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Amiri P, Samadani M, Khazaee PR, Bahaadinbeigy K. Development of the Dardashna Checklist for Identifying Triggers of Behavioral Change in Individuals With Dementia: A Qualitative Study. J Gerontol Nurs 2024; 50:37-46. [PMID: 38170462 DOI: 10.3928/00989134-20231212-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
The purpose of the current qualitative study was to describe the development of the Dardashna Checklist to clinically identify behavior change triggers in individuals with dementia. Semi-structured, in-depth, face-to-face interviews were conducted with four physicians and four experienced caregivers involved in the care of individuals with dementia. From analysis of participants' interviews, themes extracted included Triggers of Behavioral Change in Individuals With Dementia and Types of Behavioral Changes, using the checklist structure as a guide. The information gathered by this checklist conveys important messages to experienced physicians or caregivers who want to help less experienced caregivers or individuals with dementia. In this case, physicians' prescriptions and the responses of other experienced caregivers will be more targeted and useful. This checklist will help facilitate clinical care decisions, improve quality of life, reduce expenses and side effects of medications, and improve communication among persons with dementia, their caregivers, and health care providers. [Journal of Gerontological Nursing, 50(1), 37-46.].
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Hung YH, Wang WF, Chang MC, Jhang KM. Case Management-based Collaborative Care Model Associated with improvement in neuropsychiatric outcomes in community-dwelling people living with dementia. BMC Geriatr 2023; 23:339. [PMID: 37259035 DOI: 10.1186/s12877-023-04024-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 05/07/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND This study aimed to explore the association between adherence of collaborative care model and short-term deterioration of BPSD after controlling patient and caregiver factors. METHODS This retrospective case-control study enrolled 276 participants who were newly diagnosed with dementia and BPSD. A dementia collaborative care team interviewed patients and caregivers to form a care plan and provided individualized education or social resource referrals. A multivariate logistic regression model with backward selection was used to test factors associated with BPSD deterioration, defined as worse neuropsychiatric inventory (NPI) scores 1 year after joining the care model. RESULTS Male sex (odds ratio [OR] = 0.45; 95% confidence interval [CI] = 0.25-0.84) and higher clinical dementia rating scale sum of boxes scores (CDR-SOB) (OR = 0.90; 95% CI = 0.83-0.98) were protective factors, whereas spouse caregivers and withdrawals from the care model (OR = 3.42; 95% CI = 1.28-9.15) were risk factors for BPSD deterioration. CONCLUSIONS Our study showed that both patient and caregiver factors were associated with deterioration of BPSD. The case manager-centered dementia collaborative care model is beneficial for the management of BPSD. Healthcare systems may consider implementing a case management model in clinical dementia care practice.
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Affiliation(s)
- Yu-Hsuan Hung
- School of Medicine, Department of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Education, Changhua Christian Hospital, Changhua, Taiwan
| | - Wen-Fu Wang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
| | - Ming-Che Chang
- Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Kai-Ming Jhang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan.
- , No. 135 Nanxiao St, Changhua City, 500, Taiwan.
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Mank A, van Maurik IS, Rijnhart JJM, Rhodius‐Meester HFM, Visser LNC, Lemstra AW, Sikkes SAM, Teunissen CE, van Giessen EM, Berkhof J, van der Flier WM. Determinants of informal care time, distress, depression, and quality of life in care partners along the trajectory of Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12418. [PMID: 37114014 PMCID: PMC10126754 DOI: 10.1002/dad2.12418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/19/2023] [Accepted: 03/01/2023] [Indexed: 04/29/2023]
Abstract
Introduction We evaluated determinants associated with care partner outcomes along the Alzheimer's disease (AD) stages. Methods We included n = 270 care partners of amyloid-positive patients in the pre-dementia and dementia stages of AD. Using linear regression analysis, we examined determinants of four care partner outcomes: informal care time, caregiver distress, depression, and quality of life (QoL). Results More behavioral symptoms and functional impairment in patients were associated with more informal care time and depressive symptoms in care partners. More behavioral symptoms were related with more caregiver distress. Spouse care partners spent more time on informal care and QoL was lower in female care partners. Behavioral problems and subtle functional impairment of the patient predisposed for worse care partner outcomes already in the pre-dementia stages. Discussion Both patient and care partner determinants contribute to the care partner outcomes, already in early disease stages. This study provides red flags for high care partner burden.
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Affiliation(s)
- Arenda Mank
- Alzheimer Center Amsterdam, Department of NeurologyVrije Universiteit AmsterdamAmsterdam UMC VUmcAmsterdamthe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamthe Netherlands
- Amsterdam UMCVrije Universiteit AmsterdamDepartment of Epidemiology and Data ScienceAmsterdam Public Health InstituteAmsterdamthe Netherlands
| | - Ingrid S. van Maurik
- Alzheimer Center Amsterdam, Department of NeurologyVrije Universiteit AmsterdamAmsterdam UMC VUmcAmsterdamthe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamthe Netherlands
- Amsterdam UMCVrije Universiteit AmsterdamDepartment of Epidemiology and Data ScienceAmsterdam Public Health InstituteAmsterdamthe Netherlands
| | | | - Hanneke F. M. Rhodius‐Meester
- Alzheimer Center Amsterdam, Department of NeurologyVrije Universiteit AmsterdamAmsterdam UMC VUmcAmsterdamthe Netherlands
- Department of Internal MedicineGeriatric Medicine SectionVrije Universiteit AmsterdamAmsterdam UMCAmsterdamthe Netherlands
- Department of Geriatric MedicineThe Memory ClinicOslo University HospitalOsloNorway
| | - Leonie N. C. Visser
- Department of Medical PsychologyAmsterdam UMC, AMCUniversity of AmsterdamAmsterdamthe Netherlands
- Amsterdam Public Health Research InstituteQuality of CareAmsterdamthe Netherlands
| | - Afina W. Lemstra
- Alzheimer Center Amsterdam, Department of NeurologyVrije Universiteit AmsterdamAmsterdam UMC VUmcAmsterdamthe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamthe Netherlands
| | - Sietske A. M. Sikkes
- Alzheimer Center Amsterdam, Department of NeurologyVrije Universiteit AmsterdamAmsterdam UMC VUmcAmsterdamthe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamthe Netherlands
| | - Charlotte E. Teunissen
- Amsterdam NeuroscienceNeurodegenerationAmsterdamthe Netherlands
- Neurochemistry LaboratoryDepartment of Clinical ChemistryVrije UniversiteitAmsterdam UMC, VUmcAmsterdamthe Netherlands
| | - Elsmarieke M. van Giessen
- Department of Radiology & Nuclear Medicine Vrije Universiteit AmsterdamAmsterdam UMC, VUmcAmsterdamthe Netherlands
| | - Johannes Berkhof
- Amsterdam UMCVrije Universiteit AmsterdamDepartment of Epidemiology and Data ScienceAmsterdam Public Health InstituteAmsterdamthe Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center Amsterdam, Department of NeurologyVrije Universiteit AmsterdamAmsterdam UMC VUmcAmsterdamthe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamthe Netherlands
- Amsterdam UMCVrije Universiteit AmsterdamDepartment of Epidemiology and Data ScienceAmsterdam Public Health InstituteAmsterdamthe Netherlands
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Yang YH, Situmeang RFV, Ong PA, Liscic RM. Application of virtual reality for dementia management. BRAIN SCIENCE ADVANCES 2022. [DOI: 10.26599/bsa.2022.9050019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Age is recognized as the major factors of dementia, especially in for Alzheimer’s disease (AD). Given to the aged population, the increased number of demented population has been receiving a great impact in our society. Unfortunately, so far, no cured medicines have been demonstrated to provide effective treatment in AD. The combination of pharmacological and non-pharmacological interventions has been proposed to manage dementia with potential benefits especially in decreasing caregiver’s burden and behavior, as well as psychological problems of demented patients. Recently, giving to the glorious development in digital technologies, the virtual reality, one of the non-pharmacological interventions has been used extensively in dementia managements for its strengths which can be adapted in accordance with the heterogeneous needs from demented patients and their caregivers. However, various study designs and other reasons made these results difficult to be interpreted. In this review our goal is to provide a better understanding for these points.
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Affiliation(s)
- Yuan-Han Yang
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, China
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, China
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan, China
| | - Rocksy FV Situmeang
- Siloam Hospitals Lippo Village, Pelita Harapan University, Banten, Indonesia
| | - Paulus Anam Ong
- Department of Neurology, Hasan Sadikin Hospital, Bandung, Indonesia
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Iravani B, Abdollahi E, Eslamdoust-Siahestalkhi F, Soleimani R. Neuropsychiatric Symptoms of Alzheimer's Disease and Caregiver Burden. Front Neurol 2022; 13:877143. [PMID: 35968317 PMCID: PMC9372403 DOI: 10.3389/fneur.2022.877143] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/12/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction/Objectives In addition to cognitive decline, one of the most important problems for caregivers of patients with Alzheimer's is neuropsychiatric symptoms (NPS). This study aimed to evaluate the NPS in patients with Alzheimer's disease (AD) and investigate its relationship with caregiver burden (CB). Methods In a cross-sectional study of 85 patients with AD referred to Shafa Hospital in Rasht and their caregivers in 2020, information was collected using a demographic questionnaire, Neuropsychiatric Inventory Questionnaire (NPI-Q), and the Caregiver Burden Inventory (CBI). Data were analyzed by Spearman correlation, t-test, and linear regression, with SPSS version 22. Results The mean age of the patients and their caregivers were 74.95 ± 8.87 years and 43.98 ± 11.38 years, respectively. The mean total score of NPS in patients with AD was 44.25 (0–144) and the mean CB score was 36.27 (0–96), which was a moderate level. According to the results, 91% of patients had apathy, while happiness/euphoria was reported as the most uncommon symptom. In addition, there was a significant relationship between the score of NPS and CB (r = 0.542, P < 0.0001), as well as all its sub-components, time-dependence burden with more correlation (r = 0.509, P < 0.0001), and social burden with less correlation (r = 0.352, P < 0.001). NPS, hallucination, aberrant motor behavior (AMB), delusion, and depression were most correlated with CB. Also, the mean score of CB was significantly higher in women than in men (P = 0.045). Living in a rural area had a significant relationship with NPS score (P = 0.026). Also, linear regression showed that with increasing 1 year of patients' age, the mean score of patient's NPS decreased by 0.374 (P = 0.048). Conclusion Neuropsychiatric symptoms, especially hallucination, aberrant motor behavior (AMB), delusion, and depression were associated with caregiver burden. Apathy was the most common symptom in patients with AD.
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Frías CE, Casafont C, Cabrera E, Zabalegui A. Validation of the Spanish Version of the Double Knowledge Expectations and Received Knowledge Significant Other Scale for Informal Caregivers of People with Dementia (KESO-DEM/RKSO-DEM). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5314. [PMID: 35564708 PMCID: PMC9104362 DOI: 10.3390/ijerph19095314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 04/06/2022] [Accepted: 04/22/2022] [Indexed: 12/07/2022]
Abstract
Dementia is associated with cognitive decline. Becoming an informal caregiver raises questions, requiring information and support from health professionals to guide home care. A multicenter, longitudinal study was carried out to validate the Spanish version of the double scale of expected and received knowledge for informal caregivers of people with dementia (KESO-DEM/RKSO-DEM), the analysis of the dimensional structure of the instrument, its validity and reliability, and temporary stability was carried out. An analysis of criterion and construct validity, internal consistency, and test−retest stability was performed. The evaluation of the interrelation between dimensions was statistically significant. Regarding internal consistency, the scale values were good both for the scale totals and for each dimension of knowledge, with Cronbach’s alpha coefficients of 0.97. For criterion validity, all items showed temporal stability for both questionnaires (p < 0.05). The availability of a valid, reliable tool for the measurement of expected and received knowledge in caregivers of people with dementia allows an approach based on the real needs of the family and the patient. It is important to design care protocols for people with dementia that are adapted to their needs and expectations and to their non-curative treatment, to improve the emotional well-being of patients and informal caregivers.
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Affiliation(s)
- Cindy E. Frías
- Hospital Clinic of Barcelona, 08836 Barcelona, Spain; (C.E.F.); (C.C.)
| | - Claudia Casafont
- Hospital Clinic of Barcelona, 08836 Barcelona, Spain; (C.E.F.); (C.C.)
| | - Esther Cabrera
- School of Health Sciences, TecnoCampus, Pompeu Fabra University, 08302 Mataro, Spain;
- Department of Care Management and Social Work, Sechenov University, 119435 Moscow, Russia
| | - Adelaida Zabalegui
- Department of Nursing, Hospital Clinic of Barcelona, 08836 Barcelona, Spain
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Abstract
The prevalence of cannabis use among older adults (aged 65 and above) for both recreational and medicinal purposes has significantly increased in recent years. Information regarding the safety of cannabis in this population is important since aging is associated with metabolic changes, multiple morbidities, increases in prescription medication use, and an overall decline in functioning. In this Perspectives article, we review special considerations pertinent to older adults-specifically, the impact of cannabis on cognition and on falls and injuries, its drug interactions, and its potential medicinal applications for treating the behavioral and psychological symptoms of dementia. Knowledge about the role of cannabis in brain health, injury risk, and drug interactions remains limited since the available evidence stems primarily from adolescent and young adult cohorts, plus a limited number of small observational studies with older adults. In terms of utilizing certain cannabinoids to treat the behavioral and psychological symptoms of dementia, some studies have found promising results, but because of the lack of consistency in the literature, it is premature to draw conclusions. Controlled research trials specifically with geriatric participants are needed to understand the effects of cannabis use in this vulnerable population.
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Wang H, Yue H, Ren M, Feng D. Dyadic effects of family-functioning and resilience on quality of life in advanced lung cancer patients and caregivers: An actor-partner interdependence mediation model. Eur J Oncol Nurs 2021; 52:101963. [PMID: 34004522 DOI: 10.1016/j.ejon.2021.101963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/23/2021] [Accepted: 04/11/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Lung cancer as a stressful event profoundly impacts the entire family, especially patients and their family caregivers. This study uses a dyadic analysis approach to explore the dyadic effects of family functioning on the quality of life (QoL), and whether resilience acts as a mediator in advanced lung cancer patient-caregiver dyads. METHODS This was a cross-sectional study, and 287 dyads of advanced lung cancer patients and their caregivers were enrolled. Family-functioning, resilience, and QoL were assessed by the General Functioning subscale of the Family Assessment Device (FAD), the 10-item Connor-Davidson Resilience Scale, and the Short Form-8 (SF-8) Health Survey, respectively. Data were analyzed using the actor-partner interdependence mediation model. RESULTS This study found that, for patients and caregivers, resilience mediates the actor effects of family-functioning on QoL. That is, family-functioning was positively related to their resilience, which improved QoL. Another important finding is that caregivers' family-functioning had significant indirect effects on patients' QoL through their resilience. CONCLUSIONS Positive family functioning perceived by patients and caregivers can improve their QoL by developing their own resilience. Furthermore, family-functioning perceived by caregivers can also improve patients' QoL through their resilience. Medical staff should identify vulnerable patients and caregivers with poorer family-functioning and resilience, and make focused intervention to improve the QoL of both lung cancer patients and their family caregivers.
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Affiliation(s)
- Hui Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
| | - Haorun Yue
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250017, China.
| | - Minmin Ren
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
| | - Danjun Feng
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
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