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Hammar LM, Lövenmark A, Swall A. The benefits of caregiver singing and receptive music in dementia care: a qualitative study of professional caregivers' experiences. Arts Health 2024:1-15. [PMID: 38389120 DOI: 10.1080/17533015.2024.2320248] [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: 07/06/2023] [Accepted: 02/13/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND For persons with dementia, receptive music may reduce negative expressions and increase positive ones. Caregiver singing (CS) is an intervention aimed at facilitating care situations and involves caregivers singing for or together with persons with dementia during care activities. In the literature, CS is commonly addressed as a music activity rather than a care intervention. The aim was to describe caregivers' experiences of the reactions of persons with dementia when using CS and receptive music in dementia care. METHOD The data comprised three focus group interviews with 12 professional caregivers in dementia care, analysed using qualitative content analysis. RESULTS the analysis resulted in two themes: "CS increases interaction and builds companionship" and "Receptive music soothes, awakens memories and reflects the person's self". CONCLUSION Both CS and receptive music was shown to have positive influences, and while the results were sometimes intertwined, CS was shown to better facilitate problematic care situations.
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Affiliation(s)
- Lena Marmstål Hammar
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Annica Lövenmark
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Anna Swall
- School of Health and Welfare, Dalarna University, Falun, Sweden
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Haunch K, Downs M, Oyebode J. 'Making the most of time during personal care': nursing home staff experiences of meaningful engagement with residents with advanced dementia. Aging Ment Health 2023; 27:2346-2354. [PMID: 36786726 DOI: 10.1080/13607863.2023.2177254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/24/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES Dementia progressively affects cognitive functioning, including the ability to communicate. Those who struggle to communicate are often considered unable to relate to other people. Frontline care workers are in a position to connect with residents. However, we know little about their perspectives. The aim of this study was to understand how and when nursing home staff meaningfully engaged with residents with advanced dementia. METHODS Semi-structured interviews, supplemented by informal conversations, were conducted with 21 staff from seven nursing homes. Inductive thematic analysis identified themes in the accounts. RESULTS Four themes related to how staff engaged with residents with advanced dementia (initiating meaningful engagement, recognising subtle reactions, practising caring behaviours, patience and perseverance). Two themes related to when meaningful engagement occurred (lacking time to connect, making the most of time during personal care). CONCLUSION A key barrier to implementing formal interventions to improve care is lack of staff time. Staff overcome this by using personal care time for meaningful engagement with residents. Their approach, developed through experience, is consonant with person-centred dementia care. Building on this, future research should use participatory approaches building on practice wisdom to further develop and evaluate meaningful engagement with residents with advanced dementia.
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Affiliation(s)
- Kirsty Haunch
- School of Healthcare, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Murna Downs
- Centre for Applied Dementia, University of Bradford, Bradford, UK
| | - Jan Oyebode
- Centre for Applied Dementia, University of Bradford, Bradford, UK
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3
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Stuart-Röhm K, Baker FA, Clark I. Training formal caregivers in the use of live music interventions during personal care with persons living with dementia: a systematic mixed studies review. Aging Ment Health 2023; 27:1876-1886. [PMID: 36803176 DOI: 10.1080/13607863.2023.2180485] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 01/20/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVES To examine research on the training of formal caregivers in live music interventions within care situations with persons with dementia. METHODS This review was registered with PROSPERO (CRD42020196506). PubMed, PsycINFO (Ovid), MEDLINE, Discovery EBSCO, Embase, CINAHL (Complete), AMED and ProQuest Dissertations and Theses Global were searched in September 2020 and again in October 2022. English, peer-reviewed studies on formal caregivers trained in using live music when caring one-on-one with persons with dementia were included. The Mixed Methods Assessment Tool (MMAT) was employed to assess quality, and narrative synthesis with effect sizes (Hedges-g) and thematic analysis were used for quantitative and qualitative studies respectively. RESULTS Nine studies (four qualitative, three quantitative, two mixed methods studies) were included. Quantitative studies demonstrated significant differences for music training on outcomes measuring agitation and emotional expression. Thematic analysis yielded five themes: emotional wellbeing; mutual relationship; shifts in caregivers' experiences; care environment; and insights into person-centered care. CONCLUSION Training for staff in live music interventions may benefit the delivery of person-centered care by supporting communication, easing care, and capacitating caregivers to meet the needs of persons with dementia. Findings appeared context specific due to high heterogeneity and small sample sizes. Further research on quality of care and caregiver outcomes, and sustainability of training is recommended.
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Affiliation(s)
| | - Felicity A Baker
- The University of Melbourne, Melbourne, VIC, Australia
- Norwegian Academy of Music, Oslo, Norway
| | - Imogen Clark
- The University of Melbourne, Melbourne, VIC, Australia
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Cremer S, Vluggen S, Man-Van-Ginkel JMD, Metzelthin SF, Zwakhalen SM, Bleijlevens MHC. Effective nursing interventions in ADL care affecting independence and comfort - a systematic review. Geriatr Nurs 2023; 52:73-90. [PMID: 37269607 DOI: 10.1016/j.gerinurse.2023.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 06/05/2023]
Abstract
Despite its frequent provision, evidence of nursing interventions in Activities of Daily Living (ADL) remains unclear. Hence, we addressed the research question: What are the effects of ADL nursing interventions on independence and comfort in adults across all care settings? We conducted a systematic review of randomized controlled trials and quasi-experimental studies described in systematic reviews. In three databases, we searched for systematic reviews that we used as a portal to select (quasi) experimental studies. After narratively summarizing the studies on characteristics, effects, and interventions, we assessed the risk of bias. Among the 31 included studies, 14 studies evaluated independence, 14 studies measured comfort, and three studies assessed both outcomes. Seven interventions significantly improved independence and seven interventions significantly improved comfort. The studies varied highly in intervention components, outcome measures, and quality. Evidence on ADL nursing interventions affecting independence and comfort remains fragmented and inconclusive, limiting guidance for nursing professionals.
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Affiliation(s)
- S Cremer
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands; Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands.
| | - S Vluggen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands; Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - J M de Man-Van-Ginkel
- Department of Gerontology and Geriatrics, Nursing Science, Leiden University Medical Centre, Postzone C-07-Q, Postbus 9600, Leiden, RC 2300, The Netherlands
| | - S F Metzelthin
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands; Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - S M Zwakhalen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands; Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - M H C Bleijlevens
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands; Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
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5
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Odell-Miller H, Blauth L, Bloska J, Bukowska AA, Clark IN, Crabtree S, Engen RB, Knardal S, Kvamme TK, McMahon K, Petrowitz C, Smrokowska-Reichmann A, Stensæth K, Tamplin J, Wosch T, Wollersberger N, Baker FA. The HOMESIDE Music Intervention: A Training Protocol for Family Carers of People Living with Dementia. Eur J Investig Health Psychol Educ 2022; 12:1812-1832. [PMID: 36547028 PMCID: PMC9778265 DOI: 10.3390/ejihpe12120127] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
Background: The number of people living with dementia (PwD) worldwide is expected to double every 20 years. Many continue living at home, receiving support from family caregivers who may experience significant stress, simultaneously to that of the PwD. Meaningful and effective home-based interventions to support PwD and their caregivers are needed. The development of a theory- and practice-driven online home-based music intervention (MI) is delivered by credentialed music therapists, nested within the HOMESIDE RCT trial. Methods: Dyads including the PwD and their family carer are randomised to MI, reading (RI) or standard care (SC). MI aims to support health wellbeing and quality of life by training caregivers to intentionally use music (singing, instrument playing, movement/dancing, and music listening) with their family member (PwD) in daily routines. MI is underpinned by cognitive, relational, social, and psychological theories of mechanisms of change. Results: Preliminary sub-cohort results analyses show MI can be delivered and is accepted well by participants and music-therapist interventionists across five countries. Conclusions: The specialist skills of a music therapist through MI enable carers to access music when music therapists are not present, to meet carer and PwD needs. Music therapists embrace this changing professional role, observing therapeutic change for members of the dyads.
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Affiliation(s)
- Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge CB1 1PT, UK
- Correspondence:
| | - Laura Blauth
- Music Therapy Lab, Institute for Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, 97072 Würzburg, Germany
| | - Jodie Bloska
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Anna A. Bukowska
- Institute of Applied Sciences, University of Physical Education in Krakow, 31-571 Krakow, Poland
| | - Imogen N. Clark
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Sarah Crabtree
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Runa B. Engen
- Centre for Research in Music and Health, Norwegian Academy of Music, 0369 Oslo, Norway
| | - Solgunn Knardal
- Centre for Research in Music and Health, Norwegian Academy of Music, 0369 Oslo, Norway
| | - Tone K. Kvamme
- Centre for Research in Music and Health, Norwegian Academy of Music, 0369 Oslo, Norway
| | - Kate McMahon
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Carina Petrowitz
- Music Therapy Lab, Institute for Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, 97072 Würzburg, Germany
| | | | - Karette Stensæth
- Centre for Research in Music and Health, Norwegian Academy of Music, 0369 Oslo, Norway
| | - Jeanette Tamplin
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Thomas Wosch
- Music Therapy Lab, Institute for Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, 97072 Würzburg, Germany
| | - Nina Wollersberger
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Felicity A. Baker
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Melbourne, VIC 3010, Australia
- Centre for Research in Music and Health, Norwegian Academy of Music, 0369 Oslo, Norway
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6
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Mabire JB, Bouaziz N, de Malherbe A, Charras K. Inclusive Choir for Persons Living with Dementia: A Qualitative Study. ACTIVITIES, ADAPTATION & AGING 2022. [DOI: 10.1080/01924788.2022.2151801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
| | - Nathalie Bouaziz
- Centre d’Accueil de Jour la Porte Verte, Accueil de jour, Versailles, France
| | - Adèle de Malherbe
- Centre d’Accueil de Jour la Porte Verte, Accueil de jour, Versailles, France
| | - Kevin Charras
- Living lab Vieillissement et Vulnérabilités, Service de Gériatrie, CHU de Rennes, Rennes, France
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Cohen L, Sher-Censor E, Oppenheim D, Dassa A, Ayalon L, Palgi Y. Emotional availability in dyads of nursing aide - resident with dementia: Old tool, new perspective. DEMENTIA 2022; 21:882-898. [DOI: 10.1177/14713012211065396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives This study examined the emotional availability of nursing aide-resident with dementia dyads in a long-term care-facility. Emotional availability refers to the nursing aide’s sensitivity toward the resident, structuring their interactions in a non-intrusive and non-hostile manner and the resident’s responsiveness to and involvement of the nursing aide. The study evaluated the reciprocity in the emotional availability of nursing aides and the residents and examined whether emotional availability varies with the level of difficulty of taking care of the residents and with the context of the interaction. Method The study was conducted in three wards in one long-term care-facility. Twenty nursing aides and 40 residents took part in the study. Each nursing aide was videotaped during feeding, structured and unstructured interactions, with two residents, one that was nominated by the head nurse as difficult to take care of and one that was nominated as easy to take care of. The interactions were coded using the emotional availability scales. Results Linear mixed-effect model analyses indicated that higher emotional availability of nursing aides was related to higher emotional availability of the residents. Nursing aides’ emotional availability did not vary between “difficult” and “easy” residents or across the three interaction contexts. “Difficult” residents involved their nursing aides less than “easy” residents. Discussion The study documented the reciprocal nature of the interaction between nursing aides and residents with dementia. It suggests that nursing aides have an important role in promoting residents’ responsiveness and involvement.
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Affiliation(s)
- Liora Cohen
- Department of Gerontology, University of Haifa, Haifa, Israel
| | - Efrat Sher-Censor
- School of Psychological Sciences and the Center for the Study of Child Development, University of Haifa, Haifa, Israel
| | - David Oppenheim
- School of Psychological Sciences and the Center for the Study of Child Development, University of Haifa, Haifa, Israel
| | - Ayelet Dassa
- Music Department, Bar-Ilan University, Ramat-Gan, Israel
| | - Liat Ayalon
- Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat-Gan, Israel
| | - Yuval Palgi
- Department of Gerontology, University of Haifa, Israel
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Gulliver A, Pike G, Banfield M, Morse AR, Katruss N, Valerius H, Pescud M, McMaster M, West S. The Music Engagement Program for people with Alzheimer's disease and dementia: Pilot feasibility trial outcomes. EVALUATION AND PROGRAM PLANNING 2021; 87:101930. [PMID: 33711690 DOI: 10.1016/j.evalprogplan.2021.101930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 01/11/2021] [Accepted: 02/28/2021] [Indexed: 06/12/2023]
Abstract
Alzheimer's disease and dementia are common, highly disabling conditions frequently requiring residential care. This exploratory proof-of-concept study aimed to determine if the specialised Music Engagement Program (MEP) was sustainable, acceptable, and effective in improving quality of life, emotional wellbeing, and depression symptoms in this population. Sixteen residents, six staff members, and three family and community members took part in the evaluation of the MEP for people living with dementia in a residential aged-care nursing home in Canberra, Australia. Multiple methods were used. Quantitative evaluation assessed residents' depression symptoms (Cornell scale) at pre- and post-intervention, and emotional wellbeing pre- and post-session. Qualitative interviews with staff, and family and community members addressed the MEP's acceptability and potential sustainability. Results showed residents' mean depression scores were reduced from pre- to post-intervention (p = .039; dz = 0.72). Interviews established multiple benefits for residents including improved mood, calmness, and reduced aggression. However, staff did not believe it was feasible to continue the MEP sessions beyond the trial period without an external facilitator, citing potential difficulties in adhering to internal activities due to time constraints. This pilot study provides encouraging preliminary evidence for the MEP's acceptability and potential effectiveness for improving depression and wellbeing in this group.
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Affiliation(s)
- Amelia Gulliver
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Building 63 Eggleston Road, Acton, Canberra, ACT, 2601, Australia.
| | - Georgia Pike
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Building 63 Eggleston Road, Acton, Canberra, ACT, 2601, Australia
| | - Michelle Banfield
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Building 63 Eggleston Road, Acton, Canberra, ACT, 2601, Australia
| | - Alyssa R Morse
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Building 63 Eggleston Road, Acton, Canberra, ACT, 2601, Australia
| | - Natasha Katruss
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Building 63 Eggleston Road, Acton, Canberra, ACT, 2601, Australia
| | - Harley Valerius
- Noah's Ark Inc., 2/6 Farr Pl, Isaacs ACT 2607, Canberra, Australia
| | - Melanie Pescud
- Menzies Centre for Health Governance, School of Regulation and Global Governance (RegNet), College of Asia and the Pacific, The Australian National University, Coombs Extension Building (no 8), Fellows Road, Acton, Canberra, ACT, 2601, Australia
| | - Mitchell McMaster
- Centre for Research on Ageing, Health, and Wellbeing, Research School of Population Health, The Australian National University, Florey Building 54, Mills Road, Acton, Canberra, ACT, 2601, Australia
| | - Susan West
- School of Education / School of Theology, Charles Sturt University, 15 Blackall Street, Barton, Canberra, ACT, 2600, Australia
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Varshney SU, Varshney U, McCall WV. A proposal for a novel approach to reduce burdens of care for people with dementia: A hypothesis. Alzheimers Dement 2021; 18:211-221. [PMID: 34129281 DOI: 10.1002/alz.12388] [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: 08/28/2020] [Accepted: 04/22/2021] [Indexed: 11/06/2022]
Abstract
Cognitive impairment of dementia patients affects their ability to communicate and cooperate with care. Dementia patients need a specialized communication to increase their cooperation during daily care and a scale to measure cooperation with care. To improve communication, we created and applied a digital communication platform (DCP) in an observational study. To measure cooperation with care, we created and tested psychometric properties of the Cooperation with Care Scale-Revised (CWCS-R) in an institutional review board-approved 6-week prospective study. DCP intervention was associated with decreased agitation and use of psychotropic medications for nursing home (NH) dementia patients. CWCS-R is both a reliable and valid tool to measure cooperation with care in NH dementia patients. Innovations in communication with dementia patients and a scale to measure cooperation with care could reduce burdens of care and improve quality of life for patients, their family members, and staff. It may potentially help decrease cost of dementia care.
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Affiliation(s)
- Smita U Varshney
- AlzhaCare LLC, Kennesaw, Georgia, USA.,Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Upkar Varshney
- Computer Information Systems Department, Georgia State University, Atlanta, Georgia, USA
| | - William V McCall
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
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Theorell T, Engström G, Hallinder H, Lennartsson AK, Kowalski J, Emami A. The use of saliva steroids (cortisol and DHEA-s) as biomarkers of changing stress levels in people with dementia and their caregivers: A pilot study. Sci Prog 2021; 104:368504211019856. [PMID: 34030538 PMCID: PMC10305820 DOI: 10.1177/00368504211019856] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The rationale was to explore the efficacy/sensitivity of using morning and evening cortisol levels as biomarkers for stress reduction in persons with dementia (PWDs) and their family caregivers (FCGs) participating in a music intervention program. Thirty-two PWD and their FGC were recruited to an 8-week, home-based music intervention program. Daily home-based collection of saliva samples took place at bedtime and upon awakening. Cortisol was analyzed in the morning and evening saliva samples and DHEA-s in the morning samples. Trends over 40 workdays (15-40 observations per subject) were assessed using linear regression analysis. Twenty-three PWD (72% of invited, 16 men and 7 women, age 69-93) and 24 caregivers (75%, 8 men and 16 women, age 37-90) completed the intervention for at least 6 weeks and were included in the analysis. One-fourth of the PWD and FCG had decreasing evening cortisol, accompanied by decreasing morning cortisol levels. In one-fourth of the participants the ratio between cortisol and DHEA-S in the morning samples was improved, indicating improved balance between energy mobilization and regeneration. Several participants showed no significant endocrine change. There was a statistically significant (two-sided test) correlation within the PWD-caregiver dyads in evening cortisol trend and a statistically significant decrease (two-sided test) in the morning-evening cortisol slope for the FCG group. Reduction in stress, as measured by evening cortisol, was observed in a substantial number of the participants. Recording endocrine stress is helpful for the unbiased assessment of the intervention.
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Affiliation(s)
- Tores Theorell
- Stress Research Institute, Stockholm
University, Stockholm, Sweden
- Department of International Health,
Karolinska Institute, Stockholm, Sweden
| | | | | | | | - Jan Kowalski
- JK Biostatistics, Karlbergsvägen,
Stockholm, Sweden
| | - Azita Emami
- School of Nursing, University of
Washington, Seattle, WA, USA
- Division of Occupational Therapy,
Department of Neuroscience, Care Sciences & Society (NVS), Karolinska
Institutet, Stockholm, Sweden
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Resnick B, Boltz M, Galik E, Fix S, Holmes S, Zhu S, Barr E. Testing the Impact of FFC-AL-EIT on Psychosocial and Behavioral Outcomes in Assisted Living. J Am Geriatr Soc 2021; 69:459-466. [PMID: 33095469 PMCID: PMC8116977 DOI: 10.1111/jgs.16886] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/28/2020] [Accepted: 09/30/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study tested the impact of Function Focused Care for Assisted Living Using the Evidence Integration Triangle (FFC-AL-EIT) on: (1) care interactions between residents and direct care staff; and (2) behavior and psychological symptoms associated with dementia among residents. DESIGN This was a randomized controlled trial. SETTING A total of 59 assisted living facilities in Maryland, Pennsylvania, and Massachusetts participated. PARTICIPANTS The sample included 550 mostly White (98%), female (69%) residents with a mean age of 89.30 (standard deviation = 7.63) years. INTERVENTION The four-step FFC-AL-EIT intervention was implemented by a function focused care nurse facilitator working with a facility champion over 12 months. The steps included: (1) environment and policy assessments; (2) education; (3) establishing resident function focused care service plans; and (4) mentoring and motivating. MEASURES Resident descriptive data (e.g., age, sex, education, and comorbidities), depression, agitation, resistiveness to care, and the quality of care interactions were obtained at baseline and 4 and 12 months. Treatment fidelity data included environment and policy assessments, performance of function focused care by staff, and service plan assessments. RESULTS There was a significant positive treatment effect related to depression, agitation, resistiveness to care, and quality of care interactions with either less decline or some improvement in these behaviors and symptoms in the treatment versus control group. CONCLUSION The study provides some statistical support, which may not necessarily be clinically significant evidence, for psychosocial outcomes of residents and care interactions between staff and residents in assisted living settings.
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Affiliation(s)
- Barbara Resnick
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Marie Boltz
- Pennsylvania State University College of Nursing, 306 Nursing Sciences Building, University Park, PA 16802
| | - Elizabeth Galik
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Steven Fix
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Sarah Holmes
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Shijun Zhu
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Erik Barr
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
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12
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Swall A, Hammar LM, Gransjön Craftman Å. Like a bridge over troubled water - a qualitative study of professional caregiver singing and music as a way to enable person-centred care for persons with dementia. Int J Qual Stud Health Well-being 2020; 15:1735092. [PMID: 32212959 PMCID: PMC7170273 DOI: 10.1080/17482631.2020.1735092] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2020] [Indexed: 01/31/2023] Open
Abstract
Purpose: To describe the perspectives of caregivers in terms of using singing and music in their everyday work, and of their effect on care and interaction with the person with dementia.Methods: A qualitative design was used, consisting of group discussions with professional caregivers from three nursing homes in a medium-sized city in a rural area of Sweden.Results: The results demonstrate that caregiver singing and music can be powerful and useful in the care of and in communication with persons with dementia. Music, for example, can be used to facilitate socialization as it opens up for discussion, while caregiver singing was preferable when it came to the facilitation of care situations and interaction.Conclusions: Singing and music can be powerful and useful tools in the care of and in communication with persons with dementia. Regardless of whether singing or music is used, the most important factor is that a person-centred approach is adopted so as to make the music a facilitative tool. Caregiver singing and music are ways to connect with the person with dementia and an understanding of their use can contribute to dementia research. This in turn can increase awareness of the possible ways to strengthen the partnership between caregivers and persons with dementia.
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Affiliation(s)
- Anna Swall
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Lena Marmstål Hammar
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
- Division of Nursing, Department of Neurobiology, Care Sciences, Karolinska Institutet, Stockholm, Sweden
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Backhouse T, Dudzinski E, Killett A, Mioshi E. Strategies and interventions to reduce or manage refusals in personal care in dementia: A systematic review. Int J Nurs Stud 2020; 109:103640. [DOI: 10.1016/j.ijnurstu.2020.103640] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 05/07/2020] [Accepted: 05/10/2020] [Indexed: 11/25/2022]
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Rodrigo-Claverol M, Malla-Clua B, Marquilles-Bonet C, Sol J, Jové-Naval J, Sole-Pujol M, Ortega-Bravo M. Animal-Assisted Therapy Improves Communication and Mobility among Institutionalized People with Cognitive Impairment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5899. [PMID: 32823839 PMCID: PMC7459682 DOI: 10.3390/ijerph17165899] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/02/2020] [Accepted: 08/12/2020] [Indexed: 11/17/2022]
Abstract
Disorders of communication, social relationships, and psychomotricity are often characterized by cognitive impairment, which hinders daily activities and increases the risk of falls. This study aimed to evaluate the efficacy of an animal-assisted therapy (AAT) program in an institutionalized geriatric population with cognitive impairment. The variables evaluated included level of communication and changes in gait and/or balance. We performed a two-arm, parallel controlled, open-label, nonrandomized cluster clinical trial in two nursing home centers from an urban area. Patients in the two centers received 12 weekly sessions of physiotherapy, but the experimental group included AAT with a therapy dog. The study included a total of 46 patients (23 Control Group [CG], 23 Experimental Group [EG]) with a median age of 85.0 years. Of these, 32.6% had mild-moderate cognitive decline (Global Deterioration Scale of Reisberg [GDS] 2-4) and 67.4% severe cognitive decline (GDS 5-6). After the intervention, patients in the CG and EG showed a statistically significant improvement in all the response variables. When comparing both groups, no statistically significant differences were found in any of the Tinetti scale results (measuring gait and balance). However, the communication of patients in the EG, measured on the Holden scale, showed a statistically significant greater improvement postintervention than that of patients in the CG. AAT can be useful as a complementary, effective treatment for patients with different degrees of cognitive decline.
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Affiliation(s)
- Maylos Rodrigo-Claverol
- Primary Health Care Center Bordeta-Magraners, Catalan Institute of Health, 25001 Lleida, Spain; (B.M.-C.); (C.M.-B.); (J.J.-N.)
- Ilerkan Association, 25005 Lleida, Spain;
| | - Belén Malla-Clua
- Primary Health Care Center Bordeta-Magraners, Catalan Institute of Health, 25001 Lleida, Spain; (B.M.-C.); (C.M.-B.); (J.J.-N.)
| | - Carme Marquilles-Bonet
- Primary Health Care Center Bordeta-Magraners, Catalan Institute of Health, 25001 Lleida, Spain; (B.M.-C.); (C.M.-B.); (J.J.-N.)
| | - Joaquim Sol
- Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain; (J.S.); (M.O.-B.)
- Institut Català de la Salut, Atenció Primària, 25007 Lleida, Spain
- Metabolic Physiopathology Research Group, Experimental Medicine Department, Lleida University-Lleida Biochemical Research Institute (UdL-IRBLleida), 25198 Lleida, Spain
| | - Júlia Jové-Naval
- Primary Health Care Center Bordeta-Magraners, Catalan Institute of Health, 25001 Lleida, Spain; (B.M.-C.); (C.M.-B.); (J.J.-N.)
- Ilerkan Association, 25005 Lleida, Spain;
| | | | - Marta Ortega-Bravo
- Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain; (J.S.); (M.O.-B.)
- Institut Català de la Salut, Atenció Primària, 25007 Lleida, Spain
- Research Group in Therapies in Primary Care, Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
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Barrett E, Burke M, Whelan S, Santorelli A, Oliveira BL, Cavallo F, Dröes RM, Hopper L, Fawcett-Henesy A, Meiland FJM, Mountain G, Moyle W, Raciti M, Pegman G, Teare A, Sancarlo D, Riccardi F, D'Onofrio G, Giuliani F, Russo A, Bleaden A, Greco A, Casey D. Evaluation of a Companion Robot for Individuals With Dementia: Quantitative Findings of the MARIO Project in an Irish Residential Care Setting. J Gerontol Nurs 2020; 45:36-45. [PMID: 31237660 DOI: 10.3928/00989134-20190531-01] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 05/14/2019] [Indexed: 11/20/2022]
Abstract
The current study focuses on the short-term effect of MARIO, a social robot, on quality of life, depression, and perceived social support in persons with dementia (PWD) and evaluates their acceptability of MARIO. Ten PWD in one nursing home took part in a 4-week pilot study, where each participant had up to 12 sessions with MARIO. Sessions comprised engagement in music, news, reminiscence, games, and calendar applications. Standardized questionnaires were administered before and after the 4-week period. Participants had a sustained interest in MARIO during their interactions and an acceptance of MARIO's appearance, sound, and applications. Consequently, participants spent more time socially engaged. No statistically significant differences were found in quality of life, depression, and perceived social support. PWD can engage with a social robot in a real-world nursing home. Future research should incorporate a larger sample and longer intervention period. [Journal of Gerontological Nursing, 45(7), 36-45.].
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Batt-Rawden KB, Stedje K. Singing as a health-promoting activity in elderly care: a qualitative, longitudinal study in Norway. J Res Nurs 2020; 25:404-418. [PMID: 34394654 PMCID: PMC7932378 DOI: 10.1177/1744987120917430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The current standards of care of the older person recommend employing non-pharmacological approaches to challenges, including safe approaches to managing pain and stress, enhancing symptom relief, and fostering independent lifestyles with the highest quality of life possible. More research is needed to enable nurses and other medical staff to use singing and music-based interventions, to access singing-based programmes, and promote a greater use of choirs in nursing homes. A solid basis of positive experiences and feedback through evidence in practice is required to help promote support for such activities. Aims To identify, explore and describe experiences, attitudes, beliefs, issues, processes and changes among nurses, carers and leaders in reference to implementation of the educational programme 'Singing Nursing Homes', Norway. To increase knowledge and understanding of how an educational song programme could become an integral part of nursing practice and quality of care in nursing and care homes, and identify why this would be constructive. Since its inception in 2015, 'Singing Norway' wanted to offer a professional, evidence-based programme for nursing homes throughout the country. Methods A longitudinal, qualitative and explorative approach. In-depth interviews and focus group interviews of female employees (n = 19) from three nursing homes in Norway, 2018. Results Nursing home employees perceived singing to have potential benefits for their patients, such as reducing uneasiness, increased comfort, well-being and joy, improved sleep, and believed singing had the potential to reduce the need for medication and prevent accidents among their patients. By facilitating opportunities for learning and practice, staff in nursing homes were able to use singing as part of their 'art of caring', enhancing environmental care for the older person. Singing was found to have positive effects for the patients, their relatives and the staff, which improved the psychosocial working climate overall. Conclusions Singing interventions could be a vital component for the enhancement of health, well-being and quality of life for the patients and staff in nursing homes.
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Affiliation(s)
- Kari Bjerke Batt-Rawden
- Associate Professor/Sociologist, Department of Health Sciences Gjøvik, Norwegian University of Science and Technology, Norway
| | - Kristi Stedje
- Music Therapist, Department of Music and Health, University College of Music, Norway
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Wood S. Beyond Messiaen's birds: the post-verbal world of dementia. MEDICAL HUMANITIES 2020; 46:73-83. [PMID: 31142577 PMCID: PMC7042969 DOI: 10.1136/medhum-2018-011616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/15/2019] [Accepted: 01/30/2019] [Indexed: 06/09/2023]
Abstract
This paper investigates the use of verbatim musical transcription as a research method in dementia care. It reports on an art-based ethnographic study (Aesthetic Research in Everyday Life (Aeriel)) in which verbatim transcription was applied to everyday interactions in dementia care, making use of musical-instead of verbal-notation. Starting from the notion that medical and healthcare settings can be sites of 'found performance', the paper reviews literature relating to artistic methodologies within medical humanities, music, ethnography and dementia care. From this review, it proposes a research design and method of verbatim musical transcription as a potential avenue of investigating communication between carer and cared for in dementia care. The paper offers an illustrative example from Aeriel and draws conclusions from the synthesis of verbal and musical data analysis. Findings indicate an important advance in studies of dementia care communication towards a concept of the 'post-verbal' enabled by a musical research method and the clinical applications that it offers.
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Affiliation(s)
- Stuart Wood
- Guildhall School of Music and Drama, London, UK
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Huber A, Oppikofer S, Meister L, Langensteiner F, Meier N, Seifert A. Music & Memory: The Impact of Individualized Music Listening on Depression, Agitation, and Positive Emotions in Persons with Dementia. ACTIVITIES, ADAPTATION & AGING 2020. [DOI: 10.1080/01924788.2020.1722348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Andreas Huber
- Center for Gerontology, University of Zurich, Zurich, Switzerland
| | - Sandra Oppikofer
- Center for Gerontology, University of Zurich, Zurich, Switzerland
| | - Laura Meister
- Center for Gerontology, University of Zurich, Zurich, Switzerland
| | | | - Nico Meier
- Domicil Bern, Kompetenzzentrum Demenz Bethlehemacker, Bern, Switzerland
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Froggatt K, Best A, Bunn F, Burnside G, Coast J, Dunleavy L, Goodman C, Hardwick B, Jackson C, Kinley J, Davidson Lund A, Lynch J, Mitchell P, Myring G, Patel S, Algorta GP, Preston N, Scott D, Silvera K, Walshe C. A group intervention to improve quality of life for people with advanced dementia living in care homes: the Namaste feasibility cluster RCT. Health Technol Assess 2020; 24:1-140. [PMID: 31971506 PMCID: PMC7008353 DOI: 10.3310/hta24060] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND People with advanced dementia who live and die in nursing homes experience variable quality of life, care and dying. There is a need to identify appropriate, cost-effective interventions that facilitate high-quality end-of-life care provision. OBJECTIVES To establish the feasibility and acceptability to staff and family of conducting a cluster randomised controlled trial of the Namaste Care intervention for people with advanced dementia in nursing homes. DESIGN The study had three phases: (1) realist review and (2) intervention refinement to inform the design of (3) a feasibility cluster randomised controlled trial with a process evaluation and economic analysis. Clusters (nursing homes) were randomised in a 3 : 1 ratio to intervention or control (usual care). The nature of the intervention meant that blinding was not possible. SETTING Nursing homes in England providing care for people with dementia. PARTICIPANTS Residents with advanced dementia (assessed as having a Functional Assessment Staging Test score of 6 or 7), their informal carers and nursing home staff. INTERVENTION Namaste Care is a complex group intervention that provides structured personalised care in a dedicated space, focusing on enhancements to the physical environment, comfort management and sensory engagement. MAIN OUTCOME MEASURES The two contender primary outcome measures were Comfort Assessment in Dying - End of Life Care in Dementia for quality of dying (dementia) and Quality of Life in Late Stage Dementia for quality of life. The secondary outcomes were as follows: person with dementia, sleep/activity (actigraphy), neuropsychiatric symptoms, agitation and pain; informal carers, satisfaction with care at the end of life; staff members, person-centred care assessment, satisfaction with care at the end of life and readiness for change; and other data - health economic outcomes, medication/service use and intervention activity. RESULTS Phase 1 (realist review; 86 papers) identified that a key intervention component was the activities enabling the development of moments of connection. In phase 2, refinement of the intervention enabled the production of a user-friendly 16-page A4 booklet. In phase 3, eight nursing homes were recruited. Two homes withdrew before the intervention commenced; four intervention and two control homes completed the study. Residents with advanced dementia (n = 32) were recruited in intervention (n = 18) and control (n = 14) homes. Informal carers (total, n = 12: intervention, n = 5; control, n = 7) and 97 staff from eight sites (intervention, n = 75; control, n = 22) were recruited over a 6-month period. Recruitment is feasible. Completion rates of the primary outcome questionnaires were high at baseline (100%) and at 4 weeks (96.8%). The Quality of Life in Late Stage Dementia was more responsive to change over 24 weeks. Even where economic data were missing, these could be collected in a full trial. The intervention was acceptable; the dose varied depending on the staffing and physical environment of each care home. Staff and informal carers reported changes for the person with dementia in two ways: increased social engagement and greater calm. No adverse events related to the intervention were reported. CONCLUSIONS A subsequent definitive trial is feasible if there are amendments to the recruitment process, outcome measure choice and intervention specification. FUTURE WORK In a full trial, consideration is needed of the appropriate outcome measure that is sensitive to different participant responses, and of clear implementation principles for this person-centred intervention in a nursing home context. TRIAL REGISTRATION Current Controlled Trials ISRCTN14948133. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 6. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Katherine Froggatt
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Ashley Best
- Clinical Trials Research Centre, University of Liverpool, Liverpool, UK
| | - Frances Bunn
- Department of Health and Human Sciences, University of Hertfordshire, Hatfield, UK
| | - Girvan Burnside
- Clinical Trials Research Centre, University of Liverpool, Liverpool, UK
| | - Joanna Coast
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lesley Dunleavy
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Claire Goodman
- Department of Health and Human Sciences, University of Hertfordshire, Hatfield, UK
| | - Ben Hardwick
- Clinical Trials Research Centre, University of Liverpool, Liverpool, UK
| | - Clare Jackson
- Clinical Trials Research Centre, University of Liverpool, Liverpool, UK
| | | | | | - Jennifer Lynch
- Department of Health and Human Sciences, University of Hertfordshire, Hatfield, UK
| | - Paul Mitchell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Gareth Myring
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Shakil Patel
- Lancashire Clinical Trials Unit, University of Central Lancashire, Preston, UK
| | - Guillermo Perez Algorta
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Nancy Preston
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | | | - Kate Silvera
- Clinical Trials Research Centre, University of Liverpool, Liverpool, UK
| | - Catherine Walshe
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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Dowson B, McDermott O, Schneider J. What indicators have been used to evaluate the impact of music on the health and wellbeing of people with dementia? A review using meta-narrative methods. Maturitas 2019; 127:26-34. [DOI: 10.1016/j.maturitas.2019.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/17/2019] [Accepted: 06/03/2019] [Indexed: 01/17/2023]
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Holden SK, Sheffler J, Stewart R, Thompson S, Persson J, Finseth T, Sillau S, Kluger BM. Feasibility of Home-Based Neurologic Music Therapy for Behavioral and Psychological Symptoms of Dementia: A Pilot Study. J Music Ther 2019; 56:265-286. [DOI: 10.1093/jmt/thz009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Family caregivers often feel ill-equipped to handle bothersome behavioral and psychological symptoms of dementia, such as agitation, apathy, and sleep disturbances, leading to increased caregiver distress and nursing home placement for people with dementia. Therapies for such symptoms are currently limited and non-pharmacological options are preferred, given potential side effects of medications. Neurologic music therapy (NMT) could provide an additional treatment option for managing behavioral and psychological symptoms for community-dwelling people with dementia and their caregivers. This pilot study sought to evaluate the feasibility, acceptability, and effectiveness of home-based NMT for behavioral and psychological symptoms of dementia. Eighteen persons with dementia-caregiver dyads were enrolled to receive one-hour weekly sessions of home-based NMT for 6 weeks. Demographic, quality of life, neuropsychiatric symptom, and caregiver burden and self-efficacy information was collected at baseline, 6 weeks, and 12 weeks. Seven dyads (38.9%) withdrew from therapy before completing all sessions; these participants had higher Neuropsychiatric Inventory scores and were of older age at baseline. For those who completed therapy, neuropsychiatric symptom scores improved at 6 weeks, an effect that was sustained at 12 weeks. No other outcome measures changed significantly after therapy. Initiating NMT too late in the course of dementia, when behavioral symptoms are already present, may be impractical for people with dementia and increase caregiver stress, even when provided within the home. Introducing and incorporating the principles of NMT earlier in the course of dementia could allow for increased comfort and benefit for people with dementia and their caregivers.
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Affiliation(s)
- Samantha K Holden
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Julia Sheffler
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA
| | | | | | | | - Taylor Finseth
- Department of Neurology, Aurora St. Luke’s Medical Center, Milwaukee, WI, USA
| | - Stefan Sillau
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Benzi M Kluger
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
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Bunn F, Lynch J, Goodman C, Sharpe R, Walshe C, Preston N, Froggatt K. Improving living and dying for people with advanced dementia living in care homes: a realist review of Namaste Care and other multisensory interventions. BMC Geriatr 2018; 18:303. [PMID: 30522450 PMCID: PMC6282262 DOI: 10.1186/s12877-018-0995-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 11/26/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Seventy percent of people with advanced dementia live and die in care homes. Multisensory approaches, such as Namaste Care, have been developed to improve the quality of life and dying for people with advanced dementia but little is known about effectiveness or optimum delivery. The aim of this review was to develop an explanatory account of how the Namaste Care intervention might work, on what outcomes, and in what circumstances. METHODS This is a realist review involving scoping of the literature and stakeholder interviews to develop theoretical explanations of how interventions might work, systematic searches of the evidence to test and develop the theories, and their validation with a purposive sample of stakeholders. Twenty stakeholders - user/patient representatives, dementia care providers, care home staff, researchers -took part in interviews and/or workshops. RESULTS We included 85 papers. Eight focused on Namaste Care and the remainder on other types of sensory interventions such as music therapy or massage. We identified three context-mechanism-outcome configurations which together provide an explanatory account of what needs to be in place for Namaste Care to work for people living with advanced dementia. This includes: providing structured access to social and physical stimulation, equipping care home staff to cope effectively with complex behaviours and variable responses, and providing a framework for person-centred care. A key overarching theme concerned the importance of activities that enabled the development of moments of connection for people with advanced dementia. CONCLUSIONS This realist review provides a coherent account of how Namaste Care, and other multisensory interventions might work. It provides practitioners and researchers with a framework to judge the feasibility and likely success of Namaste Care in long term settings. Key for staff and residents is that the intervention triggers feelings of familiarity, reassurance, engagement and connection. STUDY REGISTRATION This study is registered as PROSPERO CRD42016047512.
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Affiliation(s)
- Frances Bunn
- Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB UK
| | - Jennifer Lynch
- Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB UK
| | - Claire Goodman
- Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB UK
| | - Rachel Sharpe
- Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB UK
| | - Catherine Walshe
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YG UK
| | - Nancy Preston
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YG UK
| | - Katherine Froggatt
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YG UK
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Pigliautile M, Ragni S, Longo A, Bartorelli L, Mecocci P. The "Artwork Effect" paradigm: A model for planning and assessing cognitive stimulation for people with dementia through museum visits. DEMENTIA 2018; 19:2867-2875. [PMID: 30509140 DOI: 10.1177/1471301218814638] [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: 11/15/2022]
Abstract
This paper proposes a paradigm ("Artwork Effect" paradigm) to study the impact of museum stimulation programs for people with dementia. The literature concerning viewing and making art is considered. The paradigm, comprising qualitative and quantitative measures, is illustrated. The implementation of a shared paradigm of assessment can contribute to the validation of an assessment model to evaluate museum stimulation programs for people with dementia: a low-cost nonpharmacological intervention useful for the stimulation of cognitive functions and for increasing the well-being of people with dementia and their caregivers.
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Affiliation(s)
- Martina Pigliautile
- Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy; Fondazione Roma Sanità, Rome, Italy
| | - Silvia Ragni
- Fondazione Roma Sanità e Associazione Italiana Psicogeriatria, Rome, Italy
| | - Annalisa Longo
- Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy; A.M.A.T.A. UMBRIA, Perugia, Italy
| | - Luisa Bartorelli
- Fondazione Roma Sanità e Associazione Italiana Psicogeriatria, Rome, Italy
| | - Patrizia Mecocci
- Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
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Rio R. A Community-Based Music Therapy Support Group for People With Alzheimer's Disease and Their Caregivers: A Sustainable Partnership Model. Front Med (Lausanne) 2018; 5:293. [PMID: 30460236 PMCID: PMC6232122 DOI: 10.3389/fmed.2018.00293] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 09/25/2018] [Indexed: 11/24/2022] Open
Abstract
People with Alzheimer's and related dementias and their family caregivers who reside at home have unique strengths and needs. They have the strengths of being in a place with which they are familiar, with people whom they are in close relationship. Often it is the spouse who provides the primary care of their loved one, and as the disease progresses both members of the couple are at risk for depression, isolation, and decreased contact with peers and community networks that serve to help maintain sociocultural, intellectual, physical, sensory, and spiritual needs. The person with Alzheimer's Disease (AD) loses life skills and sense of self as their memory loss worsens, and the caregiver-loved one, whether they are the spouse, relative, or close companion, becomes increasingly burdened physically and emotionally. Meaningful support through a community-based peer group helps meet the needs of the person with dementia and their caregiver from the first symptoms to the later stages of AD, through a carefully designed music therapy program tailored to preferences, culture, and ability. The music therapist working in the community provides practical leadership in coordination with local agencies, understands the needs of the person with dementia and their caregiver from a cultural and psychosocial perspective, and is creatively equipped in all facets of musical engagement for health and wellness, and fosters cognitive/intellectual, socio-emotional, physical, and spiritual support. The MT support group was found to relieve some of the strain on caregivers by allowing for greater emotional support through relationships with peers and professionals, and through the increase of meaningful interactions with their loved one with dementia. Through enjoyment of shared, pleasurable music experiences that stimulate memories, movement, language, and socialization, the person with AD and their caregiver developed a deeper connection with each other, and gained support, creative expression, and comfort from their peer group, as well as practical networking and sharing of resources and information related to their specific health and wellness needs. The community-based MT support group has been replicated twice within the region, and is a promising model for other communities. Formal research is recommended to provide further evidence of the effectiveness of the approach, and to allow for greater accessibility for marginalized people to participate in a program such as this in their own community.
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Affiliation(s)
- Robin Rio
- Arizona State University, Tempe, AZ, United States
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25
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Wood S, Crow F. The music matrix: A qualitative participatory action research project to develop documentation for care home music therapy services. BRITISH JOURNAL OF MUSIC THERAPY 2018. [DOI: 10.1177/1359457518794183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article presents a small Participatory Action Research project involving music therapists working in a care home company, creating a documentation tool (The Music Matrix) that is fit for purpose. The project emerged out of a commonly held dissatisfaction with existing documentation among the Music Therapists in the care home company’s national team. The Music Matrix tool uses graphic notation to record observations of client participation, systematised into 10 dimensions of activity. The tool was developed in a cycle of practice and reflection between members of the music therapy team and stakeholders in the wider organisation. This was systematised in a three-stage trial process of profiling, peer review and thematic synthesis of feedback. Findings suggest that the tool was viewed to be useful in a number of aspects. First, it enabled insights for Music Therapists, in seeing patterns and recognising unacknowledged habits in their own practice. It helped show complex experience in an immediate graphic way. This was useful for reporting to stakeholders and was flexible in applying to numerous formats of practice. However, this flexibility also created a level of uncertainty for some research respondents, as the tool’s wide applicability does not have the appearance of objectivity afforded by other methods. Stakeholders saw applications beyond music therapy, particularly for non-musical care work and activities. Insights emerged regarding how Music Therapists can usefully meet the many demands that care documentation serves.
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Curtis A, Gibson L, O'Brien M, Roe B. Systematic review of the impact of arts for health activities on health, wellbeing and quality of life of older people living in care homes. DEMENTIA 2018; 17:645-669. [PMID: 30041548 DOI: 10.1177/1471301217740960] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Care home populations frequently feature older people who often experience poor physical health and cognitive difficulties, along with vulnerability to psychological and social stressors. To date there has been no systematic review which focuses on the impact of arts for health activities to the care home population. Evidence was sourced from several databases and 71 studies were deemed eligible for inclusion in this review. These studies underwent data extraction and quality appraisal and the findings associated with health, wellbeing and quality of life are presented within this paper.
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Ray KD, Götell E. The Use of Music and Music Therapy in Ameliorating Depression Symptoms and Improving Well-Being in Nursing Home Residents With Dementia. Front Med (Lausanne) 2018; 5:287. [PMID: 30356835 PMCID: PMC6190855 DOI: 10.3389/fmed.2018.00287] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 09/17/2018] [Indexed: 12/31/2022] Open
Abstract
Background: Studies have shown music therapy can improve depression symptoms in dementia and the use of music activities show promise to have positive impacts on wellbeing. However, few studies show the influence of a music intervention led by certified nursing assistants (CNAs) trained by music therapists to address depression symptoms and wellbeing in individuals with dementia. Methods: Credentialed music therapists (1) administered 2-weeks of music therapy, (2) a 3-days training to CNAs, (3) followed by 2-weeks of music activities, singing and music-with-movement, led by CNAs for 62 nursing home residents with moderate dementia, (4) then measured depression symptoms using the Cornell Scale for Depression. We obtained video consent for 26 of the 62 residents who were video recorded receiving CNA-led music-based caregiving activities. Using the Music in Dementia Scale, over 200 h of video data was observed and raters measured changes in well-being, e.g., levels of enjoyment, mood and engagement in the residents, during the CNA facilitated music activities. Results: A repeated measures ANOVA revealed that mean depression scores differed statistically significantly between time points, p ≤ 0.001. Residents' baseline depression symptoms significantly declined following 2 weeks of music therapy, p ≤ 0.001, increased during a 2-weeks wash-out period, p = 0.389, but appeared to stabilize following the 2-weeks music activity, p = 1.00. A video analysis and paired sampled t-test demonstrated a significant improvement in wellbeing in residents who engaged in music with movement, p = 0.003. Wellbeing improved slightly, but not significantly for residents who participated in the singing intervention, p = 0.165. Conclusion: Findings suggest that music therapy can significantly decrease depression symptoms in nursing home residents with dementia. Music activities designed by music therapists and facilitated by CNAs may help sustain the reduction of depression symptoms and improve wellbeing in nursing home residents with moderate to severe dementia.
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Affiliation(s)
- Kendra D Ray
- Planning and Research Department, Menorah Center for Nursing and Rehabilitation, MJHS, Brooklyn, NY, United States
| | - Eva Götell
- Ersta Sköndal Bräcke University College, Stockholm, Sweden
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Abstract
People with cognitive impairment often require assistance with activities of daily living. It is when providing assistance with these activities that many caregivers experience behaviors that have been categorized as disruptive or problematic and called resistiveness to care. These behaviors are considered to be a source of burden and job burnout for caregivers. Nurses wanting to help caregivers, who manage these trying situations, need to understand the concept of resistiveness to care and communicate this knowledge clearly with health care providers. Therefore, a literature search was conducted in 2012 within the databases CINAHL, Medline (PubMed), ProQuest, and PsychINFO. This produced 40 relevant articles. Because no concept analysis existed for resistiveness to care, a principle-based concept analysis was performed. The analysis helped construct a theoretically defined concept. Further analysis highlighted that more research is needed to advance the concept of resistiveness to care to enhance professional communication surrounding this phenomenon.
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Affiliation(s)
| | | | - Lisa Kitko
- Pennsylvania State University, University Park, USA
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Robb SL, Hanson-Abromeit D, May L, Hernandez-Ruiz E, Allison M, Beloat A, Daugherty S, Kurtz R, Ott A, Oyedele OO, Polasik S, Rager A, Rifkin J, Wolf E. Reporting quality of music intervention research in healthcare: A systematic review. Complement Ther Med 2018; 38:24-41. [PMID: 29857877 PMCID: PMC5988263 DOI: 10.1016/j.ctim.2018.02.008] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/21/2018] [Accepted: 02/22/2018] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Concomitant with the growth of music intervention research, are concerns about inadequate intervention reporting and inconsistent terminology, which limits validity, replicability, and clinical application of findings. OBJECTIVE Examine reporting quality of music intervention research, in chronic and acute medical settings, using the Checklist for Reporting Music-based Interventions. In addition, describe patient populations and primary outcomes, intervention content and corresponding interventionist qualifications, and terminology. METHODS Searching MEDLINE, PubMed, CINAHL, HealthSTAR, and PsycINFO we identified articles meeting inclusion/exclusion criteria for a five-year period (2010-2015) and extracted relevant data. Coded material included reporting quality across seven areas (theory, content, delivery schedule, interventionist qualifications, treatment fidelity, setting, unit of delivery), author/journal information, patient population/outcomes, and terminology. RESULTS Of 860 articles, 187 met review criteria (128 experimental; 59 quasi-experimental), with 121 publishing journals, and authors from 31 countries. Overall reporting quality was poor with <50% providing information for four of the seven checklist components (theory, interventionist qualifications, treatment fidelity, setting). Intervention content reporting was also poor with <50% providing information about the music used, decibel levels/volume controls, or materials. Credentialed music therapists and registered nurses delivered most interventions, with clear differences in content and delivery. Terminology was varied and inconsistent. CONCLUSIONS Problems with reporting quality impedes meaningful interpretation and cross-study comparisons. Inconsistent and misapplied terminology also create barriers to interprofessional communication and translation of findings to patient care. Improved reporting quality and creation of shared language will advance scientific rigor and clinical relevance of music intervention research.
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Affiliation(s)
- Sheri L. Robb
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Deanna Hanson-Abromeit
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Lindsey May
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Eugenia Hernandez-Ruiz
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Megan Allison
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Alyssa Beloat
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Sarah Daugherty
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Rebecca Kurtz
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Alyssa Ott
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | | | - Shelbi Polasik
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Allison Rager
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Jamie Rifkin
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Emily Wolf
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
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Swall A, Ebbeskog B, Lundh Hagelin C, Fagerberg I. Stepping out of the shadows of Alzheimer's disease: a phenomenological hermeneutic study of older people with Alzheimer's disease caring for a therapy dog. Int J Qual Stud Health Well-being 2018; 12:1347013. [PMID: 28699394 PMCID: PMC5510223 DOI: 10.1080/17482631.2017.1347013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: Living with Alzheimer’s disease (AD) can involve a person being unable to recall and convey information in daily life. There are several ways to provide person-centred care to older people with AD, e.g. by empowering them in a situation. The use of animal-assisted therapy (AAT) with a therapy dog in the care of people with dementia is increasing, with the presence of a therapy dog being described as improving, among other things, the well-being and socialization of the person. The aim of this study was to illuminate meanings of care for people with AD in their encounters with a therapy dog. Method: The study used video-recorded observations of the person with AD and the dog. Data were transcribed and analysed using a phenomenological hermeneutic method. Results: The main theme was “Using one’s own resources and abilities as a human being”, which meant being the person one can be and distancing oneself from the symptoms of AD during the time with the dog. Conclusions: The feelings evoked in the people with AD included empathy and altruism, which allowed for a sense of joy and tenderness, which may induce a sense of self-worth, of being needed, and of being meaningful.
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Affiliation(s)
- Anna Swall
- a Department of Health Sciences, School of Health and Social Studies , Dalarna University , Falun , Sweden
| | - Britt Ebbeskog
- b Karolinska Institutet, Department of Neurobiology , Care Science and Society , Stockholm , Sweden
| | - Carina Lundh Hagelin
- b Karolinska Institutet, Department of Neurobiology , Care Science and Society , Stockholm , Sweden.,c Sophiahemmet University , Department of Nursing Science , Stockholm , Sweden
| | - Ingegerd Fagerberg
- d Department of Health Care Science , Ersta Sköndal Bräcke University College , Stockholm , Sweden
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Kårefjärd A, Nordgren L. Effects of dog-assisted intervention on quality of life in nursing home residents with dementia. Scand J Occup Ther 2018; 26:433-440. [PMID: 29693512 DOI: 10.1080/11038128.2018.1467486] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND People with dementia often have a poor quality of life. Therefore, methods that can improve their life situation must be identified. One promising method is dog-assisted intervention. AIM This study aimed to investigate the effects of dog-assisted intervention on quality of life in nursing home residents with dementia. MATERIALS AND METHODS A one-group, pretest post-test study design was used. Quality of life was measured using the QUALID in 59 nursing home residents prior to and after a dog-assisted intervention. Non-parametric tests were used to analyze the data, and effect sizes were calculated. RESULTS The participants' total scores improved significantly between baseline and post-test 1 (p = < 0.001) and worsened significantly at post-test 2 (p = 0.025). The largest effect size was found for the item 'Verbalization suggests discomfort' (p = 0.001). CONCLUSION The results indicate that dog-assisted interventions can have positive effects on quality of life in nursing home residents with moderate to severe dementia. SIGNIFICANCE The results contribute to a growing knowledge base about non-pharmacological methods that can be used in dementia care. Occupational therapists should consider dog-assisted interventions when planning activities that can reduce the illness burden and improve the quality of life for people with dementia.
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Affiliation(s)
- Ann Kårefjärd
- a ReHabenheten , Vård-och omsorgsförvaltningen , Eskilstuna , Sweden
| | - Lena Nordgren
- b Centre for Research and Development , Sörmland County Council, Centre for Clinical Research Sörmland, Uppsala University , Uppsala , Sweden
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Measurement of agitation and aggression in adult and aged neuropsychiatric patients: review of definitions and frequently used measurement scales. CNS Spectr 2017; 22:407-414. [PMID: 28179043 DOI: 10.1017/s1092852917000050] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Agitation and aggression in adult psychiatric patients with psychoses and in persons with dementia increase the burden of disease and frequently cause hospitalization. The implementation of currently available management strategies and the development of new ones is hindered by inconsistent terminology that confuses agitation with aggression. This confusion is maintained by many rating scales that fail to distinguish between these two syndromes. We review the frequently used rating scales with a particular focus on their ability to separate agitation from aggression. Agitation and aggression are two different syndromes. For example, reactive aggression is often precipitated by rejection of care and may not be associated with agitation per se. We propose, in treatment studies of behavioral symptoms of dementia and challenging behaviors in psychoses, that outcomes should be evaluated separately for agitation and aggression. This is important for investigation of drug effectiveness since the medication may be effective against one syndrome but not the other. Separate assessments of agitation and aggression should be a general principle of trial design with particular salience for registration studies of medications proposed for approval by the U.S. Food and Drug Administration and other regulatory bodies.
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Williams CL, Newman D, Hammar LM. Preliminary Psychometric Properties of the Verbal and Nonverbal Interaction Scale: An Observational Measure for Communication in Persons with Dementia. Issues Ment Health Nurs 2017; 38:381-390. [PMID: 28448228 DOI: 10.1080/01612840.2017.1279248] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Little attention has been given to sociable/unsociable communication in persons with dementia despite the importance of these behaviors in maintaining engagement in marital relationships. An observational measure of verbal and nonverbal communication in persons with dementia (Verbal and Nonverbal Interaction Scale-CR) who were engaged in conversations with spouses was tested for reliability and validity. Married persons with dementia were video-recorded at home conversing with spouses over 10 weeks (N = 118 recordings). Reliability [inter-coder (.92), test-retest (r =.61-.77), internal consistency (α =.65 -.79)] were adequate. Following an intervention, the Verbal and Nonverbal Interaction Scale-CR predicted improved communication over 10 weeks. The ratio of sociable to unsociable communication improved by 4.46 points per session [β = 4.46, t(10) = 1.96, p =.039]. VNVIS-CR is recommended to describe sociable and unsociable communication in persons with dementia as they engage in conversations with spouses.
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Affiliation(s)
- Christine L Williams
- a Christine E. Lynn College of Nursing, Florida Atlantic University , Boca Raton , Florida , USA
| | - David Newman
- a Christine E. Lynn College of Nursing, Florida Atlantic University , Boca Raton , Florida , USA
| | - Lena Marmstål Hammar
- b School of Education, Health and Social Studies, Dalarna University , Falun , Sweden
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Shirai Y, Koerner SS. Examining the Influence of Care-Recipient Resistance on Family Caregiver Emotional and Physical Well-Being: Average Frequency Versus Daily Fluctuation. J Appl Gerontol 2016; 37:203-227. [PMID: 27006432 DOI: 10.1177/0733464816631594] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Although existing cross-sectional research suggests that dependent older family members' resistive behavior (care-recipient [CR] resistance: verbal or nonverbal rejection or resistance toward caregiver [CG] assistance) can be challenging for informal family CGs, we know little about the impact of the occurrence patterns of CR-resistance-average frequency versus daily fluctuation-on CG emotional and physical well-being. To document CGs' daily experiences with CR-resistance and their emotional and physical well-being, the present study applied short-term repeated measures, collecting data on 8 consecutive days from 63 CGs in Southern Arizona, the United States. Multilevel modeling of the daily data revealed that neither average frequency nor daily fluctuation in CR-resistance alone had a significant impact on CG emotional/physical health. However, the combination of experiencing relatively high frequency and high daily fluctuation in CR-resistance was associated with significant increases in CG physical health symptoms ( b = .34, p < .01). Specifically, on days when a CG faced more CR-resistance than his or her usual amount, significant increases in physical health symptoms existed for CGs with relatively high average frequency of CR-resistance, but not for CGs with relatively low average frequency of CR-resistance. Based on our results, it appears that monitoring and maintaining a reasonable level of CR-resistance are effective strategies to maintain CG resilience to the negative impact of CR-resistance daily fluctuation. The findings are interpreted in light of Stress Theory, and recommendations for future research and practical interventions are offered.
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Jones C, Sung B, Moyle W. Assessing engagement in people with dementia: a new approach to assessment using video analysis. Arch Psychiatr Nurs 2015; 29:377-82. [PMID: 26577550 DOI: 10.1016/j.apnu.2015.06.019] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/26/2015] [Accepted: 06/26/2015] [Indexed: 11/26/2022]
Abstract
The study of engagement in people with dementia is important to determine the effectiveness of interventions that aim to promote meaningful activity. However, the assessment of engagement for people with dementia in relation to our current work that uses social robots is fraught with challenges. The Video Coding - Incorporating Observed Emotion (VC-IOE) protocol that focuses on six dimensions of engagement: emotional, verbal, visual, behavioral, collective and signs of agitation was therefore developed. This paper provides an overview of the concept of engagement in dementia and outlines the development of the VC-IOE to assess engagement in people with dementia when interacting with social robots.
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Affiliation(s)
- Cindy Jones
- Menzies Health Institute Queensland, Centre for Health Practice Innovation, Nathan Campus, Nathan, QLD, Australia; Griffith University, School of Nursing and Midwifery, Nathan, QLD, Australia.
| | - Billy Sung
- Menzies Health Institute Queensland, Centre for Health Practice Innovation, Nathan Campus, Nathan, QLD, Australia.
| | - Wendy Moyle
- Menzies Health Institute Queensland, Centre for Health Practice Innovation, Nathan Campus, Nathan, QLD, Australia; Griffith University, School of Nursing and Midwifery, Nathan, QLD, Australia.
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Abstract
There is an increasing incidence of dementia in our aging population, and consequently an urgent need to develop treatments and activities that may alleviate the symptoms of dementia. Accumulating evidence shows that persons with dementia enjoy music, and their ability to respond to music is potentially preserved even in the late or severe stages of dementia when verbal communication may have ceased. Media interest in this topic has contributed to the public perception that music abilities are an "island of preservation" in an otherwise cognitively impaired person with dementia. In this chapter, we review the current literature on music cognition in dementia and show that there has been very scarce rigorous scientific investigation of this issue, and that various types of music memory exist and are differentially impaired in the different types of dementia. Furthermore, we discuss the recent development of music activities as a nonpharmacological treatment for dementia and highlight the methodological limitations of the current literature on this topic. While it has been reported that music activities can improve behavior, (particularly agitation), mood, and cognition in persons with dementia, recent large-scale randomized control studies have questioned the specificity of the effect of music and found that it is no more beneficial than other pleasant activities. Nevertheless, music is unique in its powerful ability to elicit both memories and emotions. This can provide an important link to individual's past and a means of nonverbal communication with carers, which make it an ideal stimulus for persons with dementia.
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Affiliation(s)
- Amee Baird
- ARC Centre of Excellence in Cognition and Its Disorders, Macquarie University, Sydney, Australia; Hunter Brain Injury Service, Newcastle, New South Wales, Australia
| | - Séverine Samson
- PSITEC Laboratory-EA 4072, Neuropsychology: Auditory, Cognition and Action Group, Department of Psychology, University of Lille, Lille, France; Pitié-Salpêtrière Hospital, Paris, France.
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Raglio A, Filippi S, Bellandi D, Stramba-Badiale M. Global music approach to persons with dementia: evidence and practice. Clin Interv Aging 2014; 9:1669-76. [PMID: 25336931 PMCID: PMC4199985 DOI: 10.2147/cia.s71388] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Music is an important resource for achieving psychological, cognitive, and social goals in the field of dementia. This paper describes the different types of evidence-based music interventions that can be found in literature and proposes a structured intervention model (global music approach to persons with dementia, GMA-D). The literature concerning music and dementia was considered and analyzed. The reported studies included more recent studies and/or studies with relevant scientific characteristics. From this background, a global music approach was proposed using music and sound-music elements according to the needs, clinical characteristics, and therapeutic-rehabilitation goals that emerge in the care of persons with dementia. From the literature analysis the following evidence-based interventions emerged: active music therapy (psychological and rehabilitative approaches), active music therapy with family caregivers and persons with dementia, music-based interventions, caregivers singing, individualized listening to music, and background music. Characteristics of each type of intervention are described and discussed. Standardizing the operational methods and evaluation of the single activities and a joint practice can contribute to achieve the validation of the application model. The proposed model can be considered a low-cost nonpharmacological intervention and a therapeutic-rehabilitation method for the reduction of behavioral disturbances, for stimulation of cognitive functions, and for increasing the overall quality of life of persons with dementia.
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Affiliation(s)
- Alfredo Raglio
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- APSP “Margherita Grazioli”, Povo, Trento, Italy
| | | | - Daniele Bellandi
- Geriatric Department, Sospiro Foundation, Sospiro, Cremona, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Swall A, Ebbeskog B, Lundh Hagelin C, Fagerberg I. Can therapy dogs evoke awareness of one's past and present life in persons with Alzheimer′s disease? Int J Older People Nurs 2014; 10:84-93. [DOI: 10.1111/opn.12053] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 12/20/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Anna Swall
- Department of Neurobiology, Caring Science and Social Science; Karolinska Institutet; Stockholm Sweden
- Sophiahemmet University; Stockholm Sweden
| | - Britt Ebbeskog
- Department of Neurobiology, Caring Science and Social Science; Karolinska Institutet; Stockholm Sweden
| | - Carina Lundh Hagelin
- Sophiahemmet University; Stockholm Sweden
- Department of Learning, Informatics, Management and Ethics; Cancer and Palliative care; Karolinska Institutet; Stockholm Sweden
| | - Ingegerd Fagerberg
- Department of Neurobiology, Caring Science and Social Science; Karolinska Institutet; Stockholm Sweden
- Department of Health Care Science; Ersta Sköndal University College; Stockholm Sweden
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Zeiler K. A philosophical defense of the idea that we can hold each other in personhood: intercorporeal personhood in dementia care. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2014; 17:131-141. [PMID: 24065459 DOI: 10.1007/s11019-013-9515-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Since John Locke, regnant conceptions of personhood in Western philosophy have focused on individual capabilities for complex forms of consciousness that involve cognition such as the capability to remember past events and one's own past actions, to think about and identify oneself as oneself, and/or to reason. Conceptions of personhood such as Locke's qualify as cognition-oriented, and they often fail to acknowledge the role of embodiment for personhood. This article offers an alternative conception of personhood from within the tradition of phenomenology of the body. The article presents a phenomenological analysis of joint musical activity in dementia care and outlines an intercorporeal conception of personhood based on this analysis. It also provides a philosophical basis for the idea that others can hold us in personhood, and it questions a strict one-body-one-person logic that has pertained in much personhood debate.
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Affiliation(s)
- Kristin Zeiler
- Department of Medical and Health Sciences, Linköping University, Linköping, Spain,
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Ridder HMO, Stige B, Qvale LG, Gold C. Individual music therapy for agitation in dementia: an exploratory randomized controlled trial. Aging Ment Health 2013; 17:667-78. [PMID: 23621805 PMCID: PMC4685573 DOI: 10.1080/13607863.2013.790926] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Accepted: 03/22/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Agitation in nursing home residents with dementia leads to increase in psychotropic medication, decrease in quality of life, and to patient distress and caregiver burden. Music therapy has previously been found effective in treatment of agitation in dementia care but studies have been methodologically insufficient. The aim of this study was to examine the effect of individual music therapy on agitation in persons with moderate/severe dementia living in nursing homes, and to explore its effect on psychotropic medication and quality of life. METHOD In a crossover trial, 42 participants with dementia were randomized to a sequence of six weeks of individual music therapy and six weeks of standard care. Outcome measures included agitation, quality of life and medication. RESULTS Agitation disruptiveness increased during standard care and decreased during music therapy. The difference at -6.77 (95% CI (confidence interval): -12.71, -0.83) was significant (p = 0.027), with a medium effect size (0.50). The prescription of psychotropic medication increased significantly more often during standard care than during music therapy (p = 0.02). CONCLUSION This study shows that six weeks of music therapy reduces agitation disruptiveness and prevents medication increases in people with dementia. The positive trends in relation to agitation frequency and quality of life call for further research with a larger sample.
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Affiliation(s)
- Hanne Mette O Ridder
- Doctoral Programme in Music Therapy, Department of Communication & Psychology, Aalborg University, Aalborg Øst, Denmark.
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