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van Voorden G, Koopmans RTCM, Strik-Lips MM, Smalbrugge M, Zuidema SU, van den Brink AMA, Persoon A, Oude Voshaar RC, Gerritsen DL. Organizational characteristics of highly specialized units for people with dementia and severe challenging behavior. BMC Geriatr 2024; 24:681. [PMID: 39143456 PMCID: PMC11323444 DOI: 10.1186/s12877-024-05257-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 07/29/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND People with dementia and severe challenging behavior in the Netherlands can be temporarily admitted to highly specialized units when their behavior is not manageable in regular dementia special care units (DSCUs). With scarce evidence available for the treatment of these patients, treatment in these units is in a pioneering phase. To gain more insight into these units, this study investigated organizational characteristics, i.e. admission and discharge characteristics, staffing, the physical environment, and the management of severe challenging behavior. METHODS Three data collection methods were used: 1) a digital questionnaire to be completed by the unit manager, 2) an interview with the physician responsible for medical care and often another practitioner, and 3) an observation of the physical environment for which the OAZIS-dementia questionnaire was used. Descriptive analysis was used for quantitative data and thematic analysis for qualitative data, after which data was interpreted together. Thirteen units participated, with their sizes ranging from 10 to 28 places. RESULTS Patients were mainly admitted from regular DSCUs, home or mental health care, and discharged to regular DSCUs. A multidisciplinary team comprising at least an elderly care physician or geriatrician, psychologist, and nursing staff member and other therapists as needed provided the treatment. Nursing staff hours per patient considerably differed among units. Nursing staff played a central role in the treatment. Competences such as reflectiveness on one's own behavior, and being able to cope with stressful situations were described as relevant for nursing staff. Investing in a stable nursing staff team was described as important. The units varied in whether their work-up was more intuitive or methodological. In the diagnostic phase, observation together with an extensive analysis of the patient's biography was essential. The units used a broad variety of interventions, and all paid attention to sensory stimuli. In the observation of the physical environment, the safety scored well and domesticity relatively low. CONCLUSION Highly specialized units show strong heterogeneity in organizational characteristics and management, which can be understood in the light of the pioneering phase. Despite this, similarities were found in nursing staff roles, frequent multidisciplinary evaluation, and attention to sensory stimuli.
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Affiliation(s)
- Gerrie van Voorden
- Radboudumc Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands.
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands.
- University Knowledge Network for Older Adult Care Nijmegen (UKON), Radboud University Medical Center, Nijmegen, Netherlands.
- Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands.
| | - Raymond T C M Koopmans
- Radboudumc Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
- University Knowledge Network for Older Adult Care Nijmegen (UKON), Radboud University Medical Center, Nijmegen, Netherlands
- Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
- Joachim en Anna, Center for Specialized Geriatric Care, De Waalboog, Nijmegen, Netherlands
| | - Mijke M Strik-Lips
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
| | - Martin Smalbrugge
- Department of Medicine for Older People, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Aging and Later Life, Amsterdam, Netherlands
| | - Sytse U Zuidema
- Department of Primary and Long-Term Care, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Alzheimer Center Groningen, Groningen, Netherlands
| | - Anne M A van den Brink
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
| | - Anke Persoon
- Radboudumc Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
- University Knowledge Network for Older Adult Care Nijmegen (UKON), Radboud University Medical Center, Nijmegen, Netherlands
- Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
| | - Richard C Oude Voshaar
- Alzheimer Center Groningen, Groningen, Netherlands
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Debby L Gerritsen
- Radboudumc Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
- University Knowledge Network for Older Adult Care Nijmegen (UKON), Radboud University Medical Center, Nijmegen, Netherlands
- Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
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Özata Değerli MN, Altuntaş O. Are behavioral and psychological symptoms of dementia related to sensory processing? APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-7. [PMID: 37410707 DOI: 10.1080/23279095.2023.2232067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Problems with sensory processing may have an impact on the behavioral and psychological symptoms that can be seen in Alzheimer's patients. Examining the relationship between the two factors may provide a new perspective for the management of behavioral and psychological symptoms of dementia. Mid-stage Alzheimer's patients completed the Neuropsychiatric Inventory and Adolescent/Adult Sensory Profile. The relationship between behavioral and psychological symptoms of dementia and sensory processing was investigated. Sixty individuals with a mean age of 75.35 (7.86) years and diagnosed with Alzheimer's Dementia 6.6 (2.92) years ago participated in the study. Individuals with severe behavioral and psychological symptoms had higher scores than individuals with moderate behavioral and psychological symptoms in low registration and sensory sensitivity quadrants . A relationship was found between sensory processing and behavioral and psychological symptoms of dementia in mid-stage Alzheimer's patients. This study highlighted the sensory processing differences in patients with Alzheimer's dementia. In future studies, interventions for sensory processing skills may play a role in improving the quality of life of individuals by contributing to the management of behavioral and psychological symptoms of dementia.
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Affiliation(s)
- Medine Nur Özata Değerli
- Faculty of Health Sciences, Department of Occupational Therapy, Hacettepe University, Ankara, Turkey
| | - Onur Altuntaş
- Faculty of Health Sciences, Department of Occupational Therapy, Hacettepe University, Ankara, Turkey
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Zaree M, Hassani Mehraban A, Lajevardi L, Saneii S, Pashazadeh Azari Z, Mohammadian Rasnani F. Translation, reliability and validity of Persian version of Adolescent/Adult Sensory Profile in dementia. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:1-7. [PMID: 33874830 DOI: 10.1080/23279095.2021.1904927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Our study aimed at the reliability and validity of the Persian version of the Adolescent/Adult Sensory Profile (AASP). This study was conducted on 130 people with dementia as well as 77 healthy elderlies. After translating the AASP into Persian, its content validity was determined based on 9 experts working in the same field. Cronbach's alpha and the Intraclass correlation coefficient (ICC) were calculated to assess the internal consistency and test-retest reliability of the Persian version of AASP. The two groups of people with dementia and healthy elderlies were compared in terms of scores in the four quadrants by performing an Independent t-test. All items in the Content Validity Ratio (CVR) and Content Validity Index (CVI) received an acceptable score. The Cronbach's alpha score for different parts of AASP was also calculated (α between 0.894 and 0.916; p < 0.001). The test-retest reliability of sub-tests of AASP was excellent (ICC between 0.885 and 0.948; p < 0.001). There was a statistically significant difference between the healthy Elderlies and dementia persons for low registration, sensory avoiding quadrants (p < 0.05). The Persian version of the AASP questionnaire is a reliable and valid questionnaire for people with dementia in Iran.
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Affiliation(s)
- Masoome Zaree
- Department of Occupational Therapy, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran
| | - Afsoon Hassani Mehraban
- Department of Occupational Therapy, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran
| | - Laleh Lajevardi
- Department of Occupational Therapy, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran
| | - SeyedHassan Saneii
- Department of Basic Sciences, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Pashazadeh Azari
- Faculty of Rehabilitation, Occupational Therapy Department, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Fatemeh Mohammadian Rasnani
- Department of Psychiatry, School of Medicine, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Rhodus EK, Hunter EG, Rowles GD, Bardach SH, Parsons K, Barber J, Thompson M, Jicha GA. Sensory Processing Abnormalities in Community-Dwelling Older Adults with Cognitive Impairment: A Mixed Methods Study. Gerontol Geriatr Med 2022; 8:23337214211068290. [PMID: 35024382 PMCID: PMC8744206 DOI: 10.1177/23337214211068290] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 12/26/2022] Open
Abstract
Mild cognitive impairment (MCI) or dementia often leads to behavioral and psychiatric symptoms of dementia (BPSD). Sensory processing abnormalities may be associated with BPSD. The purpose of this study was to explore relationships among sensory processing, behavior, and environmental features within the homes of people with MCI or dementia. This project used mixed methods to assess participants' sensory processing, care partner perspectives on behaviors, and in situ observations of the home environment. Nine participants with cognitive impairment (MCI n = 8, early dementia = 1) and their care partners were included. Seven participants with cognitive impairment were reported to have abnormal sensory processing. Findings suggest that unique environmental adaptations, tailored to personal and sensory preferences for each participant, were associated with a decreased level of behavioral disruption during the observation periods. Implementing sensory-based approaches to maximize environment adaptation may be beneficial in reducing disruptive behaviors for adults with cognitive impairment.
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Affiliation(s)
- Elizabeth K Rhodus
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, USA
| | - Elizabeth G Hunter
- Graduate Center for Gerontology, University of Kentucky, Lexington, KY, USA
| | - Graham D Rowles
- Graduate Center for Gerontology, University of Kentucky, Lexington, KY, USA
| | - Shoshana H Bardach
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth University, Lebanon, NH, USA
| | - Kelly Parsons
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - Justin Barber
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - MaryEllen Thompson
- Department of Occupational Science and Occupational Therapy, Eastern Kentucky University, Richmond, KY, USA
| | - Gregory A Jicha
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
- Department of Neurology, University of Kentucky, Lexington, KY, USA
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Goodall G, Ciobanu I, Taraldsen K, Sørgaard J, Marin A, Draghici R, Zamfir MV, Berteanu M, Maetzler W, Serrano JA. The Use of Virtual and Immersive Technology in Creating Personalized Multisensory Spaces for People Living With Dementia (SENSE-GARDEN): Protocol for a Multisite Before-After Trial. JMIR Res Protoc 2019; 8:e14096. [PMID: 31538942 PMCID: PMC6786690 DOI: 10.2196/14096] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/05/2019] [Accepted: 07/07/2019] [Indexed: 11/25/2022] Open
Abstract
Background The number of people living with dementia is rapidly increasing. With dementia’s impact on memory, communication, and self-identity, it is important to identify ways of meeting individual needs of diagnosed individuals and their caregivers. This study will test a new intervention, SENSE-GARDEN, that integrates autobiographical music, films, pictures, and scents with innovative technology to create an immersive environment tailored specifically for the individual. Objective The SENSE-GARDEN study is an Active Assisted Living Program–funded multicenter project. The primary objective of the study is to assess whether a personalized, innovative technology-based intervention can improve the well-being of older adults living with moderate to severe dementia. The study will also assess whether the intervention can improve coping and reduce burden in caregivers. Methods A controlled before-after study design will be used. There will be 3 sites in 3 trial countries: Belgium, Norway, and Portugal. A total of 55 people with dementia (PWDs) will be recruited. All eligible participants for the study will be randomized into the intervention or control group. For the first three months of the study, all participants will receive the SENSE-GARDEN intervention. For the final month of the study, the intervention group will continue visits to the SENSE-GARDEN, and the control group will discontinue visits. A mixed-methods approach will be used, including the use of standardized outcome measures, quantitative physiological data, and qualitative interview data. Results The trials commenced recruitment in August 2019, and all data are expected to be collected by the end of May 2020. A user-centered design process is underway, with results from the first phase of user interviews indicating that people with mild cognitive impairment, family caregivers, and professional caregivers consider the SENSE-GARDEN to be a potentially valuable tool in providing numerous benefits to dementia care. Feasibility testing of the SENSE-GARDEN has been completed and results are expected to be published in October 2019. Conclusions Findings from the SENSE-GARDEN trials will provide insights into the use of technology for personalizing interventions to the PWD. This will have potential implications on not only dementia research, but it may also have influences on care practice. International Registered Report Identifier (IRRID) DERR1-10.2196/14096
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Affiliation(s)
- Gemma Goodall
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ileana Ciobanu
- University of Medicine and Pharmacy Carol Davlia, Bucharest, Romania.,ELIAS University Hospital, Bucharest, Romania
| | - Kristin Taraldsen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jon Sørgaard
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Andreea Marin
- University of Medicine and Pharmacy Carol Davlia, Bucharest, Romania.,ELIAS University Hospital, Bucharest, Romania
| | - Rozeta Draghici
- University of Medicine and Pharmacy Carol Davlia, Bucharest, Romania.,ELIAS University Hospital, Bucharest, Romania
| | - Mihai-Viorel Zamfir
- University of Medicine and Pharmacy Carol Davlia, Bucharest, Romania.,ELIAS University Hospital, Bucharest, Romania
| | - Mihai Berteanu
- University of Medicine and Pharmacy Carol Davlia, Bucharest, Romania.,ELIAS University Hospital, Bucharest, Romania
| | - Walter Maetzler
- Department of Neurology, Christian-Albrechts-University, Kiel, Germany
| | - J Artur Serrano
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,Norwegian Centre for eHealth Research, University Hospital of North Norway, Tromsø, Norway
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