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Mathews G, Li X, Wilkinson H. The role and impact of therapeutic counselling on the emotional experience of adults living with dementia: A systematic review. DEMENTIA 2024; 23:882-902. [PMID: 38626888 PMCID: PMC11163847 DOI: 10.1177/14713012241233765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Introduction There is limited psychological support available to help people living with dementia to deal with the emotional consequences of their condition. Anxiety and depression are commonly experienced in this population, yet the use of counselling and psychotherapeutic interventions is not well documented. Aim This systematic review sought to understand the current knowledge on the role and impact of therapeutic counselling on the emotional experience of adults living with dementia. Methods Qualitative and quantitative research designs were accepted for review. A comprehensive search of the main biomedical, nursing and other specialist databases was performed to access articles published between 2015 and 2022. Trial registers and academic journals were also searched. 43 original studies were included: qualitative (n = 15); RCTs (n = 9); other designs (n = 19); plus eight systematic reviews. Results The majority of studies were conducted in Europe, the United Kingdom in particular, although a range of countries from across the globe were represented. The combined evidence from the different study designs suggest a range of ways that people living with different stages of dementia can participate in, and gain emotional benefit from, therapeutic counselling. Key themes identified: (1) The emotional and well-being benefits of therapeutic counselling; (2) No one size fits all - relational and tailored approaches driven by person-centred values; (3) Training, supervision and building community for counsellors; (4) Involvement of people with dementia in therapeutic interventions. Conclusions Our findings from this systematic review show that different therapeutic approaches have been tested with people at different stages of a dementia diagnosis. The results suggest the value of therapeutic counselling as a supportive medium to help with the processing and coping of difficult emotions and feelings across the trajectory of a dementia illness.
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Affiliation(s)
- Gill Mathews
- Edinburgh Centre for Research on the Experience of Dementia (ECRED), School of Health in Social Science, University of Edinburgh, UK
| | - Xiaoyang Li
- Edinburgh Centre for Research on the Experience of Dementia (ECRED), School of Health in Social Science, University of Edinburgh, UK
| | - Heather Wilkinson
- Edinburgh Centre for Research on the Experience of Dementia (ECRED), School of Health in Social Science, University of Edinburgh, UK
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Huan T, Intrator O, Simning A, Boockvar K, Grabowski DC, Cai S. Mental Health Treatment Among Nursing Home Residents With Alzheimer's Disease and Related Dementias. J Am Med Dir Assoc 2024; 25:105088. [PMID: 38885931 DOI: 10.1016/j.jamda.2024.105088] [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: 02/15/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVES To examine the prevalence of mental health treatment among nursing home (NH) long-stay residents with Alzheimer's disease and related dementias (ADRD) and explore factors associated with utilization. DESIGN Retrospective cohort study. Minimum Data Set data (April 2017-September 2018), Medicare Master Beneficiary Summary File, Part B Carrier file and Part D prescription file were used to identify mental illness and ADRD diagnoses, patient characteristics, and mental health treatment. SETTING AND PARTICIPANTS All US Medicare- or Medicaid-certified NHs. Fee-for-service Medicare beneficiaries aged 65 and older who had a quarterly or annual Minimum Data Set assessment with ADRD and were enrolled in Medicare Parts B and D. Two cohorts: residents with both ADRD and psychiatric disorders; residents with ADRD only. METHODS Primary outcomes: receipt of (1) any mental health treatment (medication or psychotherapy); (2) any psychotherapy in a calendar quarter. SECONDARY OUTCOMES antipsychotics, antidepressants, hypnotics, antiepileptics, short-session ( ≤ 30 minutes), long-session ( ≥ 45 minutes), and family/group psychotherapy. Covariates included predisposing, enabling characteristics, and needs factors. Generalized Estimating Equation models of quarterly data, nested within patients, were estimated for each outcome among each cohort. RESULTS Analyses included 1,913,945 resident-quarter observations from 503,077 unique NH long-stay residents. Overall, 68.5% of NH long-stay residents with ADRD have psychiatric disorders; of these, 85% received mental health treatment. African American or Hispanic residents were less likely to use antidepressants. African American residents or residents living in rural locations were less likely to receive long-session psychotherapy. Hispanic residents were more likely to receive long-session psychotherapy. Residents in minority groups were more likely to receive group/family psychotherapy. CONCLUSIONS AND IMPLICATIONS Most of NH long-stay residents with ADRD had psychiatric disorders and most of them received treatment. Antidepressants or long-session psychotherapy were less likely to be provided to African American residents. Factors that determine the efficacy of mental health treatment and reasons for the racial disparities require further exploration.
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Affiliation(s)
- Tianwen Huan
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA; Geriatrics and Extended Care Data and Analysis Center, Canandaigua VA Medical Center, Canandaigua, NY, USA.
| | - Orna Intrator
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA; Geriatrics and Extended Care Data and Analysis Center, Canandaigua VA Medical Center, Canandaigua, NY, USA
| | - Adam Simning
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA; Department of Psychiatry, University of Rochester, Rochester, NY, USA
| | - Kenneth Boockvar
- Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama, Birmingham, AL, USA; Geriatrics Research, Education, and Clinical Center, Birmingham VA Health Care System, Birmingham, AL, USA
| | - David C Grabowski
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Shubing Cai
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA; Geriatrics and Extended Care Data and Analysis Center, Canandaigua VA Medical Center, Canandaigua, NY, USA
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Kårelind F, Finkel D, Zarit SH, Wijk H, Bielsten T, Johansson L. Post-diagnostic support for persons with young-onset dementia - a retrospective analysis based on data from the Swedish dementia registry SveDem. BMC Health Serv Res 2024; 24:649. [PMID: 38773535 PMCID: PMC11110303 DOI: 10.1186/s12913-024-11108-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/14/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Approximately 3.9 million persons worldwide have young-onset dementia. Symptoms related to young-onset dementia present distinct challenges related to finances, employment, and family. To provide tailored support, it is important to gain knowledge about the formal support available for persons with young-onset dementia. Therefore, this paper aims to describe formal support for persons with young-onset dementia in Sweden and the factors influencing this support. METHODS This retrospective study used data on persons under 65 years of age (n = 284) from The Swedish Registry for Cognitive/Dementia Disorders (SveDem) between 2021 and 2022. SveDem was established to monitor the quality of dementia care in Sweden. Characteristics of participants were obtained, including age, sex, dementia diagnosis, MMSE, medications, accommodation, and care setting. Descriptive statistics and logistic regression were used to test for associations between participant characteristics and post-diagnostic support. RESULTS Information and educational support were usually offered to the person with young-onset dementia (90.1%) and their family (78.9%). Approximately half of the sample were offered contact with a dementia nurse (49.3%), counsellor (51.4%), or needs assessor (47.9%). A minority (28.5%) were offered cognitive aids. Six regression models were conducted based on participant characteristics to predict the likelihood that persons were offered support. Support was not predicted by age, sex, children at home, accommodation, or medications. Lower MMSE scores (p < .05) and home help (p < .05) were significantly associated with offer of a needs assessor. Living together was a significant predictor (p < .01) for information and educational support offered to the family. Care setting significantly predicted (p < .01) an offer of information and educational support for the person and family members, as well as contact with a counsellor. CONCLUSION This study indicates potential formal support shortages for persons with young-onset dementia in some areas of dementia care. Despite equal support across most characteristics, disparities based on care setting highlight the importance of specialised dementia care. Pre-diagnostic support is minimal, indicating challenges for persons with young-onset dementia to access these services before diagnosis. While our study has identified areas in need of improvement, we recommend further research to understand the changing support needs of those with young-onset dementia.
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Affiliation(s)
- Fanny Kårelind
- Studies on Integrated Health and Welfare (SIHW), Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Deborah Finkel
- Studies on Integrated Health and Welfare (SIHW), Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Center for Economic and Social Research, University of Southern California, Los Angeles, USA
| | - Steven H Zarit
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Human Development and Family Studies, Penn State University, University Park, USA
| | - Helle Wijk
- Institute of Health and Care Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Therese Bielsten
- Studies on Integrated Health and Welfare (SIHW), Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Linda Johansson
- Studies on Integrated Health and Welfare (SIHW), Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Chou MY, Wong YC, Wang SY, Chi CH, Wang TH, Huang MJ, Huang PH, Li PH, Wang MF. Potential antidepressant effects of a dietary supplement from Huáng qí and its complex in aged senescence-accelerated mouse prone-8 mice. Front Nutr 2023; 10:1235780. [PMID: 37575325 PMCID: PMC10421658 DOI: 10.3389/fnut.2023.1235780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Healthcare is an emerging industry with significant market potential in the 21st century. Therefore, this study aimed to evaluate the benefits of tube feeding Huáng qí and its complexes for 8 weeks on 3-month-old senescence-accelerated mouse prone-8 (SAMP8) mice, 48 in total, randomly divided into 3 groups including control, Huáng qí extract [820 mg/kg Body weight (BW)/day], and Huáng qí complexes (6.2 mL /kg BW/day), where each group consisted of males (n = 8) and females (n = 8). Behavioral tests (locomotion test and aging score assessment on week 6, the single-trial passive avoidance test on week 7, and the active shuttle avoidance test on week 8) were conducted to evaluate the ability of the mice to learn and remember. In addition, after sacrificing the animals, the blood and organs were measured for antioxidant and aging bioactivities, including malondialdehyde (MDA) content and superoxide dismutase (SOD) activity and catalase activities (CAT), and the effects on promoting aging in SAMP8 mice were investigated. The findings showed that Huáng qí enhanced locomotor performance and had anti-aging effects, with positive effects on health, learning, and memory in SAMP-8 mice (p < 0.05), whether applied as a single agent (820 mg/kg BW/day) or as a complex (6.2 mL/kg BW/day) (p < 0.05). Based on existing strengths, a more compelling platform for clinical validation of human clinical evidence will be established to enhance the development and value-added of astragalus-related products while meeting the diversified needs of the functional food market.
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Affiliation(s)
- Ming-Yu Chou
- School of Business, Qanzhou Vocational and Technical University, Jinjiang, China
- International Aging Industry Research & Development Center (AIC), Providence University, Taichung, Taiwan (R.O.C.)
| | - Yue-Ching Wong
- Department of Nutrition, Chung Shan Medical University, Taichung, Taiwan (R.O.C.)
| | - Shih-Yi Wang
- International Aging Industry Research & Development Center (AIC), Providence University, Taichung, Taiwan (R.O.C.)
| | - Ching-Hsin Chi
- International Aging Industry Research & Development Center (AIC), Providence University, Taichung, Taiwan (R.O.C.)
| | - Teng-Hsu Wang
- PhytoHealth Corporation, Taipei city, Taiwan (R.O.C.)
| | - Mao-Jung Huang
- School of General Education, Hsiuping University of Science and Technology, Taichung, Taiwan (R.O.C.)
| | - Ping-Hsiu Huang
- School of Food, Jiangsu Food and Pharmaceutical Science College, Huai’an, China
| | - Po-Hsien Li
- Department of Food and Nutrition, Providence University, Taichung, Taiwan (R.O.C.)
| | - Ming-Fu Wang
- International Aging Industry Research & Development Center (AIC), Providence University, Taichung, Taiwan (R.O.C.)
- Department of Food and Nutrition, Providence University, Taichung, Taiwan (R.O.C.)
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Sass C, Griffiths AW, Shoesmith E, Charura D, Nicholson P. Delivering effective counselling for people with dementia and their families: Opportunities and challenges. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Cara Sass
- Centre for Dementia Research Leeds Beckett University Leeds UK
- Leeds Institute of Health Sciences University of Leeds Leeds UK
| | - Alys Wyn Griffiths
- Centre for Dementia Research Leeds Beckett University Leeds UK
- Institute of Population Health University of Liverpool Liverpool UK
| | - Emily Shoesmith
- Centre for Dementia Research Leeds Beckett University Leeds UK
- Department of Health Sciences University of York York UK
| | - Divine Charura
- School of Health and Community Studies Leeds Beckett University Leeds UK
- School of Education, Language and Psychology York St John University York UK
| | - Paul Nicholson
- School of Health and Community Studies Leeds Beckett University Leeds UK
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Griffiths AW, Shoesmith E, Sass C, Nicholson P, Charura D. Relational counselling as a psychosocial intervention for dementia: Qualitative evidence from people living with dementia and family members. DEMENTIA 2021; 20:2091-2108. [PMID: 33382000 PMCID: PMC8361473 DOI: 10.1177/1471301220984912] [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] [Indexed: 11/16/2022]
Abstract
Counselling and other psychotherapeutic interventions can be offered to people with
dementia and their caregivers, to treat specific conditions or symptoms (e.g. affective
disorders such as depression). Psychotherapeutic interventions also offer the opportunity
for individuals with dementia and their families/caregivers to engage in psychological
support for a wide range of presentations. However, little is known about how those within
this demographic who receive these interventions perceive the experience. This study aimed
to understand the experiences of individuals with dementia or caring for someone with
dementia, before and after a 12-week relational counselling intervention delivered through
a third sector organisation within England. Semi-structured interviews were completed with
participants (29 pre-intervention and 25 post-intervention). Framework analysis was
conducted, with four main themes identified; expectations and outcomes of counselling,
emotional impact of life with dementia, appraisals of identity and importance of
therapeutic relationship. Participants reported that counselling interventions addressed a
range of needs and concerns that they had, enabling them to reassess and reconsider these.
Specific training is needed before therapists deliver therapeutic interventions with
people with dementia, to ensure that appropriate support is provided for those with more
severe cognitive impairment or who may have fluctuating capacity. Future research should
explore the experiences of people with dementia and their caregivers, across different
counselling modalities, to establish the appropriateness and effectiveness of relational
counselling.
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Affiliation(s)
- Alys Wyn Griffiths
- School of Health & Community Studies, Leeds Beckett University, Leeds, UK
| | - Emily Shoesmith
- School of Health & Community Studies, Leeds Beckett University, Leeds, UK; Department of Health Sciences, University of York, UK
| | - Cara Sass
- School of Health & Community Studies, Leeds Beckett University, Leeds, UK; Leeds Institute of Health Sciences, University of Leeds, UK
| | - Paul Nicholson
- School of Health & Community Studies, Leeds Beckett University, Leeds, UK
| | - Divine Charura
- School of Health & Community Studies, Leeds Beckett University, Leeds, UK; School of Education, Language & Psychology, York St John University, UK
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