Cognitive stimulation and activities of daily living for individuals with mild-to-moderate dementia: A scoping review

Participant and caregiver experiences of an activities of daily living-focused cognitive stimulation program for individuals with mild-to-moderate dementia (CS-ADL)

Background

Individuals with dementia experience a progressive deterioration in their cognitive and functional abilities, and as a result, require support from informal family caregivers. Non-pharmacological interventions, such as cognitive stimulation, are increasingly being used to address this deterioration. This study explored the participant and caregiver experiences of CS-ADL (Cognitive Stimulation in Activities of Daily Living), an activities of daily living-focused group cognitive stimulation program for individuals with mild-to-moderate dementia.

Methods

A descriptive qualitative design was implemented. CS-ADL participants and caregivers were recruited in dyads through a Psychiatry of Later Life service where CS-ADL was delivered. Semi-structured interviews were completed with each dyad either in-person or via the telephone. Data retrieved were analyzed through reflexive thematic analysis.

Results

CS-ADL was experienced as an acceptable intervention that positively influenced the everyday life of both dyad members, with benefits reported in the memory, mood, daily routine, and social interaction of participants. Furthermore, the facilitation style of group facilitators positively influenced participants' engagement in CS-ADL. Limited data was gathered regarding the experience of activities of daily living.

Conclusion

This is the first study to explore experiences of CS-ADL, producing a preliminary addition to the evidence-base for CS-ADL. However, further research is required to confirm study findings and explore the experiences of activities of daily living in greater depth.

Dementia care and prevention in community settings: a built environment framework for cognitive health promotion

PURPOSE OF REVIEW

Most people with dementia live in the community. As lifespan increases, one in three persons aged 85+ are expected to live with dementia. We conduct a systematic search to identify frameworks for dementia care and prevention in community settings. This is important to ensure quality of life for people living with cognitive decline (PLCD).

RECENT FINDINGS

61 frameworks are synthesized into the dementia care and prevention in community (DCPC) framework. It highlights three levels of provision: built environment and policy supports, access and innovation, and inclusion across stages of decline. Domains of intervention include: basic needs; built environment health and accessibility; service access and use; community health infrastructure; community engagement; mental health and wellbeing; technology; end-of-life care; cultural considerations; policy, education, and resources. Personhood is not adequately represented in current built environment frameworks. This is supplemented with 14 articles on lived experiences at home and social practices that contribute to PLCD's social identity and psychological safety.

SUMMARY

Policy makers, health and built environment professionals must work together to promote "personhood in community" with PLCD. Clinicians and community staff may focus on inclusion, social identity and a sense of at-homeness as attainable outcomes despite diagnosis.