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Bourgeois C, Brigaud E, Louis E, Azzoune L, Gambonnet M, Vitou V, Jeandel C, Erkes J, Bayard S. Unlocking the benefits of montessori-based reading activities in nursing home: A multiple baseline study on groups of individuals with severe dementia. DEMENTIA 2024:14713012241270805. [PMID: 39102610 DOI: 10.1177/14713012241270805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
OBJECTIVE Group activities are commonly offered to residents of nursing homes, and increasingly with a person-centred care approach. The aim of this study is to compare the impacts of a Montessori-based reading activity with a more traditional reading activity. METHOD A multiple baseline design was used, with 3 groups of 5 older adults with moderate to severe dementia. All sessions were videorecorded and analysed by independent judges, blinded to our hypotheses and conditions. Impacts of the type of activity (storytelling or Montessori-based reading) on verbal interactions, engagement level, affect and behavioural aspects were estimated with both visual analyses and statistical analyses using the between-case standardised mean differences method. RESULTS Significant differences were found in favour of the Montessori-based activities with regard to the number of verbal interactions, constructive and passive engagement and positive affect expressed, with moderate to large effect size (from 0.46 to 1.66). CONCLUSION The Montessori-based reading group activity really seems to be preferable to a more traditional storytelling activity, with multiple benefits for residents. Depending on the preserved abilities and interests of the participants, it can also be aimed at people with severe dementia.
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Affiliation(s)
- Cécile Bourgeois
- EPSYLON EA 4556, University Paul Valéry Montpellier 3, France
- Fondation Partage et Vie, France
| | | | - Ella Louis
- LIP-PC2S EA 4145, University Savoie Mont Blanc, France
| | - Lynda Azzoune
- EPSYLON EA 4556, University Paul Valéry Montpellier 3, France
| | - Marie Gambonnet
- EPSYLON EA 4556, University Paul Valéry Montpellier 3, France
| | | | - Claude Jeandel
- Fondation Partage et Vie, France
- Geriatrics Department, Montpellier University Hospital, France
| | - Jérôme Erkes
- EPSYLON EA 4556, University Paul Valéry Montpellier 3, France
- AG&D, France
| | - Sophie Bayard
- EPSYLON EA 4556, University Paul Valéry Montpellier 3, France
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Kong L, Zhang X, Zhu X, Meng L, Zhang Q. Effects of Otago Exercise Program on postural control ability in elders living in the nursing home: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e33300. [PMID: 36930130 PMCID: PMC10019243 DOI: 10.1097/md.0000000000033300] [Citation(s) in RCA: 2] [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: 11/02/2022] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Losing postural control ability and related injuries are of particular concern for elders living in the nursing home (NH). The Otago Exercise Program (OEP) is a multimodal exercise training program initially designed as an individually tailored home exercise for community-dwelling elders, but whether its movement characteristics and exercise intensity meet NH elders' needs still needs to be clarified. This study aimed to determine the effects of the OEP in enhancing postural control ability among elders in the NH. METHODS A systematic literature search of English language databases (Cochrane Library, PubMed, EMBASE, CINAHL, and Web of Science) and Chinese language databases (China National Knowledge Infrastructure, Wanfang, and Chongqing VIP) until 15 April 2022 were performed by 2 reviewers on searching randomized controlled trial (RCT) and non-RCT. A meta-analysis was performed using Review Manager 5.3 software. Continuous data were expressed as mean difference (MD) with 95% confidence intervals (95% CI). Dichotomous data were presented as risk ratios (RRs) with 95% CI. Study methodological quality was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions for RCTs and Risk Of Bias In Non-randomized Studies-of Interventions for non-RCTs by 3 reviewers. RESULTS Nine studies with 546 participants were included in this review. Two hundred and sixty-nine participants received OEP, and 277 only had conventional exercise training. Compared to the conventional exercise training group, the NH elders in the OEP group have considerably decreased in fall risk (MD = -0.84; 95% CI = -1.17, -0.51; P < .00001) and positively increased in postural balance (MD = 5.55; 95% CI = 3.60, 7.50; P < .00001), functional mobility in short-distance (MD = -6.39; 95% CI = -8.07, -4.70; P < .00001), lower-limb muscle strength (MD = 4.32; 95% CI = 3.71, 4.93; P < .00001), and health status (risk ratio = 0.35; 95% CI = 0.18, 0.66; P = .001). CONCLUSIONS Current evidence suggests that OEP is practical and feasible in NH. The nursing personnel can receive sufficient support for maintaining and enhancing these elders' postural control ability, especially during the COVID-19 pandemic.
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Affiliation(s)
- Lingyu Kong
- Physical Education and Sports School, Soochow University, Suzhou, PR China
| | - Xinwen Zhang
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, PR China
| | - Xinrui Zhu
- School of Rehabilitation Medicine, Weifang Medical University, Weifang, PR China
| | - Lingyue Meng
- Physical Education and Sports School, Soochow University, Suzhou, PR China
| | - Qiuxia Zhang
- Physical Education and Sports School, Soochow University, Suzhou, PR China
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Schuhmacher TP, Andresen M, Fallahpour M. Clinical reasoning of occupational therapists in selecting activities together with older adults with dementia to postpone further development of cognitive decline. Scand J Occup Ther 2023; 30:98-108. [PMID: 36086795 DOI: 10.1080/11038128.2022.2112282] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Research suggests that participation in activities has the potential to prevent or delay the development of later-life cognitive decline and dementia. This area is unexplored within occupational therapy. AIM To explore and describe the clinical reasoning of occupational therapists in selecting activities together with older adults with dementia to participate in, with the goal to postpone further development of cognitive decline in a sample from the German part of Switzerland. METHODS A constructivist grounded theory approach was used. Six in-depth, semi-structured interviews with occupational therapists working in geriatric units in the German part of Switzerland were conducted. RESULTS Three main categories were identified: (i) from the discovery of 'who the older adult is' to the discovery of 'meaningful activities', (ii) reflecting on occupational therapists' individuality, and (iii) matching the activity to older adults' skills. A core category was developed: Pursuing active participation through meaningful and chosen activities. CONCLUSIONS The study suggests that to pursue enabling active participation in activities among older adults with dementia, and promoting the quality of participation, occupational therapists must consider the identified elements that are important in selecting the activities which might be used to postpone cognitive decline in each individual.
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Affiliation(s)
- Tanya Pia Schuhmacher
- Department of Allied Health, Division of Occupational Therapy, See-Spital Horgen, Zürich, Switzerland
| | - Mette Andresen
- Department of Nutrition, Rehabilitation and Midwifery, Division of Occupational Therapy, University College Absalon, Naestved, Denmark
| | - Mandana Fallahpour
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
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Shryock SK, Meeks S. Activity, Activity Personalization, and Well-Being in Nursing Home Residents With and Without Cognitive Impairment: An Integrative Review. Clin Gerontol 2022; 45:1058-1072. [PMID: 33218291 DOI: 10.1080/07317115.2020.1844356] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Engagement in personally relevant and pleasant activity is a facet of many theories of well-being. This integrated review and narrative synthesis explored the hypothesis that activity participation improves well-being for nursing home residents. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched MEDLINE, PsycINFO, Academic Search Complete, Psychology and Behavioral Sciences Collection, Embase, and CINAHL for research published between 2006 and 2018. We included peer-reviewed, English-language studies of nursing-home residents, with interventions focused on activities and on well-being or affect outcomes. RESULTS After screening, the search yielded 45 studies: 15 reviews of specific activities and 30 empirical articles. We found consistent support for tailored activity interventions and less consistent support for specific or generic activity interventions with the possible exception of music therapy. Research focused on specific activity types had methodological limitations and confounds with activity preferences. CONCLUSIONS Participation in activities may improve well-being in residents of nursing homes. Tailored activities are likely to be superior to those provided indiscriminately to all residents. CLINICAL IMPLICATIONS Improving quality of life in long-term care should include opportunities to engage in activities; those most effective will be tailored to individuals and no single activity will be effective for everyone.
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Bourdon E, Belmin J. [The enriched garden concept: An innovation in geriatrics]. SOINS. GERONTOLOGIE 2022; 27:31-36. [PMID: 36280369 DOI: 10.1016/j.sger.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Societal expectations underline the importance of offering nursing home résidents an environment that is favorable to health and quality of life. Experimental studies conducted on the enriched environment have shown interesting perspectives without, however, transposing them to the living environment of the older persons. The enriched garden is an innovative concept in geriatrics, resulting from translational research that could provide encouraging answers to the question of improving the living environment in psycho-geriatric institutions.
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Affiliation(s)
- Etienne Bourdon
- Laboratoire éducation et promotion de la santé (Laboratoire éducations et pratiques de santé UR 3412), Université Sorbonne Paris Nord, 74 rue Marcel-Cachin, 93017 Bobigny, France; Hôpital Charles-Foix, Assistance publique-Hôpitaux de Paris, 7 avenue de la République, 94200 Ivry-sur-Seine, France
| | - Joël Belmin
- Hôpital Charles-Foix, Assistance publique-Hôpitaux de Paris, 7 avenue de la République, 94200 Ivry-sur-Seine, France; Faculté de médecine, Sorbonne Université, 91 boulevard de l'Hôpital, 75103 Paris, France.
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Barriers and enablers to leisure provision in residential aged care: personal care attendant perspectives. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x2200071x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
This exploratory descriptive study investigated barriers and enablers to the provision of leisure activities for people living in three Australian residential aged care facilities (RACFs) that operated under a household model of care. This research is unique in the international context, as few studies have explored the understandings and experiences of personal care attendants' (PCAs) perceptions of what impacts leisure provision for people living in RACFs. Qualitative data were collected from 17 PCAs via four focus groups. Barriers to leisure provision were identified as PCA–resident ratios, competing demands of the PCA role and a prioritisation of physical care tasks over leisure-related activities. The severity of residents' dementia (cognitive and functional deficits) as well as behavioural and psychological symptoms of dementia were also framed as barriers to participation in and the provision of leisure. Participants identified enablers of leisure provision as related to perceptions of leisure, the experiential knowledge of staff, organisational support and resourcing. The study findings suggest that enhancing leisure provision for people living with dementia will require attention to system issues (i.e. staffing levels, ratios, PCA role demands) as well as PCA knowledge and capability to facilitate person-centred leisure.
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Bourdon E, Havreng-Théry C, Lafuente C, Belmin J. Effect of the Physical Environment on Health and Well-Being of Nursing Homes Residents: A Scoping Review. J Am Med Dir Assoc 2022; 23:1826.e1-1826.e20. [PMID: 35787419 DOI: 10.1016/j.jamda.2022.05.026] [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: 03/03/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES In what way the physical environment of nursing homes (NHs) influences the health and well-being of nursing residents is not well codified. The authors aimed to review scientifically based knowledge on this topic. DESIGN A systematic scoping review of research into the effect that physical environment in nursing homes has on residents' health. SETTING AND PARTICIPANTS Search for relevant English-language articles in PubMed and the Cochrane database before April 15, 2022. Article selection and data extraction were performed by 2 researchers. Studies were included if conducted on nursing home residents and if they examined associations between components of the physical environment and health outcomes. MEASURES The review was performed in accordance with the PRISMA statement. RESULTS Of 1347 articles retrieved, 59 met the inclusion criteria-40 observational, 1 survey, and 18 interventional studies, of which 5 were randomized controlled trials. Certain environmental features repeatedly show significant positive effect on resident's health, such as noise reduction, tuning of lighting, natural light, easy access to garden, dining environment, and resident-centered interior renovation. Nursing home size was not found to have a direct relationship to resident health and well-being, although it is related to more than only the physical environment (eg, social environment). CONCLUSIONS AND IMPLICATIONS This review provides guidance in selective areas of the physical environment for the design of nursing homes, with potential benefits for the health and well-being of residents.
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Affiliation(s)
- Etienne Bourdon
- Laboratoire Éducation et Promotion de la Santé (LEPS UR 3412), Université Sorbonne Paris Nord, Bobigny, France; Service de Gériatrie, Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris and Faculté de Médecine Sorbonne, Ivry-sur-Seine, France
| | - Charlotte Havreng-Théry
- Laboratoire Éducation et Promotion de la Santé (LEPS UR 3412), Université Sorbonne Paris Nord, Bobigny, France; Laboratoire d'Informatique et d'Ingénierie des Connaissances en e-Santé (LIMICS, INSERM UMRS 1142), Sorbonne Université, Paris, France
| | - Carmelo Lafuente
- Service de Gériatrie, Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris and Faculté de Médecine Sorbonne, Ivry-sur-Seine, France; Clinical Epidemiology and Ageing (CePia), Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Est-Créteil, Créteil, France
| | - Joël Belmin
- Service de Gériatrie, Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris and Faculté de Médecine Sorbonne, Ivry-sur-Seine, France; Laboratoire d'Informatique et d'Ingénierie des Connaissances en e-Santé (LIMICS, INSERM UMRS 1142), Sorbonne Université, Paris, France.
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Developing a Meaningful Garden Space in a Care Home with Staff and Family Members: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127025. [PMID: 35742271 PMCID: PMC9222630 DOI: 10.3390/ijerph19127025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 02/04/2023]
Abstract
Background: Care home residents are often passive and lack active engagement in meaningful activities. The aim of this qualitative study was to co-develop a plan for a meaningful garden space in an urban care home in the north of England, to inform the subsequent building of such a garden space on the care home premises. Methods: Members of staff participated in focus groups conducted at the care home. Family carers were interviewed by telephone. Both focus groups and interviews were audio-recorded, with transcripts analysed independently using thematic analysis by two researchers, and consensus achieved on final themes. Findings: Two focus groups with staff (n = 17) and seven interviews with family carers were held. Thematic analysis generated seven key themes for the garden about its meaning and environmental features: (1) Current opinions on physical environment; (2) access; (3) adaptation to the environment; (4) staffing; (5) socialising; (6) sensory features; and (7) active meaningful participation. The garden needed to be accessible to residents in wheelchairs, and in all weathers and seasonal conditions, as well as being adapted to the needs of people living with dementia. Areas for social activities, such as picnics, and intergenerational activities, as well as private spaces, were recommended. Throughout the garden, sensory features were suggested, incorporating the use of vision, smell, touch, and sound, such as through water features. Moreover, it was recommended that residents should be able to contribute to the delivery of the activities themselves, including through a café and a vegetable garden. Conclusions: Family carers and staff considered that the garden would benefit from an intensive update to meet the needs of residents. This study therefore has practical implications for care home design, which are of even greater importance since the pandemic, as outdoor spaces were considered safer for care home visiting.
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Harrison SL, Dyer SM, Laver KE, Milte RK, Fleming R, Crotty M. Physical environmental designs in residential care to improve quality of life of older people. Cochrane Database Syst Rev 2022; 3:CD012892. [PMID: 35253911 PMCID: PMC8900466 DOI: 10.1002/14651858.cd012892.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND The demand for residential aged care is increasing due to the ageing population. Optimising the design or adapting the physical environment of residential aged care facilities has the potential to influence quality of life, mood and function. OBJECTIVES To assess the effects of changes to the physical environment, which include alternative models of residential aged care such as a 'home-like' model of care (where residents live in small living units) on quality of life, behaviour, mood and depression and function in older people living in residential aged care. SEARCH METHODS CENTRAL, MEDLINE, Embase, six other databases and two trial registries were searched on 11 February 2021. Reference lists and grey literature sources were also searched. SELECTION CRITERIA Non-randomised trials, repeated measures or interrupted time series studies and controlled before-after studies with a comparison group were included. Interventions which had modified the physical design of a care home or built a care home with an alternative model of residential aged care (including design alterations) in order to enhance the environment to promote independence and well-being were included. Studies which examined quality of life or outcomes related to quality of life were included. Two reviewers independently assessed the abstracts identified in the search and the full texts of all retrieved studies. DATA COLLECTION AND ANALYSIS Two reviewers independently extracted data, assessed the risk of bias in each included study and evaluated the certainty of evidence according to GRADE criteria. Where possible, data were represented in forest plots and pooled. MAIN RESULTS Twenty studies were included with 77,265 participants, although one large study included the majority of participants (n = 74,449). The main comparison was home-like models of care incorporating changes to the scale of the building which limit the capacity of the living units to smaller numbers of residents and encourage the participation of residents with domestic activities and a person-centred care approach, compared to traditional designs which may include larger-scale buildings with a larger number of residents, hospital-like features such as nurses' stations, traditional hierarchical organisational structures and design which prioritises safety. Six controlled before-after studies compared the home-like model and the traditional environment (75,074 participants), but one controlled before-after study included 74,449 of the participants (estimated on weighting). It is uncertain whether home-like models improve health-related quality of life, behaviour, mood and depression, function or serious adverse effects compared to traditional designs because the certainty of the evidence is very low. The certainty of the evidence was downgraded from low-certainty to very low-certainty for all outcomes due to very serious concerns due to risk of bias, and also serious concerns due to imprecision for outcomes with more than 400 participants. One controlled before-after study examined the effect of home-like models on quality of life. The author stated "No statistically significant differences were observed between the intervention and control groups." Three studies reported on global behaviour (N = 257). One study found little or no difference in global behaviour change at six months using the Neuropsychiatric Inventory where lower scores indicate fewer behavioural symptoms (mean difference (MD) -0.04 (95% confidence interval (CI) -0.13 to 0.04, n = 164)), and two additional studies (N = 93) examined global behaviour, but these were unsuitable for determining a summary effect estimate. Two controlled before-after studies examined the effect of home-like models of care compared to traditional design on depression. After 18 months, one study (n = 242) reported an increase in the rate of depressive symptoms (rate ratio 1.15 (95% CI 1.02 to 1.29)), but the effect of home-like models of care on the probability of no depressive symptoms was uncertain (odds ratio 0.36 (95% CI 0.12 to 1.07)). One study (n = 164) reported little or no difference in depressive symptoms at six months using the Revised Memory and Behaviour Problems Checklist where lower scores indicate fewer depressive symptoms (MD 0.01 (95% CI -0.12 to 0.14)). Four controlled before-after studies examined function. One study (n = 242) reported little or no difference in function over 18 months using the Activities of Daily Living long-form scale where lower scores indicate better function (MD -0.09 (95% CI -0.46 to 0.28)), and one study (n = 164) reported better function scores at six months using the Interview for the Deterioration of Daily Living activities in Dementia where lower scores indicate better function (MD -4.37 (95% CI -7.06 to -1.69)). Two additional studies measured function but could not be included in the quantitative analysis. One study examined serious adverse effects (physical restraints), and reported a slight reduction in the important outcome of physical restraint use in a home-like model of care compared to a traditional design (MD between the home-like model of care and traditional design -0.3% (95% CI -0.5% to -0.1%), estimate weighted n = 74,449 participants at enrolment). The remaining studies examined smaller design interventions including refurbishment without changes to the scale of the building, special care units for people with dementia, group living corridors compared to a non-corridor design, lighting interventions, dining area redesign and a garden vignette. AUTHORS' CONCLUSIONS There is currently insufficient evidence on which to draw conclusions about the impact of physical environment design changes for older people living in residential aged care. Outcomes directly associated with the design of the built environment in a supported setting are difficult to isolate from other influences such as health changes of the residents, changes to care practices over time or different staff providing care across shifts. Cluster-randomised trials may be feasible for studies of refurbishment or specific design components within residential aged care. Studies which use a non-randomised design or cluster-randomised trials should consider approaches to reduce risk of bias to improve the certainty of evidence.
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Affiliation(s)
- Stephanie L Harrison
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, Australia
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK
| | - Suzanne M Dyer
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Kate E Laver
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Rachel K Milte
- Caring futures institute, Flinders University, Adelaide, Australia
| | - Richard Fleming
- School of Science Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Maria Crotty
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia
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Brennan S, Doan T. Small-Scale Living Environments' Impact on Positive Behaviors and Quality of Life for Residents with Dementia. JOURNAL OF AGING AND ENVIRONMENT 2022. [DOI: 10.1080/26892618.2022.2030845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sumiyo Brennan
- Institute for Gerontology, J.F. Oberlin University, Tokyo, Japan
| | - Therese Doan
- School of Nursing, San Francisco State University, San Francisco, CA, USA
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11
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Bourdon E, Belmin J. Enriched gardens improve cognition and independence of nursing home residents with dementia: a pilot controlled trial. ALZHEIMERS RESEARCH & THERAPY 2021; 13:116. [PMID: 34134758 PMCID: PMC8207740 DOI: 10.1186/s13195-021-00849-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/28/2021] [Indexed: 11/26/2022]
Abstract
Background Dementia is a major issue worldwide, and considerable efforts were made to design therapeutic mediation tools and evaluate their benefits on the health of patients. Methods Design: Multi-center cluster-controlled pilot trial. Settings and participants: Four nursing homes that offered separated access to one conventional sensory garden (CSG) and one enriched garden (EG). The participants were residents with dementia, independent for walking and with no severe dementia or behavioural troubles. Eligible residents were divided into three groups according to the proximity of their room: close to the CSG or EG gardens for the first two groups and further from the gardens for the third (control) group. Interventions: We asked staff members to frequently invite residents to visit the EG or the CSG depending on their group allocation. No invitation to gardens was made to the control group. We installed 12 enrichment modules in the EG that stimulated cognitive, independence and walking/balance functions. Measures: Cognitive function (MMSE), independence for activities of daily living (ADL) and risk of falls (unipodal stance and timed up and go – (TUG)) were assessed at baseline and after 6 months. Results The 120 participants were 81·0 ± 3·5 years old and comprised of 83 women. Their MMSE score was 17·5 ± 2·9. Patients’ characteristics were not significantly different between the three groups. Among the participants invited to visit the EG group, 6-month changes in MMSE showed improvement compared to other groups (+ 0·93 ± 0·65 vs −0·25 ± 0·71 and −0·24 ± 0·73 in the EG vs CSG and control groups, respectively, P < 0·0001). Changes in ADL, TUG and unipodal stance were significantly improved in the group visiting the EG as compared to other groups, which indicates better functioning. Conclusions EGs offer a new approach to therapeutic mediation for residents of nursing homes with dementia. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-021-00849-w.
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Affiliation(s)
- Etienne Bourdon
- Hôpital Charles Foix, Groupe hospitalier APHP.Sorbonne, 7 avenue de la République, 94200, Ivry-sur-Seine, France.,Laboratoire Education et Pratiques en Santé (LEPS), EA3412, Université Paris Sorbonne Nord, Bobigny, France
| | - Joël Belmin
- Hôpital Charles Foix, Groupe hospitalier APHP.Sorbonne, 7 avenue de la République, 94200, Ivry-sur-Seine, France. .,Faculté de Médecine, Sorbonne Université, Paris, France.
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Casey D, Barrett E, Kovacic T, Sancarlo D, Ricciardi F, Murphy K, Koumpis A, Santorelli A, Gallagher N, Whelan S. The Perceptions of People with Dementia and Key Stakeholders Regarding the Use and Impact of the Social Robot MARIO. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8621. [PMID: 33233605 PMCID: PMC7699754 DOI: 10.3390/ijerph17228621] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 12/22/2022]
Abstract
People with dementia often experience loneliness and social isolation. This can result in increased cognitive decline which, in turn, has a negative impact on quality of life. This paper explores the use of the social robot, MARIO, with older people living with dementia as a way of addressing these issues. A descriptive qualitative study was conducted to explore the perceptions and experiences of the use and impact of MARIO. The research took place in the UK, Italy and Ireland. Semi-structured interviews were held in each location with people with dementia (n = 38), relatives/carers (n = 28), formal carers (n = 28) and managers (n = 13). The data was analyzed using qualitative content analysis. The findings revealed that despite challenges in relation to voice recognition and the practicalities of conducting research involving robots in real-life settings, most participants were positive about MARIO. Through the robot's user-led design and personalized applications, MARIO provided a point of interest, social activities, and cognitive engagement increased. However, some formal carers and managers voiced concern that robots might replace care staff.
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Affiliation(s)
- Dympna Casey
- School of Nursing and Midwifery, Aras Moyola, NUI, Galway, Ireland; (K.M.); (N.G.); (S.W.)
| | - Eva Barrett
- College of Engineering and Science, Alice Perry Building, NUI, Galway, Ireland;
| | - Tanja Kovacic
- UNESCO Child and Family Research Centre, School of Political Science and Sociology, NUI, Galway, Ireland;
| | - Daniele Sancarlo
- Sistemi Informativi, Innovazione e Ricerca, IRCCS Casa Sollievo della Sofferenza. Viale Cappuccini, 1 71013 San Giovanni Rotondo FG, Italy; (D.S.); (F.R.)
| | - Francesco Ricciardi
- Sistemi Informativi, Innovazione e Ricerca, IRCCS Casa Sollievo della Sofferenza. Viale Cappuccini, 1 71013 San Giovanni Rotondo FG, Italy; (D.S.); (F.R.)
| | - Kathy Murphy
- School of Nursing and Midwifery, Aras Moyola, NUI, Galway, Ireland; (K.M.); (N.G.); (S.W.)
| | - Adamantios Koumpis
- Institut Digital Enabling, Berner Fachhochschule, CH-3012 Bern, Switzerland;
| | - Adam Santorelli
- Faculty of Engineering, Macdonald Engineering Building, 817 Sherbrooke Street West, Room 382 Montreal, Montreal, QC H3A 0C3, Canada;
| | - Niamh Gallagher
- School of Nursing and Midwifery, Aras Moyola, NUI, Galway, Ireland; (K.M.); (N.G.); (S.W.)
| | - Sally Whelan
- School of Nursing and Midwifery, Aras Moyola, NUI, Galway, Ireland; (K.M.); (N.G.); (S.W.)
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13
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Kielsgaard K, Horghagen S, Nielsen D, Kristensen HK. Approaches to engaging people with dementia in meaningful occupations in institutional settings: A scoping review. Scand J Occup Ther 2020; 28:329-347. [PMID: 32776817 DOI: 10.1080/11038128.2020.1791952] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND People with dementia in institutional settings lack engagement in meaningful occupations, which may cause decreased quality of life. Although many researchers and professionals have proposed approaches to engage people with dementia in these occupations, an overview seems to be missing. AIM This scoping review provides an overview by categorizing and describing the characteristics of the approaches. MATERIAL AND METHOD A thorough literature search in nine databases identified the studies on approaches. We included 54 studies, and extracted bibliometric data. A content analysis revealed the characteristics of the approaches. RESULTS Four categories of approaches were uncovered. First, the literature defined the concept of meaningful occupation in various ways. Second, a category of approaches provided theoretical knowledge of meaningful occupations. The third category focussed on specific themes, such as certain methods. The final described comprehensive multilevel approaches. CONCLUSION This review contributes to knowledge of the diversity of approaches to engage people with dementia in meaningful occupation within institutional settings. SIGNIFICANCE We suggest that occupational therapy researchers and practitioners consider how the concept of meaningful occupation is embedded in the theoretical landscape. Furthermore, activity programming requires reflexive decision-making at the policy and practice level, as engagement in meaningful occupations is complex.
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Affiliation(s)
- Kamilla Kielsgaard
- Unit of Rehabilitation, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Nursing and Occupational Therapy, UCL University College, Odense, Denmark
| | - Sissel Horghagen
- Unit of Rehabilitation, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Occupational Therapy, NTNU, Faculty of Medicine and Health Science, Trondheim, Norway
| | - Dorthe Nielsen
- Center for Global Health, University of Southern Denmark, Odense, Denmark.,Health Sciences Research Centre, UCL University College, Odense, Denmark.,Migrant Health Clinic, Odense University Hospital, Odense, Denmark
| | - Hanne Kaae Kristensen
- Unit of Rehabilitation, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Health Sciences Research Centre, UCL University College, Odense, Denmark
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14
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Shi C, Zhang Y, Li C, Li P, Zhu H. Using the Delphi Method to Identify Risk Factors Contributing to Adverse Events in Residential Aged Care Facilities. Risk Manag Healthc Policy 2020; 13:523-537. [PMID: 32581615 PMCID: PMC7281847 DOI: 10.2147/rmhp.s243929] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 05/13/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to identify risk factors associated with adverse events in residential aged care facilities in China. Patients and Methods After compiling a list of risk factors for adverse events generated from in-depth interviews with managers of residential aged care facilities, a three-round Delphi method was used to reach consensus. The synthesized risk factors were presented on a Likert scale to the expert panelists three times to validate their responses. Results The list identified 67 items as risk factors for adverse events, attached to four first-level indexes (ie, environmental facility, nursing staff, older adults' characteristics, and management factors). The experts' authority coefficient was 0.87. The positive coefficients were 82.76%, 91.67%, and 100%, and the coordination coefficients were 0.154, 0.297, and 0.313 in the first, second, and third rounds, respectively. Conclusion Using a Delphi method, this study established a consensus on risk factors contributing to adverse events and developed a risk assessment grade for use in future aged care practice and research. The resulting list is useful in prioritizing risk-reduction activities and assessing intervention or education strategies for preventing adverse events in residential aged care facilities. Impact This study fills the gap in risk identification in the Chinese residential aged care system to ensure provision of best-practice care to this vulnerable population. Nursing staff and management factors at the top of the list are not only the most common causes of adverse events but also the core elements in creating a secure and error-free environment. This list was intended to support predictive and prevention-oriented decision-making by managers and nursing supervisors to reduce preventable adverse events.
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Affiliation(s)
- Chunhong Shi
- Nursing Department, XiangNan University, Chenzhou 423000, People's Republic of China
| | - Yinhua Zhang
- Nursing Department, Hunan University of Chinese Medicine, Changsha 410208, People's Republic of China
| | - Chunyan Li
- Nursing Department, XiangNan University, Chenzhou 423000, People's Republic of China
| | - Pan Li
- Nursing Department, XiangNan University, Chenzhou 423000, People's Republic of China
| | - Haili Zhu
- Nursing Department, Hunan Academy of Traditional Chinese Medicine Affiliated Hospital, Changsha, 410006, People's Republic of China
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15
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Prins M, Willemse BM, Heijkants CH, Pot AM. Nursing home care for people with dementia: Update of the design of the Living Arrangements for people with Dementia (LAD)-study. J Adv Nurs 2019; 75:3792-3804. [PMID: 31566778 PMCID: PMC6900200 DOI: 10.1111/jan.14199] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 09/10/2019] [Indexed: 11/29/2022]
Abstract
AIM The aim of the current study is to describe the extended design of the Living Arrangements for people with Dementia (LAD)-study. BACKGROUND The demand for long-term care in care homes increases with the growing number of people with dementia. However, quality of care in care homes needs improvement. It is important to monitor quality of care in care homes for the purposes of conducting scientific research, providing input for policy, and promoting practice improvement. DESIGN The Living Arrangements for people with Dementia -study monitors changes in - quality of - care in care homes since 2008. With its extended design, the Living Arrangements for people with Dementia -study now also focuses on additional topics that are considered to improve quality of care: implementation of person-centred care, involvement of family carers and volunteers and reducing psychotropic drugs and physical restraints using a multidisciplinary approach. METHODS The data collection of the Living Arrangements for people with Dementia -study entails an interview with the manager and questionnaires are completed by care staff, family carers, volunteers, and multidisciplinary team members. This study is partly funded by the Dutch Ministry of Health, Welfare and Sports, grant number 323,088 and partly funded by the participating care homes. DISCUSSION Results of the Living Arrangements for people with Dementia -study will shed more light on variables related to quality of care in care homes for people with dementia. IMPACT Based on the obtained information, appropriate efforts to improve quality of care can be discussed and implemented. Furthermore, the results of this study guide policy making, because it expands knowledge about the effects of changing policies and exposes topics that need further attention. TRIAL REGISTRATION Not applicable. This article does not report the results of a healthcare intervention on human participants.
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Affiliation(s)
- Marleen Prins
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.,Department of Clinical, Neuro & Developmental Psychology, Section Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bernadette M Willemse
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Ceciel H Heijkants
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Anne Margriet Pot
- Department of Clinical, Neuro & Developmental Psychology, Section Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Optentia, North-West University, Johannesburg, South Africa.,School of Psychology, University of Queensland, Brisbane, Qld., Australia
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16
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Ferdous F. Positive Social Interaction by Spatial Design: A Systematic Review of Empirical Literature in Memory Care Facilities for People Experiencing Dementia. J Aging Health 2019; 32:949-961. [PMID: 31517554 DOI: 10.1177/0898264319870090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The objective of this review is to outline a comprehensive set of possible design interventions focusing on spatial and environmental design factors influencing positive social interaction, which is one of the key aspects of quality of life (QoL) in long-term care facilities (LTCFs). Methods: This systematic literature review synthesized research evidence from seven databases (after the year 2000) spanning medical and health literature, environmental psychology, architecture, interior design, and evidence-based design literature. Results: The key spatial design characteristics of the facilities shown to affect positive social interaction were as follows: (a) The Physical Environment and Setting; (b) Accessibility, Legibility, and Layout; (c) Social Environment and Network; and (d) Staff-Resident Ratio and Care Philosophy. Conclusion: Several critical spatial design features of the facilities were identified. Spatial design interventions could influence the design decisions for future care facilities and provide designers the guidelines that are generalizable regardless of geographic location of the LTCF.
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17
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Chaudhury H, Cooke HA, Cowie H, Razaghi L. The Influence of the Physical Environment on Residents With Dementia in Long-Term Care Settings: A Review of the Empirical Literature. THE GERONTOLOGIST 2019; 58:e325-e337. [PMID: 28329827 DOI: 10.1093/geront/gnw259] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Indexed: 11/14/2022] Open
Abstract
Background and Objectives The physical environment in long-term care facilities has an important role in the care of residents with dementia. This paper presents a literature review focusing on recent empirical research in this area and situates the research with therapeutic goals related to the physical environment. Research Design and Methods A comprehensive literature search was conducted in Ageline, PsychINFO, CINAHL, Medline and Google Scholar databases to identify relevant articles. A narrative approach was used to review the literature. Results A total of 103 full-text items were reviewed, including 94 empirical studies and 9 reviews. There is substantial evidence on the influence of unit size, spatial layout, homelike character, sensory stimulation, and environmental characteristics of social spaces on residents' behaviors and well-being in care facilities. However, research in this area is primarily cross-sectional and based on relatively small and homogenous samples. Discussion and Implications Given the increasing body of empirical evidence, greater recognition is warranted for creating physical environments appropriate and responsive to residents' cognitive abilities and functioning. Future research needs to place greater emphasis on environmental intervention-based studies, diverse sample populations, inclusion of residents in different stages and with multiple types of dementia, and on longitudinal study design.
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Affiliation(s)
- Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Heather A Cooke
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Heather Cowie
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Leila Razaghi
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
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18
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de Boer B, Beerens HC, Katterbach MA, Viduka M, Willemse BM, Verbeek H. The Physical Environment of Nursing Homes for People with Dementia: Traditional Nursing Homes, Small-Scale Living Facilities, and Green Care Farms. Healthcare (Basel) 2018; 6:E137. [PMID: 30486306 PMCID: PMC6315793 DOI: 10.3390/healthcare6040137] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 11/22/2018] [Accepted: 11/22/2018] [Indexed: 02/07/2023] Open
Abstract
It is well recognized that the physical environment is important for the well-being of people with dementia. This influences developments within the nursing home care sector where there is an increasing interest in supporting person-centered care by using the physical environment. Innovations in nursing home design often focus on small-scale and homelike care environments. This study investigated: (1) the physical environment of different types of nursing homes, comparing traditional nursing homes with small-scale living facilities and green care farms; and (2) how the physical environment was being used in practice in terms of the location, engagement and social interaction of residents. Two observational studies were carried out. Results indicate that the physical environment of small-scale living facilities for people with dementia has the potential to be beneficial for resident's daily life. However, having a potentially beneficial physical environment did not automatically lead to an optimal use of this environment, as some areas of a nursing home (e.g., outdoor areas) were not utilized. This study emphasizes the importance of nursing staff that provides residents with meaningful activities and stimulates residents to be active and use the physical environment to its full extent.
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Affiliation(s)
- Bram de Boer
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands.
| | - Hanneke C Beerens
- Opera Consultancy and Implementation, 5026 RK Tilburg, The Netherlands.
| | - Melanie A Katterbach
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands.
| | - Martina Viduka
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands.
| | - Bernadette M Willemse
- Netherlands Institute of Mental Health and Addiction, Program on Aging, 3521 VS Utrecht, The Netherlands.
| | - Hilde Verbeek
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands.
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19
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Keating F, Cole L, Grant R. An evaluation of group reminiscence arts sessions for people with dementia living in care homes. DEMENTIA 2018; 19:805-821. [PMID: 30012038 DOI: 10.1177/1471301218787655] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dementia has been identified as one of the major challenges in the 21st Century. The detrimental effects of dementia can jeopardise personhood, thus person-centred interventions including reminiscence and arts practice have been recommended as tools to promote social inclusion and improve the quality of life. This study aimed to evaluate the effectiveness of group reminiscence arts sessions for people living with dementia in care homes (residential and nursing homes) using a comparative and time series design to collect data on quality of life. The intervention was conducted in six care homes in London over a period of 24 weeks and compared with six care homes not receiving the intervention (control). Dementia Care Mapping was used as the primary data collection instrument to measure positive behaviours and rate quality of life before, during and after group reminiscence arts sessions. The evaluation team observed the sessions at three-weekly intervals. Statistical modelling found that positive behaviours and quality of life of care home residents participating in group reminiscence arts sessions increased over the 24-week period. Well-being increased sharply during each session and plateaued at 50 minutes with a sustained positive effect after the sessions. On a longer timescale, well-being and quality of life increased slowly and steadily from one session to the next. The findings were statistically significant ( p < 0.001). The study concludes that group reminiscence arts sessions can have a positive and sustained impact on the quality of life of people with dementia. However, the evidence on the sustainability of the effect over time remains unknown. More research is needed to assess in much greater depth the association between quality of life and group reminiscence arts sessions.
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Affiliation(s)
- Frank Keating
- Department of Social Work, Royal Holloway University of London, UK.,Faculty of Health, Social Care and Education, Kingston and St George's University, UK
| | - Laura Cole
- Social Care Workforce Research Unit, King's College London, UK.,Faculty of Health, Social Care and Education, Kingston and St George's University, UK
| | - Robert Grant
- Faculty of Health, Social Care and Education, Kingston and St George's University, UK
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20
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Du Toit SHJ, Shen X, McGrath M. Meaningful engagement and person-centered residential dementia care: A critical interpretive synthesis. Scand J Occup Ther 2018; 26:343-355. [PMID: 29490537 DOI: 10.1080/11038128.2018.1441323] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND People with moderate to advanced dementia living in residential care are at risk of occupational deprivation. Person-centered care has been adopted as a guiding principle in the provision of residential care for older adults with dementia. In this context, there has been shift in occupational therapy practice from addressing occupational performance towards focusing on meaningful engagement. While both meaningful engagement and person-centered care have been well researched the relationship between the two concepts is poorly understood. AIM A critical interpretative synthesis was conducted to determine how principles of person-centered care inform occupational therapy practice in relation to promotion of meaningful engagement among residents with moderate to advanced dementia. METHODS A systematic search of research addressing meaningful engagement of people with moderate to advanced dementia identified 26 papers. RESULTS Papers were classified as theoretical papers and empirical research. Two overarching constructs emerged, namely promoting a culture of collaborative care and understanding the resident as a person with a past, present and future. CONCLUSIONS Occupational deprivation prevails and person-centered care is not fully addressed if opportunities for growth and engagement for residents with moderate to advanced dementia is not extended beyond their life history. SIGNIFICANCE Creating continued opportunities for building agency of residents with dementia could promote occupational justice in residential care.
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Affiliation(s)
- Sanetta H J Du Toit
- a Faculty of Health Sciences , The University of Sydney , Lidcombe , NSW , Australia
| | - Xizi Shen
- a Faculty of Health Sciences , The University of Sydney , Lidcombe , NSW , Australia
| | - Margaret McGrath
- a Faculty of Health Sciences , The University of Sydney , Lidcombe , NSW , Australia
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21
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Smit D, de Lange J, Willemse B, Pot AM. Predictors of activity involvement in dementia care homes: a cross-sectional study. BMC Geriatr 2017; 17:175. [PMID: 28778153 PMCID: PMC5545000 DOI: 10.1186/s12877-017-0564-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 07/24/2017] [Indexed: 11/13/2022] Open
Abstract
Background Despite the finding that involvement in activities is one of the most important needs of residents with dementia living in care homes, care facilities struggle to fulfill this need. Over the years, various factors are suggested which may contribute to or disable activity provision in dementia care homes. These include limited financial resources, task oriented staff and disease-related characteristics of residents. This study aims to further clarify which of these factors predict higher activity involvement. Methods Data were derived from the second measurement (2011) of the Living Arrangements for people with Dementia study. One thousand two hundred eighteen people residing in 139 dementia care homes were involved. Forty predictors of higher involvement were studied. Multilevel backward regression analyses were performed. Results The most important predictors of higher involvement were: absence of agitation, less ADL dependency, and a higher cognitive status of the residents, higher staff educational level, lower experienced job demands by care staff and a smaller number of residents living in the dementia care wards of a facility. More social supervisor support as perceived by staff was found to predict less activity involvement. Conclusions To increase the activity involvement of care home residents with dementia it seems vital to: 1) reduce staff’s experienced job demands; 2) elevate their overall educational level; 3) train staff to provide suitable activities, taking account of the behavior and preserved capabilities of residents; and 4) foster transition towards small-scale care. In order to achieve these aims, care organizations might need to evaluate the use of their financial means. Electronic supplementary material The online version of this article (doi:10.1186/s12877-017-0564-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dieneke Smit
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands. .,Program on Aging, Netherlands Institute of Mental Health and Addiction, PO box 725, 3500 AS, Utrecht, the Netherlands.
| | - Jacomine de Lange
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK, Rotterdam, the Netherlands
| | - Bernadette Willemse
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.,Program on Aging, Netherlands Institute of Mental Health and Addiction, PO box 725, 3500 AS, Utrecht, the Netherlands
| | - Anne Margriet Pot
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.,Program on Aging, Netherlands Institute of Mental Health and Addiction, PO box 725, 3500 AS, Utrecht, the Netherlands.,School of Psychology, University of Queensland, Brisbane, Australia
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22
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Bortnick KN. An Ecological Framework to Support Small-Scale Shared Housing for Persons with Neurocognitive Disorders of the Alzheimer's and Related Types: A Literature Review. Hong Kong J Occup Ther 2017; 29:26-38. [PMID: 30186070 PMCID: PMC6091999 DOI: 10.1016/j.hkjot.2017.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 03/10/2017] [Accepted: 03/14/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Small scale shared housing arrangements (SHAs) is a deinstitutionalized model of care designed to resemble a typical home of <10 people and are increasingly available for persons with neurocognitive disorders of the Alzheimer's and related types (NCD). However, there is little aggregate evidence of their effect on persons with NCD thus, a literature review was performed. METHODS Database searches were conducted across CINAHL Complete, OTseeker, PubMed, Ovid, Academic One File, ProQuest Nursing and Allied Health, the World Wide Web and Google Scholar using the several key words that included neurocognitive disorders, Alzheimer's, dementia, quality of life, well-being, occupational performance, activities of daily living, small scale shared housing, sheltered housing and group homes. Bibliographic references from final articles were also examined. Selection criteria involved three steps: screening perspective articles by title and abstract, assessing full text for eligibility and finally, reviewing full-texts. RESULTS 16 studies were selected for final review where most found the association of SHAs with various occupational performance indicators unique to the NCD population better than or equal to controls (traditional models of long term care). A small minority of studies had mixed or inconclusive results. No study found SHAs necessarily worse than controls. CONCLUSION The SHA model has many benefits for person's with NCD and may be especially advantageous for those in the early stages of the disease process. The occupational therapy profession should continue to raise awareness of SHAs and consider ecological theory as a valid basis for their expansion.
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Affiliation(s)
- Kevin N. Bortnick
- Department of Occupational Therapy, University of St.
Augustine for Health Sciences, St. Augustine, FL, USA
- 2254 Fifth Ct SE Vero Beach, FL
32962, USA
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23
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Björk S, Lindkvist M, Wimo A, Juthberg C, Bergland Å, Edvardsson D. Residents' engagement in everyday activities and its association with thriving in nursing homes. J Adv Nurs 2017; 73:1884-1895. [PMID: 28229474 DOI: 10.1111/jan.13275] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2017] [Indexed: 01/17/2023]
Abstract
AIM To describe the prevalence of everyday activity engagement for older people in nursing homes and the extent to which engagement in everyday activities is associated with thriving. BACKGROUND Research into residents' engagement in everyday activities in nursing homes has focused primarily on associations with quality of life and prevention and management of neuropsychiatric symptoms. However, the mere absence of symptoms does not necessarily guarantee experiences of well-being. The concept of thriving encapsulates and explores experiences of well-being in relation to the place where a person lives. DESIGN A cross-sectional survey. METHOD A national survey of 172 Swedish nursing homes (2013-2014). Resident (n = 4831) symptoms, activities and thriving were assessed by staff using a study survey based on established questionnaires. Descriptive statistics, simple and multiple linear regression, and linear stepwise multiple regression were performed. RESULTS The most commonly occurring everyday activities were receiving hugs and physical touch, talking to relatives/friends and receiving visitors, having conversation with staff not related to care and grooming. The least commonly occurring everyday activities were going to the cinema, participating in an educational program, visiting a restaurant and doing everyday chores. Positive associations were found between activity engagement and thriving, where engagement in an activity program, dressing nicely and spending time with someone the resident likes had the strongest positive association with resident thriving. CONCLUSIONS Engagement in everyday activities can support personhood and thriving and can be conceptualized and implemented as nursing interventions to enable residents to thrive in nursing homes.
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Affiliation(s)
| | - Marie Lindkvist
- Department of Statistics, Umeå School of Business and Economics, Umeå University, Sweden.,Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Anders Wimo
- Division of Neurogeriatrics, Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | | | - Ådel Bergland
- Lovisenberg Diaconal University College, Oslo, Norway
| | - David Edvardsson
- Department of Nursing, Umeå University, Sweden.,School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
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24
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Beerens HC, de Boer B, Zwakhalen SMG, Tan FES, Ruwaard D, Hamers JPH, Verbeek H. The association between aspects of daily life and quality of life of people with dementia living in long-term care facilities: a momentary assessment study. Int Psychogeriatr 2016; 28:1323-31. [PMID: 27068245 DOI: 10.1017/s1041610216000466] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND To improve the quality of life (QoL) of people with dementia (PwD) living in long-term care facilities, insight into the association between QoL and how people spend their daily lives is urgently needed. This study investigated which aspects of daily life are related to QoL in dementia. METHODS An observational study was conducted. Daily life was assessed with the tablet-based Maastricht Electronic Daily Life Observation-tool (MEDLO-tool). Aspects included activity, engagement in the activity, social interaction, physical effort, mood, and agitation. QoL was assessed by formal nursing caregivers using the Quality of Life-Alzheimer's Disease scale (QoL-AD). A total of 9,660 momentary assessments were conducted. RESULTS The mean age of the 115 participants was 84 years and most (75%) were women. Bivariate analyses showed that residents with a higher QoL carried out less passive/purposeless activities (25% vs. 38%), were more engaged in active, expressive, and social activities, (40% vs. 27%), had more social interaction (34% vs. 22%), and had better mood scores (scale 1-7, 5.0 vs. 4.8), compared with residents with a lower QoL (all p-values < 0.001). Multivariate analyses showed that having more social interaction and a positive mood are related to a higher QoL. CONCLUSIONS The results underline the importance of social interaction and a positive mood for a higher QoL. Future research should investigate the importance of engagement in activities in more detail.
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Affiliation(s)
- Hanneke C Beerens
- 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
| | - Bram de Boer
- 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
| | - Sandra M G Zwakhalen
- 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
| | - Frans E S Tan
- Department of Methodology & Statistics,CAPHRI School for Public Health and Primary Care,Faculty of Health,Medicine and Life Sciences,Maastricht University,Maastricht,the Netherlands
| | - Dirk Ruwaard
- 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
| | - Jan P H Hamers
- 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
| | - Hilde Verbeek
- 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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Smit D, de Lange J, Willemse B, Twisk J, Pot AM. Activity involvement and quality of life of people at different stages of dementia in long term care facilities. Aging Ment Health 2016; 20:100-9. [PMID: 26032736 DOI: 10.1080/13607863.2015.1049116] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Involvement in activities is assumed to positively influence the quality of life of people with dementia, yet activity provision in long-term care remains limited. This study aims to provide more insight into the value of activity involvement for domains of the quality of life of long-term dementia care residents, taking resident characteristics and cognitive status into account. METHOD Data were derived from 144 long-term care facilities participating in the second measurement (2010/2011) of the living arrangements for dementia study. Amongst 1144 residents, the relationship between time involved in activities (activity pursuit patterns; RAI-MDS) and quality of life (Qualidem) was studied using multilevel linear regression analyses. Analyses were adjusted for residents' age, gender, neuropsychiatric symptoms, ADL dependency and cognition. To check for effect modification of cognition, interactions terms of the variables activity involvement and cognitive status were added to the analyses. RESULTS Despite resident's cognitive status, their activity involvement was significantly related to better scores on care relationship, positive affect, restless tense behaviour, social relations, and having something to do. A negative relationship existed between the activity involvement and positive self-image. The explained variance in the quality of life between residents caused by the activity involvement was small. CONCLUSION Activity involvement seems to be a small yet important contributor to higher well-being in long-term care resident at all stages of dementia. Adjusting activities to individual preferences and capabilities might enlarge this relationship. Further research is needed to confirm this hypothesis, using measurement instruments less sensitive to recall bias and differentiating between the active and passive activity involvement.
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Affiliation(s)
- Dieneke Smit
- a Department of Clinical Psychology , Faculty of Psychology and Education , Vrije Universiteit , Amsterdam , The Netherlands.,b Program on Aging , Netherlands Institute of Mental Health and Addiction , Utrecht , The Netherlands
| | - Jacomine de Lange
- c Research Centre Innovations in Care , Rotterdam University of Applied Sciences , Rotterdam , The Netherlands
| | - Bernadette Willemse
- a Department of Clinical Psychology , Faculty of Psychology and Education , Vrije Universiteit , Amsterdam , The Netherlands.,b Program on Aging , Netherlands Institute of Mental Health and Addiction , Utrecht , The Netherlands
| | - Jos Twisk
- d Department of Methodology and Applied Biostatistics , Faculty of Earth and Life Sciences , Vrije Universiteit , Amsterdam , The Netherlands.,e EMGO+ Institute for Health and Care research , Amsterdam , The Netherlands
| | - Anne Margriet Pot
- a Department of Clinical Psychology , Faculty of Psychology and Education , Vrije Universiteit , Amsterdam , The Netherlands.,b Program on Aging , Netherlands Institute of Mental Health and Addiction , Utrecht , The Netherlands.,e EMGO+ Institute for Health and Care research , Amsterdam , The Netherlands.,f School of Psychology , University of Queensland , Brisbane , Australia
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Winblad B, Amouyel P, Andrieu S, Ballard C, Brayne C, Brodaty H, Cedazo-Minguez A, Dubois B, Edvardsson D, Feldman H, Fratiglioni L, Frisoni GB, Gauthier S, Georges J, Graff C, Iqbal K, Jessen F, Johansson G, Jönsson L, Kivipelto M, Knapp M, Mangialasche F, Melis R, Nordberg A, Rikkert MO, Qiu C, Sakmar TP, Scheltens P, Schneider LS, Sperling R, Tjernberg LO, Waldemar G, Wimo A, Zetterberg H. Defeating Alzheimer's disease and other dementias: a priority for European science and society. Lancet Neurol 2016; 15:455-532. [DOI: 10.1016/s1474-4422(16)00062-4] [Citation(s) in RCA: 1001] [Impact Index Per Article: 125.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 10/06/2015] [Accepted: 02/09/2016] [Indexed: 12/15/2022]
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Palacios-Ceña D, Gómez-Calero C, Cachón-Pérez JM, Velarde-García JF, Martínez-Piedrola R, Pérez-De-Heredia M. Is the experience of meaningful activities understood in nursing homes? A qualitative study. Geriatr Nurs 2016; 37:110-5. [DOI: 10.1016/j.gerinurse.2015.10.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/18/2015] [Accepted: 10/26/2015] [Indexed: 11/16/2022]
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den Ouden M, Bleijlevens MHC, Meijers JMM, Zwakhalen SMG, Braun SM, Tan FES, Hamers JPH. Daily (In)Activities of Nursing Home Residents in Their Wards: An Observation Study. J Am Med Dir Assoc 2015; 16:963-8. [PMID: 26155723 DOI: 10.1016/j.jamda.2015.05.016] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 05/27/2015] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Research shows that nursing home residents are largely inactive. This inactivity negatively influences physical fitness, and participation in daily activities is known to have a positive influence on physical function and quality of life. Existing research does not provide sufficient insight into the daily activities in which nursing home residents participate. This insight is needed to develop future interventions so as to encourage nursing home residents to participate in daily activities and, thereby, decrease inactivity. The purpose of this study was to obtain insight into daily (in)activities of psychogeriatric and somatic nursing home residents during the day and their body positions during these (in)activities. DESIGN Cross-sectional observation study. SETTING Nursing homes in the Netherlands (19 psychogeriatric and 11 somatic wards). PARTICIPANTS Participants were 723 home residents in 7 nursing homes. MEASUREMENTS Observations were conducted using a self-developed observation list. Residents were observed in their wards during 5 random observation times between 7:00 am and 11:00 pm, in which the daily activity and position of the resident during this activity were scored. Percentages of activities and positions were calculated for each observation time. RESULTS In total, 3282 observations (91% of the intended 3615 observations) were conducted. Nursing home residents of both psychogeriatric and somatic wards were mainly observed partaking in in activities, such as sleeping, doing nothing, and watching TV (range: 45%-77% of the 5 observation times). Furthermore, residents were engaged in activities of daily living (ADLs) (range: 15%-38%) that mainly comprised activities related to mobility (range: 10%-19%) and eating and drinking (range: 2%-17%). Engagement of residents in instrumental ADLs (IADLs) was rarely observed (up to 3%). Residents were largely observed in a lying or sitting position (range: 89%-92%). CONCLUSION Most of the psychogeriatric and somatic nursing home residents spend their day inactive in a lying or sitting position in the ward. To encourage nursing home residents in daily activities in the wards, interventions are needed that (1) focus on increasing ADLs and IADLs, and (2) encourage standing and walking.
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Affiliation(s)
- Mirre den Ouden
- Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
| | - Michel H C Bleijlevens
- Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Judith M M Meijers
- Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Sandra M G Zwakhalen
- Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Susy M Braun
- Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands; Faculty of Health, Research Centre for Autonomy and Participation of People with a Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Frans E S Tan
- Department of Methodology and Statistics, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Jan P H Hamers
- Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
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Development and Evaluation of a Clinical Manual on Errorless Learning in People with Dementia. BRAIN IMPAIR 2015. [DOI: 10.1017/brimp.2015.8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Various studies have shown the efficacy of errorless learning (EL) in teaching patients with dementia a wide variety of skills and everyday tasks, with some studies showing beneficial effects and others reporting limited or no advantage. However, EL procedures vary greatly and, to date, no clinical guidelines or manuals are available. Here, we present a nationwide survey exploring the interest in, and feasibility of, EL in dementia care in The Netherlands. Based on the survey results and available evidence in the literature, we subsequently drafted an EL manual and had this concept manual evaluated in a Delphi round using the AGREE instrument. Forty-five health professionals associated with 22 dementia care facilities in The Netherlands, including those survey respondents who had piloted an EL intervention in accordance with the concept manual and an eight-strong expert panel representing various disciplines, deemed EL to be meaningful and feasible for use in dementia care and their residential facilities. Although our manual was favourably received, future studies are required to examine how EL can best be implemented in clinical practice and to determine the optimal outcome measures and quality indicators to reliably evaluate intervention outcomes and to consider the cost-effectiveness of the approach.
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