches, especially around topics like rehabilitation vs. habilitation, assistive devices, responsive behaviors, and fall risk. She explains her practical, detective-style framework for understanding and managing responsive behaviors (like waking at night or agitation) by identifying triggers and using strategies such as acknowledge–reassure–redirect and meaningful routines. The episode also touches on the complexities of billing, maintenance care, and determining medical necessity in a progressive condition, emphasizing person-centered, ethical care that balances evidence, function, safety, and the realities of caregiving. Rachel recently launched the beta cohort of her new Certified Dementia Clinician (CDCn) Course, a 20-module, interdisciplinary training designed for OTs, PTs, SLPs, social workers, and other clinicians working with people living with dementia.

310: The Evidence-Based Approach To Dementia Care With Rachel Wiley, MS, OTR/L