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Nguyen AN, Nguyen BT, Nguyen BT, Nguyen BTT, Nguyen NTA, Dang NTK, Nguyen ATP, Nguyen AT, Pham T, Mantyh WG, Tran D, Le OTP, Ta M. Care needs assessment of older adults with dementia in a semi-rural district in Vietnam: A community-based cross-sectional study. Psychogeriatrics 2024; 24:249-258. [PMID: 38155441 PMCID: PMC11058465 DOI: 10.1111/psyg.13068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND The increasing needs of people living with dementia (PLWD) in Vietnam present an enormous public health challenge. Vietnam is an understudied country, and little is known regarding the overall unmet needs of caregivers or the demographic risk factors associated with unmet caregiving needs. This study aimed to determine the burden of unmet care needs of community-dwelling PLWD and identify sociodemographic risks associated with unmet care needs. METHODS A cross-sectional study in a rural area facing urbanisation in Hanoi, Vietnam recruited PWLD-caregiver dyads with multistage sampling. We utilised the Camberwell Assessment of Need for the Elderly (CANE) instrument to evaluate care needs across four domains. Caregivers rated PLWD needs, with higher scores indicating greater unmet needs. The Mann-Whitney test was employed for comparing two groups, while the Kruskal-Wallis test was used for comparisons involving more than two groups in the analysis, and a P-value of less than 0.05 was considered statistically significant. RESULTS Among 90 PLWD participating in the study, the overall mean care needs score was 11.6 ± 4.3, with only 16.2% of PLWD having their care needs met. Environmental and physical needs were more frequently met than psychological or social needs. Only 48.0% and 43.9% of environmental and physical needs were met respectively, and a meagre 20.9% and 23.6% for psychological and social needs. Unmet care needs were more frequent for PWLD who were female, single or divorced, had lower monthly household income, or who were in more advanced stages of dementia, as indicated by Clinical Dementia Rating scores ≥1. CONCLUSIONS Unmet needs for PWLD are common. Increased caregiver education, resources, and services in Vietnam are urgently required to improve the quality of life for this population.
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Affiliation(s)
- Anh Ngoc Nguyen
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
| | - Binh Thanh Nguyen
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
- Hanoi Medical University, Hanoi, Vietnam
| | - Binh Thanh Nguyen
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
| | - Binh Thi Thanh Nguyen
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
| | - Nguyet Thi Anh Nguyen
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
| | - Nhung Thi Kim Dang
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
| | | | - Anh Trung Nguyen
- Hanoi Medical University, Hanoi, Vietnam
- National Geriatric Hospital, Hanoi, Vietnam
| | - Thang Pham
- National Geriatric Hospital, Hanoi, Vietnam
| | | | - Duyen Tran
- Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | - Oanh Thi Phương Le
- Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | - My Ta
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, CA, USA
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Wu SA, Morrison-Koechl JM, McAiney C, Middleton L, Lengyel C, Slaughter S, Carrier N, Yoon MN, Keller HH. Multi-Level Factors Associated with Relationship-Centred and Task-Focused Mealtime Practices in Long-Term Care: A Secondary Data Analysis of the Making the Most of Mealtimes Study. Can J Aging 2023; 42:696-709. [PMID: 37278323 DOI: 10.1017/s0714980823000156] [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] [Indexed: 06/07/2023] Open
Abstract
Mealtimes in long-term care (LTC) can reinforce relationships between staff and residents through relationship-centred care (RCC) practices; however, meals are often task-focused (TF). This cross-sectional study explores multi-level contextual factors that contribute to RCC and TF mealtime practices. Secondary data from residents in 32 Canadian LTC homes were analyzed (n = 634; mean age 86.7 ± 7.8; 31.1% male). Data included resident health record review, standardized mealtime observation tools, and valid questionnaires. A higher average number of RCC (9.6 ± 1.4) than TF (5.6 ± 2.1) practices per meal were observed. Multi-level regression revealed that a significant proportion of variation in the RCC and TF scores was explained at the resident- (intraclass correlation coefficient [ICC]RCC = 0.736; ICCTF = 0.482), dining room- (ICCRCC = 0.210; ICCTF = 0.162), and home- (ICCRCC = 0.054; ICCTF = 0.356) levels. For-profit status and home size modified the associations between functional dependency and practices. Addressing multi-level factors can reinforce RCC practices and reduce TF practices.
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Affiliation(s)
- Sarah A Wu
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | | | - Carrie McAiney
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Laura Middleton
- Kinesiology and Health Sciences, University of Waterloo, Waterlo, ON, Canada
| | - Christina Lengyel
- Department of Food and Human Nutrition Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Susan Slaughter
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Natalie Carrier
- École des sciences des aliments, de nutrition et d'études familiales, Université de Moncton, Moncton, NB, Canada
| | - Minn-Nyoung Yoon
- Department of Dentistry & Dental Hygiene, University of Alberta, Calgary, AB, Canada
| | - Heather H Keller
- Kinesiology and Health Sciences, University of Waterloo, Waterlo, ON, Canada
- Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada
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Speckemeier C, Niemann A, Weitzel M, Abels C, Höfer K, Walendzik A, Wasem J, Neusser S. Assessment of innovative living and care arrangements for persons with dementia: a systematic review. BMC Geriatr 2023; 23:464. [PMID: 37525120 PMCID: PMC10391868 DOI: 10.1186/s12877-023-04187-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 07/20/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Alternative forms of housing for persons with dementia have been developed in recent decades. These concepts offer small groups of residents familiar settings combined with efforts to provide normal daily life. The aim of this systematic review is to collate and analyze these more innovative forms of housing regarding residents' quality of life, behavioral aspects, as well as functional, cognitive and emotional aspects. METHODS Searches were conducted in PubMed, EMBASE and PsycInfo in November 2020. Studies comparing traditional and more innovative living environments for persons with dementia were eligible. Concepts are described based on the results of additional searches. Risk of bias of included studies was assessed using checklists from the Joanna Briggs Institute. RESULTS A total of 21 studies corresponding to 11 different concepts were included, namely Green Houses (USA), Group Living (Sweden), Cantou (France), Group Homes (Japan), Small-scale Group Living (Austria), Special Care Facilities (Canada), Shared-housing Arrangements (Germany), Residential Groups (Germany), Residential Care Centers / Woodside Places (USA/Canada), Small-scale Living (Netherlands/ Belgium), and Green Care Farms (Netherlands). The concepts are broadly similar in terms of care concepts, but partly differ in group sizes, staff qualifications and responsibilities. Several studies indicate that innovative forms of housing may encourage social behavior, preserve activity performance and/or positively influence emotional status compared to more traditional settings, while other studies fail to demonstrate these effects. Some studies also show increased behavioral and psychological symptoms of dementia (BPSD) in residents who live in more innovative housing concepts. The effect on cognition remains indistinct. DISCUSSION The positive effects may be attributable to the inherent characteristics, including small group sizes, a stimulating design, and altered staff roles and responsibilities. Arguably, some of these characteristics might also be the reason for increased BPSD. Studies had variable methodological quality and results have to be considered with caution. Future research should examine these effects more closely and should investigate populations' preferences with regards to housing in the event of dementia.
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Affiliation(s)
- C Speckemeier
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany.
| | - A Niemann
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - M Weitzel
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - C Abels
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - K Höfer
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - A Walendzik
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - J Wasem
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - S Neusser
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
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Yang H, Lv Z, Xu Y, Chen H. Leisure-Related Social Work Interventions for Patients with Cognitive Impairment: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1906. [PMID: 36767272 PMCID: PMC9915088 DOI: 10.3390/ijerph20031906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
The social work profession has been exploring nonpharmacological interventions for patients with cognitive impairment, but there are few evidence-based research outputs. Systematically evaluating the effectiveness of social work interventions for people with cognitive impairment can shed light on the matter to further improve similar interventions. Randomized controlled trials of nonpharmacological interventions for patients with cognitive impairment were selected from key literature databases in both English and Chinese from 2010 to 2021. A systematic review and meta-analysis with Revman 5.4 were performed. Seven trials were included, involving 851 patients with cognitive impairment. The meta-analysis showed that, in terms of overall cognitive function, the Montreal Cognitive Assessment score (MD = 1.64, 95% CI [0.97, 2.30], p < 0.001) of the intervention group was superior to the control group, but there was no significant difference in the Mini-Mental State Examination score between the two groups (MD = 0.33, 95% CI [-0.16, 0.82], p = 0.18). Compared with the control group, nonpharmacological intervention can effectively improve the neuropsychiatric condition of patients (SMD = -0.42, 95% CI [-0.64, -0.20], p = 0.0002). In summary, the current evidence shows that nonpharmacological social work interventions had a positive effect on the cognitive function and neuropsychiatric status of patients with cognitive impairment. Suggestions for future nonpharmacological intervention practice are discussed.
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Affiliation(s)
- Hui Yang
- Department of Sociology and Social Work, Minzu University of China, No. 27 Zhongguancun S St, Haidian, Beijing 100081, China
| | - Zhezhen Lv
- Department of Sociology and Social Work, Minzu University of China, No. 27 Zhongguancun S St, Haidian, Beijing 100081, China
| | - Yuyue Xu
- Department of Sociology and Social Work, Minzu University of China, No. 27 Zhongguancun S St, Haidian, Beijing 100081, China
| | - Honglin Chen
- Department of Social Sciences, University of Eastern Finland; Yliopistonranta 1, P.O. Box 1627, FI-70211 Kuopio, Finland
- Department of Social Work, Fudan University, No.220 Han Dan Road, Shanghai 200433, China
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Katsarou A, Intas G, Polydoropoulou E, Platis C, Pierrakos G. Investigating the Needs of Patients Suffering from Chronic Diseases: A Cross-Sectional Study. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1425:429-435. [PMID: 37581816 DOI: 10.1007/978-3-031-31986-0_41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
INTRODUCTION Chronic diseases represent a huge challenge for the health systems globally due to the rapidly increasing number of patients and their long-term need for healthcare. The purpose of this study was to investigate the needs of patients suffering from chronic diseases. METHODOLOGY This is a cross-sectional study. The study population consisted of 840 adults with chronic diseases. The data collection was done with an improvised needs survey questionnaire, which included 56 questions. Statistical analyses were performed using IBM SPSS Statistics for Windows, v.25.0, statistical significance being considered at p < 0.05. RESULTS The main diseases of the patients were chronic renal failure (22.6%), multiple sclerosis (19%), cancer (19%), diabetes mellitus (7.1%), dementia (6%), and chronic obstructive pulmonary disease (6%). The majority of patients (82.1%) were sick for more than 24 months. Patients seek information from health professionals (4.07 ± 1.4), feel tired (4.05 ± 1.4), have to share their feelings with other family members (4.01 ± 1.4), feel anxious about the future (3.94 ± 1.3), and feel out of control (3.80 ± 1.5). CONCLUSIONS Patients with chronic diseases suffer from numerous physical, mental, emotional, and cognitive problems. Paying attention to the unmet needs of patients could have beneficial effects on both patients and their caregivers.
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Affiliation(s)
| | - George Intas
- Department of Nursing, General Hospital of Nikea, Nikaia, Greece
| | | | | | - George Pierrakos
- Department of Business Administration and Director of Social Policy Division, Organization and Management of Primary Healthcare Services, Athens University of West Attica, Aigaleo, Greece
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Yous ML, Boamah SA, Hunter PV, Coker E, Hadjistavropoulos T, Sussman T, Kaasalainen S. Exploring the factors influencing meaningful engagement of persons living with advanced dementia through the Namaste Care Program: a qualitative descriptive study. Palliat Care Soc Pract 2023; 17:26323524231165319. [PMID: 37025503 PMCID: PMC10071147 DOI: 10.1177/26323524231165319] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 03/07/2023] [Indexed: 04/04/2023] Open
Abstract
Background: Meaningful engagement has been described as active participation based on a person’s interests, preferences, personhood, or perceived value. It has many benefits for persons living with dementia in long-term care (LTC) homes, including improvement in physical and cognitive function, and mental health. People with advanced dementia continue to need and benefit from inclusion and social contact in LTC, yet there is not a well-developed understanding of how to support this. A tailored intervention called Namaste Care has been shown to be an effective approach to meaningfully engage residents in LTC, decrease behavioral symptoms, and improve their comfort and quality of life. There is a need to consider how best to deliver this intervention. Objective: The aim of this study was to describe environmental, social, and sensory factors influencing meaningful engagement of persons with advanced dementia during Namaste Care implementation in LTC. Methods: In this qualitative descriptive study, focus groups and interviews were conducted with families, volunteers, staff, and managers at two LTC homes. Directed content analysis was conducted. The Comprehensive Process Model of Engagement was used as a coding framework. Results: With respect to environmental attributes, participants emphasized that a designated quiet space and a small group format were helpful for engagement. In terms of social attributes, participants emphasized Namaste Care staff capacity to deliver individualized care. Regarding sensorial factors, familiarity with the activities delivered in the program was emphasized. Conclusion: Findings reveal the need to offer small group programs that include adapted recreational and stimulating activities, such as Namaste Care, for residents at the end of life in LTC. Such programs facilitate meaningful engagement for persons with dementia as they focus on individual preferences, comfort, and inclusion while recognizing changing needs and abilities of residents.
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Affiliation(s)
- Marie-Lee Yous
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - Sheila A. Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Paulette V. Hunter
- Department of Psychology, St. Thomas More College, University of Saskatchewan, Saskatoon, SK, Canada
| | - Esther Coker
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- St. Peter’s Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Thomas Hadjistavropoulos
- Department of Psychology and Centre on Aging and Health, University of Regina, Regina, SK, Canada
| | - Tamara Sussman
- School of Social Work, McGill University, Montreal, QC, Canada
| | - Sharon Kaasalainen
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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Are nurse`s needs assessment methods robust enough to recognise palliative care needs in people with dementia? A scoping review. BMC Nurs 2022; 21:194. [PMID: 35854261 PMCID: PMC9297617 DOI: 10.1186/s12912-022-00947-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with dementia are most at risk of experiencing serious health related suffering, if they do not have a palliative care approach introduced early enough in the illness. It can be challenging for nurses to assess experienced needs of people, who are thought no longer able to self-report such as people with dementia. Assessment help to understand the care the patient and their family need promptly. It is unknown how nurses recognise holistic palliative care needs in people with dementia during routine care. METHODS Scoping review where EMBASE, MEDLINE, CINAHL, PsycInfo databases, and references were searched with an advanced search strategy, which was built on three concepts (nurses, dementia, and nursing assessment) using corresponding Medical Subject Headings. Data were charted in a piloted extraction form, based on the assessment domains within the nursing process followed by summarise and synthesise results narratively. RESULTS 37 out of 2,028 qualitative and quantitative articles published between 2000 and 2021, and relating to 2600 + nurses, were identified. Pain was sole focus of assessment in 29 articles, leaving 8 articles to describe assessment of additional needs (e.g., discomfort). Nurses working in a nursing home assess pain and other needs by observing the persons with dementia behaviour during routine care. Nurses in the acute care setting are more likely to assess symptoms with standard assessment tools at admission and evaluate symptoms by observational methods. Across settings, about one third of pain assessments are supported by person-centred pain assessment tools. Assessments were mostly triggered when the person with dementia vocalised discomfort or a change in usual behaviour was observed. Nurses rely on family members and colleagues to gain more information about needs experienced by people with dementia. CONCLUSION There is a scarcity of evidence about techniques and methods used by nurses to assess needs other than pain experienced by people with dementia. A holistic, person-centred screening tool to aid real-time observations at the bedside and used in conversations with health care professionals and families/friends, may improve need recognition other than pain, to ensure holistic needs could then be addressed timely to improve care in people with dementia.
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Minyo MJ, Judge KS. Perceived Unmet Need and Need-Related Distress of People Living With Dementia. Gerontol Geriatr Med 2022; 8:23337214221092886. [PMID: 35651650 PMCID: PMC9149624 DOI: 10.1177/23337214221092886] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 11/16/2022] Open
Abstract
The unmet needs of people living with dementia have been shown to be
multidimensional and impact well-being. However, there are a lack of studies
examining variability of unmet needs and need-related distress from the person
living with dementia’s perspective. The current study (n = 12)
examined the self-reported unmet needs and need-related distress of people with
mild to moderate dementia. Seventy-five percent of participants
(n = 9) identified at least one unmet need and 50%
(n = 6) reported 10 or more unmet needs. “Finding and
Arranging Services” and “Health Information” subscales had the highest reported
average unmet needs. The most frequently reported unmet need-item was
“getting information about your memory problems?”
Participants reported variability in distress for both unmet and met needs.
Continued research can provide beneficial information on the relationship
between unmet needs, need-related distress, and outcomes of well-being for
future interventions.
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Affiliation(s)
- Morgan J. Minyo
- Department of Psychology, Cleveland State University, Cleveland, OH, USA
- Center for Research and Education, Benjamin Rose Institute on Aging, Cleveland, OH, USA
| | - Katherine S. Judge
- Department of Psychology, Cleveland State University, Cleveland, OH, USA
- Center for Research and Education, Benjamin Rose Institute on Aging, Cleveland, OH, USA
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Schweighart R, O’Sullivan JL, Klemmt M, Teti A, Neuderth S. Wishes and Needs of Nursing Home Residents: A Scoping Review. Healthcare (Basel) 2022; 10:854. [PMID: 35627991 PMCID: PMC9140474 DOI: 10.3390/healthcare10050854] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 12/10/2022] Open
Abstract
Falling birth rates and rising life expectancy are leading to global aging. The proportional increase in older people can be observed in almost all countries and regions worldwide. As a result, more people spend their later years in nursing homes. In homes where person-centered care is implemented, residents report greater satisfaction and quality of life. This approach is based on the wishes and needs of the residents. Therefore, the purpose of this scoping review is to explore the wishes and needs of nursing home residents. A scoping review of the literature was conducted in which 12 databases were systematically searched for relevant articles according to PRISMA-ScR guidelines. Both quantitative and qualitative study designs were considered. A total of 51 articles met the inclusion criteria. Included articles were subjected to thematic analysis and synthesis to categorize findings into themes. The analysis identified 12 themes to which the wishes and needs were assigned: (1) Activities, leisure, and daily routine; (2) Autonomy, independence, choice, and control; (3) Death, dying, and end-of-life; (4) Economics; (5) Environment, structural conditions, meals, and food; (6) Health condition; (7) Medication, care, treatment, and hygiene; (8) Peer relationship, company, and social contact; (9) Privacy; (10) Psychological and emotional aspects, security, and safety; (11) Religion, spirituality; and (12) Sexuality. Nursing home residents are not a homogeneous group. Accordingly, a wide range of needs and wishes are reported in the literature, assigned to various topics. This underscores the need for tailored and person-centered approaches to ensure long-term well-being and quality of life in the nursing home care setting.
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Affiliation(s)
| | - Julie Lorraine O’Sullivan
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany;
| | - Malte Klemmt
- Faculty of Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, 97070 Würzburg, Germany; (M.K.); (S.N.)
| | - Andrea Teti
- Institute of Gerontology, University of Vechta, 49377 Vechta, Germany;
| | - Silke Neuderth
- Faculty of Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, 97070 Würzburg, Germany; (M.K.); (S.N.)
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Abstract
In the late stages of dementia, individuals rely on others for their wellbeing and this creates an ethical imperative for responsive dementia care. Through a qualitative evidence synthesis of literature on what constitutes responsive dementia care, we identified dignity of identity as a central theme. Dignity of identity is the status each of us holds in relation to others and reflects our past experiences and our aspirations for the future. We did a qualitative evidence synthesis of 10 qualitative studies conducted with a total of 149 research participants, 95 of whom had dementia, and 54 of whom were paid and family member caregivers to people with dementia. Using "new materialism disability studies" as our theoretical framework, we illustrate how environments, both material and discursive, shape the abilities of people with dementia in residential care settings (RSCs) to live well and we use our findings to point to ways forward in dignity of identity-enhancing dementia care practice. Echoing the literature, we observe that people with dementia have the virtual capacity to live with dignity of identity and illustrate how material conditions and discourse influence the transition of dignity of identity in people with dementia from a virtual capacity to an actual capacity and how demonstrated capacity in turn influences material conditions and discourse surrounding care for people with dementia in RSCs. We call for a greater acknowledgement within literature on dignity and dementia of structural barriers to dignity of identity-enhancing care. The COVID-19 pandemic has shown us the fatal consequences of insufficient material conditions in RCSs and we hope that on a societal level there is improvement to both the material conditions in RCSs as well as an improvement in discourse about those who live and work in RCSs.
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Affiliation(s)
- Cera E Cruise
- Department of Community Health Sciences, Cumming School of Medicine, 70401University of Calgary, Calgary, AB, Canada
| | - Bonnie M Lashewicz
- Department of Community Health Sciences, Cumming School of Medicine, 70401University of Calgary, Calgary, AB, Canada
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Zimmerman S, Resnick B, Ouslander J, Levy C, Gaugler JE, Sloane PD, Mor V. Pragmatic Trials and Improving Long-Term Care: Recommendations From a National Institutes of Health Conference. J Am Med Dir Assoc 2022; 23:323-327. [DOI: 10.1016/j.jamda.2022.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/06/2022] [Indexed: 12/27/2022]
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12
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Zimmerman S, Resnick B, Ouslander J, Levy C, Gaugler JE, Sloane PD, Mor V. Pragmatic Trials and Improving Long-Term Care: Recommendations From a National Institutes of Health Conference. J Am Geriatr Soc 2022; 70:688-694. [PMID: 35195278 PMCID: PMC8915540 DOI: 10.1111/jgs.17697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Sheryl Zimmerman
- Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Address correspondence to Sheryl Zimmerman, PhD, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr Blvd, Campus Box 7590, Chapel Hill, NC 27599-7590, USA. (S. Zimmerman)
| | - Barbara Resnick
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Joseph Ouslander
- Department of Integrated Medical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Cari Levy
- Department of Veterans Affairs, Rocky Mountain Regional VA Medical Center, and University of Colorado, Aurora, CO, USA
| | - Joseph E. Gaugler
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Philip D. Sloane
- Cecil G. Sheps Center for Health Services Research and Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Vincent Mor
- Center of Innovation in Long-term Services and Supports, Providence VA Medical Center; Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA
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Shrestha S, Tranvåg O. Dementia care in Nepalese old age homes: Critical challenges as perceived by healthcare professionals. Int J Older People Nurs 2022; 17:e12449. [PMID: 35139253 DOI: 10.1111/opn.12449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 09/07/2021] [Accepted: 01/17/2022] [Indexed: 11/28/2022]
Abstract
AIM To explore and describe critical challenges in current dementia care practice as perceived by healthcare professionals (HCPs) in old age homes (OAHs) in Kathmandu, Nepal. BACKGROUND In Nepal, the number of older people with dementia is rapidly rising, and there is a need for knowledge of how to provide quality dementia care in OAHs. METHODS An exploratory hermeneutic design, employing qualitative interviews with eleven HCPs caring for residents with dementia in a total of five OAHs. FINDINGS The analysis showed that HCPs found limited educational training in dementia-specific care to be a critical challenge leading to reduced quality in caregiving practice. Insufficient HCP competence in dementia-specific care undermined adequate coping with residents' cognitive disturbances and the behavioural and psychological symptoms in dementia (BPSD). Poor HCP/medical doctor (MD)-to-patient ratio was perceived as a critical challenge preventing proper diagnostic examination, treatment and dementia-specific care practice. CONCLUSIONS Limited educational training, sparse competence in mastering residents' cognitive disturbances and BPSD, and insufficient resources to ensure sufficient numbers of HCPs and MDs for proper diagnostic examination, treatment and dementia-specific care were identified as critical challenges restricting quality dementia care in these Nepalese OAHs. IMPLICATIONS FOR PRACTICE The study findings indicate a need for a clear Nepalese policy and a national plan for dementia care in OAHs that includes strategies for HCP educational training and how to provide resources to ensure a sufficient workforce of HCPs and MDs for proper diagnostic examination, treatment and dementia-specific care.
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Affiliation(s)
- Soni Shrestha
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Oscar Tranvåg
- Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Zimmerman S, Resnick B, Ouslander J, Levy C, Gaugler JE, Sloane PD, Mor V. Pragmatic trials and improving long-term care: Recommendations from a national institutes of health conference. Geriatr Nurs 2022; 44:288-292. [DOI: 10.1016/j.gerinurse.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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15
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Zhao Y, Liu L, Ding Y, Chan HYL. Understanding dementia care in care home setting in China: An exploratory qualitative study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1511-1521. [PMID: 33118264 DOI: 10.1111/hsc.13213] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/24/2020] [Accepted: 10/09/2020] [Indexed: 06/11/2023]
Abstract
Dementia education for healthcare providers has gained growing attention in China. This study aimed to explore the current dementia care practices in care home setting in China because people with dementia have increased need for residential care as the cognitive function worsens. An exploratory qualitative study was conducted among care staff and residents with dementia in four care homes in a metropolitan city in China between May and August 2019. Participant observations were conducted to understand how the care environment and activities affect residents with dementia. Care records were reviewed to explore the kind of care provided. In-depth individual interviews were conducted with a purposive sample of 15 care staff members of different ranks to clarify the care practices and understand their training needs with dementia care. Field notes of observations, nursing care records and interviews transcripts were triangulated for qualitative content analysis. The theme emerged is 'suboptimal dementia care practices'. Four categories about dementia care practices in care homes were identified: (a) care environment (hospital-like layout, inappropriate lighting, environmental noise, inappropriate use of colour and unclear signage), (b) care culture (being medical-oriented, overlooking individual uniqueness and privacy), (c) attitudes towards dementia (treating as children, being authoritative, adopting punitive approaches, trying to respect the residents and having a positive learning attitude) and (d) dementia care competence (questing for specific training and resources, questing for culturally specific practices and strengthening communication with family). Creating a dementia-friendly and enabling environment, shifting the care culture paradigm from disease-oriented to person-centred and developing culturally sensitive care practices are imperative. Dementia care education for care home staff using a systematic, comprehensive approach is fundamental to achieve these goals.
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Affiliation(s)
- Yayi Zhao
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Li Liu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yaping Ding
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Helen Y L Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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16
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Ottoboni G, Chirico I, Povolná P, Dostálová V, Holmerová I, Janssen N, Dassen F, de Vugt M, Sánchez-Gómez MC, García-Peñalvo F, Franco-Martin MA, Chattat R. Psychosocial care in dementia in European higher education: Evidence from the SiDECar ("Skills in DEmentia Care") project. NURSE EDUCATION TODAY 2021; 103:104977. [PMID: 34051541 DOI: 10.1016/j.nedt.2021.104977] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 03/26/2021] [Accepted: 05/11/2021] [Indexed: 05/25/2023]
Abstract
In dementia care, psychosocial interventions can increase people's quality of life with dementia and their caregivers. Despite their effectiveness, their translation into practice lacks the desirable systematicity. Systematic educational programs on psychosocial interventions in dementia will improve this translation, as it prepares professionals to face the complexity of dementia care. This study aimed to systematically map out the extent to which higher education programs in Europe include teaching activities about psychosocial care of dementia. We collected quantitative and qualitative data about 303 higher education teaching activities on psychosocial care in dementia across Europe. The analysis revealed that the number of teaching activities focusing on psychosocial care in dementia was relative. Although the results reflected UNESCO indications, the teaching activities on psychosocial care in dementia appeared less systematized than optimal. As world health agencies recommend, international higher education systems should consider more psychosocial care topics because they can prepare professionals to respond timely and effectively to dementia patients and caregivers' needs.
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Affiliation(s)
- G Ottoboni
- Department of Psychology, University of Bologna, Bologna, Italy.
| | - I Chirico
- Department of Psychology, University of Bologna, Bologna, Italy.
| | - P Povolná
- Charles University, Faculty of Humanities, Czech Republic; Institute for Postgraduate Medical Education, Prague, Czech Republic.
| | - V Dostálová
- Charles University, Faculty of Humanities, Czech Republic; Institute for Postgraduate Medical Education, Prague, Czech Republic.
| | - I Holmerová
- Charles University, Faculty of Humanities, Czech Republic; Institute for Postgraduate Medical Education, Prague, Czech Republic.
| | - N Janssen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, the Netherlands.
| | - F Dassen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, the Netherlands.
| | - M de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, the Netherlands.
| | | | | | | | - R Chattat
- Department of Psychology, University of Bologna, Bologna, Italy.
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Rampioni M, Stara V, Felici E, Rossi L, Paolini S. Embodied Conversational Agents for Patients With Dementia: Thematic Literature Analysis. JMIR Mhealth Uhealth 2021; 9:e25381. [PMID: 34269686 PMCID: PMC8325086 DOI: 10.2196/25381] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/27/2021] [Accepted: 03/10/2021] [Indexed: 01/04/2023] Open
Abstract
Background As the world’s population rapidly ages, the number of older adults with cognitive impairment will also increase. Several studies have identified numerous complex needs of people with dementia, which assistive technologies still fail to support. Recent trends have led to an increasing focus on the use of embodied conversational agents (ECAs) as virtual entities able to interact with a person through natural and familiar verbal and nonverbal communication. The use of ECAs could improve the accessibility and acceptance of assistive technologies matching those high-level needs that are not well covered to date. Objective The aim of this thematic literature analysis was to map current studies in the field of designing ECAs for patients with dementia in order to identify the existing research trend and possible gaps that need to be covered in the near future. The review questions in this study were as follows: (1) what research frameworks are used to study the interaction between patients with dementia and ECAs? (2) what are the findings? and (3) what are the barriers reported in these studies? Methods Separate literature searches were conducted in PubMed, Web of Science, Scopus, and Embase databases by using specific umbrella phrases to target the population (patients with dementia) and the technology-based intervention (embodied conversational agent). Studies that met the inclusion criteria were appraised through the Mixed Methods Appraisal Tool and then discussed in a thematic analysis. Results The search process identified 115 records from the databases and study references. After duplicates (n=45) were removed, 70 papers remained for the initial screening. A total of 7 studies were finally included in the qualitative synthesis. A thematic analysis of the reviewed studies identified major themes and subthemes: the research frameworks used to gather users’ perspectives on ECAs (theme 1), the insights shared by the 7 studies as well as the value of user involvement in the development phases and the challenge of matching the system functionalities with the users’ needs (theme 2), and the main methodological and technical problems faced by each study team (theme 3). Conclusions Our thematic literature analysis shows that the field of ECAs is novel and poorly discussed in the scientific community and that more sophisticated study designs and proofs of efficacy of the approach are required. Therefore, by analyzing the main topic of the narrative review, this study underscores the challenge of synchronizing and harmonizing knowledge, efforts, and challenges in the dementia care field and its person-centered paradigm through the user-centered design approach. Enabling strict collaboration between interdisciplinary research networks, medical scientists, technology developers, patients, and their formal and informal caregivers is still a great challenge in the field of technologies for older adults.
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Affiliation(s)
- Margherita Rampioni
- Model of Care and New Technologies, IRCCS INRCA - National Institute of Health and Science on Aging, Ancona, Italy
| | - Vera Stara
- Model of Care and New Technologies, IRCCS INRCA - National Institute of Health and Science on Aging, Ancona, Italy
| | - Elisa Felici
- Model of Care and New Technologies, IRCCS INRCA - National Institute of Health and Science on Aging, Ancona, Italy
| | - Lorena Rossi
- Model of Care and New Technologies, IRCCS INRCA - National Institute of Health and Science on Aging, Ancona, Italy
| | - Susy Paolini
- Unit of Neurology, IRCCS INRCA - National Institute of Health and Science on Aging, Ancona, Italy
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18
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Ashrafizadeh H, Gheibizadeh M, Rassouli M, Hajibabaee F, Rostami S. Explaining Caregivers' Perceptions of Palliative Care Unmet Needs in Iranian Alzheimer's Patients: A Qualitative Study. Front Psychol 2021; 12:707913. [PMID: 34276526 PMCID: PMC8280315 DOI: 10.3389/fpsyg.2021.707913] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The needs of Alzheimer's patients are very complex and diverse and many of them are considered unmet needs. Understanding and responding to the unmet and complex needs of Alzheimer's patients can affect the quality of care. Therefore, the present study aimed to explain the perception of formal and informal caregivers of the unmet needs of Iranian Alzheimer's patients. Methods: The present qualitative study employed a Directed Content Analysis approach and was conducted in Iran in 2020. This research was done through in-depth and semi-structured interviews with 19 qualified caregivers enrolled (11 informal caregivers and 8 formal caregivers) with the mean age of 46.05 ± 10.98 years in a purposive sampling method. Interviews continued until data saturation. Data analysis was performed simultaneously with data collection. After recording and transcribing, the data were analyzed using the Elo and Kyngas method based on the National Consensus Project framework (NCP). Data management was done with MAXQDA software. In order to achieve the accuracy and validity of the study, the criteria presented by Lincoln and Guba Credibility, Dependability, Confirmability, and Transformability were considered and used. Results: The mean age of participants was 46.05 ± 10.98. Participants in this study acknowledged that Alzheimer's patients need comprehensive needs management with a holistic approach to increase quality of life. This theme based on the NCP framework consists of seven main categories including "Structure and processes of care," "Physical aspects of care," "Psychological and psychiatric aspects of care," "Social aspects of care," "Cultural aspects of care," "Care of the patient nearing the end of life," and "Ethical and legal aspects of care" with 16 subcategories. Conclusion: The findings of this study provide a deep understanding of the unmet needs of Alzheimer's patients in Iran. Identifying the unmet needs of patients can pave the way for the treatment team to provide effective solutions to meet the needs and empower caregivers to provide comprehensive care for patients.
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Affiliation(s)
- Hadis Ashrafizadeh
- Student Research Committee, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahin Gheibizadeh
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Rassouli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hajibabaee
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahnaz Rostami
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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19
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Olson NL, Albensi BC. Dementia-Friendly "Design": Impact on COVID-19 Death Rates in Long-Term Care Facilities Around the World. J Alzheimers Dis 2021; 81:427-450. [PMID: 33814449 DOI: 10.3233/jad-210017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Persons with dementia (PWD) make up a large portion of the long-term care (LTC) population the world over. Before a global pandemic swept the world, governments and healthcare providers struggled with how to best care for this unique population. One of the greatest challenges is a PWD's tendency to "walk with purpose" and exhibit unsafe wayfinding and elopement, which places them at risk of falls and injury. Past solutions included increased use of restraints and pharmacological interventions, but these have fallen out of favor over the years and are not optimal. These challenges put enormous strain on staff and caregivers, who are often poorly trained in dementia care, underpaid, overworked, and overstressed. PWD are impacted by these stresses, and unmet needs in LTC places an even greater stress on them and increases their risks of morbidity and mortality. The physical design of their environments contributes to the problem. Old, institutionalized buildings have poor lighting, poor ventilation, long dead-end hallways, poor visual cues, lack of home-like décor, shared bedrooms and bathrooms, and are often dense and overcrowded. These design elements contribute to the four 'A's' of dementia: apathy, anxiety, agitation, and aggression, and they also contributed to the rapid spread of COVID-19 in these facilities the world over. In this review, we present current "dementia friendly" design models in the home, community, and LTC, and argue how they could have saved lives during the pandemic and reduced the stresses on both the dementia resident and the caregiver/staff.
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Affiliation(s)
- Nancy L Olson
- Division of Neurodegenerative Disorders, St Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada
| | - Benedict C Albensi
- Division of Neurodegenerative Disorders, St Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada.,Department of Pharmacology & Therapeutics, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
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Abstract
OBJECTIVES Nursing home residents with dementia are sensitive to detrimental auditory environments. This paper presents the first literature review of empirical research investigating (1) the (perceived) intensity and sources of sounds in nursing homes, and (2) the influence of sounds on health of residents with dementia and staff. DESIGN A systematic review was conducted in PubMed, Web of Science and Scopus. Study quality was assessed with the Mixed Methods Appraisal Tool. We used a narrative approach to present the results. RESULTS We included 35 studies. Nine studies investigated sound intensity and reported high noise intensity with an average of 55-68 dB(A) (during daytime). In four studies about sound sources, human voices and electronic devices were the most dominant sources. Five cross-sectional studies focused on music interventions and reported positives effects on agitated behaviors. Four randomized controlled trials tested noise reduction as part of an intervention. In two studies, high-intensity sounds were associated with decreased nighttime sleep and increased agitation. The third study found an association between music and less agitation compared to other stimuli. The fourth study did not find an effect of noise on agitation. Two studies reported that a noisy environment had negative effects on staff. CONCLUSIONS The need for appropriate auditory environments that are responsive to residents' cognitive abilities and functioning is not yet recognized widely. Future research needs to place greater emphasis on intervention-based and longitudinal study design.
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21
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Saragih ID, Tonapa SI, Sun TL, Chia-Ju L, Lee BO. Effects of robotic care interventions for dementia care: A systematic review and meta-analysis randomised controlled trials. J Clin Nurs 2021; 30:3139-3152. [PMID: 34041803 DOI: 10.1111/jocn.15856] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/15/2021] [Accepted: 05/01/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The role of robotic care has been studied because it may be a care option applicable to dementia care. However, the effects of robotic care in dementia care are still inconclusive. AIM To explore the span of the effects of robotic care intervention among patients with dementia. DESIGN Systematic review and meta-analysis. METHODS This study searched systematically using the following databases: Academic Search Complete, CINAHL, Cochrane Library, MEDLINE, PubMed, SocINDEX, UpToDate (OVID) and Web of Science. The eligibility criteria were patients with dementia, randomised controlled trials and publications in English. The PEDro scale was used to assess the methodological quality in the included studies. The meta-analysis was performed using a fixed-effects model to calculate the pooled effects of robotic care interventions. STATA 16.0 was used for statistical analysis. The results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. RESULTS A total of 15 studies met the eligibility criteria and included 1684 participants. Overall, the robotic care interventions had positive effects on agitation (SMD = 0.09; 95% CI [-0.22-0.33]), anxiety (SMD = -0.07; 95% CI [-0.42-0.28]), cognitive function (SMD = 0.16; 95% CI [-0.08-0.40]), depression (SMD = -0.35; 95% CI [-0.69-0.02]), neuropsychiatric symptoms (SMD = 0.16; 95% CI [-0.29-0.61]), total hours of sleep during daytime (SMD = -0.31; 95% CI [-0.55 to 0.07]) and quality of life (SMD = 0.24; 95% CI [-0.23-0.70]). CONCLUSION Robotic care intervention may be an effective and alternative intervention for improving the health outcomes for people with dementia. The robotic care effect on anxiety should be confirmed. Further studies may consider the frequency, duration of intervention and possible negative outcomes after robotic care interventions. RELEVANCE TO CLINICAL PRACTICE As a non-pharmacological approach, nursing staff may consider the robotic care intervention in providing care for patients with dementia since this intervention has clinical benefits.
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Affiliation(s)
| | - Santo Imanuel Tonapa
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,School of Nursing, Sam Ratulangi University, Manado, Indonesia
| | - Tien-Lung Sun
- Department of Industrial Engineering, Yuan-Ze University, Taoyuan, Taiwan
| | - Lin Chia-Ju
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Bih-O Lee
- College of Nursing & Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
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22
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Carvacho R, Carrasco M, Lorca MBF, Miranda-Castillo C. Met and unmet needs of dependent older people according to the Camberwell Assessment of Need for the Elderly (CANE): A scoping review. Rev Esp Geriatr Gerontol 2021; 56:225-235. [PMID: 33888307 DOI: 10.1016/j.regg.2021.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 02/05/2021] [Accepted: 02/09/2021] [Indexed: 11/24/2022]
Abstract
In order to address the complexity of needs of dependent older people, multidimensional and person-centered needs assessment is required. The objective of this review is to describe met and unmet needs of dependent older people, living in the community or in institutions, and the factors associated with those needs. Selection criteria included papers about need asessment which employed the Camberwell Assesment of Need for the Elderly (CANE). A search through MEDLINE, SCOPUS, WOS and CINHAL databases was carried out. Twenty-one articles were finally included. Unmet needs were found more frequently in psychosocial areas (mainly in "company", "daytime activities" and "psychological distress") and in institutionalized population. In addition, unmet needs were often associated with depressive symptoms, dependency, and caregiver burden. Discrepancies between self-reported needs and needs perceived by formal and informal caregivers were identified. It is important that professionals and caregivers try to make visible the perspective of older people and their psychological and social needs, particularly when the person is dependent, depressed or cognitively impaired.
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Affiliation(s)
- Raffaela Carvacho
- Pontificia Universidad Católica de Chile, School of Psychology, Santiago, Chile; Millennium Institute for Caregiving Research, Santiago, Chile
| | - Marcela Carrasco
- Pontificia Universidad Católica de Chile, Faculty of Medicine, Santiago, Chile; UC Center for Studies in Age and Ageing, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - María Beatriz Fernández Lorca
- Pontificia Universidad Católica de Chile, Institute of Sociology, Santiago, Chile; Millennium Institute for Caregiving Research, Santiago, Chile; UC Center for Studies in Age and Ageing, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Miranda-Castillo
- Universidad Andres Bello, Faculty of Nursing, Santiago, Chile; Millennium Institute for Caregiving Research, Santiago, Chile; Millennium Institute for Research in Depression and Personality, Santiago, Chile.
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Chamberlain SA, Duggleby W, Teaster PB, Estabrooks CA. Characteristics of Socially Isolated Residents in Long-Term Care: A Retrospective Cohort Study. Gerontol Geriatr Med 2020; 6:2333721420975321. [PMID: 33283023 PMCID: PMC7686605 DOI: 10.1177/2333721420975321] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/22/2020] [Accepted: 10/29/2020] [Indexed: 12/21/2022] Open
Abstract
Objectives: To identify socially isolated long-term care residents
and to compare their demographic characteristics, functional status, and health
conditions to residents who are not isolated. Methods: We conducted
a retrospective cohort study using the Resident Assessment Instrument, Minimum
Data Set, 2.0 (RAI-MDS) data, from residents in 34 long-term care homes in
Alberta, Canada (2008–2018). Using logistic regression, we compared the
characteristics, conditions, and functional status of residents who were
socially isolated (no contact with family/friends) and non-socially isolated
residents. Results: Socially isolated residents were male, younger,
and had a longer length of stay in the home, than non-socially isolated
residents. Socially isolated residents lacked social engagement and exhibited
signs of depression. Discussion: Socially isolated residents had
unique care concerns, including psychiatric disorders, and co-morbid conditions.
Our approach, using a single item in an existing data source, has the potential
to assist clinicians in screening for socially isolated long-term care
residents.
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Affiliation(s)
| | | | - Pamela B Teaster
- Virginia Polytechnic Institute and State University, Blacksburg, USA
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Shiells K, Pivodic L, Holmerová I, Van den Block L. Self-reported needs and experiences of people with dementia living in nursing homes: a scoping review. Aging Ment Health 2020; 24:1553-1568. [PMID: 31163987 DOI: 10.1080/13607863.2019.1625303] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: With rates of dementia continuing to rise, the impetus on improving care for people with dementia is growing. Unmet needs of people with dementia living in nursing homes have been linked with worsening neuropsychiatric symptoms, higher levels of depression, and reduced quality of life. Furthermore, proxy accounts exploring the needs of people with dementia have frequently been shown to be unreliable. Therefore, this literature review aims to explore the self-reported needs and experiences of people with dementia in nursing homes.Method: A scoping review of the literature was carried out using the databases PubMed and PsycINFO to search for relevant articles according to PRISMA guidelines. Search terms were designed to include both quantitative and qualitative study designs. Thematic synthesis was used to categorise findings into themes related to self-reported needs and experiences.Results: A total of 41 articles met the eligibility criteria. An analysis of study characteristics revealed more than half of studies used a qualitative design. Thematic synthesis resulted in eight themes: activities, maintaining previous roles, reminiscence, freedom and choice, appropriate environment, meaningful relationships, support with grief and loss, end-of-life care.Conclusion: Whilst the voice of people with dementia has previously been neglected in research, this review has shown that people with dementia in nursing homes are able to describe their experiences and communicate their needs. The findings in this review have provided a contribution towards guiding evidence-based practice that is tailored to the needs of nursing home residents with dementia.
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Affiliation(s)
- Kate Shiells
- Centre of Expertise in Longevity and Long-term Care, Faculty of Humanities, Charles University, Prague, Czech Republic
| | - Lara Pivodic
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
| | - Iva Holmerová
- Centre of Expertise in Longevity and Long-term Care, Faculty of Humanities, Charles University, Prague, Czech Republic
| | - Lieve Van den Block
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
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25
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The use of technology to promote meaningful engagement for adults with dementia in residential aged care: a scoping review. Int Psychogeriatr 2020; 32:913-935. [PMID: 31547900 DOI: 10.1017/s1041610219001388] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION A considerable number of adults with dementia live in residential aged care facilities, where loneliness and boredom are common. Computer-based and electronic technologies have advanced significantly and there is potential for such technologies to improve engagement of residents with dementia. However, the nature and extent of the evidence supporting the use of these technologies is unclear. OBJECTIVES The aim of this study was to investigate the use of computer-based and electronic technologies for enhancing meaningful engagement of adults with dementia living in residential aged care. METHODS A scoping review was conducted. Nine databases were searched from 2008-2018. Included studies were summarized, compared and synthesized according to technology type. RESULTS Twenty studies were included. Most studies were conducted in Australia (n = 7) and Europe (n = 8). Study designs were quantitative (n = 12), mixed methods (n = 5), descriptive (n = 2) or qualitative (n = 1). Studies aimed to investigate interaction, engagement, behaviors or quality of life (n = 14), to examine the feasibility of technologies (n = 3), or had both aims (n = 3). Technology type fell into two categories: robotics (n = 14) and multi-media computer programs (n = 6). Across both technology types, there were conflicting results in relation to positive impact on meaningful engagement. Studies only investigated the doing, belonging and connecting aspects of meaningful engagement. Additionally, there was a lack of consistency across studies in how activity, interaction and engagement were measured. CONCLUSION The role and potential of new technologies to enhance meaningful engagement for those with dementia should focus on creating human-to-human interactions while taking individual preference and person-centered principles into account.
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Feng Y, Barakova EI, Yu S, Hu J, Rauterberg GWM. Effects of the Level of Interactivity of a Social Robot and the Response of the Augmented Reality Display in Contextual Interactions of People with Dementia. SENSORS 2020; 20:s20133771. [PMID: 32635640 PMCID: PMC7374302 DOI: 10.3390/s20133771] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/02/2020] [Accepted: 07/03/2020] [Indexed: 12/28/2022]
Abstract
The well-being of people with dementia (PWD) living in long-term care facilities is hindered due to disengagement and social isolation. Animal-like social robots are increasingly used in dementia care as they can provide companionship and engage PWD in meaningful activities. While most previous human–robot interaction (HRI) research studied engagement independent from the context, recent findings indicate that the context of HRI sessions has an impact on user engagement. This study aims to explore the effects of contextual interactions between PWD and a social robot embedded in the augmented responsive environment. Three experimental conditions were compared: reactive context-enhanced robot interaction; dynamic context-enhanced interaction with a static robot; a control condition with only the dynamic context presented. Effectiveness evaluations were performed with 16 participants using four observational rating scales on observed engagement, affective states, and apathy related behaviors. Findings suggested that the higher level of interactivity of a social robot and the interactive contextualized feedback helped capture and maintain users’ attention during engagement; however, it did not significantly improve their positive affective states. Additionally, the presence of either a static or a proactive robot reduced apathy-related behaviors by facilitating purposeful activities, thus, motivating behavioral engagement.
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Affiliation(s)
- Yuan Feng
- Department of Industrial Design, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (J.H.); (G.W.M.R.)
- Department of Industrial Design, Northwestern Polytechnical University, Xi’an 710072, China;
- Correspondence: (Y.F.); (E.I.B.)
| | - Emilia I. Barakova
- Department of Industrial Design, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (J.H.); (G.W.M.R.)
- Correspondence: (Y.F.); (E.I.B.)
| | - Suihuai Yu
- Department of Industrial Design, Northwestern Polytechnical University, Xi’an 710072, China;
| | - Jun Hu
- Department of Industrial Design, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (J.H.); (G.W.M.R.)
| | - G. W. Matthias Rauterberg
- Department of Industrial Design, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (J.H.); (G.W.M.R.)
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Ferreira AR, Simões MR, Moreira E, Guedes J, Fernandes L. Modifiable factors associated with neuropsychiatric symptoms in nursing homes: The impact of unmet needs and psychotropic drugs. Arch Gerontol Geriatr 2020; 86:103919. [DOI: 10.1016/j.archger.2019.103919] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 07/01/2019] [Accepted: 07/24/2019] [Indexed: 01/15/2023]
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Hoffmann F, Strautmann A, Allers K. Hospitalization at the end of life among nursing home residents with dementia: a systematic review. BMC Palliat Care 2019; 18:77. [PMID: 31506100 PMCID: PMC6737675 DOI: 10.1186/s12904-019-0462-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 09/06/2019] [Indexed: 12/24/2022] Open
Abstract
Background Half of nursing home residents (NHR) suffer from dementia. End-of-life hospitalizations are often burdensome in residents with dementia. A systematic review was conducted to study the occurrence of hospitalizations at the end of life in NHR with dementia and to compare these figures to NHR without dementia. Methods A systematic literature search in MEDLINE, CINAHL and Scopus was conducted in May 2018. Studies were included if they reported proportions of in-hospital deaths or hospitalizations of NHR with dementia in the last month of life. Two authors independently selected studies, extracted data, and assessed quality of studies. Results Nine hundred forty-five citations were retrieved; 13 studies were included. Overall, 7 studies reported data on in-hospital death with proportions ranging between 0% in Canada and 53.3% in the UK. Studies reporting on the last 30 days of life (n = 8) varied between 8.0% in the Netherlands and 51.3% in Germany. Two studies each assessed the influence of age and sex. There seem to be fewer end-of-life hospitalizations in older age groups. The influence of sex is inconclusive. All but one study found that at the end of life residents with dementia were hospitalized less often than those without (n = 6). Conclusions We found large variations in end-of-life hospitalizations of NHR with dementia, probably being explained by differences between countries. The influence of sex and age might differ when compared to residents without dementia. More studies should compare NHR with dementia to those without and assess the influence of sex and age. Trial registration PROSPERO registration number CRD42018104263.
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Affiliation(s)
- Falk Hoffmann
- Department of Health Services Research, Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 140, 26129, Oldenburg, Germany.
| | - Anke Strautmann
- Department of Health Services Research, Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 140, 26129, Oldenburg, Germany
| | - Katharina Allers
- Department of Health Services Research, Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 140, 26129, Oldenburg, Germany
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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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Tapia Muñoz T, Slachevsky A, León-Campos MO, Madrid M, Caqueo-Urízar A, Rohde GC, Miranda-Castillo C. Predictors of unmet needs in Chilean older people with dementia: a cross-sectional study. BMC Geriatr 2019; 19:106. [PMID: 30987587 PMCID: PMC6466805 DOI: 10.1186/s12877-019-1131-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 04/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The needs of people with dementia (PWD) have not been assessed in any Latin American country. Several European countries have already related unmet needs with quality of life, caregiver's age, burden, stress, anxiety and depression. The aim of this study was to identify met and unmet needs in Chilean older adults with dementia and to determine if those needs were associated with PWD's, their informal caregivers' and social factors. METHOD This was a cross-sectional study. One-hundred and sixty-six informal caregivers and their care recipients were interviewed. PWD was assessed about cognitive function and their caregivers answered instruments about PWD's needs, functional status and behavioral and psychological symptoms. Caregiver's burden, depression, anxiety and social support were also evaluated. A stepwise multiple linear regression analysis was performed to determine predictors of unmet needs in Chilean PWD. RESULTS The most frequent met needs were "Looking after home" (81.3%%), "Food" (78.9%) and "Selfcare" (75.3%). Most common unmet needs were "Daily living activities" (39.2%), "Company" (36.1%), and "Memory" (34.9%). Caregivers' lower age was correlated to a higher number of PWD's unmet needs (rs = -.216; p < 0.005). Higher PWD's dependence was associated with higher number of unmet needs (rs = .177; p < 0.05). The best predictors of unmet needs were caregivers' low level of social support, high burden, young age and high level of anxiety. CONCLUSION It is necessary to address psychological and social needs of PWD. The fact that PWD's unmet needs were associated mostly with caregivers' factors, highlights the importance of considering both, the PWD and their informal caregivers as targets of institutional support. It is expected that recently launched national public policies decrease PWD's unmet needs by the provision of new services for them and their informal caregivers.
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Affiliation(s)
| | - Andrea Slachevsky
- Gerosciences Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Physiopathology Department, ICBM, Neurosciences Department, East Neuroscience Department, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador & University of Chile, Santiago, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - María O. León-Campos
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
| | - Michel Madrid
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
| | | | - Gustav C. Rohde
- Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - Claudia Miranda-Castillo
- Universidad Andres Bello, Faculty of Nursing, Sazié 2212, Santiago, Chile
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
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Meyer C, O’Keefe F. Non-pharmacological interventions for people with dementia: A review of reviews. DEMENTIA 2018; 19:1927-1954. [DOI: 10.1177/1471301218813234] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective Aged care services increasingly respond to the needs of people with dementia. Non-pharmacological approaches are preferable to reduce responsive behaviours, improve/maintain functional capacity and reduce emotional disorders. This rapid review of systematic reviews aimed to consolidate the evidence for non-pharmacological interventions and determine outcome effectiveness. Methods Systematic review literature was comprehensively searched for non-pharmacological interventions for dementia in residential care. Quality ratings used adapted GRADE methodology, and ease of implementation assessed. Results Of 629 abstracts screened, 81 full-text articles were retrieved, 38 articles included. The strongest evidence for reducing responsive behaviours was music, sensory stimulation, simulated presence and validation therapies. Exercise and light therapy improved/maintained activities of daily living, while cognitive stimulation and reminiscence improved cognition. Strongest evidence for reducing emotional disorders was music, psychological interventions and reminiscence. Conclusion Much evidence of varying quality exists, with resource-constrained residential care providers now able to make evidence-based decisions about non-pharmacological interventions.
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Affiliation(s)
- Claudia Meyer
- Bolton Clarke Research Institute, Australia; La Trobe University, Australia
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Smaling HJA, Joling KJ, van de Ven PM, Bosmans JE, Simard J, Volicer L, Achterberg WP, Francke AL, van der Steen JT. Effects of the Namaste Care Family programme on quality of life of nursing home residents with advanced dementia and on family caregiving experiences: study protocol of a cluster-randomised controlled trial. BMJ Open 2018; 8:e025411. [PMID: 30327407 PMCID: PMC6196971 DOI: 10.1136/bmjopen-2018-025411] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Quality of life of people with advanced dementia living in nursing homes is often suboptimal. Family caregivers can feel frustrated with limited contact with their relatives, which results in visits that are perceived as stressful and not very meaningful. Few psychosocial interventions are specifically developed for people with advanced dementia, and actively involve family caregivers or volunteers. Also, interventions usually stop when it becomes difficult for people to participate. The Namaste Care Family programme aims to increase the quality of life of people with advanced dementia, and improve family caregiving experiences through connecting to people and making them comfortable. METHODS AND ANALYSIS Our study will evaluate the effects of the Namaste Care Family programme on quality of life of people with advanced dementia living in nursing homes and family caregiving experiences using a cluster-randomised controlled trial. Longitudinal analyses will be performed taking into account clustering at the nursing home level. Both a cost-effectiveness and a cost-utility analysis from a societal perspective will be performed. We will modify the Namaste Care Family programme to increase family and volunteer involvement in ongoing and end-of-life care. Data collection involves assessments by family caregivers, nursing staff and elderly care physicians using questionnaires, and observations by the researchers at baseline and multiple times over 12 months. The last questionnaire will be sent up to month 24 after the death of the person with dementia. During semistructured interviews, the feasibility, accessibility and sustainability of the Namaste Care Family programme will be assessed. ETHICS AND DISSEMINATION The study protocol is approved by the Medical Ethics Review Committee of the VU University Medical Center in Amsterdam (protocol no. 2016.399) and registered with the Nederlands Trial Register (NTR5692). The findings will be disseminated via publications in peer-reviewed journals, conference presentations and presentations for healthcare professionals where appropriate. TRIAL REGISTRATION NUMBER NTR5692.
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Affiliation(s)
- Hanneke J A Smaling
- Department of Public and Occupational Health, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Karlijn J Joling
- Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Peter M van de Ven
- Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Judith E Bosmans
- Department of Health Sciences, Amsterdam Public Health Research Institute, VU University, Amsterdam, The Netherlands
| | - Joyce Simard
- School of Nursing and Midwifery, College of Health and Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Ladislav Volicer
- School of Aging Studies, University of South Florida, Land O'Lakes, Florida, USA
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Anneke L Francke
- Department of Public and Occupational Health, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Jenny T van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
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León-Campos MO, Slachevsky Chonchol A, Miranda-Castillo C. Afrontamiento, apoyo social y depresión en cuidadores informales y su relación con necesidades no cubiertas de personas con demencia. ANSIEDAD Y ESTRES-ANXIETY AND STRESS 2018. [DOI: 10.1016/j.anyes.2018.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Carey CJ, Heid AR, Van Haitsma K. Preferences for Everyday Living: Understanding the Impact of Cognitive Status on Preference Importance Ratings in Nursing Homes. J Gerontol Nurs 2018; 44:9-17. [PMID: 28990636 DOI: 10.3928/00989134-20171002-03] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 08/25/2017] [Indexed: 11/20/2022]
Abstract
Assessing everyday living preferences for nursing home residents is a cornerstone of delivering person-centered care (PCC), yet little is known about how cognitive ability can influence the importance of reported preferences. The current study examined the effect of cognitive ability on the level and stability of reported importance of preferences for everyday living in a sample of 255 nursing home residents across 3 months. Participants were grouped by cognitive impairment status (none-to-low, mild, and moderate) at baseline and completed the Preferences for Everyday Living Inventory, Nursing Home version interview at baseline and 3 months. Repeated measures analyses of covariance revealed no significant differences (p > 0.001) between cognitive groups on their reported level of importance of preferences at baseline and no significant change over 3 months. These data highlight the value of assessing everyday care preferences to help support delivery of PCC for individuals with and without cognitive impairment. [Journal of Gerontological Nursing, 44(5), 9-17.].
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35
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Legere LE, McNeill S, Schindel Martin L, Acorn M, An D. Nonpharmacological approaches for behavioural and psychological symptoms of dementia in older adults: A systematic review of reviews. J Clin Nurs 2018; 27:e1360-e1376. [DOI: 10.1111/jocn.14007] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Laura E Legere
- Registered Nurses’ Association of Ontario (RNAO); Toronto ON Canada
| | - Susan McNeill
- Registered Nurses’ Association of Ontario (RNAO); Toronto ON Canada
| | | | - Michelle Acorn
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Toronto ON Canada
| | - Diana An
- Registered Nurses’ Association of Ontario (RNAO); Toronto ON Canada
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Schmidt H, Eisenmann Y, Golla H, Voltz R, Perrar KM. Needs of people with advanced dementia in their final phase of life: A multi-perspective qualitative study in nursing homes. Palliat Med 2018; 32:657-667. [PMID: 29235393 DOI: 10.1177/0269216317746571] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND People with advanced dementia present an important target group for palliative care. They suffer a range of symptoms, and their verbal communication abilities are highly restricted. At present, little is known about their needs in the final phase of life. AIM To identify the needs of people with advanced dementia in their final phase of life and to explore the aspects relevant to first recognize and then meet these needs. DESIGN Multi-perspective qualitative study using grounded theory methodology conducting group discussions, individual interviews, and participant observation. SETTING/PARTICIPANTS The study encompassed nursing homes and involved health professionals, relatives, and residents with advanced dementia. RESULTS Data were collected in six nursing homes. Nine group discussions and three individual interviews were conducted comprising 42 health professionals and 14 relatives. Participant observations aided in giving the perspective of 30 residents with advanced dementia. Data analysis generated a total of 25 physical, psychosocial, and spiritual needs divided into 10 categories. Physical needs were classified as follows: "food intake," "physical well-being," and "physical activity and recovery." Categories of psychosocial needs were classified as follows: "adaptation of stimuli," "communication," "personal attention," "participation," "familiarity and safety," as well as "self-determination." Spiritual needs addressed "religion." The results revealed a multitude of key aspects for recognizing and meeting these needs, stressing the importance of personhood. CONCLUSION People with advanced dementia in their final phase of life have a multitude of individual and complex needs. This evidence contributes to narrowing the current research gap, offering an orientation framework for research and practice.
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Affiliation(s)
- Holger Schmidt
- 1 Department of Palliative Medicine, University Hospital of Cologne, Cologne, Germany
| | - Yvonne Eisenmann
- 1 Department of Palliative Medicine, University Hospital of Cologne, Cologne, Germany
| | - Heidrun Golla
- 1 Department of Palliative Medicine, University Hospital of Cologne, Cologne, Germany
| | - Raymond Voltz
- 1 Department of Palliative Medicine, University Hospital of Cologne, Cologne, Germany.,2 Clinical Trials Center Cologne (ZKS), Medical Faculty, University of Cologne, Cologne, Germany.,3 Center for Integrated Oncology (CIO Köln Bonn), University Hospital of Cologne, Cologne, Germany.,4 Center for Health Services Research (ZVFK), Medical Faculty, University of Cologne, Germany
| | - Klaus Maria Perrar
- 1 Department of Palliative Medicine, University Hospital of Cologne, Cologne, Germany
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Soto-Rubio AL, Tomás Miguel JM, Pérez-Marín M, Barreto Martín P. Patients with limited communication in end-of-life situations: Initial psychometric properties of a discomfort observation scale. J Health Psychol 2017; 24:1734-1743. [PMID: 28810438 DOI: 10.1177/1359105317696139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This work presents an observational scale which takes into account different observable indicators of discomfort of patients in end-of-life situations with difficulties in communicating due to cognitive impairment, fatigue or sedation and provides details of its validation. In all, 71 adults participated. Model fit was adequate (χ2(27) = 43.28, p = .024, comparative fit index = .975, root mean square error of approximation = .092 and confidence interval 90% (.033-.140)). Alpha coefficient was .70 and composite reliability index was .90. Our study provides data regarding the properties of a discomfort assessment scale. Such a scale is needed and could be very useful for the evaluation of such patients and thus to attend to their needs.
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38
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Smit D, de Lange J, Willemse B, Pot AM. Predictors of activity involvement in dementia care homes: a cross-sectional study. BMC Geriatr 2017; 17:175. [PMID: 28778153 PMCID: PMC5545000 DOI: 10.1186/s12877-017-0564-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 07/24/2017] [Indexed: 11/13/2022] Open
Abstract
Background Despite the finding that involvement in activities is one of the most important needs of residents with dementia living in care homes, care facilities struggle to fulfill this need. Over the years, various factors are suggested which may contribute to or disable activity provision in dementia care homes. These include limited financial resources, task oriented staff and disease-related characteristics of residents. This study aims to further clarify which of these factors predict higher activity involvement. Methods Data were derived from the second measurement (2011) of the Living Arrangements for people with Dementia study. One thousand two hundred eighteen people residing in 139 dementia care homes were involved. Forty predictors of higher involvement were studied. Multilevel backward regression analyses were performed. Results The most important predictors of higher involvement were: absence of agitation, less ADL dependency, and a higher cognitive status of the residents, higher staff educational level, lower experienced job demands by care staff and a smaller number of residents living in the dementia care wards of a facility. More social supervisor support as perceived by staff was found to predict less activity involvement. Conclusions To increase the activity involvement of care home residents with dementia it seems vital to: 1) reduce staff’s experienced job demands; 2) elevate their overall educational level; 3) train staff to provide suitable activities, taking account of the behavior and preserved capabilities of residents; and 4) foster transition towards small-scale care. In order to achieve these aims, care organizations might need to evaluate the use of their financial means. Electronic supplementary material The online version of this article (doi:10.1186/s12877-017-0564-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dieneke Smit
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands. .,Program on Aging, Netherlands Institute of Mental Health and Addiction, PO box 725, 3500 AS, Utrecht, the Netherlands.
| | - Jacomine de Lange
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK, Rotterdam, the Netherlands
| | - Bernadette Willemse
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.,Program on Aging, Netherlands Institute of Mental Health and Addiction, PO box 725, 3500 AS, Utrecht, the Netherlands
| | - Anne Margriet Pot
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.,Program on Aging, Netherlands Institute of Mental Health and Addiction, PO box 725, 3500 AS, Utrecht, the Netherlands.,School of Psychology, University of Queensland, Brisbane, Australia
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39
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Liapis J, Harding KE. Meaningful use of computers has a potential therapeutic and preventative role in dementia care: A systematic review. Australas J Ageing 2017. [DOI: 10.1111/ajag.12446] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jimmy Liapis
- Eastern Health - Occupational Therapy; Wantirna Health Geriatric Evaluation and Management Unit; Melbourne Victoria Australia
| | - Katherine E Harding
- Eastern Health - Allied Health Clinical Research Office; Melbourne Victoria Australia
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Aasgaard HS, Landmark BT, Öresland S. Healthcare personnel’s experiences of enhancing social community for people living in dementia special care units. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/2057158517693534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Building trustworthy relationships that promote equal participation is a fundamental feature of daily living in dementia care. Creating a social community is thus a key component of quality of life for residents in dementia special care units. The aim of this study was to explore healthcare personnel’s experiences of enhancing social community in common spaces in dementia special care units. A qualitative descriptive design consisted of four focus-group interviews with 15 healthcare personnel. The transcribed interviews were analyzed inductively using qualitative content analysis. The findings revealed that healthcare personnel’s experiences of enhancing social community in common spaces were related to three main themes, expressed as dilemmas between knowing versus not knowing each other, safety versus unsafety and presence versus absence . Our analysis indicates that to enhance social community, it is essential for healthcare personnel to be able to create different forms of proximity to residents: physical, narrative and moral. Moreover, the meaning and role of ‘proximity’ in dementia care should be further explored as organizational context influences spatial-structural practices and may disrupt proximity in dementia care.
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Affiliation(s)
| | - Bjørg T Landmark
- Faculty of Health and Social Sciences, University College of Southeast Norway, Norway
- Institute of Research and Development for Nursing and Care Services, Municipality of Drammen, Norway
| | - Stina Öresland
- Faculty of Health and Social Sciences, University College of Southeast Norway, Norway
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Klapwijk MS, Caljouw MA, Pieper MJ, van der Steen JT, Achterberg WP. Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study. Dement Geriatr Cogn Disord 2016; 42:186-197. [PMID: 27668927 PMCID: PMC5290445 DOI: 10.1159/000448806] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/18/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To determine which characteristics are associated with quality of life (QOL) in residents with moderate to very severe dementia in long-term care facilities (LTCFs). MATERIAL AND METHODS This was a cross-sectional analysis of a cluster randomized controlled study in 12 Dutch LTCFs that enrolled 288 residents, with moderate to severe dementia assessed with the Reisberg Global Deterioration Scale (Reisberg GDS) and QOL with the QUALIDEM. Characteristics that were hypothesized to be associated with the six domains of QOL (applicable to very severe dementia) included demographic variables, activities of daily living (Katz ADL), cognitive performance (Cognitive Performance Scale; CPS), pain (Pain Assessment Checklist for Seniors with Limited Ability to Communicate; PACSLAC-D), neuropsychiatric symptoms (Neuropsychiatric Inventory-Nursing Home Version; NPI-NH) and comorbidities. RESULTS Multivariate logistic regression modelling showed associations with age in the domain Social isolation [odds ratio, OR, 0.95 (95% confidence interval, CI, 0.91-0.99)], ADL level in the domain Positive affect [OR 0.89 (95% CI 0.83-0.95)] and the domain Social relations [OR 0.87 (95% CI 0.81-0.93)], severity of dementia in the domain Social relations [OR 0.28 (95% CI 0.12-0.62)] and in the domain Social isolation [OR 2.10 (95% CI 1.17-3.78)], psychiatric disorders in the domain Positive affect [OR 0.39 (95% CI 0.17-0.87)] and pulmonary diseases in the domain Negative affect [OR 0.14 (95% CI 0.03-0.61)] of the QUALIDEM. Neuropsychiatric symptoms were independently associated with all six domains of the QUALIDEM [OR 0.93 (95% CI 0.90-0.96) to OR 0.97 (95% CI 0.95-0.99)]. Pain was associated with the domains Care relationship [OR 0.92 (95% CI 0.84-1.00)] and Negative affect [OR 0.92 (95% CI 0.85-1.00)]. CONCLUSION QOL in dementia is independently associated with age, ADL, dementia severity, pain, psychiatric disorders, pulmonary diseases and neuropsychiatric symptoms. It is possible to detect persons with dementia at risk for a lower QOL. This information is important for developing personalized interventions to improve QOL in persons with dementia in LTCFs.
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Affiliation(s)
- Maartje S. Klapwijk
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Leiden, The Netherlands,Marente, LTCF ‘van Wijckerslooth’, Oegstgeest, Leiden, The Netherlands,*Maartje S. Klapwijk, MD, Department of Public Health and Primary Care Leiden University Medical Center PO Box 9600, NL-2300 RC Leiden (The Netherlands) E-Mail
| | - Monique A.A. Caljouw
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Leiden, The Netherlands
| | - Marjoleine J.C. Pieper
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Leiden, The Netherlands,Topaz, LTCF ‘Zuydtwijck’, Leiden, The Netherlands
| | - Jenny T. van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Leiden, The Netherlands
| | - Wilco P. Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Leiden, The Netherlands
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Mariani E, Engels Y, Koopmans R, Chattat R, Vernooij‐Dassen M. Shared decision-making on a 'life-and-care plan' in long-term care facilities: research protocol. Nurs Open 2016; 3:179-187. [PMID: 27708828 PMCID: PMC5047345 DOI: 10.1002/nop2.42] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 12/07/2015] [Indexed: 01/25/2023] Open
Abstract
AIM To determine whether the number of residents' preferences and needs together with the actions taken to satisfy them recorded into their 'life-and-care plans' will increase and the process of shared decision-making will improve the residents' psychosocial well-being. BACKGROUND Shared decision-making is defined as a process where healthcare professionals and patients make decisions together, using the best available evidence. The aims of the present study were to assess the feasibility and acceptability of an SDM framework for care planning in long-term care facilities and its potential effectiveness on the proportion of dementia residents whose own preferences and needs and the related actions, are known, satisfied and documented in their 'life-and-care plans'. DESIGN The current project is a feasibility trial and it was approved in November 2013. METHODS Research subjects are triads composed of the resident with dementia, a family caregiver and the professional usually taking care for the resident. Professional caregivers of two nursing homes, one located in Italy and one in the Netherlands, will receive a specific training in SDM principles and will guide the SDM interview in the triad. The primary outcome will be the proportion of residents whose preferences and needs, together with the related actions to meet them, are known, documented and satisfied in their 'life-and-care plans'. TRIAL REGISTRATION NCT02118701.
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Affiliation(s)
- Elena Mariani
- Scientific Institute for Quality of Healthcare (IQ healthcare)Radboud University Medical CentreP.O. Box 91016500 HBNijmegenThe Netherlands
- Department of PsychologyAlma Mater StudiorumUniversity of BolognaViale Berti Pichat 540127BolognaItaly
| | - Yvonne Engels
- Department of Anaesthesiology, Pain and Palliative MedicineRadboud University Medical CentreP.O. Box 91016500 HBNijmegenThe Netherlands
| | - Raymond Koopmans
- Department of Primary and Community CareRadboud University Medical CentreP.O. Box 91016500 HBNijmegenThe Netherlands
| | - Rabih Chattat
- Department of PsychologyAlma Mater StudiorumUniversity of BolognaViale Berti Pichat 540127BolognaItaly
| | - Myrra Vernooij‐Dassen
- Scientific Institute for Quality of Healthcare (IQ healthcare)Radboud University Medical CentreP.O. Box 91016500 HBNijmegenThe Netherlands
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Ferreira AR, Dias CC, Fernandes L. Needs in Nursing Homes and Their Relation with Cognitive and Functional Decline, Behavioral and Psychological Symptoms. Front Aging Neurosci 2016; 8:72. [PMID: 27148044 PMCID: PMC4838629 DOI: 10.3389/fnagi.2016.00072] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 03/28/2016] [Indexed: 11/13/2022] Open
Abstract
Unmet needs are becoming acknowledged as better predictors of the worst prognostic outcomes than common measures of functional or cognitive decline. Their accurate assessment is a pivotal component of effective care delivery, particularly in institutionalized care where little is known about the needs of its residents, many of whom suffer from dementia and show complex needs. The aims of this study were to describe the needs of an institutionalized sample and to analyze its relationship with demographic and clinical characteristics. A cross-sectional study was conducted with a sample from three nursing homes. All residents were assessed with a comprehensive protocol that included Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15), Neuropsychiatric Inventory (NPI) and Adults and Older Adults Functional Inventory (IAFAI). To identify needs, the Camberwell Assessment of Need for the Elderly (CANE) was used. The final sample included 175 residents with a mean age of 81 standard deviation (SD = 10) years. From these, 58.7% presented cognitive deficit (MMSE) and 45.2% depressive symptoms (GDS). Statistically significant negative correlations were found between MMSE score and met (r s = -0.425), unmet (r s = -0.369) and global needs (r s = -0.565). Data also showed significant correlations between depressive symptoms and unmet (r s = 0.683) and global needs (r s = 0.407), and between behavioral and psychological symptoms (BPSD) and unmet (r s = 0.181) and global needs (r s = 0.254). Finally, significant correlations between functional impairment and met (r s = 0.642), unmet (r s = 0.505) and global needs (r s = 0.796) were also found. These results suggest that in this sample, more unmet needs are associated with the worst outcomes measured. This is consistent with previous findings and seems to demonstrate that the needs of those institutionalized elderly remain under-diagnosed and untreated.
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Affiliation(s)
- Ana Rita Ferreira
- Department of Health Information and Decision Sciences (CIDES), PhD Program in Clinical and Health Services Research (PDICSS), Faculty of Medicine, University of Porto Porto, Portugal
| | - Cláudia Camila Dias
- Department of Health Information and Decision Sciences (CIDES), Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto Porto, Portugal
| | - Lia Fernandes
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, Center for Health Technology and Services Research (CINTESIS), University of Porto, Clinic of Psychiatry and Mental Health, CHSJ Porto, Portugal
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Baud Mermoud V, Morin D. Regards croisés entre l’évaluation de la qualité de vie perçue par le résident hébergé en établissement médico-social et par le soignant référent. Rech Soins Infirm 2016. [DOI: 10.3917/rsi.126.0038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Casey ANS, Low LF, Jeon YH, Brodaty H. Residents Perceptions of Friendship and Positive Social Networks Within a Nursing Home. THE GERONTOLOGIST 2015; 56:855-67. [PMID: 26603182 DOI: 10.1093/geront/gnv146] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 08/18/2015] [Indexed: 11/14/2022] Open
Abstract
PURPOSE OF THE STUDY (i) To describe nursing home residents' perceptions of their friendship networks using social network analysis (SNA) and (ii) to contribute to theory regarding resident friendship schema, network structure, and connections between network ties and social support. DESIGN AND METHODS Cross-sectional interviews, standardized assessments, and observational data were collected in three care units, including a Dementia Specific Unit (DSU), of a 94-bed Sydney nursing home. Full participation consent was obtained for 36 residents aged 63-94 years. Able residents answered open-ended questions about friendship, identified friendship ties, and completed measures of nonfamily social support. RESULTS Residents retained clear concepts of friendship and reported small, sparse networks. Nonparametric pairwise comparisons indicated that DSU residents reported less perceived social support (median = 7) than residents from the other units (median = 17; U = 10.0, p = .034, r = -.51), (median = 14; U = 0.0, p = .003, r = -.82). Greater perceived social support was moderately associated with higher number of reciprocated ties [ρ(25) = .49, p = .013]. IMPLICATIONS Though some residents had friendships, many reported that nursing home social opportunities did not align with their expectations of friendship. Relationships with coresidents were associated with perceptions of social support. SNA's relational perspective elucidated network size, tie direction, and density, advancing understanding of the structure of residents' networks and flow of subjective social support through that structure. Understanding resident expectations and perceptions of their social networks is important for care providers wishing to improve quality of life in nursing homes.
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Affiliation(s)
- Anne-Nicole S Casey
- Dementia Collaborative Research Centre/Centre for Healthy Brain Ageing, The University of New South Wales, Sydney, Australia.
| | | | - Yun-Hee Jeon
- Sydney Nursing School, The University of Sydney, New South Wales, Australia
| | - Henry Brodaty
- Dementia Collaborative Research Centre/Centre for Healthy Brain Ageing, The University of New South Wales, Sydney, Australia
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Low LF, Russell F, McDonald T, Kauffman A. Grandfriends, an Intergenerational Program for Nursing-Home Residents and Preschoolers: A Randomized Trial. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2015. [DOI: 10.1080/15350770.2015.1067130] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mazurek J, Szcześniak D, Talarska D, Wieczorowska-Tobis K, Kropińska S, Kachaniuk H, Rymaszewska J. Needs assessment of elderly people living in Polish nursing homes. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.gmhc.2014.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Soril LJJ, Leggett LE, Lorenzetti DL, Silvius J, Robertson D, Mansell L, Holroyd-Leduc J, Noseworthy TW, Clement FM. Effective use of the built environment to manage behavioural and psychological symptoms of dementia: a systematic review. PLoS One 2014; 9:e115425. [PMID: 25517508 PMCID: PMC4269426 DOI: 10.1371/journal.pone.0115425] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 11/23/2014] [Indexed: 11/28/2022] Open
Abstract
Objective To determine the effectiveness of built environment interventions in managing behavioural and psychological symptoms of dementia (BPSD) among residents in long-term care settings. Methods Systematic review of literature published from 1995–2013. Studies were included if they: were randomized controlled trials, quasi-experimental trials, or comparative cohort studies; were in long-term or specialized dementia care; included residents with dementia and BPSD; and examined effectiveness of a built environment intervention on frequency and/or severity of BPSD. Quality of included studies was assessed using the Downs and Black Checklist. Study design, patient population, intervention, and outcomes were extracted and narratively synthesized. Results Five low to moderate quality studies were included. Three categories of interventions were identified: change/redesign of existing physical space, addition of physical objects to environment, and type of living environment. One of the two studies that examined change/redesign of physical spaces reported improvements in BPSD. The addition of physical objects to an existing environment (n = 1) resulted in no difference in BPSD between treatment and control groups. The two studies that examined relocation to a novel living environment reported decreased or no difference in the severity and/or frequency of BPSD post-intervention. No studies reported worsening of BPSD following a built environment intervention. Conclusions The range of built environment interventions is broad, as is the complex and multi-dimensional nature of BPSD. There is inconclusive evidence to suggest a built environment intervention which is clinically superior in long-term care settings. Further high-quality methodological and experimental studies are required to demonstrate the feasibility and effectiveness of such interventions.
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Affiliation(s)
- Lesley J. J. Soril
- Department Community Health Sciences, University of Calgary, Teaching Research and Wellness Building, Calgary, Alberta, Canada
- Institute for Public Health, University of Calgary, Teaching Research and Wellness Building, Calgary, Alberta, Canada
| | - Laura E. Leggett
- Department Community Health Sciences, University of Calgary, Teaching Research and Wellness Building, Calgary, Alberta, Canada
- Institute for Public Health, University of Calgary, Teaching Research and Wellness Building, Calgary, Alberta, Canada
| | - Diane L. Lorenzetti
- Department Community Health Sciences, University of Calgary, Teaching Research and Wellness Building, Calgary, Alberta, Canada
- Institute for Public Health, University of Calgary, Teaching Research and Wellness Building, Calgary, Alberta, Canada
- Institute of Health Economics, Edmonton, Alberta, Canada
| | | | | | | | - Jayna Holroyd-Leduc
- Department Community Health Sciences, University of Calgary, Teaching Research and Wellness Building, Calgary, Alberta, Canada
- Department of Medicine, University of Calgary, Foothills Medical Centre South Tower, Calgary, Alberta, Canada
- Alberta Health Services, Calgary, Alberta, Canada
| | - Tom W. Noseworthy
- Department Community Health Sciences, University of Calgary, Teaching Research and Wellness Building, Calgary, Alberta, Canada
- Institute for Public Health, University of Calgary, Teaching Research and Wellness Building, Calgary, Alberta, Canada
- Alberta Health Services, Calgary, Alberta, Canada
| | - Fiona M. Clement
- Department Community Health Sciences, University of Calgary, Teaching Research and Wellness Building, Calgary, Alberta, Canada
- Institute for Public Health, University of Calgary, Teaching Research and Wellness Building, Calgary, Alberta, Canada
- * E-mail:
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Tak SH, Zhang H, Hong SH. Preferred computer activities among individuals with dementia: a pilot study. J Gerontol Nurs 2014; 41:50-7. [PMID: 25369583 DOI: 10.3928/00989134-20141029-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 10/01/2014] [Indexed: 11/20/2022]
Abstract
Computers offer new activities that are easily accessible, cognitively stimulating, and enjoyable for individuals with dementia. The current descriptive study examined preferred computer activities among nursing home residents with different severity levels of dementia. A secondary data analysis was conducted using activity observation logs from 15 study participants with dementia (severe = 115 logs, moderate = 234 logs, and mild = 124 logs) who participated in a computer activity program. Significant differences existed in preferred computer activities among groups with different severity levels of dementia. Participants with severe dementia spent significantly more time watching slide shows with music than those with both mild and moderate dementia (F [2,12] = 9.72, p = 0.003). Preference in playing games also differed significantly across the three groups. It is critical to consider individuals' interests and functional abilities when computer activities are provided for individuals with dementia. A practice guideline for tailoring computer activities is detailed.
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Casey AN, Low LF, Goodenough B, Fletcher J, Brodaty H. Computer-Assisted Direct Observation of Behavioral Agitation, Engagement, and Affect in Long-Term Care Residents. J Am Med Dir Assoc 2014; 15:514-520. [DOI: 10.1016/j.jamda.2014.03.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 02/28/2014] [Accepted: 03/07/2014] [Indexed: 12/01/2022]
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