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Helbling M, Grandjean ML, Srinivasan M. Effects of multisensory environment/stimulation therapy on adults with cognitive impairment and/or special needs: A systematic review and meta-analysis. SPECIAL CARE IN DENTISTRY 2024; 44:381-420. [PMID: 37515496 DOI: 10.1111/scd.12906] [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: 02/06/2023] [Revised: 06/30/2023] [Accepted: 07/12/2023] [Indexed: 07/31/2023]
Abstract
AIM This review aimed to evaluate the effects of multisensory environments/stimulation (MSE/MSS) therapy, on the behavior and psychological symptoms in adults with cognitive impairment and/or special needs. METHODS Online database searches were performed to identify studies reporting on the effects of MSS/MSE therapy in adults (>18 years). Data were extracted for the following investigated outcomes including anxiety, depression, mood, behavioral attributes, biomedical parameters, cognition, motor skills, quality of life (QoL), pain, and end of life quality. Two reciprocally blinded investigators extracted the data. Inter-investigator reliability (𝝹) was calculated. A meta-analysis and a qualitative analysis were performed on the information extracted. RESULTS Thirty-six studies were included for data extraction and analysis. Meta-analysis of the included studies revealed a significant improvement with the MSE/MSS therapy, for agitation (p = .018), anxiety (p = .023), cognition (p < .001), and depression (p < .001). MSS/MSE therapy demonstrated a tendency for the improvement of the QoL in adults (p = .05). CONCLUSION MSE/MSS therapies are beneficial in cognitively impaired adults and improve their anxiety, depression, cognitive and other behavioral attributes such as agitative behaviors. Promoting these therapies in geriatric care may help to improve/reduce the challenging/care-resistant behaviors in adults and facilitate effective provision of the necessary care.
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Affiliation(s)
- Meret Helbling
- Clinic of General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Marie-Laure Grandjean
- Clinic of General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Murali Srinivasan
- Clinic of General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Solé C, Celdrán M, Cifre I. Psychological and Behavioral Effects of Snoezelen Rooms on Dementia. ACTIVITIES, ADAPTATION & AGING 2022. [DOI: 10.1080/01924788.2022.2151805] [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)
- Carme Solé
- School of Psychology, Education and Sport Sciences, Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Montse Celdrán
- Department of Cognition, Development and Educational Psychology, University of Barcelona (Spain), Barcelona, Spain
| | - Ignacio Cifre
- School of Psychology, Education and Sport Sciences, Blanquerna, Universitat Ramon Llull, Barcelona, Spain
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Shabha G, Edwards DJ, Gaines K, Laycok P. Toward an Integrated Context-Based Design Approach for Dementia Residential Care Homes: A Review of Key Operational Design Problems. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2022; 15:323-342. [PMID: 35833917 DOI: 10.1177/19375867221100210] [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: 11/16/2022]
Abstract
OBJECTIVES, PURPOSE, OR AIM This article seeks to develop a context-based management system focusing on assessing key operational and design problems and affecting wayfinding in dementia residential care homes. BACKGROUND Dementia is multifaceted neurocognitive impairments largely attributed to cognitive deterioration manifested in memory loss and visuospatial deficit which have wider practical implications to both environmental safety and wayfinding and navigation of dementia user. Two key questions were addressed in this context: (1) How can cognitively facilitating assistive technology (AT) be made more user-focused to mitigate the impacts of cognitive impairments on environmental safety and wayfinding? (2) How can design intervention and changes in design topology, colors and texture, and internal finishing aid wayfinding, navigation, and orientation in dementia residential care homes? METHOD A systematic literature review and analysis was undertaken to assess the efficacy of key cognitively-related AT to support activities of daily living and environmental safety of dementia sufferers in a care home and aid wayfinding, navigation, and orientation. RESULTS Several key design variables to facilitate wayfinding and spatial orientation were identified which include design topology, floor finishing, signposting, and use of color and texture strengthened by meaning, emotional connection to places and cognitively focused intervention via memory cueing and objects-centered recognition. CONCLUSIONS Key operational and design guidelines were proposed to assist built environment, care home developers, clinicians and healthcare professionals, and care services providers. There is a need to move toward a dementia-centered design to address the challenges facing people living with dementia in care homes. This should be based on the interrelated behavioral, cognitive, and communication factors.
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Affiliation(s)
- Ghasson Shabha
- School of Engineering and the Built Environment, Birmingham City University, Birmingham, United Kingdom
| | - David J Edwards
- School of Engineering and the Built Environment, Birmingham City University, Birmingham, United Kingdom
| | - Kristi Gaines
- Department of Design, Texas Tech University (TTU), Lubbock, TX, USA
| | - Paul Laycok
- School of Engineering and the Built Environment, Birmingham City University, Birmingham, United Kingdom
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Bourdon E, Havreng-Théry C, Lafuente C, Belmin J. Effect of the Physical Environment on Health and Well-Being of Nursing Homes Residents: A Scoping Review. J Am Med Dir Assoc 2022; 23:1826.e1-1826.e20. [PMID: 35787419 DOI: 10.1016/j.jamda.2022.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES In what way the physical environment of nursing homes (NHs) influences the health and well-being of nursing residents is not well codified. The authors aimed to review scientifically based knowledge on this topic. DESIGN A systematic scoping review of research into the effect that physical environment in nursing homes has on residents' health. SETTING AND PARTICIPANTS Search for relevant English-language articles in PubMed and the Cochrane database before April 15, 2022. Article selection and data extraction were performed by 2 researchers. Studies were included if conducted on nursing home residents and if they examined associations between components of the physical environment and health outcomes. MEASURES The review was performed in accordance with the PRISMA statement. RESULTS Of 1347 articles retrieved, 59 met the inclusion criteria-40 observational, 1 survey, and 18 interventional studies, of which 5 were randomized controlled trials. Certain environmental features repeatedly show significant positive effect on resident's health, such as noise reduction, tuning of lighting, natural light, easy access to garden, dining environment, and resident-centered interior renovation. Nursing home size was not found to have a direct relationship to resident health and well-being, although it is related to more than only the physical environment (eg, social environment). CONCLUSIONS AND IMPLICATIONS This review provides guidance in selective areas of the physical environment for the design of nursing homes, with potential benefits for the health and well-being of residents.
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Affiliation(s)
- Etienne Bourdon
- Laboratoire Éducation et Promotion de la Santé (LEPS UR 3412), Université Sorbonne Paris Nord, Bobigny, France; Service de Gériatrie, Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris and Faculté de Médecine Sorbonne, Ivry-sur-Seine, France
| | - Charlotte Havreng-Théry
- Laboratoire Éducation et Promotion de la Santé (LEPS UR 3412), Université Sorbonne Paris Nord, Bobigny, France; Laboratoire d'Informatique et d'Ingénierie des Connaissances en e-Santé (LIMICS, INSERM UMRS 1142), Sorbonne Université, Paris, France
| | - Carmelo Lafuente
- Service de Gériatrie, Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris and Faculté de Médecine Sorbonne, Ivry-sur-Seine, France; Clinical Epidemiology and Ageing (CePia), Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Est-Créteil, Créteil, France
| | - Joël Belmin
- Service de Gériatrie, Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris and Faculté de Médecine Sorbonne, Ivry-sur-Seine, France; Laboratoire d'Informatique et d'Ingénierie des Connaissances en e-Santé (LIMICS, INSERM UMRS 1142), Sorbonne Université, Paris, France.
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Hayden L, Passarelli C, Shepley SE, Tigno W. A scoping review: Sensory interventions for older adults living with dementia. DEMENTIA 2022; 21:1416-1448. [PMID: 35230906 DOI: 10.1177/14713012211067027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This scoping review focused on the existing scholarly literature exploring sensory interventions and immersive environments developed for, and used by, older adults living with dementia. The purpose of the scoping review is 1) to understand the various sensory interventions that have been developed, used, and have provided data to show how such interventions are expected to impact the lives of individuals living with dementia; and 2) to understand how the field is moving forward. We chose to map the literature to understand the types of interventions, the types of outcomes measured, and the contexts of their implementation. Our search was constrained to references from 1990 to 1 June 2019 in the following databases: Academic Search Complete, CINAHL Complete, MEDLINE, PsycINFO databases, and Summon Search discovery layer. We screened 2305 articles based on their titles and abstracts, and 465 were sent to full text review, of which 170 were included in our full text extraction. Once the data were extracted, we created emic categories, which emerged from the data, for data that were amenable to categorization (e.g., study setting, intervention type, and outcome type). We developed ten different categories of interventions: art, aromatics, light, multi-component interventions, multisensory rooms, multisensory, music, nature, touch, and taste. Sensory interventions are a standard psychosocial approach to managing the personal expressions commonly experienced by people living with dementia. Our findings can help providers, caregivers, and researchers better design interventions for those living with dementia, to help them selectively choose interventions for particular outcomes and settings. Two areas emerging in the field are nature interventions (replacing traditional "multisensory rooms" with natural environments that are inherently multisensory and engaging) and multi-component interventions (where cognitive training programs are enhanced by adding sensory components).
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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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Cheng C, Baker GB, Dursun SM. Use of multisensory stimulation interventions in the treatment of major neurocognitive disorders. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1699738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Catherine Cheng
- Neurochemical Research Unit, Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Glen B. Baker
- Neurochemical Research Unit, Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Serdar M. Dursun
- Neurochemical Research Unit, Department of Psychiatry, University of Alberta, Edmonton, Canada
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Lorusso LN, Bosch SJ. Impact of Multisensory Environments on Behavior for People With Dementia: A Systematic Literature Review. THE GERONTOLOGIST 2019; 58:e168-e179. [PMID: 28201710 DOI: 10.1093/geront/gnw168] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Indexed: 11/13/2022] Open
Abstract
Purpose of the Study Behavioral and psychological symptoms of dementia (BPSD) affect quality of life for people with dementia. Nonpharmacological interventions are the preferred first line of treatment, and it is theorized that BPSD are directly influenced by sensory imbalance and improved by sensory equilibrium. The purpose of this article is to investigate the evidence regarding the use of multisensory environments (MSEs) as treatment for BPSD. Design and Methods A systematic literature review was performed using the PICO framework within PsycINFO, Web of Science, ERIC, PubMED, and Cinahl databases, as well as additional hand-searched documents. Included articles were published during 1990 to 2015 and report empirical studies of MSE BPSD interventions that include furniture, fixtures, and equipment to provide visual, auditory, tactile, and olfactory stimulation. Desired elements include ergonomic vibroacoustic furniture, bubble tubes, color-changing lights, and fiber optics. Results Twelve articles met the inclusion criteria for review. Evidence supports the positive impact of sensory stimulation as a nonpharmacological behavioral treatment for dementia. Many studies investigated both behavior and mood, and several investigated biomedical parameters including heart rate and cognition. Significant differences were not found in the between-group studies when MSE was compared with other one-to-one interventions. Results on long-term effects were mixed. Variations can be seen in terms of research methods, types of environmental interventions, duration, and specific characteristics of participants, thus confounding the reliability of findings. Implications Key findings and directions for future research are discussed including primary outcomes, study design, environmental intervention types, and relevant assessment tools.
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Affiliation(s)
- Lesa N Lorusso
- Department of Interior Design, College of Design, Construction and Planning, University of Florida, Gainesville
| | - Sheila J Bosch
- Department of Interior Design, College of Design, Construction and Planning, University of Florida, Gainesville
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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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Parry L. Can patient and carers' experiences shape services? BMJ Support Palliat Care 2018; 9:287-290. [PMID: 30291104 DOI: 10.1136/bmjspcare-2018-001618] [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: 07/20/2018] [Revised: 09/03/2018] [Accepted: 09/05/2018] [Indexed: 11/04/2022]
Abstract
Dementia is an increasingly recognised medical condition which, towards its later stages, leads to the manifestation of symptoms that often require palliation. Hospice admission for patients with dementia has been shown to increase caregiver satisfaction. Yet, admission can be harmful for the patient. This feature follows the case of one patient, Mr Smith, who was admitted to Royal Trinity Hospice (RTH) for symptom control, along with providing respite for his carers. Shortly into Mr Smith's admission, he became increasingly agitated and was ultimately discharged home. After investigating the cause of early discharge, it was concluded that the newly built, modernised private rooms were in fact very dissimilar to the homes of patients with dementia. Adapting the clinical environment to improve patient and carer satisfaction has been explored in numerous studies. Significant amendments used by hospices and care homes include bold signs and natural lighting to facilitate way-finding, in addition to vintage furnishings to create a sense of familiarity. Taking recent evidence into consideration, RTH designed a new dementia-friendly bay situated on the ground floor of its inpatient unit. Since then, many other patients with dementia have been admitted to the hospice, one being Mr Thomas. Unlike Mr Smith, Mr Thomas was much more relaxed during his admission and his wife commented on how pleased she was with his care. This feature demonstrates the importance of being receptive to feedback and identifying the need for change.
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Affiliation(s)
- Laura Parry
- St George's University of London, Surrey CR4 1NT, UK
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11
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Mileski M, Baar Topinka J, Brooks M, Lonidier C, Linker K, Vander Veen K. Sensory and memory stimulation as a means to care for individuals with dementia in long-term care facilities. Clin Interv Aging 2018; 13:967-974. [PMID: 29844663 PMCID: PMC5962307 DOI: 10.2147/cia.s153113] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Objective The primary objective of this study was to identify and further examine the facilitators and barriers of utilizing sensory and memory stimulation as a means to care for individuals with dementia who live in long-term care settings. Materials and methods The authors conducted a literature review of 30 academic articles found using the databases such as CINAHL, PubMed, and Academic Search Ultimate from the past 15 years. Facilitator and barrier themes were found within each article and analyzed for their relevance to sensory and memory stimulation therapies and their effects on individuals with dementia. Results The most common facilitator was improved communication. The top three barriers were access, staff training, and mixed results. Discussion Reminiscence therapy appears to provide a person-centered method of care for those who otherwise have problems communicating. These implementations will be more effective if they have the support of staff and management. Conclusion The authors conclude that sensory and memory stimulation therapies have the potential to help improve many dementia-specific issues for individuals living in long-term care settings.
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Affiliation(s)
- Michael Mileski
- School of Health Administration, Texas State University, San Marcos, TX, USA
| | - Joseph Baar Topinka
- School of Health Administration, Texas State University, San Marcos, TX, USA
| | - Matthew Brooks
- School of Health Administration, Texas State University, San Marcos, TX, USA
| | - Corie Lonidier
- School of Health Administration, Texas State University, San Marcos, TX, USA
| | - Kelly Linker
- School of Health Administration, Texas State University, San Marcos, TX, USA
| | - Kelsey Vander Veen
- School of Health Administration, Texas State University, San Marcos, TX, USA
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Caspar S, Davis ED, Douziech A, Scott DR. Nonpharmacological Management of Behavioral and Psychological Symptoms of Dementia: What Works, in What Circumstances, and Why? Innov Aging 2018; 2:igy001. [PMID: 30480128 PMCID: PMC6176983 DOI: 10.1093/geroni/igy001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Objective Behavioral and psychological symptoms of dementia (BPSD) refer to the often distressing, noncognitive symptoms of dementia. BPSD appear in up to 90% of persons with dementia and can cause serious complications. Reducing the use of antipsychotic medications to treat BPSD is an international priority. This review addresses the following questions: What nonpharmacological interventions work to manage BPSD? And, in what circumstances do they work and why? Method A realist review was conducted to identify and explain the interactions among context, mechanism, and outcome. We searched electronic databases for empirical studies that reported a formal evaluation of nonpharmacological interventions to decrease BPSD. Results Seventy-four articles met the inclusion criteria. Three mechanisms emerged as necessary for sustained effective outcomes: the caring environment, care skill development and maintenance, and individualization of care. We offer hypotheses about how different contexts account for the success, failure, or partial success of these mechanisms within the interventions. Discussion Nonpharmacological interventions for BPSD should include consideration of both the physical and the social environment, ongoing education/training and support for care providers, and individualized approaches that promote self-determination and continued opportunities for meaning and purpose for persons with dementia.
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Affiliation(s)
- Sienna Caspar
- Faculty of Health Sciences-Therapeutic Recreation, University of Lethbridge, Alberta, Canada
| | - Erin D Davis
- Faculty of Health Sciences-Therapeutic Recreation, University of Lethbridge, Alberta, Canada
| | - Aimee Douziech
- Faculty of Health Sciences-Therapeutic Recreation, University of Lethbridge, Alberta, Canada
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Moreira NB, Gonçalves G, da Silva T, Zanardini FEH, Bento PCB. Multisensory exercise programme improves cognition and functionality in institutionalized older adults: A randomized control trial. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2018; 23:e1708. [PMID: 29436078 DOI: 10.1002/pri.1708] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 10/27/2017] [Accepted: 01/02/2018] [Indexed: 11/08/2022]
Abstract
AIM The aim of this study was to verify the effects of a multisensory exercise programme on the cognition and functionality of institutionalized older adults. METHODS Forty-five volunteers were randomly allocated to 2 groups, the multisensory exercise programme (n = 24) and the control group that received no treatment (n = 21). The programme consisted of 3 50-min sessions of progressive exercises per week for 16 weeks that challenged their strength, balance, coordination, multisensory stimulation, and flexibility in different tasks. Cognition (Montreal Cognitive Assessment), balance (Berg Scale), mobility (Timed Up and Go), and functional performance (Physical Performance Test) were measured preintervention and postintervention. Statistical analyses were performed using Student's t test and 2-way ANOVA. RESULTS The multisensory exercise programme showed statistically significant improvements (p < .05) on cognition (effect size [ES]: 0.92), balance (ES: 0.77), mobility (ES: 0.51), and functional performance (ES: 0.86) as compared with the control group, which showed no statistical significant differences at the postintervention time point. CONCLUSIONS The multisensory exercise programme improved the cognition and functionality of institutionalized older adults. The introduction of a motor and multisensory-based approach in care routines may improve residents' health and engagement to the environment.
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Affiliation(s)
- Natália Boneti Moreira
- Center for Motor Behavior Studies Center (CECOM), PhD Program in Physical Education, Federal University of Paraná, Curitiba, Brazil.,Physiotherapy, Dom Bosco College, Curitiba, Brazil
| | | | | | | | - Paulo Cesar Barauce Bento
- Center for Motor Behavior Studies Center (CECOM), PhD Program in Physical Education, Federal University of Paraná, Curitiba, Brazil
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Marquardt G, Bueter K, Motzek T. Impact of the design of the built environment on people with dementia: an evidence-based review. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2018; 8:127-57. [PMID: 25816188 DOI: 10.1177/193758671400800111] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE In this review the impact of the design of the built environment on people with dementia in long-term care settings is systematically analyzed and summarized. Architects and designers will be provided with credible evidence on which they can confidently base their design decisions. Researchers will be able to determine which environmental aspects have been well investigated and where there are gaps in the current state of the research. BACKGROUND A great number of studies have established a relationship between the design of the physical environment of long-term care settings and outcomes of people with dementia. However, the methods employed are heterogeneous and the results are often conflicting. Consequently, the process of integrating the best evidence available into architectural designs may be hindered. METHODS A systematic literature search was conducted reviewing studies that meet certain inclusion criteria. Using an evidence-based approach, the methodical quality of the studies was rated. RESULTS One hundred sixty-nine studies were found. They were thematically summarized into four main categories: basic design decisions, environmental attributes, ambience, and environmental information. The effectiveness of the interventions on the behavior, cognition, function, well being, social abilities, orientation, and care outcomes on people with dementia was illustrated by matrices. CONCLUSIONS Results of this review indicate that, with the exception of cognition, specific design interventions are beneficial to the outcomes of people with dementia. Overall, the field of environmental design for people with dementia is well researched in many aspects and only few gaps in knowledge were identified.
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Koller D, McPherson AC, Lockwood I, Blain-Moraes S, Nolan J. The impact of Snoezelen in pediatric complex continuing care: A pilot study. J Pediatr Rehabil Med 2018; 11:31-41. [PMID: 29630558 DOI: 10.3233/prm-150373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Snoezelen is an environment that provides sensory stimulation to individuals in health care and rehabilitative settings. With the presentation of various instruments and materials, individuals can encounter a range of sensory experiences including visual, tactile, and auditory with the purpose of inducing relaxation and restoration. Little is known about how children and adolescents experience this form of sensory stimulation, particularly those in complex continuing care who may have limited verbal and mobility capacity. METHODS This pilot study examined autonomic physiological responses and observational data on five children and adolescents in complex continuing care within a large rehabilitation hospital. Responses to Snoezelen and watching television were compared against baseline data collected during pre-intervention phases. RESULTS Using a single-subject design, this preliminary study found that individual participant responses varied considerably. Four of the five participants exhibited significant changes between sessions on one or two distinct physiological measures. The authors call on additional studies that apply unique and multiple methods capable of accessing the preferences of children and adolescent in rehabilitative care. CONCLUSIONS As an outcome, contributions to evidence-based practice can be made while supporting children's participation rights in health care decision making.
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Affiliation(s)
- Donna Koller
- Early Childhood Studies, Ryerson University, Toronto, ON, Canada
| | - Amy C McPherson
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Ilana Lockwood
- Early Childhood Studies, Ryerson University, Toronto, ON, Canada
| | | | - Jason Nolan
- Early Childhood Studies, Ryerson University, Toronto, ON, Canada
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16
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Haigh J, Mytton C. Sensory interventions to support the wellbeing of people with dementia: A critical review. Br J Occup Ther 2015. [DOI: 10.1177/0308022615598996] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Promoting the wellbeing of people with dementia is central to current social policies. To address the psychological impact of dementia, sensory stimulation is one approach practised by occupational therapists. This article will critically review the primary research that tests the link between sensory interventions and wellbeing for people with dementia. This research is inspired by theory relating to person-centred care and sensory processing. Method A literature search was conducted using electronic databases for health and social care. Nine papers were identified that met the inclusion criteria. These were critically appraised to identify the quality of the evidence available, and to collate emerging themes from their results. Results Although the studies appraised varied widely in the quality of their methodologies, some significant results and themes were found that do link sensory stimulation with emotional wellbeing and occupational engagement. Two distinctly different methods of intervention were documented in the evidence base. Most studies tested the impact of session based interventions in specific environments. One large scale randomised controlled trial implemented sensory care plans that were embedded in the lived environment of participants. This approach is more congruent with sensory processing theory and occupational science theories than time-bound sessions of sensory stimulation. Conclusion Attending to the sensory needs of people with dementia can positively affect their emotional wellbeing and their ability to engage in occupations. This can be incorporated into the reasoning and interventions of occupational therapists when supporting this client group.
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Affiliation(s)
| | - Carol Mytton
- Senior Lecturer, Occupational Therapy, Oxford Brookes University, UK
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17
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Bianchi AJ, Guépet-Sordet H, Manckoundia P. [Changes in olfaction during ageing and in certain neurodegenerative diseases: up-to-date]. Rev Med Interne 2014; 36:31-7. [PMID: 25304170 DOI: 10.1016/j.revmed.2014.09.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 07/18/2014] [Accepted: 09/15/2014] [Indexed: 11/29/2022]
Abstract
Olfaction is a complex sensory system, and increasing interest is being shown in the link between olfaction and cognition, notably in the elderly. In this literature review, we revisit the specific neurophysiological features of the olfactory system and odorants that lead to a durable olfactory memory and an emotional memory, for which the implicit component produces subconscious olfactory conditioning. Olfaction is known to affect cognitive abilities and mood. We also consider the impairment of olfactory function due to ageing and to neurodegenerative diseases, in particular Alzheimer's disease and Parkinson's disease, through anatomopathological changes in the peripheral and central olfactory structures. The high frequency of these olfactory disorders as well as their early occurrence in Alzheimer disease and Parkinson disease are in favour of their clinical detection in subjects suffering from these two neurodegenerative diseases. Finally, we analyse the impact of olfactory stimulation on cognitive performance and attention. Current observational data from studies in elderly patients with Alzheimer-type dementia are limited to multiple sensory stimulation methods, such as the Snoezelen method, and aromatherapy. These therapies have shown benefits for dementia-related mood and behaviour disorders in the short term, with few side effects. Since olfactory chemosensory stimulation may be beneficial, it may be proposed in patients with dementia, especially Alzheimer-type dementia, as a complementary or even alternative therapy to existing medical strategies.
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Affiliation(s)
- A-J Bianchi
- Service de soins de suite et de réadaptation gériatrique, hospices civils de Beaune, BP 40104, avenue Guigone-de-Salins, 21203 Beaune cedex, France
| | - H Guépet-Sordet
- Service de médecine interne gériatrie, hôpital de Champmaillot, CHU, BP 87 909, 2, rue Jules-Violle, 21079 Dijon cedex, France
| | - P Manckoundia
- Service de médecine interne gériatrie, hôpital de Champmaillot, CHU, BP 87 909, 2, rue Jules-Violle, 21079 Dijon cedex, France; Inserm U1093 motricité-plasticité : performance, dysfonctionnement, vieillissement et technologies d'optimisation, université de Bourgogne, BP 27877, 21078 Dijon cedex, France.
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Maseda A, Sánchez A, Marante MP, González-Abraldes I, Buján A, Millán-Calenti JC. Effects of Multisensory Stimulation on a Sample of Institutionalized Elderly People With Dementia Diagnosis: A Controlled Longitudinal Trial. Am J Alzheimers Dis Other Demen 2014; 29:463-73. [PMID: 24604894 PMCID: PMC10852778 DOI: 10.1177/1533317514522540] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
Long-term effects of multisensory stimulation were assessed using a "Snoezelen" room on older residents with dementia. Thirty patients were randomly assigned to 3 groups: multisensory stimulation environment (MSSE) group, individualized activities (activity) group, and control group. The MSSE and activity groups participated in two 30-minute weekly individualized intervention sessions over 16 weeks. Pre-, mid-, posttrial, and 8-week follow-up behavior, mood, cognitive, and functional impairment in basic activities of daily living were registered. Items included in the physically nonaggressive behavior factor improved significantly in post- versus pretrial in the MSSE group compared to the activity group, with no significant differences between MSSE and control groups. The MSSE and activity groups demonstrated behavior improvements and higher scores on the Cohen-Mansfield agitation inventory, verbal agitated behavior factor, and Neuropsychiatric Inventory-Nursing Home, with no significant differences between groups. The MSSE could have long-term positive effects on such neuropsychiatric symptoms in older people with dementia.
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Affiliation(s)
- Ana Maseda
- Department of Medicine, Faculty of Health Sciences, Gerontology Research Group, University of A Coruña, Campus de Oza, A Coruña, Spain
| | - Alba Sánchez
- Department of Medicine, Faculty of Health Sciences, Gerontology Research Group, University of A Coruña, Campus de Oza, A Coruña, Spain
| | - M Pilar Marante
- Department of Medicine, Faculty of Health Sciences, Gerontology Research Group, University of A Coruña, Campus de Oza, A Coruña, Spain
| | - Isabel González-Abraldes
- Department of Medicine, Faculty of Health Sciences, Gerontology Research Group, University of A Coruña, Campus de Oza, A Coruña, Spain
| | - Ana Buján
- Department of Medicine, Faculty of Health Sciences, Gerontology Research Group, University of A Coruña, Campus de Oza, A Coruña, Spain
| | - José Carlos Millán-Calenti
- Department of Medicine, Faculty of Health Sciences, Gerontology Research Group, University of A Coruña, Campus de Oza, A Coruña, Spain
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Riley-Doucet CK, Dunn KS. Using Multisensory Technology to Create a Therapeutic Environment for People with Dementia in an Adult Day Center: A Pilot Study. Res Gerontol Nurs 2013; 6:225-33. [DOI: 10.3928/19404921-20130801-01] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 07/10/2013] [Indexed: 12/17/2022]
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20
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Sánchez A, Millán-Calenti JC, Lorenzo-López L, Maseda A. Multisensory stimulation for people with dementia: a review of the literature. Am J Alzheimers Dis Other Demen 2013; 28:7-14. [PMID: 23221029 PMCID: PMC10697227 DOI: 10.1177/1533317512466693] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
The use of multisensory stimulation in people with dementia is becoming increasingly popular in the last decades. The aim of this review is to analyze the therapeutic effectiveness of multisensory stimulation in people with dementia. We made a search on Medline and Web of Science databases referred to all researches published from the year 1990 to 2012, which used multisensory stimulation techniques in people with dementia. The revision of the 18 articles which fulfilled the inclusion/exclusion criteria seems to prove evidence that multisensory stimulation environments produce immediate positive effects on the behavior and mood of people with dementia. Based on the above, we think it can be a useful nonpharmacological intervention on neuropsychological symptoms though, in any case, it would be necessary to start more reliable protocols from the methodological point of view in order to establish its long-term effectiveness.
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Affiliation(s)
- Alba Sánchez
- Gerontology Research Group, Department of Medicine, University of A Coruña, Faculty of Health Sciences, Campus de Oza, A Coruña, Spain
| | - José C. Millán-Calenti
- Gerontology Research Group, Department of Medicine, University of A Coruña, Faculty of Health Sciences, Campus de Oza, A Coruña, Spain
| | - Laura Lorenzo-López
- Gerontology Research Group, Department of Medicine, University of A Coruña, Faculty of Health Sciences, Campus de Oza, A Coruña, Spain
| | - Ana Maseda
- Gerontology Research Group, Department of Medicine, University of A Coruña, Faculty of Health Sciences, Campus de Oza, A Coruña, Spain
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Uriri-Glover J, McCarthy M, Cesarotti E. Alzheimer disease: what new evidence shows. Nurs Manag (Harrow) 2012; 43:26-32. [PMID: 23069663 DOI: 10.1097/01.numa.0000421671.10723.ad] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Johannah Uriri-Glover
- ASU College of Nursing and Health Innovation, John Hartford Center for Geriatric Nursing Excellence, Arizona State University College of Nursing and Health Innovation, Phoenix, Arizona, USA
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Uriri-Glover J, McCarthy M, Cesarotti E. Solving the puzzle of Alzheimer disease. Nurse Pract 2012; 37:20-28. [PMID: 22850534 DOI: 10.1097/01.npr.0000418381.60864.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Managing patients with dementia and Alzheimer disease can be a challenge. Often, families and caregivers ask clinicians about the latest treatments. This article summarizes the latest evidence-based practice related to pharmacologic and nonpharmacologic management of patients with Alzheimer disease.
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Affiliation(s)
- Johannah Uriri-Glover
- ASU College of Nursing and Health Innovation John Hartford Center for Geriatric Nursing Excellence, Arizona State University College of Nursing and Health Innovation, Phoenix, AZ, USA
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McClive-Reed KP, Gellis ZD. Anxiety and related symptoms in older persons with dementia: directions for practice. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2011; 54:6-28. [PMID: 21170777 DOI: 10.1080/01634372.2010.524284] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Anxiety disorders and related symptoms commonly occur in older people with cognitive impairment or dementia, significantly worsening functioning and reducing quality of life. This review of the literature outlines the extent of the problem, and focuses on current best practices in psychosocial interventions anxiety in persons with dementia. Discussion follows on promising nonpharmacological interventions that are recommended for further consideration and future research.
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