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Nicol J, Loehr J, Christensen J, Lang J, Peacock S. Duet playing in dementia care: a new therapeutic music technology. Disabil Rehabil Assist Technol 2024:1-14. [PMID: 38785041 DOI: 10.1080/17483107.2024.2351498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/30/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE Supporting the relational worlds of people living with dementia, especially the spousal dyad, is a growing focus in dementia care as is advancing the therapeutic use of music in dementia care. This paper describes a mixed-methods, multi-phase, iterative research study designed to develop the Music Memory Makers (MMM) Duet System, a novel therapeutic music technology, that allows non-musicians to play a personalized repertoire of songs arranged as duets. METHODS Following a pilot phase to iteratively assess and refine the MMM Duet System for recreational and therapeutic purposes, multiple sources of data were used to investigate five older spousal dyads' experiences with the system, two couples living with dementia and three who were not. We assessed perceptions of task difficulty, joint agency, and enjoyment as well as therapeutic benefits associated with enhancing the spousal relationship and sense of couplehood. RESULTS Findings suggest playing meaningful songs together is an enjoyable interactive activity that prompts musical reminiscence, involves joint agency, and supports relationship continuity within a relational, positive approach to dementia care. All couples mastered the task, none evaluated it as "very challenging," and positive couple interactions were evoked, commonly before and after playing the duets. CONCLUSIONS The MMM Duet System is recommended for further research and development as an innovative way to support couples living with dementia with commercial implications, and as a new music technology suitable for use as a research tool.
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Affiliation(s)
- Jennifer Nicol
- Education, University of Saskatchewan, Saskatoon, Canada
| | - Janeen Loehr
- Psychology, University of Saskatchewan, Saskatoon, Canada
| | | | - Jennifer Lang
- Music Education, University of Saskatchewan, Saskatoon, Canada
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2
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Fuller OK, McLennan ED, Egan CL, Burrows EL, Febbraio MA. Impact of voluntary exercise training on the metabolic and behavioral characteristics of the rTg4510 transgenic mouse model of frontotemporal dementia. Behav Brain Res 2024; 460:114810. [PMID: 38122903 DOI: 10.1016/j.bbr.2023.114810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
Frontotemporal dementia (FTD) is a neurodegenerative disorder that affects the frontal and temporal lobes of the brain, primarily in individuals under 65 years of age, and is the second most common form of dementia worldwide. There is no cure for FTD and current treatments offer limited symptomatic relief. Regular physical activity exhibits cognitive and neuroprotective benefits in healthy individuals and in various neurodegenerative diseases, such as Alzheimer's disease, but few studies have examined its efficacy in FTD. Accordingly, we investigated the impact of voluntary exercise training (VET) on the metabolic and behavioral characteristics of the rTg4510 transgenic mouse model of familial FTD. We show that regardless of genotype, VET increased energy expenditure, decreased sleep duration, and improved long-term memory in rTg4510 mice and WT littermates. Moreover, VET appeared to improve hyperactivity, a common feature of FTD, in rTg4510 mice. Although further work is required, these findings provide important insights into the potential benefits of physical activity in FTD.
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Affiliation(s)
- Oliver K Fuller
- Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Emma D McLennan
- Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Casey L Egan
- Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Emma L Burrows
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Mark A Febbraio
- Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Australia.
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Kouloutbani K, Venetsanou F, Karteroliotis KE, Politis A. Physical Exercise as a Nonpharmacological Intervention for the Treatment of Neuropsychiatric Symptoms in Persons With Dementia: A Meta-analysis of Randomized Controlled Trials. Alzheimer Dis Assoc Disord 2023; 37:73-81. [PMID: 36821178 DOI: 10.1097/wad.0000000000000544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/28/2022] [Indexed: 02/24/2023]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) are prevalent in dementia and affect both patients and caregivers in multiple ways. Because of the complications of drug treatments, nonpharmacological interventions, such as exercise, are of particular value. This study aimed to investigate the effect of exercise on the NPS of dementia and draw recommendations for the disease management. METHODS Meta-analyses were conducted on the findings of randomized controlled trials identified during an initial systematic review of the literature, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The included studies examined the effect of exercise interventions on patients with dementia or mild cognitive impairment using valid assessment tools. The quality of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluation analysis. RESULTS The meta-analyses revealed that exercise significantly limits NPS [mean difference: -5.28, (95% CI, -9.46, -1.11), P = 0.01] and symptoms of depression [standardized mean difference: -0.16, (95% CI, -0.29, -0.02), P = 0.02], and has a beneficial effect on agitation symptoms. The Grading of Recommendations, Assessment, Development, and Evaluation analysis results showed that exercise has a moderate and high confidence positive effect on NPS and depression, respectively. CONCLUSIONS Exercise could be an alternative approach for nonpharmacological treatment of NPS in dementia. Therefore, exercise could be utilized as a treatment of choice or to support existing treatment regimens.
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Affiliation(s)
- Komanthi Kouloutbani
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Dafni
| | - Fotini Venetsanou
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Dafni
| | | | - Antonios Politis
- First Department of Psychiatry, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
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Tan DGH, Boo BMB, Chong CS, Tan MMLL, Wong BS. Effectiveness of home-based, non-exercise interventions for dementia: A systematic review. Front Aging Neurosci 2022; 14:846271. [PMID: 36034133 PMCID: PMC9403464 DOI: 10.3389/fnagi.2022.846271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 07/18/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Dementia is a neurodegenerative condition characterized by cognitive decline and increased functional dependency. With most persons living with dementia (PLWDs) residing at home, home-based interventions provide a convenient and individualized alternative for person-centered care. Most of the evidence focused on specific interventions or exercise-based activities; there remains a gap in understanding the impacts of a broader range of non-exercise interventions on PLWDs and their caregivers. This review aimed to understand the impacts of home-based, non-exercise interventions on the behavioral, functional, cognitive, and mood outcomes of PLWDs, and their caregiver's quality of life (QoL), burden and mood. Methods Search for studies published up to June 2020 was conducted on CINAHL, PsycArticles, PubMed, SAGE Journals, Science Direct, and Web of Science. A search was also done manually based on the bibliographies of selected articles. The inclusion criteria for the systematic review were: (i) participants with a medical diagnosis of dementia, (ii) participants who resided at own home, (iii) intervention in the home setting, (iv) investigate interventions other than physical exercise, (v) randomized controlled trials (RCTs) or quasi-experimental studies, and (vi) full-text study published in English and in a peer-reviewed journal. Results and discussion Eighteen studies consisting of 14 RCTs and 4 quasi-experimental studies were included. Interventions included were occupational therapy, cognitive rehabilitation, tailored activity program, cognitive stimulation therapy, personalized reminiscence, music therapy, reality orientation, biobehavioral and multicomponent interventions. Results were mixed, but important intervention features were highlighted. Personalized activities for PLWDs that are aligned to their interest and ability appeared to contribute to intervention effectiveness especially in reducing behavioral symptoms and improving functional status. Involvement of caregivers in interventions is another feature of effective interventions for both the PLWDs and the caregivers' QoL, provided it is not deemed demanding or challenging to the caregivers. The inclusion of caregiver's education was effective in reducing caregivers' burden, particularly when the interventions improved the PLWD's functional status.
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Affiliation(s)
- Davynn Gim Hoon Tan
- Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
| | | | - Cheyenne Shuen Chong
- Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
| | | | - Boon-Seng Wong
- Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
- Department of Physiology, National University of Singapore, Singapore, Singapore
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Flo BK, Matziorinis AM, Skouras S, Sudmann TT, Gold C, Koelsch S. Study protocol for the Alzheimer and music therapy study: An RCT to compare the efficacy of music therapy and physical activity on brain plasticity, depressive symptoms, and cognitive decline, in a population with and at risk for Alzheimer’s disease. PLoS One 2022; 17:e0270682. [PMID: 35771851 PMCID: PMC9246122 DOI: 10.1371/journal.pone.0270682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 06/13/2022] [Indexed: 11/28/2022] Open
Abstract
Background There is anecdotal evidence for beneficial effects of music therapy in patients with Alzheimer’s Disease (AD). However, there is a lack of rigorous research investigating this issue. The aim of this study is to evaluate the effects of music therapy and physical activity on brain plasticity, mood, and cognition in a population with AD and at risk for AD. Methods One-hundred and thirty-five participants with memory complaints will be recruited for a parallel, three-arm Randomized Controlled Trial (RCT). Inclusion criteria are a diagnosis of mild (early) AD or mild cognitive impairment (MCI), or memory complaints without other neuropsychiatric pathology. Participants are randomised into either a music therapy intervention (singing lessons), an active control group (physical activity) or a passive control group (no intervention) for 12 months. The primary outcomes are the brain age gap, measured via magnetic resonance imaging (MRI), and depressive symptoms. Secondary outcomes include cognitive performance, activities of daily living, brain structure (voxel-based morphometry and diffusion tensor imaging), and brain function (resting-state functional MRI). Trial status Screening of participants began in April 2018. A total of 84 participants have been recruited and started intervention, out of which 48 participants have completed 12 months of intervention and post-intervention assessment. Discussion Addressing the need for rigorous longitudinal data for the effectiveness of music therapy in people with and at risk for developing AD, this trial aims to enhance knowledge regarding cost-effective interventions with potentially high clinical applicability. Trial registration ClinicalTrials.gov identifier: NCT03444181, registered on February 23, 2018.
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Affiliation(s)
- Birthe K. Flo
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- * E-mail: (BKF); (SK)
| | | | - Stavros Skouras
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | | | - Christian Gold
- NORCE Norwegian Research Centre AS, Bergen, Norway
- Grieg Academy Department of Music, University of Bergen, Bergen, Norway
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
| | - Stefan Koelsch
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- * E-mail: (BKF); (SK)
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The effectiveness of physical exercise interventions in the management of neuropsychiatric symptoms in dementia patients: a systematic review. Int Psychogeriatr 2022; 34:177-190. [PMID: 33818342 DOI: 10.1017/s1041610221000193] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The management of neuropsychiatric symptoms (NPS) in patients with dementia is a major challenge. Since no effective therapy has been found to date and drug treatments are associatedwith significant side effects, there seems to be a pressing need for alternative non-pharmacological interventions. OBJECTIVES The current study aims to investigate and compare the effect of different types of physical exercise on the NPS. METHODS A systematic review of the literature was conducted according to the PRISMA guidelines. Five databases (SCOPUS, PubMed, SPORT Discus, Web of science and ScienceDirect) were searched using the appropriate algorithm. What was sought out was randomized control trials (RCTs) that applied physical activity interventions with specific characteristics (type, frequency, intensity, and duration) in patients with dementia or mild cognitive impairment, studied the effect of exercise on their NPS and compared this effect with a control group that did not follow an exercise program. RESULTS From 512 articles, 13 studies were included in this review, involving a total of 1,925 patients. The results were analyzed and synthesized according to the type of exercise applied - aerobic exercise, multidimensional interventions and muscular strength training programs. In particular, the results showed that repetitive aerobic exercise three to five times a week had a positive effect on NPS, whereas multidimensional interventions combining different types of exercise did not appear to be as effective. Strength training programs have been found to significantly reduce depression symptoms and behavioral problems in demented patients with mobility problems. CONCLUSIONS There is clear evidence that physical activity and especially aerobic exercise may be effective in the management of NPS. However, it is necessary to apply specific practical recommendations and specially designed programs to incorporate physical exercise into the daily routine of these patients.
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Koch J, Amos JG, Beattie E, Lautenschlager NT, Doyle C, Anstey KJ, Mortby ME. Non-pharmacological interventions for neuropsychiatric symptoms of dementia in residential aged care settings: An umbrella review. Int J Nurs Stud 2022; 128:104187. [DOI: 10.1016/j.ijnurstu.2022.104187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 10/19/2022]
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8
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Lee S, Allison T, O’Neill D, Punch P, Helitzer E, Moss H. OUP accepted manuscript. Health Promot Int 2022; 37:i49-i61. [PMID: 35417003 PMCID: PMC9162174 DOI: 10.1093/heapro/daac024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The majority of people living with dementia are cared for by their families. Family carers play a vital role in upholding the formal care system. Caring for a family member with dementia can be fulfilling. However, this role can have a considerable negative impact on family carers’ mental and physical health and quality of life. Several empirical research studies have recently been conducted that explore the potential benefits of music interventions for family carers of people living with dementia. Singing has been the primary musical medium employed. This article presents the first review of this literature to date. It investigates the impact of music interventions on the health and well-being of family carers of people living with dementia, and how they experience and perceive these interventions. Whittemore and Knafl’s five-stage integrative review framework was utilized: (i) problem identification; (ii) literature search; (iii) data evaluation; (iv) data analysis and synthesis; and (v) presentation of the findings. A total of 33 studies met the inclusion criteria. Analysis and synthesis resulted in three overarching themes: impact on family carers, carer perceptions of music interventions and null quantitative findings in small studies. The review found that singing and music interventions may improve family carers’ social and emotional well-being, enhance their ability to cope and care and ameliorate the caring relationship, contributing to experiences of flourishing. However, it highlighted that this area is under-researched and pointed to the need for larger, more rigorous studies.
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Affiliation(s)
- Sophie Lee
- Health Research Institute, Ageing Research Centre, Irish World Academy of Music and Dance, University of Limerick, Limerick V94 T9PX, Ireland
- Corresponding author. E-mail:
| | - Theresa Allison
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, CA 94143, USA
| | - Desmond O’Neill
- Centre for Ageing, Neurosciences and the Humanities, Trinity College Dublin, D02 PN40, Ireland
| | - Pattie Punch
- Glucksman Library, University of Limerick, Limerick V94 T9PX, Ireland
| | - Elizabeth Helitzer
- Health Research Institute, Ageing Research Centre, Irish World Academy of Music and Dance, University of Limerick, Limerick V94 T9PX, Ireland
| | - Hilary Moss
- Health Research Institute, Ageing Research Centre, Irish World Academy of Music and Dance, University of Limerick, Limerick V94 T9PX, Ireland
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9
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Bian X, Wang Y, Zhao X, Zhang Z, Ding C. Does music therapy affect the global cognitive function of patients with dementia? A meta-analysis. NeuroRehabilitation 2021; 48:553-562. [PMID: 33967069 DOI: 10.3233/nre-210018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Studies have shown that music therapy can improve a variety of symptoms of patients with dementia. The impact of music therapy on the global cognition of patients with dementia is controversial now. OBJECTIVE To explore whether music therapy has an effect on the global cognitive function of patients with dementia. METHODS PubMed, Web of Science, Embase, Google Academy and National Knowledge Infrastructure were systematically searched to collect all literature studies published since the establishment of the database until November 2020. All randomized controlled trials that met the criteria of music therapy in the intervention group and standard care in the control group with outcome measures of Mini-mental State Examination (MMSE) were included. Analysis was performed using Stata 16.0. RESULTS The results showed that compared with the control group, the MMSE score in the music therapy group was generally higher (MD = 0.86, 95% CI: 0.07-1.66, P = 0.03). CONCLUSIONS The result of this study differs from those of previous relevant meta-analyses, suggesting that music therapy is likely to improve the global cognitive function of patients with dementia, but more rigorous clinical trials are still needed to provide more sufficient and real evidence.
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Affiliation(s)
- Xiaoyi Bian
- Art teaching and research department, College of Humanities and Social Sciences, Anhui Agricultural University, Hefei, Anhui, China
| | - Yuanli Wang
- Anhui Medical University, Second clinical medical college, Hefei, Anhui, China
| | - Xiaohu Zhao
- Anhui Medical University, Second clinical medical college, Hefei, Anhui, China
| | - Zhihua Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Chengbiao Ding
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, Anhui, China.,College of Nuclear Science and Technology, University of science and technology of China, Hefei, Anhui, China
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Abstract
Aggressive behavior is one of the most disturbing symptoms of Alzheimer disease and other progressive neurodegenerative dementias. Development of strategies for management of aggressive behaviors in people with dementia is hindered by a lack of recognition that aggression is not a uniform behavioral construct. It is possible to distinguish 2 types of aggression: reactive or impulsive aggression and proactive or premeditated aggression. Research concerning aggressive behaviors in people with dementia is hindered by scales describing behavioral symptoms of dementia which do not distinguish between reactive and proactive aggressions because they do not consider the factors leading to these behaviors. Reactive aggression is caused by lack of understanding, leading to rejection of care, while proactive aggression could be caused by a psychopathic personality, hallucinations or delusions, and other determinants. It is difficult to underestimate the importance of distinguishing reactive and proactive aggressions in people with dementia because there are different strategies that can be used for management of these behaviors. For reactive aggression, delayed treatment, distraction, improved communication, and change in treatment strategy is useful, while antipsychotic medication may be needed for treatment of proactive aggression. Dementia is increasing the risk of both types of aggressions and antidepressant treatment can be helpful. Most importantly, persons exhibiting reactive aggression should not be labeled "aggressors" because this behavior could be caused by unmet persons' needs, pain and poor communication with care providers.
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Affiliation(s)
- Ladislav Volicer
- School of Aging Studies, 7831University of South Florida, Tampa, FL, USA.,3rd Medical Faculty, Charles University, Prague, Czech Republic
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Nicosia FM, Williams SL, Dannenbaum TP, Barnes DE. Resilience in the Face of Disaster: Psychosocial Effects of the 2017 Northern California Wildfires in Caregivers and Persons with Cognitive Impairment Participating in an Integrative Group Movement Program at an Adult Day Center. ACTIVITIES, ADAPTATION & AGING 2021. [DOI: 10.1080/01924788.2021.1916716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Francesca M. Nicosia
- San Francisco VA Health Care System, University of California, San Francisco, California, USA
| | - Sienna L. Williams
- San Francisco VA Healthcare System, VA Puget Sound Health Care System, Seattle, Washington, USA
| | | | - Deborah E. Barnes
- San Francisco VA Health Care System, University of California, San Francisco, California, USA
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Motta-Ochoa R, Incio-Serra N, Boulet A, Fu D, Frantz A, William M, Blain-Moraes S. Mouvement de passage: Creating connections through movement among persons with dementia. DEMENTIA 2021; 20:2573-2596. [PMID: 33877945 PMCID: PMC8564263 DOI: 10.1177/14713012211004009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
One of the challenging consequences of dementia is the change in relationships that can
co-occur with the progression of this condition. Despite this well-documented change, few
arts-based interventions target the relational dimension of dementia. This study aims to
explore the effects of one arts-based relational intervention: a movement program designed
to foster connections within a group of persons with dementia. We used ethnographic
methods—including participant observations and informal interviews—to understand the
relational effects of this program conducted by two dancers and a musician. The movement
sessions were video recorded, and participant movement trajectories were analyzed for
different ways in which they created connections. We identified two types of
connections—nonreciprocal and reciprocal—and four subtypes of connections—connection to
exercise/music, connection to participant, interpersonal connection, and group
connection—that participants engaged in during the movement program. Despite most
participants not remembering the previous movement sessions, they experienced increasing
numbers of connections over the course of the program, particularly reciprocal
interpersonal connections. Participants explored new forms of moving and creatively
transformed the movement structures proposed by the dancers. The results demonstrate the
effectiveness of this program in augmenting connections and fostering exploration and
creativity in individuals with dementia, providing a template for further developments of
interventions targeting the relational dimensions of dementia. This study also highlights
the potential of combining ethnographic methods and video analysis to include the
perspectives of persons with dementia in research.
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Affiliation(s)
- Rossio Motta-Ochoa
- School of Physical & Occupational Therapy, Faculty of Medicine, 5620McGill University, Montreal, Quebec, Canada; Biosignal Interaction and Personhood Technology (BIAPT) Lab, Montreal General Hospital, Montreal, Quebec, Canada
| | - Natalia Incio-Serra
- School of Physical & Occupational Therapy, Faculty of Medicine, 5620McGill University, Montreal, Quebec, Canada; Biosignal Interaction and Personhood Technology (BIAPT) Lab, Montreal General Hospital, Montreal, Quebec, Canada
| | | | - Dannie Fu
- Biosignal Interaction and Personhood Technology (BIAPT) Lab, Montreal General Hospital, Montreal, Quebec, Canada; Department of Biomedical Engineering, 5620McGill University, Faculty of Medicine University, Montréal, Quebec, Canada
| | - Allison Frantz
- Biosignal Interaction and Personhood Technology (BIAPT) Lab, Montreal General Hospital, Montreal, Quebec, Canada; Integrated Program in Neuroscience, 5620McGill University, Faculty of Medicine University, Montréal, Quebec, Canada
| | | | - Stefanie Blain-Moraes
- School of Physical & Occupational Therapy, Faculty of Medicine, 5620McGill University, Montreal, Quebec, Canada; Biosignal Interaction and Personhood Technology (BIAPT) Lab, Montreal General Hospital, Montreal, Quebec, Canada
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13
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Rose KM, Coop Gordon K, Schlegel EC, Mccall M, Gao Y, Ma M, Lenger KA, Ko E, Wright KD, Wang H, Stankovic J. Smarthealth technology study protocol to improve relationships between older adults with dementia and family caregivers. J Adv Nurs 2021; 77:2519-2529. [PMID: 33576064 DOI: 10.1111/jan.14714] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/16/2020] [Indexed: 11/27/2022]
Abstract
AIM The aim of this study is to develop a Smarthealth system of monitoring, modelling, and interactive recommendation solutions (for caregivers) for in-home dementia patient care that focuses on caregiver-patient relationships. DESIGN This descriptive study employs a single-group, non-randomized trial to examine functionality, effectiveness, feasibility, and acceptability of the novel Smarthealth system. METHODS Thirty persons with Alzheimer's Disease or related dementia and their family caregivers (N = 30 dyads) will receive and install Smarthealth technology in their home. There will be a 1-month observation phase for collecting baseline mood states and a 2-month implementation phase when caregivers will receive stress management techniques for each detected, negative mood state. Caregivers will report technique implementation and usefulness, sent via Ecological Momentary Assessment system to the study-provided smartphone. Caregivers will provide daily, self-reported mood and health ratings. Instruments measuring caregiver assessment of disruptive behaviours and their effect on caregivers; caregiver depressive symptoms, anxiety and stress; caregiver strain; and family functioning will be completed at baseline and 3 months. The study received funding in 2018 and ethics board approval in 2019. DISCUSSION This study will develop and test novel in-home technology to improve family caregiving relationships. Results from this study will help develop and improve the Smarthealth recommendation system and determine its usefulness, feasibility, and acceptability for persons with dementia and their family caregiver. IMPACT The Smarthealth technology discussed will provide in-home stress reduction resources at a time when older adults may be experiencing increasingly high rates of isolation and anxiety and caregiver dyads may be experiencing high levels of relationship strain. TRIAL REGISTRATION This study was registered with Clinical Trials.gov (Identifier NCT04536701).
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Affiliation(s)
- Karen M Rose
- College of Nursing, The Ohio State University, Columbus, OH, USA
| | | | - Emma C Schlegel
- College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Matthew Mccall
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, USA
| | - Ye Gao
- School of Engineering and Applied Science, Computer Science, University of Virginia, Charlottesville, VA, USA
| | - Meiyi Ma
- School of Engineering and Applied Science, Computer Science, University of Virginia, Charlottesville, VA, USA
| | - Katherine A Lenger
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, USA
| | - Eunjung Ko
- College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Kathy D Wright
- College of Nursing, The Ohio State University, Columbus, OH, USA.,Discovery Themes-Prevention and Treatment of Chronic Brain Injury Institute, The Ohio State University, Columbus, OH, USA
| | - Hongning Wang
- School of Engineering and Applied Science, Computer Science, University of Virginia, Charlottesville, VA, USA
| | - John Stankovic
- School of Engineering and Applied Science, Computer Science, University of Virginia, Charlottesville, VA, USA
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14
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Erzincanli S, Kasar KS. Effect of Hand Massage on Pain, Anxiety, and Vital Signs in Patients Before Venipuncture Procedure: A Randomized Controlled Trial. Pain Manag Nurs 2021; 22:356-360. [PMID: 33472757 DOI: 10.1016/j.pmn.2020.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 12/05/2020] [Accepted: 12/08/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Massage is one of the relaxation techniques commonly used in recent years to control pain, stress, and anxiety. AIMS This study was conducted to evaluate the effect of hand massage application on pain, anxiety, and vital signs before venipuncture procedure. METHODS The sample of the study consisted of 97 individuals (48 experimental and 49 controls) who were admitted to a training and research hospital in Turkey between December 2018 and May 2019. Individuals assigned to the experimental group received hand massage. The data were obtained with an individual information form, a visual analog scale (VAS), and the State-Trait Anxiety Inventory (STAI). RESULTS The mean age of the participants was 49.52 ± 12.48 years. There was no significant difference between the pain levels of the experimental and control groups (p > .05), but the anxiety level of the experimental group was significantly less than that of the control group (p < .05). There was also a significant difference between the experimental and control groups in terms of systolic and diastolic blood pressure and heart rate. The blood pressure and heart rate of the experimental group decreased significantly (p < .05). CONCLUSION Hand massage was found to be a simple, non-pharmacologic, inexpensive, and independent nursing practice that could be used to reduce anxiety and positively affect vital signs in patients before venipuncture procedure.
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Affiliation(s)
- Saadet Erzincanli
- Department of Nursing, Faculty of Health Sciences, Aksaray University, Aksaray, Turkey.
| | - Kadriye Sayin Kasar
- Department of Nursing, Faculty of Health Sciences, Aksaray University, Aksaray, Turkey
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15
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Mmako NJ, Courtney-Pratt H, Marsh P. Green spaces, dementia and a meaningful life in the community: A mixed studies review. Health Place 2020; 63:102344. [PMID: 32543430 DOI: 10.1016/j.healthplace.2020.102344] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/09/2020] [Accepted: 04/17/2020] [Indexed: 11/15/2022]
Abstract
Engagement in green spaces impacts positively on wellbeing and quality of life. However, little is known about the impacts of green space engagement specifically for people living with the experience of dementia in the community; people with a heightened need to maintain a quality life. In this mixed study review, we explore existing evidence for quality of life impacts of contact with green spaces by people living with dementia in the community. Findings show that gardens and horticultural programs, green care farms, parks, urban woodlands and neighbourhood outdoor environments can impact positively in several ways. Four key mechanisms are identified: Engaging in meaningful activities; Empowerment; Positive risk taking; and Reinforcing Identity. These findings provide conceptual links between psychosocial understandings of the relationships between nature and wellbeing with rights-based dementia discourses. We conclude that evidence specific for people living with dementia in the community setting is growing and there is potential for green spaces to enable an active and meaningful community-life, despite cognitive decline. This is worthy of consideration by policy makers, practitioners and carers. Future studies can broaden this field of research and include investigations into lesser-explored aspects of quality of life, such as spirituality, and methods that incorporate the voices of people living with dementia.
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Affiliation(s)
- Nkolika Janet Mmako
- Wicking Dementia Research & Education Centre, University of Tasmania, Private Bag 143, Hobart, Tasmania, 7001, Australia.
| | - Helen Courtney-Pratt
- Wicking Dementia Research and Education Centre, University of Tasmania, Private Bag 143, Hobart, 7001, Australia.
| | - Pauline Marsh
- Centre for Rural Health, University of Tasmania, Private Bag 103, Hobart, Tasmania, 7001, Australia.
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16
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Lewis K, Livsey L, Naughton RJ, Burton K. Exercise and dementia: what should we be recommending? QUALITY IN AGEING AND OLDER ADULTS 2020. [DOI: 10.1108/qaoa-10-2019-0053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Purpose
Exercise has the potential to provide benefits for people living with dementia, yet the balance of evidence is uncertain. This paper aims to provide an evidence synthesis to determine whether exercise improves their health and well-being and what exercise should be recommended.
Design/methodology/approach
Structured search for existing literature reviews on exercise for dementia. Relevant articles were selected and critically appraised against systematic criteria. The findings from 15 high quality reviews were collated by using a best evidence synthesis approach.
Findings
The evidence is convincing for improving physical health, promising for cognitive benefits, mixed for psychological benefits and limited for behavioural outcomes. No evidence of harm was found. Overall, exercise can improve physical and mental health for people living with dementia: there is sufficient evidence to recommend multimodal exercise.
Social implications
The potential beneficial outcomes are of significant importance both for people with dementia and their caregivers. In the absence of more specific findings, the current recommendation for older adults in general is pragmatically justified – some activity is better than none, more activity provides greater benefits. Adding social interaction may be important for psychological and behavioural outcomes.
Originality/value
To the best of the authors’ knowledge, this paper is the first to encapsulate the literature to date on exercise for dementia. Combining the findings from previous reviews enabled a novel synthesis across the range of relevant interventions and outcomes.
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17
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Wei S, Mai Y, Peng W, Ma J, Sun C, Li G, Liu Z. The effect of nonpharmacologic therapy on global cognitive functions in patients with Alzheimer's disease: an updated meta-analysis of randomized controlled trials. Int J Neurosci 2019; 130:28-44. [PMID: 31251099 DOI: 10.1080/00207454.2019.1638377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background: The effectiveness of non-pharmacologic therapy (NPT) in treating the global cognition dysfunction associated with Alzheimer's disease (AD) has not been clearly demonstrated. Therefore, we performed a meta-analysis to address this issue.Methods: The Cochrane Central Register of Controlled Trials, PUBMED, EMBASE and other databases were searched, and outcomes measured by the Mini-Mental State Examination (MMSE) or the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) were analysed.Results: Seven types of NPT were included, 25 randomized controlled trials (RCTs) were selected and 3238 participants were included in the meta-analysis. There were significant differences between the NPT and control groups in the MMSE and ADAS-cog scores.Conclusions: Although more extensive trials need to be performed, NPT has been observed to be beneficial in AD patients.
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Affiliation(s)
- Shouchao Wei
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Institute of Neurology, Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yingren Mai
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Institute of Neurology, Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Wanjuan Peng
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Institute of Neurology, Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jing Ma
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Institute of Neurology, Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Chaowen Sun
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Institute of Neurology, Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Guangning Li
- Department of Neurology, Huadu District People's Hospital, Southern Medical University, Guangzhou, China
| | - Zhou Liu
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Institute of Neurology, Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
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18
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Cousins E, Tischler V, Garabedian C, Dening T. Principles and features to define and describe arts interventions for people with dementia: a qualitative realist study. Arts Health 2019; 11:202-218. [PMID: 31038435 DOI: 10.1080/17533015.2018.1490787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: There is currently no consensus regarding the definition and description of arts interventions for people with dementia. Developing a common language of classification will encourage reflection on artistic practice, support the evaluation and improvement of arts interventions, and enable their benefits to be communicated more effectively. Methods: Using a qualitative framework derived from taxonomy and realist methodology, a literature review was undertaken to identify what key principles underpin arts interventions. This analysis was complemented by focus groups and workshops incorporating the lived experience of carers, artists, practitioners and care staff. Results: Nine principles were identified as elements present in person-centred arts interventions for people with dementia: Animation, Transcendence, Selfhood, Humanity, Expression, Connection, Possibility, Involvement and Awareness. Conclusions: It is possible to identify the component parts of arts interventions for people with dementia. These principles form an empirical basis for understanding how arts interventions work, while still respecting their individual nature.
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Affiliation(s)
- Emily Cousins
- Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham , Nottingham , UK
| | - Victoria Tischler
- College of Nursing Midwifery and Healthcare, University of West , London , UK
| | - Claire Garabedian
- The Association for Dementia Studies, Institute of Health and Society, University of Worcester , Worcester , UK
| | - Tom Dening
- Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham , Nottingham , UK.,Institute of Mental Health, University of Nottingham , Nottingham , UK
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19
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Cantarella A, Borella E, Faggian S, Navuzzi A, De Beni R. Using dolls for therapeutic purposes: A study on nursing home residents with severe dementia. Int J Geriatr Psychiatry 2018; 33:915-925. [PMID: 29671901 DOI: 10.1002/gps.4872] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 01/16/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Among the psychosocial interventions intended to reduce the behavioral and psychological symptoms of dementia (BPSD), doll therapy (DT) is increasingly used in clinical practice. Few studies on DT have been based on empirical data obtained with an adequate procedure; however, none have assessed its efficacy using an active control group, and the scales used to assess changes in BPSD are usually unreliable. The aim of the present study was to measure the impact of DT on people with severe dementia with a reliable, commonly used scale for assessing their BPSD, and the related distress in formal caregivers. Effects of DT on the former's everyday abilities (ie, eating behavior) were also examined. METHOD Twenty-nine nursing home residents aged from 76 to 96 years old, with severe dementia (Alzheimer's or vascular dementia), took part in the experiment. They were randomly assigned to an experimental group that used dolls or an active control group that used hand warmers with sensory characteristics equivalent to the dolls. Benefits of DT on BPSD and related formal caregiver distress were examined with the Neuropsychiatric Inventory. The effects of DT on eating behavior were examined with the Eating Behavior Scale. RESULTS Only the DT group showed a reduction in BPSD scores and related caregiver distress. DT did not benefit eating behavior, however. CONCLUSIONS This study suggests that DT is a promising approach for reducing BPSD in people with dementia, supporting evidence emerging from previous anecdotal studies.
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Affiliation(s)
- A Cantarella
- Department of General Psychology, University of Padova, Italy
| | - E Borella
- Department of General Psychology, University of Padova, Italy
| | - S Faggian
- Centro Servizi Anni Sereni di Scorzé, Venezia, Italy
| | - A Navuzzi
- Department of General Psychology, University of Padova, Italy
| | - R De Beni
- Department of General Psychology, University of Padova, Italy
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20
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Yakimicki ML, Edwards NE, Richards E, Beck AM. Animal-Assisted Intervention and Dementia: A Systematic Review. Clin Nurs Res 2018; 28:9-29. [PMID: 29441797 DOI: 10.1177/1054773818756987] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This review discusses the relationship between animal-assisted interventions (AAI) and behavioral and psychological symptoms of dementia (BPSD). A systematic search was conducted within CINAHL, Web of Science CAB Abstracts, PubMed, Abstracts in Social Gerontology, Google Scholar, and PsycINFO for primary research articles. A total of 32 studies were included in the final review. Variation was noted in study designs and in study setting. Twenty-seven of 32 studies used dogs as the intervention. Agitation/aggression showed a significant decrease in nine of 15 studies. Eleven of 12 studies demonstrated increased social interaction with AAI. Mood had mixed results in nine studies. Quality of life was increased in three of four studies. Resident activity and nutritional intake were each increased in two studies. Animal assisted activities/interventions showed a strong positive effect on social behaviors, physical activity, and dietary intake in dementia patients and a positive effect on agitation/aggression and quality of life.
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Affiliation(s)
| | | | | | - Alan M Beck
- 1 Purdue University, West Lafayette, IN, USA
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21
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Jamin G, Luyten T, Delsing R, Braun S. The process of co-creating the interface for VENSTER, an interactive artwork for nursing home residents with dementia. Disabil Rehabil Assist Technol 2017; 13:809-818. [PMID: 29037109 DOI: 10.1080/17483107.2017.1385102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Interactive art installations might engage nursing home residents with dementia. The main aim of this article was to describe the challenging design process of an interactive artwork for nursing home residents, in co-creation with all stakeholders and to share the used methods and lessons learned. This process is illustrated by the design of the interface of VENSTER as a case. METHODS Nursing home residents from the psychogeriatric ward, informal caregivers, client representatives, health care professionals and members of the management team were involved in the design process, which consisted of three phases: (1) identify requirements, (2) develop a prototype and (3) conduct usability tests. Several methods were used (e.g. guided co-creation sessions, "Wizard of Oz"). Each phase generated "lessons learned", which were used as the departure point of the next phase. RESULTS Participants hardly paid attention to the installation and interface. There, however, seemed to be an untapped potential for creating an immersive experience by focussing more on the content itself as an interface (e.g. creating specific scenes with cues for interaction, scenes based on existing knowledge or prior experiences). "Fifteen lessons learned" which can potentially assist the design of an interactive artwork for nursing home residents suffering from dementia were derived from the design process. CONCLUSIONS This description provides tools and best practices for stakeholders to make (better) informed choices during the creation of interactive artworks. It also illustrates how co-design can make the difference between designing a pleasurable experience and a meaningful one. Implications for rehabilitation Co-design with all stakeholders can make the difference between designing a pleasurable experience and a meaningful one. There seems to be an untapped potential for creating an immersive experience by focussing more on the content itself as an interface (e.g. creating specific scenes with cues for interaction, scenes based on existing knowledge or prior experiences). Content as an interface proved to be a crucial part of the overall user experience. The case-study provides tools and best practices (15 "lessons learned") for stakeholders to make (better) informed choices during the creation of interactive artworks.
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Affiliation(s)
- Gaston Jamin
- a Maastricht Academy of Media, Design and Technology, Arts Faculty Maastricht , Zuyd University of Applied Sciences , Heerlen , The Netherlands.,b Expertise Centre for Innovative Care and Technology (EIZT) , Research Program "Stimulating Healthy Active Lifestyle" , Heerlen , The Netherlands
| | - Tom Luyten
- a Maastricht Academy of Media, Design and Technology, Arts Faculty Maastricht , Zuyd University of Applied Sciences , Heerlen , The Netherlands.,c Research Centre for Technology in Care , Zuyd University of Applied Sciences , Heerlen , The Netherlands.,f Department of Health Services Research, CAPHRI, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - Rob Delsing
- a Maastricht Academy of Media, Design and Technology, Arts Faculty Maastricht , Zuyd University of Applied Sciences , Heerlen , The Netherlands.,d Faculty of Arts , Research Centre for Technology Driven Art , Zuyd University of Applied Sciences , Maastricht , The Netherlands
| | - Susy Braun
- b Expertise Centre for Innovative Care and Technology (EIZT) , Research Program "Stimulating Healthy Active Lifestyle" , Heerlen , The Netherlands.,e Faculty of Health , Research Centre for Nutrition, Lifestyle and Exercise , Zuyd University of Applied Sciences , Heerlen , The Netherlands.,f Department of Health Services Research, CAPHRI, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
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22
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Regier NG, Hodgson NA, Gitlin LN. Characteristics of Activities for Persons With Dementia at the Mild, Moderate, and Severe Stages. THE GERONTOLOGIST 2017; 57:987-997. [PMID: 27986794 PMCID: PMC5881689 DOI: 10.1093/geront/gnw133] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 06/13/2016] [Indexed: 11/14/2022] Open
Abstract
Purpose To understand activity in dementia care, we examine relationships of disease stage with types and characteristics of meaningful activities (cueing needs, help with initiation, and recommended engagement time) provided in a home-based intervention trial designed to reduce behavioral symptoms. Design and Methods Data involved 158 activity prescriptions or written documents detailing prescribed activities, cueing needs, and engagement goals designed by occupational therapists for 56 families. Activities were categorized as arts and crafts, exercise/physical, cognitive, music/entertainment, manipulation/sensory/sorting, family/social/ reminiscence, and domestic/homemaking. Bivariate correlations examined relationships of activity categories and characteristics with disease stage (mild, moderate, or severe). Kruskal-Wallis H tests examined differences among disease stages and frequency of type of activities prescribed, recommended cues, and engagement time. For significant Kruskal-Wallis tests, pairwise comparisons utilized the Mann-Whitney U test. Results Activity categories and instructions for set up were significantly related to cognitive and functional levels. Persons with mild dementia were most often prescribed complex arts and crafts and cognitive activities. Persons with moderate dementia were most often prescribed music/entertainment. Persons with severe dementia were most often prescribed simple physical exercises and manipulation/sensory/sorting activities. Average time prescribed for activities was less for those in severe (15min) versus moderate (24min) and mild (28min) stages. The severe group required more assistance with activity initiation and cueing/redirection. Implications Type of activity, recommended cueing, and engagement time differed by dementia stage. Findings provide guidance as to how to use and set up activities across the dementia trajectory.
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Affiliation(s)
- Natalie G Regier
- Center for Innovative Care in Aging, Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Nancy A Hodgson
- Center for Innovative Care in Aging, Johns Hopkins University School of Nursing, Baltimore, Maryland
- University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania
| | - Laura N Gitlin
- Center for Innovative Care in Aging, Johns Hopkins University School of Nursing, Baltimore, Maryland
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23
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Cutshall SM, Mahapatra S, Hynes RS, Van Rooy KM, Looker SA, Ghosh A, Schleck CD, Bauer BA, Wahner-Roedler DL. Hand Massage for Cancer Patients Undergoing Chemotherapy as Outpatients: A Pilot Study. Explore (NY) 2017; 13:393-399. [PMID: 29097109 DOI: 10.1016/j.explore.2017.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 06/07/2017] [Accepted: 06/18/2017] [Indexed: 02/07/2023]
Abstract
CONTEXT There are no studies on the effect of volunteer-provided hand massage in a busy chemotherapy outpatient practice. OBJECTIVE To assess the feasibility of introducing hand massage therapy into an outpatient chemotherapy unit and to evaluate the effect of the therapy on various symptoms experienced by cancer patients. DESIGN A pilot, quasi-experimental, pretest-posttest study. SETTING Chemotherapy outpatient clinic of a large tertiary care academic medical center. PATIENTS/PARTICIPANTS Forty chemotherapy outpatients. INTERVENTION After being approached by a trained volunteer from a hand massage team, patients consented to receive a 20-minute hand massage before chemotherapy that was individualized according to patient preference and expressed needs. MAIN OUTCOME MEASURES The visual analog scale (VAS) was used to measure pain, fatigue, anxiety, muscular discomfort, nervousness, stress, happiness, energy, relaxation, calmness, and emotional well-being (on a scale from 0-10) before and after the intervention; a satisfaction survey was administered after the therapy. Patients' demographic data were summarized with descriptive statistics, and VAS total scores were compared between groups at each time point with the two-group t test. Feasibility was evaluated from the number of patients who were approached, received a hand massage, and completed the study surveys. RESULTS Of the 40 participants, 19 were men (mean age, 59.5 years). Significant improvement after hand massage was indicated by VAS scores for fatigue, anxiety, muscular discomfort, nervousness, stress, happiness, energy, relaxation, calmness, and emotional well-being (P < .05). Pain scores also improved, but the difference was not statistically significant (P = .06). All patients indicated that they would recommend hand massage to other patients, and 37 were interested in receiving it during their next chemotherapy treatment.
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Affiliation(s)
| | | | | | | | | | - Aditya Ghosh
- Department of Emergency Medicine, Mayo Clinic, Owatonna, MN
| | - Cathy D Schleck
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
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24
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White PC, Wyatt J, Chalfont G, Bland JM, Neale C, Trepel D, Graham H. Exposure to nature gardens has time-dependent associations with mood improvements for people with mid- and late-stage dementia: Innovative practice. DEMENTIA 2017; 17:627-634. [PMID: 28835119 DOI: 10.1177/1471301217723772] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Exposure to green space and nature has a potential role to play in the care of people with dementia, with possible benefits including improved mood and slower disease progression. In this observational study at a dementia care facility in the UK, we used carer-assessed measures to evaluate change in mood of residents with mid- to late-stage dementia following exposure to a nature garden. We found that exposure to nature was associated with a beneficial change in patient mood. There was a non-linear relationship between time spent outdoors and mood outcome. Improvements in patient mood were associated with relatively short duration exposures to nature, and no additional measureable increases in mood were found with exposures beyond 80-90 minutes duration. Whilst further investigation is required before causality can be determined, these results raise important questions for policy about the integration of outdoor space into the design of dementia care facilities and programmes.
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Affiliation(s)
| | | | | | - J Martin Bland
- Department of Health Sciences, University of York, York, UK
| | | | - Dominic Trepel
- Department of Health Sciences, University of York, York, UK
| | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
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25
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Maclagan LC, Maxwell CJ, Gandhi S, Guan J, Bell CM, Hogan DB, Daneman N, Gill SS, Morris AM, Jeffs L, Campitelli MA, Seitz DP, Bronskill SE. Frailty and Potentially Inappropriate Medication Use at Nursing Home Transition. J Am Geriatr Soc 2017; 65:2205-2212. [PMID: 28752589 DOI: 10.1111/jgs.15016] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND/OBJECTIVES To estimate the prevalence of potentially inappropriate medication (PIM) use among older adults with cognitive impairment or dementia prior to and following admission to nursing homes and in relation to frailty. DESIGN Retrospective cohort study using health administrative databases. SETTING Ontario, Canada. PARTICIPANTS 41,351 individuals with cognitive impairment or dementia, aged 66+ years newly admitted to nursing home between 2011 and 2014. MEASUREMENTS PIMs were defined with 2015 Beers Criteria and included antipsychotics, H2 -receptor antagonists, benzodiazepines, and drugs with strong anticholinergic properties. Medication information was obtained at nursing home admission and in the subsequent 180 days. Multivariable Cox proportional-hazards models were used to assess the impact of frailty status (determined by a 72-item frailty index) on the hazard of starting and discontinuing PIMs. RESULTS At admission, 44% of residents with cognitive impairment or dementia were on a PIM and prevalence varied by frailty (38.7% non-frail, 42.8% pre-frail, and 48.1% frail, P < .001). Following admission, many residents discontinued PIMs (23.5% for antipsychotics, 49.3% benzodiazepines, 32.2% anticholinergics, and 30.9% H2 -receptor antagonists). However, PIMs were also introduced with 10.9% newly started on antipsychotics, benzodiazepines (10.1%), anticholinergics (6.6%), and H2 -receptor antagonists (1.2%). After adjustment for other characteristics, frail residents had a similar risk of PIM discontinuation as non-frail residents except for anticholinergics (HR = 1.21, 95% CI 1.06-1.39) but were more likely to be newly prescribed benzodiazepines (HR = 1.32, 95% CI 1.20-1.44), antipsychotics (HR = 1.36, 1.23-1.49), and anticholinergics (HR = 1.34, 95% CI 1.20-1.50). CONCLUSION Many residents with cognitive impairment or dementia enter nursing homes on PIMs. PIMs are more likely to be started in frail individuals following admission. Interventions to support deprescribing of PIMs should be implemented targeting frail individuals during the transition to nursing home.
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Affiliation(s)
- Laura C Maclagan
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Colleen J Maxwell
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada
| | - Sima Gandhi
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Jun Guan
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Chaim M Bell
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of General Internal Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - David B Hogan
- Divison of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nick Daneman
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sudeep S Gill
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Division of Geriatric Medicine, Queen's University, Kingston, Ontario, Canada.,Providence Care Hospital, Kingston, Ontario, Canada
| | - Andrew M Morris
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of General Internal Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Lianne Jeffs
- Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | | | - Dallas P Seitz
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Division of Geriatric Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Susan E Bronskill
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
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26
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Rouaix N, Retru-Chavastel L, Rigaud AS, Monnet C, Lenoir H, Pino M. Affective and Engagement Issues in the Conception and Assessment of a Robot-Assisted Psychomotor Therapy for Persons with Dementia. Front Psychol 2017; 8:950. [PMID: 28713296 PMCID: PMC5491651 DOI: 10.3389/fpsyg.2017.00950] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 05/23/2017] [Indexed: 11/13/2022] Open
Abstract
The interest in robot-assisted therapies (RAT) for dementia care has grown steadily in recent years. However, RAT using humanoid robots is still a novel practice for which the adhesion mechanisms, indications and benefits remain unclear. Also, little is known about how the robot's behavioral and affective style might promote engagement of persons with dementia (PwD) in RAT. The present study sought to investigate the use of a humanoid robot in a psychomotor therapy for PwD. We examined the robot's potential to engage participants in the intervention and its effect on their emotional state. A brief psychomotor therapy program involving the robot as the therapist's assistant was created. For this purpose, a corpus of social and physical behaviors for the robot and a “control software” for customizing the program and operating the robot were also designed. Particular attention was given to components of the RAT that could promote participant's engagement (robot's interaction style, personalization of contents). In the pilot assessment of the intervention nine PwD (7 women and 2 men, M age = 86 y/o) hospitalized in a geriatrics unit participated in four individual therapy sessions: one classic therapy (CT) session (patient- therapist) and three RAT sessions (patient-therapist-robot). Outcome criteria for the evaluation of the intervention included: participant's engagement, emotional state and well-being; satisfaction of the intervention, appreciation of the robot, and empathy-related behaviors in human-robot interaction (HRI). Results showed a high constructive engagement in both CT and RAT sessions. More positive emotional responses in participants were observed in RAT compared to CT. RAT sessions were better appreciated than CT sessions. The use of a social robot as a mediating tool appeared to promote the involvement of PwD in the therapeutic intervention increasing their immediate wellbeing and satisfaction.
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Affiliation(s)
- Natacha Rouaix
- Sciences and Technology, Université Pierre et Marie CurieParis, France
| | | | - Anne-Sophie Rigaud
- Arts et Métiers ParisTechParis, France.,Broca Hospital, Assistance Publique-Hôpitaux de ParisParis, France.,LUSAGE Living Lab, Research Unit EA4468, Faculty of Medicine, Paris Descartes UniversityParis, France.,CEN STIMCOParis, France
| | - Clotilde Monnet
- Arts et Métiers ParisTechParis, France.,Broca Hospital, Assistance Publique-Hôpitaux de ParisParis, France.,LUSAGE Living Lab, Research Unit EA4468, Faculty of Medicine, Paris Descartes UniversityParis, France
| | - Hermine Lenoir
- Arts et Métiers ParisTechParis, France.,Broca Hospital, Assistance Publique-Hôpitaux de ParisParis, France.,LUSAGE Living Lab, Research Unit EA4468, Faculty of Medicine, Paris Descartes UniversityParis, France
| | - Maribel Pino
- Arts et Métiers ParisTechParis, France.,Broca Hospital, Assistance Publique-Hôpitaux de ParisParis, France.,LUSAGE Living Lab, Research Unit EA4468, Faculty of Medicine, Paris Descartes UniversityParis, France
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Wu J, Wang Y, Wang Z. The effectiveness of massage and touch on behavioural and psychological symptoms of dementia: A quantitative systematic review and meta-analysis. J Adv Nurs 2017; 73:2283-2295. [DOI: 10.1111/jan.13311] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Jie Wu
- School of Nursing; Peking University; Beijing China
| | - Yi Wang
- School of Nursing; Peking University; Beijing China
| | - Zhiwen Wang
- School of Nursing; Peking University; Beijing China
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Vilela VC, Pacheco RL, Latorraca COC, Pachito DV, Riera R. What do Cochrane systematic reviews say about non-pharmacological interventions for treating cognitive decline and dementia? SAO PAULO MED J 2017; 135:309-320. [PMID: 28746664 PMCID: PMC10019848 DOI: 10.1590/1516-3180.2017.0092060617] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 06/06/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND: Dementia is a highly prevalent condition worldwide. Its chronic and progressive presentation has an impact on physical and psychosocial characteristics and on public healthcare. Our aim was to summarize evidence from Cochrane reviews on non-pharmacological treatments for cognitive disorders and dementia. DESIGN AND SETTING: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: Cochrane reviews on non-pharmacological interventions for cognitive dysfunctions and/or type of dementia were included. For this, independent assessments were made by two authors. RESULTS: Twenty-four reviews were included. These showed that carbohydrate intake and validation therapy may be beneficial for cognitive disorders. For dementia, there is a potential benefit from physical activity programs, cognitive training, psychological treatments, aromatherapy, light therapy, cognitive rehabilitation, cognitive stimulation, hyperbaric oxygen therapy in association with donepezil, functional analysis, reminiscence therapy, transcutaneous electrical stimulation, structured decision-making on feeding options, case management approaches, interventions by non-specialist healthcare workers and specialized care units. No benefits were found in relation to enteral tube feeding, acupuncture, Snoezelen stimulation, respite care, palliative care team and interventions to prevent wandering behavior. CONCLUSION: Many non-pharmacological interventions for patients with cognitive impairment and dementia have been studied and potential benefits have been shown. However, the strength of evidence derived from these studies was considered low overall, due to the methodological limitations of the primary studies.
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Affiliation(s)
- Vitória Carvalho Vilela
- Undergraduate Medical Student, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Rafael Leite Pacheco
- Undergraduate Medical Student, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Carolina Oliveira Cruz Latorraca
- Master and Psychologist, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil; and Assistant Researcher, Cochrane Brazil, São Paulo (SP), Brazil.
| | - Daniela Vianna Pachito
- Master of Science, Neurologist and Doctoral Student, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil; and Assistant Researcher, Cochrane Brazil, São Paulo (SP), Brazil.
| | - Rachel Riera
- Doctor and Master of Science, Rheumatologist and Adjunct Professor, Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP); and Assistant Coordinator, Cochrane Brazil, São Paulo (SP), Brazil.
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Luyten T, Braun S, Jamin G, van Hooren S, de Witte L. How nursing home residents with dementia respond to the interactive art installation 'VENSTER': a pilot study. Disabil Rehabil Assist Technol 2017; 13:87-94. [PMID: 28287047 DOI: 10.1080/17483107.2017.1290701] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The goal of this study was (1) to determine whether and how nursing home residents with dementia respond to the interactive art installation in general and (2) to identify whether responses change when the content type and, therefore, the nature of the interaction with the artwork changes. The interactive art installation 'VENSTER' evokes responses in nursing home residents with dementia, illustrating the potential of interactive artworks in the nursing home environment. Frequently observed responses were naming, recognizing or asking questions about depicted content and how the installation worked, physically gesturing towards or tapping on the screen and tapping or singing along to the music. It seemed content matters a lot. When VENSTER is to be used in routine care, the choice of a type of content is critical to the intended experience/usage in practice. In this study, recognition seemed to trigger memory and (in most cases) a verbal reaction, while indistinctness led to asking for more information. When (initially) coached by a care provider, residents actively engaged physically with the screen. Responses differed between content types, which makes it important to further explore different types of content and content as an interface to provide meaningful experiences for nursing home residents. Implications for rehabilitation VENSTER can facilitate different types of responses ranging from verbal reactions to active physical engagement. The choice of a type of content is critical to the intended experience/usage in practice. Activating content seems suitable for use as a meaningful experience during the spare time in between existing activities or therapy. Sessions with interactive content are short (avg. 30 mins) and intense and can therefore potentially be used as an activating therapy, activity or exercise. In order to actively engage residents with dementia, the role of the care provider seems very important.
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Affiliation(s)
- Tom Luyten
- a Research Centre for Technology in Care at Zuyd University of Applied Sciences , Heerlen , The Netherlands.,b School of Public Health and Primary Care at Maastricht University , Maastricht , The Netherlands.,c Maastricht Academy of Media, Design and Technology , Maastricht , The Netherlands.,d Centre of Expertise for Innovative Care and Technology (EIZT) at Zuyd University of Applied Sciences , Heerlen , The Netherlands
| | - Susy Braun
- b School of Public Health and Primary Care at Maastricht University , Maastricht , The Netherlands.,c Maastricht Academy of Media, Design and Technology , Maastricht , The Netherlands.,e Research Centre for Autonomy and Participation at Zuyd University of Applied Sciences , Heerlen , The Netherlands
| | - Gaston Jamin
- c Maastricht Academy of Media, Design and Technology , Maastricht , The Netherlands.,d Centre of Expertise for Innovative Care and Technology (EIZT) at Zuyd University of Applied Sciences , Heerlen , The Netherlands
| | - Susan van Hooren
- f KenVak, Research Centre for Arts Therapies at Zuyd University of Applied Sciences , Heerlen , The Netherlands.,g Faculty of Healthcare, Zuyd University of Applied Sciences , Heerlen , The Netherlands.,h Faculty of Psychology and Educational Sciences, Open University , Heerlen , The Netherlands
| | - Luc de Witte
- a Research Centre for Technology in Care at Zuyd University of Applied Sciences , Heerlen , The Netherlands.,d Centre of Expertise for Innovative Care and Technology (EIZT) at Zuyd University of Applied Sciences , Heerlen , The Netherlands
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Osman SE, Tischler V, Schneider J. 'Singing for the Brain': A qualitative study exploring the health and well-being benefits of singing for people with dementia and their carers. DEMENTIA 2016; 15:1326-1339. [PMID: 25425445 PMCID: PMC5089222 DOI: 10.1177/1471301214556291] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Dementia has detrimental effects on cognitive, psychological and behavioural functioning, as well as significant impact on those who provide care. There is a need to find suitable psychosocial interventions to help manage the condition, enhance well-being, and to provide support for caregivers. This study explored the impact of Singing for the Brain™, an intervention based on group singing activities developed by The Alzheimer's Society for people with dementia and their carers. This qualitative study used semi-structured interviews with people with dementia and their carers. Ten interviews involving 20 participants were analysed thematically. Social inclusiveness and improvements in relationships, memory and mood were found to be especially important to participants. As well as enjoying the sessions, participants found that attending Singing for the Brain™ helped in accepting and coping with dementia.
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Affiliation(s)
| | | | - Justine Schneider
- The Institute of Mental Health, University of Nottingham, Nottingham, UK
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Schuurmans L, Enders-Slegers MJ, Verheggen T, Schols J. Animal-Assisted Interventions in Dutch Nursing Homes: A Survey. J Am Med Dir Assoc 2016; 17:647-53. [PMID: 27184522 DOI: 10.1016/j.jamda.2016.03.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/16/2016] [Accepted: 03/24/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Animal-assisted interventions (AAI) have become more and more popular in nursing homes in the past decade. Various initiatives for using animals in nursing homes have been developed over the years (eg, animal visiting programs, residential companion animals, petting zoos) and, on the whole, the number of nursing homes that refuse animals on their premises has declined. In this survey, we aimed to determine how many Dutch nursing homes offer AAIs, what type of interventions are used, and with what aim. We also focus on the use of underlying health, hygiene, and (animal) safety protocols. METHODS Using an online Dutch nursing home database, we invited all listed (457) nursing home organizations in the Netherlands (encompassing a total of 804 nursing home locations) to participate in our digital survey, powered by SurveyMonkey. The survey consisted of a total of 45 questions, divided into general questions about the use of animals in interventions; the targeted client population(s); and specific questions about goals, guidelines, and protocols. The results were analyzed with SPSS Statistics. RESULTS In the end, 244 surveys, representing 165 organizations, were returned: 125 nursing homes used AAI in one way or another, 40 did not. Nursing homes that did not offer AAI cited allergy and hygiene concerns as the most important reasons. Most nursing homes offering AAI used visiting animals, mostly dogs (108) or rabbits (76). A smaller number of nursing homes had resident animals, either living on the ward or in a meadow outside. Almost all programs involved animal-assisted activities with a recreational purpose; none of the participating nursing homes provided animal assisted therapy with therapeutic goals. Psychogeriatric patients were most frequently invited to participate. A total of 88 nursing homes used alternatives when animals were not an option or not available. The most popular alternative was the use of stuffed animals (83) followed by FurReal Friends robotic toys (14). The sophisticated robot seal Paro was used in 7 nursing homes. A large percentage (80%) of nursing homes that worked with animals did not have AAI-specific health protocols or animal welfare and safety protocols underlying the animal activities or specific selection criteria for the selection of suitable animals. CONCLUSION Most of the participating Dutch nursing homes offer AAI in recreational programs (animal-assisted activities) for psychogeriatric clients (using visiting animals, especially dogs). Most nursing homes do not have specific AAI protocols for animal welfare, hygiene, and safety during animal activities, nor do they employ specific selection criteria for participating animals and their handlers.
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Affiliation(s)
- Lonneke Schuurmans
- Anthrozoology Department, Faculty of Psychology and Educational Sciences, Open University, Herleen, The Netherlands; De Zorgboog, Nursing Home and Healthcare Institution, Bakel, The Netherlands.
| | - Marie-Jose Enders-Slegers
- Anthrozoology Department, Faculty of Psychology and Educational Sciences, Open University, Herleen, The Netherlands
| | - Theo Verheggen
- Anthrozoology Department, Faculty of Psychology and Educational Sciences, Open University, Herleen, The Netherlands
| | - Jos Schols
- Department of Health Services Research, Maastricht University, Maastricht, The Netherlands; Department of General Practice, Maastricht University, Maastricht, The Netherlands
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Johnston B, Narayanasamy M. Exploring psychosocial interventions for people with dementia that enhance personhood and relate to legacy- an integrative review. BMC Geriatr 2016; 16:77. [PMID: 27044417 PMCID: PMC4820853 DOI: 10.1186/s12877-016-0250-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 03/23/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Epidemiological predictions suggest that dementia will continue to rise and that this will have social and economic ramifications. Effective interventions, beyond pharmacological management are needed. Psychosocial interventions have largely been investigated in relation to carers of people with dementia, or with regards to their ability to manage dementia symptoms, improve cognition, and reduce challenging behaviour. However, since dementia is a life-limiting illness and people with dementia are at risk of having their personhood compromised, psychosocial interventions should seek to enhance personhood, and offer the potential for the person to leave a legacy. METHODS An integrative review was carried out to identify, assess, appraise and synthesise studies featuring interventions, which relate to both personhood and legacy. Search strategies were developed in key databases: MEDLINE; PsycINFO; Embase; Joanna Briggs Institute; CINAHL; Cochrane Database of Systematic Reviews; ASSIA. Grey literature was also identified through free-text searches. RESULTS Thirty six articles were included in the final review, these were tabulated and were assessed based on how the intervention related to personhood and legacy. Classification resulted in three themes being identified: Offering aspects of legacy; Acknowledging the person behind the patient; Facilitating meaningful engagement. Generally, personhood aspects of interventions were well reported, but further research is required to explore legacy potential of psychosocial interventions for people with dementia. CONCLUSION The integrative review provides an overview and exploration of an under-researched area, and provides directions for future research, which will help expand the evidence base and ultimately help improve patient care for people with dementia and their families.
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Affiliation(s)
- Bridget Johnston
- Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care, School of Health Sciences, The University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, England, UK.
| | - Melanie Narayanasamy
- Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care, School of Health Sciences, The University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, England, UK
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Barton C, Ketelle R, Merrilees J, Miller B. Non-pharmacological Management of Behavioral Symptoms in Frontotemporal and Other Dementias. Curr Neurol Neurosci Rep 2016; 16:14. [PMID: 26750129 PMCID: PMC4790078 DOI: 10.1007/s11910-015-0618-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Worldwide prevalence of dementia is predicted to double every 20 years. The most common cause in individuals over 65 is Alzheimer's disease (AD), but in those under 65, frontotemporal dementia (FTD) is as frequent. The physical and cognitive decline that characterizes these diseases is commonly accompanied by troublesome behavioral symptoms. These behavioral symptoms contribute to significant morbidity and mortality among both patients and caregivers. Medications have been largely ineffective in managing these symptoms and carry significant adverse effects. Non-pharmacological interventions have been recommended to precede the utilization of pharmacological treatments. This article reviews the research about these interventions with special attention to the variations by etiology, especially FTD. The authors offer recommendations for improving utilization of these strategies and future research recommendations.
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Affiliation(s)
- Cynthia Barton
- Department of Neurology, Memory and Aging Center, University of California, 675 Nelson Rising Lane, Suite 190, Box 1207, San Francisco, CA, 94158, USA.
- School of Nursing, University of California, 2 Koret Way, Box 1207, San Francisco, CA, 94143, USA.
| | - Robin Ketelle
- Department of Neurology, Memory and Aging Center, University of California, 675 Nelson Rising Lane, Suite 190, Box 1207, San Francisco, CA, 94158, USA
- School of Nursing, University of California, 2 Koret Way, Box 1207, San Francisco, CA, 94143, USA
| | - Jennifer Merrilees
- Department of Neurology, Memory and Aging Center, University of California, 675 Nelson Rising Lane, Suite 190, Box 1207, San Francisco, CA, 94158, USA
- School of Nursing, University of California, 2 Koret Way, Box 1207, San Francisco, CA, 94143, USA
| | - Bruce Miller
- Department of Neurology, Memory and Aging Center, University of California, 675 Nelson Rising Lane, Suite 190, Box 1207, San Francisco, CA, 94158, USA
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Predictive Factors for the Uptake of Coping Strategies by Spousal Dementia Caregivers. Alzheimer Dis Assoc Disord 2016; 30:80-91. [DOI: 10.1097/wad.0000000000000105] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Park H, Chun Y, Gang MS. Effects of the Patient-Centered Environment Program on Behavioral and Emotional Problems in Home-Dwelling Patients With Dementia. J Gerontol Nurs 2015; 41:40-8. [DOI: 10.3928/00989134-20151111-02] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 09/09/2015] [Indexed: 11/20/2022]
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36
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Cai FF, Zhang H. Effect of therapeutic touch on agitated behavior in elderly patients with dementia: A review. Int J Nurs Sci 2015. [DOI: 10.1016/j.ijnss.2015.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Lancioni GE, Bosco A, De Caro MF, Singh NN, O'Reilly MF, Green VA, Ferlisi G, Zullo V, D'Amico F, Addante LM, Denitto F, Zonno N. Effects of response-related music stimulation versus general music stimulation on positive participation of patients with Alzheimer's disease. Dev Neurorehabil 2015; 18:169-76. [PMID: 23869934 DOI: 10.3109/17518423.2013.802388] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Assessing the effects of response-related music stimulation versus general (response-unrelated) music stimulation on positive participation of 11 new patients with Alzheimer's disease. METHOD The patients were functioning in the severe and low-moderate ranges of the disease. Positive participation included behaviors such as, singing or rhythmic movements and smiles. Both music conditions relied on the display of music/song videos on a computer screen. In the response-related (active) condition, the patients used a simple hand response and a microswitch to determine music stimulation inputs. In the general (unrelated/passive) condition, music stimulation was automatically presented throughout the sessions. RESULTS Data showed that six of the 11 patients had higher levels of positive participation in the response-related stimulation condition. The remaining five patients did not have differences between the two conditions. CONCLUSION Based on this evidence and previous findings, one might consider the use of the active condition beneficial for daily programs.
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Affiliation(s)
- Giulio E Lancioni
- Department of Neuroscience and Sense Organs, University of Bari , Bari , Italy
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Staedtler AV, Nunez D. Nonpharmacological Therapy for the Management of Neuropsychiatric Symptoms of Alzheimer's Disease: Linking Evidence to Practice. Worldviews Evid Based Nurs 2015; 12:108-15. [DOI: 10.1111/wvn.12086] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Amber V. Staedtler
- Registered Nurse and DNP Student, Arizona State University; College of Nursing & Health Innovation; Phoenix AZ USA
| | - Diane Nunez
- Clinical Associate Professor, Arizona State University; College of Nursing & Health Innovation; Phoenix AZ USA
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A study of the effectiveness of MP3 players to support family carers of people living with dementia at home. Int Psychogeriatr 2015; 27:471-9. [PMID: 25247750 DOI: 10.1017/s1041610214001999] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Music can be therapeutic to people with dementia; however, little is known about its effect on the family carers. This project aimed to (1) assess the effects of MP3 player use by a person with dementia on caregivers' mental health and wellbeing, including their self-care and health-promoting behavior and (2) determine whether MP3 player use increases caregivers' self-reported capacity to cope with their role. METHODS A pre-post quantitative and qualitative design was used. Carers completed a survey prior to commencing and four weeks after using the player. The survey included validated measures to assess the level of stress and coping among carers. Carers also kept a diary of the way they used the MP3 player. Half of the carers were interviewed about their experiences at the end of the study. RESULTS Of 59 people who started using the MP3 player, 51 carers completed the four-week study period and surveys. Use of the MP3 player significantly decreased psychological distress, significantly improved the mental health and wellbeing of carers, significantly increased caregiver self-efficacy to manage symptoms of dementia, and was reported to provide valued respite from the high level of vigilance required for caring for a person with dementia. CONCLUSION An MP3 player loaded with music can be a low cost and relatively simple and effective additional strategy to support families caring for people with dementia in the community.
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McFadden G, Gillespie M. Application of reminiscence therapy for dementia in practice. ACTA ACUST UNITED AC 2014. [DOI: 10.12968/bjmh.2014.3.6.272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Mark Gillespie
- Nursing Lecturer, School of Nursing and Midwifery, University of the West of Scotland
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Christensen JJ, Castañeda H. Danger and dementia: caregiver experiences and shifting social roles during a highly active hurricane season. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2014; 57:825-844. [PMID: 24892232 DOI: 10.1080/01634372.2014.898009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study examined disaster preparedness and decision-making by caregivers of community-dwelling persons diagnosed with Alzheimer's or a related dementia (ADRD). Interviews were conducted with 20 caregivers in South Florida. Twelve of these interviews include caregiving experiences during the highly active 2004-2005 hurricane seasons. Results indicate that persons in earlier stages of ADRD can, and often do, remain engaged in the disaster preparation and planning process. However, during the early stages, persons may also resist evacuation, even if the caregiver felt it was necessary. During later stages of the disease, caregivers reported less resistance to disaster-related decisions, however, with the tradeoff of less ability to assist with preparation.
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Braun SM, Kleynen M, Bleijlevens MHC, Moser A, Beurskens AJ, Lexis MA. “Interactive surfaces” technology as a potential tool to stimulate physical activity in psychogeriatric nursing home residents. Disabil Rehabil Assist Technol 2014; 10:486-492. [DOI: 10.3109/17483107.2014.904449] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Marciniak R, Sheardova K, Cermáková P, Hudeček D, Sumec R, Hort J. Effect of meditation on cognitive functions in context of aging and neurodegenerative diseases. Front Behav Neurosci 2014; 8:17. [PMID: 24478663 PMCID: PMC3903052 DOI: 10.3389/fnbeh.2014.00017] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 01/11/2014] [Indexed: 12/31/2022] Open
Abstract
Effect of different meditation practices on various aspects of mental and physical health is receiving growing attention. The present paper reviews evidence on the effects of several mediation practices on cognitive functions in the context of aging and neurodegenerative diseases. The effect of meditation in this area is still poorly explored. Seven studies were detected through the databases search, which explores the effect of meditation on attention, memory, executive functions, and other miscellaneous measures of cognition in a sample of older people and people suffering from neurodegenerative diseases. Overall, reviewed studies suggested a positive effect of meditation techniques, particularly in the area of attention, as well as memory, verbal fluency, and cognitive flexibility. These findings are discussed in the context of MRI studies suggesting structural correlates of the effects. Meditation can be a potentially suitable non-pharmacological intervention aimed at the prevention of cognitive decline in the elderly. However, the conclusions of these studies are limited by their methodological flaws and differences of various types of meditation techniques. Further research in this direction could help to verify the validity of the findings and clarify the problematic aspects.
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Affiliation(s)
- Rafał Marciniak
- International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Katerina Sheardova
- International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Pavla Cermáková
- International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic ; Alzheimer's Disease Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden
| | - Daniel Hudeček
- International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Rastislav Sumec
- International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Jakub Hort
- International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic ; Memory Disorders Clinic, Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol , Prague , Czech Republic
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James IA, Hope A. Relevance of emotions and beliefs in the treatment of behaviors that challenge in dementia patients. Neurodegener Dis Manag 2013. [DOI: 10.2217/nmt.13.60] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Behavior and psychological symptoms of dementia (BPSD) is a term that is used to describe problematic behaviors perpetrated by people with progressive cognitive decline. Until recently, a rather medicalized perspective was used for BPSD and, thus, the treatments chiefly involved the use of psychotropic medication. Empirical evidence suggests that such treatments are largely ineffective and highly problematic. Indeed, for 1% of people receiving antipsychotics, such treatment is lethal. Owing to such issues, nonpharmacological therapies have been suggested as first-line treatments. However, owing to poor training and resources, and an inadequate evidence-base for many psychosocial approaches, the use of inappropriate medication remains common. This article takes a biopsychosocial view of BPSD, preferring the term ‘behaviors that challenge‘, illustrating that these behaviors are products of a number of factors, both individualistic and systemic. In this article, the roles of emotions and beliefs systems are highlighted, with specific examples given for interventions for anger in those with dementia. It demonstrates the vital role of working with healthcare systems, in particular carers, to bring about resolution. A new stepped-care model of treatment for behaviors that challenge is also presented. This model, recently presented to UK Parliament by James, is intended to encourage the use of evidence-based nonpharmacological strategies as alternatives to antipsychotics. This article is the first to illustrate the utility of the model with core study material.
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Affiliation(s)
- Ian Andrew James
- Newcastle Psychology & Challenging Behaviour, Dementia Services, Northumbria University, NTW NHS Foundation Trust, Older Peoples‘ Mental Health Services, Centre for the Health of the Elderlym, Campus for Ageing & Vitality (Formerly Newcastle General Hospital), Westgate Road, Newcastle upon Tyne, NE4 6BE, UK
| | - Angela Hope
- Challenging Behaviour Project, Dementia Services, Northumbria University, NTW NHS Foundation Trust, Older Peoples‘ Mental Health Services, Centre for the Health of the Elderlym, Campus for Ageing & Vitality (Formerly Newcastle General Hospital), Westgate Road, Newcastle upon Tyne, NE4 6BE, UK
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Cohen-Mansfield J. Nonpharmacologic Treatment of Behavioral Disorders in Dementia. Curr Treat Options Neurol 2013; 15:765-85. [DOI: 10.1007/s11940-013-0257-2] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lancioni GE, Singh NN, O'Reilly MF, Green VA, Ferlisi G, Ferrarese G, Zullo V, Perilli V, Cassano G, Cordiano N, Pinto K, Zonno N. Self-regulated music stimulation for persons with Alzheimer's disease: impact assessment and social validation. Dev Neurorehabil 2013; 16:17-26. [PMID: 23030807 DOI: 10.3109/17518423.2012.707693] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess the impact and the social rating of an active music condition (in which 10 patients with Alzheimer's disease regulated their music input) vs. a passive music condition. METHOD In the active condition, the patients used a simple hand response and a microswitch to activate music stimulation periods. In the passive condition, music stimulation was prearranged and continued through the sessions. The active and passive stimulation sessions were preceded and followed by control (non-stimulation) sessions. RESULTS The active condition sessions showed an increase in the patients' indices of positive participation (e.g., singing or music-related movements, and smiles) similar to that observed in the passive condition sessions. Social raters (140 psychology students) favored the active condition on a six-item questionnaire dealing, among others, with conditions' suitability, respect of patients' dignity and independence, and practicality. CONCLUSION An active music stimulation condition can be viable, effective, and socially preferable.
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Affiliation(s)
- Giulio E Lancioni
- Department of Neuroscience and Sense Organs, University of Bari, Bari, Italy.
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Abstract
There is a need to develop nonpharmacological treatments and methods which can serve as alternatives or complements to medications in dementia care. Previous research indicates that animal-assisted intervention (AAI) can be beneficial. The purpose of the present pilot project was to evaluate effects of AAI on quality of life (QoL) in people with dementia in four Swedish nursing homes. A pretest/posttest research design was used. Twenty people (12 women, 8 men; aged 58 to 88) were included. Nine people completed the intervention which comprised 10 training sessions with a certified therapy dog team. QoL improved in the expected direction after the intervention ( p = .035). Even though the effects of AAI may not be discernible over longer periods of time, there are still immediate effects which can promote better QoL for people living with dementia diseases.
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Ridder HMO, Stige B, Qvale LG, Gold C. Individual music therapy for agitation in dementia: an exploratory randomized controlled trial. Aging Ment Health 2013; 17:667-78. [PMID: 23621805 PMCID: PMC4685573 DOI: 10.1080/13607863.2013.790926] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Accepted: 03/22/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Agitation in nursing home residents with dementia leads to increase in psychotropic medication, decrease in quality of life, and to patient distress and caregiver burden. Music therapy has previously been found effective in treatment of agitation in dementia care but studies have been methodologically insufficient. The aim of this study was to examine the effect of individual music therapy on agitation in persons with moderate/severe dementia living in nursing homes, and to explore its effect on psychotropic medication and quality of life. METHOD In a crossover trial, 42 participants with dementia were randomized to a sequence of six weeks of individual music therapy and six weeks of standard care. Outcome measures included agitation, quality of life and medication. RESULTS Agitation disruptiveness increased during standard care and decreased during music therapy. The difference at -6.77 (95% CI (confidence interval): -12.71, -0.83) was significant (p = 0.027), with a medium effect size (0.50). The prescription of psychotropic medication increased significantly more often during standard care than during music therapy (p = 0.02). CONCLUSION This study shows that six weeks of music therapy reduces agitation disruptiveness and prevents medication increases in people with dementia. The positive trends in relation to agitation frequency and quality of life call for further research with a larger sample.
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Affiliation(s)
- Hanne Mette O Ridder
- Doctoral Programme in Music Therapy, Department of Communication & Psychology, Aalborg University, Aalborg Øst, Denmark.
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Lancioni GE, O'Reilly MF, Singh NN, Sigafoos J, Grumo G, Pinto K, Stasolla F, Signorino M, Groeneweg J. Assessing the impact and social perception of self-regulated music stimulation with patients with Alzheimer's disease. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:139-146. [PMID: 22944256 DOI: 10.1016/j.ridd.2012.07.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 07/25/2012] [Indexed: 06/01/2023]
Abstract
We assessed the impact and social rating of an active and a passive music condition implemented with six patients with Alzheimer's disease. In the active condition, the patients used a simple hand response and a microswitch to self-regulate music stimulation inputs. In the passive condition, music stimulation was automatically presented throughout the sessions. Active and passive stimulation sessions were preceded and followed by control (non-stimulation) sessions. The active condition sessions showed an increase in the patients' indices of positive participation (e.g., singing or music-related movements, and smiles) greater than that observed in the passive condition sessions for five of the six patients. Positive intervention effects could also spread to the post-intervention sessions. Social raters (42 care and rehabilitation staff members working with persons with multiple disabilities) favored the active condition on a six-item questionnaire dealing with, among others, conditions' suitability, respect of patients' dignity and independence, and practicality. The implications of the findings as to the plausibility/desirability of an active stimulation condition were discussed.
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Affiliation(s)
- Giulio E Lancioni
- Department of Neuroscience and Sense Organs, University of Bari, Bari, Italy.
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Nordgren L, Engström G. Effects of animal-assisted therapy on behavioral and/or psychological symptoms in dementia: a case report. Am J Alzheimers Dis Other Demen 2012; 27:625-32. [PMID: 23100630 PMCID: PMC10845456 DOI: 10.1177/1533317512464117] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
BACKGROUND Recently, interest in nonpharmaceutical interventions in dementia care has increased. Animal-assisted therapy has been shown to be one promising intervention but more knowledge is needed. The present article reports on a pilot study involving an 84-year-old woman with vascular dementia who was systematically trained with a therapy dog team for 8 weeks. METHODS A quasi-experimental longitudinal interventional design with pre-post measures was used. Data were collected on 3 occasions. Descriptive statistics were used for data analysis. RESULTS Some effects on the woman's ability to walk and move were identified. In addition, some effects in the woman's cognitive state were observed. CONCLUSIONS Physical, psychological, and/or social training with certified therapy dog teams can have effects on behavioral and psychological symptoms in people living with dementia. Further research is needed.
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Affiliation(s)
- Lena Nordgren
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden.
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