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Yous ML, Coker E, Hunter PV, Fisher KA, Sue JL, Nicula M, Kazmie N, Orsini T, Sussman T, Thompson G, Kaasalainen S. Acceptability and preliminary effects of the volunteer-supported Meaningful Moments program to engage older adults with advanced dementia on a hospital-based specialized dementia care unit: a mixed methods study. BMC Geriatr 2024; 24:593. [PMID: 38992599 PMCID: PMC11238390 DOI: 10.1186/s12877-024-05194-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 07/02/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Namaste Care offers practical skills for healthcare providers, volunteers, and families to meaningfully engage individuals with dementia in activities (e.g., music, massage, reminiscing, socialization, aromatherapy, snacks). A hospital-based specialized dementia care unit for patients with mid- to late-stage dementia offered an adapted version of the Namaste Care program, which was called Meaningful Moments. The aim of this study was to assess the acceptability and preliminary effects of this novel approach using trained volunteers for older adults with mid- to late-stage dementia. METHODS A mixed methods multiphase design was used. Qualitative description was used to explore acceptability of the Meaningful Moments program delivered over 6 months through focus groups (e.g., charge nurses, therapeutic recreationists, nurses, social workers) and individual interviews with one volunteer and two family members. A prospective pre-post-test study design was used to evaluate the preliminary effects of the program for patients with dementia and family members. Outcomes included quality of life, neuropsychiatric symptoms, and pain for patients with dementia and family carer role stress and the quality of visits for families. Data were collected from June 2018 to April 2019. Descriptive analyses of participants' characteristics were expressed as a mean (standard deviation [SD]) for continuous variables and count (percent) for categorical variables. Focus group and individual interview data were analyzed using thematic analysis. The generalized estimating equations (GEE) method was used to assess change in the repeated measures outcome data. RESULTS A total of 15 patients received the Meaningful Moments interventions. Families, staff, and volunteers perceived that patients experienced benefits from Meaningful Moments. Staff, volunteers, and families felt fulfilled in their role of engaging patients in the Meaningful Moments program. Individualized activities provided by volunteers were perceived as necessary for the patient population. There were no statistically significant improvements in patient outcomes. There was a statistically significant decline in family carer role stress. CONCLUSIONS Using a one-on-one approach by volunteers, patients experienced perceived benefits such as improved mood and opportunities for social interactions. There is a need for tailored activities for older adults with advanced dementia through practical strategies that can offer benefit to patients.
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Affiliation(s)
- Marie-Lee Yous
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
| | - Esther Coker
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Paulette V Hunter
- Department of Psychology, St. Thomas More College, University of Saskatchewan, 1437 College Drive, Saskatoon, SK, S7N 0W6, Canada
| | - Kathryn A Fisher
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Joanna L Sue
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Maria Nicula
- Health Research Methodology, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Nadia Kazmie
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Theresa Orsini
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Tamara Sussman
- School of Social Work, McGill University, 3506 University St, Montreal, QC, H3A 2A7, Canada
| | - Genevieve Thompson
- College of Nursing, University of Manitoba, 89 Curry Place (Fort Garry Campus), Winnipeg, MB, R3T 2N2, Canada
| | - Sharon Kaasalainen
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
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Yous ML, Hunter PV, Coker E, Fisher KA, Nicula M, Kazmie N, Bello-Haas VD, Hadjistavropoulos T, McAiney C, Thompson G, Kaasalainen S. Experiences of Families, Staff, Volunteers, and Administrators With Namaste Care for Persons With Advanced Dementia in Canadian Long-Term Care Homes. J Am Med Dir Assoc 2024; 25:830-836. [PMID: 37709261 DOI: 10.1016/j.jamda.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/14/2023] [Accepted: 08/14/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVE To explore the experiences of the Namaste Care intervention for persons with advanced dementia (ie, moderate and late-stage) in long-term care (LTC). DESIGN A qualitative descriptive design was used. Staff Carers (eg, personal support worker, nurse, or activity aide) delivered Namaste Care with the support of volunteers in a small group. Activities provided during the Namaste Care sessions to enhance quality of life included massages, aromatherapy, music, and snacks/beverages. SETTING AND PARTICIPANTS Family carers of residents with advanced dementia, LTC staff, administrators, and volunteers from 2 Canadian LTC homes, located in a midsize metropolitan area, were included. METHODS Experiences and acceptability of Namaste Care was assessed through semistructured interviews ranging from 30 to 60 minutes following the 6-month study duration period with family carers, LTC staff, administrators, and volunteers. Thematic analysis was used for interview transcripts. RESULTS A total of 16 family carers and 21 LTC staff, administrators, and volunteers participated in the study. Namaste Care was found to be acceptable and successful in enhancing the quality of life of residents due to collaborative efforts of all group of participants. Families, volunteers, and staff noted positive responses in residents, such as smiling and laughing. The program environment supported the development of relationships within the LTC community, which included families, residents, staff, and volunteers. CONCLUSIONS AND IMPLICATIONS Namaste Care was perceived by the LTC community as an acceptable intervention for persons with advanced dementia. It was perceived as offering multiple benefits for residents with advanced dementia such as improved communication and mood.
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Affiliation(s)
- Marie-Lee Yous
- School of Nursing, 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, McMaster University, Hamilton, ON, Canada
| | | | - Maria Nicula
- Health Research Methodology, McMaster University, Hamilton, ON, Canada
| | - Nadia Kazmie
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | | | - Thomas Hadjistavropoulos
- Department of Psychology and Centre on Aging and Health, University of Regina, Regina, SK, Canada
| | - Carrie McAiney
- School of Public Health Sciences, University of Waterloo, Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada
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Helbling M, Grandjean ML, Srinivasan M. Effects of multisensory environment/stimulation therapy on adults with cognitive impairment and/or special needs: A systematic review and meta-analysis. SPECIAL CARE IN DENTISTRY 2024; 44:381-420. [PMID: 37515496 DOI: 10.1111/scd.12906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/30/2023] [Accepted: 07/12/2023] [Indexed: 07/31/2023]
Abstract
AIM This review aimed to evaluate the effects of multisensory environments/stimulation (MSE/MSS) therapy, on the behavior and psychological symptoms in adults with cognitive impairment and/or special needs. METHODS Online database searches were performed to identify studies reporting on the effects of MSS/MSE therapy in adults (>18 years). Data were extracted for the following investigated outcomes including anxiety, depression, mood, behavioral attributes, biomedical parameters, cognition, motor skills, quality of life (QoL), pain, and end of life quality. Two reciprocally blinded investigators extracted the data. Inter-investigator reliability (𝝹) was calculated. A meta-analysis and a qualitative analysis were performed on the information extracted. RESULTS Thirty-six studies were included for data extraction and analysis. Meta-analysis of the included studies revealed a significant improvement with the MSE/MSS therapy, for agitation (p = .018), anxiety (p = .023), cognition (p < .001), and depression (p < .001). MSS/MSE therapy demonstrated a tendency for the improvement of the QoL in adults (p = .05). CONCLUSION MSE/MSS therapies are beneficial in cognitively impaired adults and improve their anxiety, depression, cognitive and other behavioral attributes such as agitative behaviors. Promoting these therapies in geriatric care may help to improve/reduce the challenging/care-resistant behaviors in adults and facilitate effective provision of the necessary care.
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Affiliation(s)
- Meret Helbling
- Clinic of General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Marie-Laure Grandjean
- Clinic of General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Murali Srinivasan
- Clinic of General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Li DHY, Yous ML, Hunter PV, Coker E, Just D, Bello-Haas VD, McAiney C, Wickson-Griffiths A, Kaasalainen S. Supporting the "hallway residents": a qualitative descriptive study of staff perspectives on implementing the Namaste Care intervention in long-term care. BMC Geriatr 2023; 23:661. [PMID: 37845662 PMCID: PMC10580502 DOI: 10.1186/s12877-023-04360-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/27/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Long-term care (LTC) settings are becoming home to an increasing number of people living with advanced or late-stage dementia. Residents living with advanced dementia represent some of society's most vulnerable and socially excluded populations and are thus at an increased risk of social isolation. A multisensory intervention tailored to this population, Namaste Care, has been developed to improve quality of life for residents living with advanced dementia in LTC homes. To date, limited research has explored the perspectives of staff in implementing the Namaste Care program with an emphasis on social inclusion of residents in Canadian LTC homes. This study aimed to describe the perspectives of LTC staff on the implementation facilitators and barriers of Namaste Care as a program to support the social inclusion of residents living with advanced dementia. METHODS Using a qualitative descriptive design, semi-structured interviews (n = 12) and focus groups (n = 6) were conducted in two LTC homes in Southern Ontario, Canada, over a 6-month period. Convenience sampling was used to recruit LTC home staff from the two participating sites. Thematic analysis was used to analyze data. RESULTS LTC staff (n = 46) emphasized the program's ability to recognize the unique needs of residents with advanced dementia, and also stated its potential to facilitate meaningful connections between families and residents, as well as foster care partnerships between staff and families. Findings indicated staff also perceived numerous facilitators and barriers to Namaste Care. In particular, providing staff with dedicated time for Namaste Care and implementing volunteer and family participation in the program were seen as facilitators, whereas the initial perception of the need for extra staff to deliver Namaste Care and identifying times in the day where Namaste Care was feasible for residents, families, and staff, were seen as barriers. CONCLUSIONS LTC staff recognized the need for formalized programs like Namaste Care to address the biopsychosocial needs of residents with advanced dementia and offer positive care partnership opportunities between staff and family members. Although staffing constraints remain the largest barrier to effective implementation, staff valued the program and made suggestions to build LTC home capacity for Namaste Care.
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Affiliation(s)
- Donny H Y Li
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
- Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
| | - Marie-Lee Yous
- 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
| | - Danielle Just
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Carrie McAiney
- School of Public Health Sciences, University of Waterloo and Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada
| | | | - Sharon Kaasalainen
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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Yous ML, Hunter PV, Coker E, Fisher KA, Nicula M, Kazmie N, Bello-Haas VD, Hadjistavropoulos T, McAiney C, Thompson G, Kaasalainen S. Feasibility and Effects of Namaste Care for Persons with Advanced Dementia in Canadian Long-Term Care Homes. J Am Med Dir Assoc 2023; 24:1433-1438.e5. [PMID: 37301225 DOI: 10.1016/j.jamda.2023.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To evaluate the feasibility and effects of the Namaste Care intervention for persons with advanced dementia (ie, moderate and late-stage) in long-term care (LTC) and their family carers. DESIGN A pre-posttest study design. Staff carers delivered Namaste Care for residents with the support of volunteers in a small group setting. Activities provided included aromatherapy, music, and snacks/beverages. SETTING AND PARTICIPANTS Residents with advanced dementia and family carers from 2 Canadian LTC homes, located in a midsize metropolitan area, were included. METHODS Feasibility was evaluated using a research activity log. Outcome data for residents (ie, quality of life, neuropsychiatric symptoms, pain) and family carers (ie, role stress, quality of family visits) were collected at baseline and 3 and 6 months of the intervention. Descriptive analyses and generalized estimating equations were used for quantitative data. RESULTS A total of 53 residents with advanced dementia and 42 family carers participated in the study. Mixed findings were found for feasibility as not all intervention targets were met. There was a significant improvement in resident neuropsychiatric symptoms at the 3-month time point only (95% CI -9.39, -0.39; P = .033) and family carer role stress at both time points (3-month 95% CI -37.40, -1.80; P = .031; 6-month 95% CI -48.90, -2.09; P = .033). CONCLUSIONS AND IMPLICATIONS Namaste Care is an intervention with preliminary evidence of impact. Feasibility findings revealed that not all targets were met as the intended number of sessions were not delivered. Future research should explore how many sessions per week are required to lead to an impact. It is important to assess outcomes for both residents and family carers, and to consider enhancing family engagement in delivering the intervention. Given the promise of this intervention, a large-scale randomized controlled trial with a longer follow-up should be conducted to further evaluate its outcomes.
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Affiliation(s)
- Marie-Lee Yous
- School of Nursing, McMaster University, Hamilton, Ontario, Canada.
| | - Paulette V Hunter
- Department of Psychology, St. Thomas More College, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Esther Coker
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Kathryn A Fisher
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Maria Nicula
- Health Research Methodology, McMaster University, Hamilton, Ontario, Canada
| | - Nadia Kazmie
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | | | - Thomas Hadjistavropoulos
- Department of Psychology and Centre on Aging and Health, University of Regina, Regina, Saskatchewan, Canada
| | - Carrie McAiney
- School of Public Health Sciences, University of Waterloo, Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
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Smaling HJA, Francke AL, Achterberg WP, Joling KJ, van der Steen JT. The Perceived Impact of the Namaste Care Family Program on Nursing Home Residents with Dementia, Staff, and Family Caregivers: A Qualitative Study. J Palliat Care 2023; 38:143-151. [PMID: 36200165 PMCID: PMC10026161 DOI: 10.1177/08258597221129739] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective(s): To examine the perspectives of staff, and family caregivers (i.e., family, friends, and volunteers) on the impact of the Namaste Care Family program on all involved. The Namaste Care Family program is a structured program for people with advanced dementia based on a palliative care approach in which family caregivers provide daily sessions together with staff with the aim to increase residents' quality of life. Methods: In this descriptive qualitative study, we interviewed 12 family caregivers, and 31 staff members from 10 nursing homes. Data was analyzed thematically. Results: A perceived impact of the program was identified for the residents, staff, and family caregivers. For residents, this included well-being, more engagement, enhanced interactions, changes in energy level, and weight gain. The impact on family caregivers included a more positive view of people with dementia, changes in family visits, mixed feelings during sessions, and mixed changes in relations with all involved. For staff, this included diverse work experiences, shift to more person-centered care (more time and attention for residents, and more awareness), and developing relationships with residents and colleagues. Conclusions: The Namaste Care Family program was valued for its observed benefits and shift towards a person-centered care culture.
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Affiliation(s)
- Hanneke J A Smaling
- Department of Public Health and Primary Care, 4501Leiden University Medical Center, Leiden, the Netherlands
- University Network for the Care sector Zuid-Holland, 4501Leiden University Medical Center, Leiden, the Netherlands
| | - Anneke L Francke
- Department of Public and Occupational Health, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, the Netherlands
- 8123Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, 4501Leiden University Medical Center, Leiden, the Netherlands
- University Network for the Care sector Zuid-Holland, 4501Leiden University Medical Center, Leiden, the Netherlands
| | - Karlijn J Joling
- Department of General Practice and Elderly Care Medicine, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, the Netherlands
| | - Jenny T van der Steen
- Department of Public Health and Primary Care, 4501Leiden University Medical Center, Leiden, the Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
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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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Pereira RF, Myge I, Hunter PV, Kaasalainen S. Volunteers' experiences building relationships with long-term care residents who have advanced dementia. DEMENTIA 2022; 21:2172-2190. [PMID: 35799421 PMCID: PMC9483688 DOI: 10.1177/14713012221113191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Healthcare volunteers make important contributions within healthcare settings, including
long-term care. Although some studies conducted in long-term care have shown that
volunteers contribute positively to the lives of people living with advanced dementia,
others have raised questions about the potential for increasing volunteers’ involvement.
The purpose of this study is to understand volunteers’ perspectives on their work and
relationships with long-term care residents with advanced dementia. A total of 16
volunteers participated in semi-structured interviews about their experiences. Interview
data were analyzed using an inductive approach to thematic analysis. In this analysis, a
central concept, relationships in dementia care volunteering, enveloped
four related themes: mutuality and empathy as the foundation for dementia care
relationships with residents, family as the focus of volunteer relationships,
relationships shaped by grief, and staff support for volunteer relationships.
We conclude that in long-term care settings, volunteer roles and relationship networks are
more robust than they are often imagined to be. We recommend that long-term care providers
looking to engage volunteers consider training and supporting volunteers to cultivate
relationships with residents, family, and staff; navigate experiences of loss; and be
considered as members of dementia care teams.
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Affiliation(s)
| | - Ivy Myge
- 7235University of Saskatchewan, Saskatoon, SK, Canada
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Kaasalainen S, Mccleary L, Vellani S, Pereira J. Improving End-of-Life Care for People with Dementia in LTC Homes During the COVID-19 Pandemic and Beyond. Can Geriatr J 2021; 24:164-169. [PMID: 34484498 PMCID: PMC8390320 DOI: 10.5770/cgj.24.493] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
COVID-19 pandemic has resulted in a significant increase in deaths in long-term care homes (LTCH). People with dementia living in LTCHs represent one of the most frail and marginalized populations in Canada. The surge of COVID-19 cases in LTCHs and rationing of health-care resources during the pandemic have amplified the pre-existing need for improvements in palliative and end-of-life care in LTCHs. This position statement, created by a task force commissioned by the Alzheimer Society of Canada, provides recommendations for a multipronged coordinated approach to improving palliative and end-of-life care of people with dementia living in LTCHs during the COVID-19 pandemic and beyond.
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Affiliation(s)
| | - Lynn Mccleary
- Faculty of Applied Health Sciences, Nursing, Brock University, St. Catharines, ON
| | - Shirin Vellani
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON
| | - Jose Pereira
- Division of Palliative Care, Department of Family Medicine, McMaster University, Hamilton, ON.,Pallium Canada, Ottawa, ON
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Bethell J, O'Rourke HM, Eagleson H, Gaetano D, Hykaway W, McAiney C. Social Connection is Essential in Long-Term Care Homes: Considerations During COVID-19 and Beyond. Can Geriatr J 2021; 24:151-153. [PMID: 34079609 PMCID: PMC8137460 DOI: 10.5770/cgj.24.488] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
COVID-19 has had a profound impact on long-term care (LTC) homes in Canada. But the measures put in place to control infection within LTC homes have also had devastating impacts on the health and well-being of residents through the effects on social connection. Here, we offer guiding principles to enable social connection and promote health and quality of life for LTC residents during COVID-19 and beyond. These principles were generated by a working group of the COVID-19 and Dementia Task Force, convened by the Alzheimer Society of Canada to identify the urgent and emerging issues raised by COVID-19 for Canadians with dementia.
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Affiliation(s)
- Jennifer Bethell
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON
| | | | - Heather Eagleson
- Canadian Consortium on Neurodegeneration in Aging (CCNA) Engagement of People with Lived Experience of Dementia Advisory Group (https://ccna-ccnv.ca/contact/)
| | - Daniel Gaetano
- Canadian Consortium on Neurodegeneration in Aging (CCNA) Engagement of People with Lived Experience of Dementia Advisory Group (https://ccna-ccnv.ca/contact/)
| | - Wayne Hykaway
- Canadian Consortium on Neurodegeneration in Aging (CCNA) Engagement of People with Lived Experience of Dementia Advisory Group (https://ccna-ccnv.ca/contact/)
| | - Carrie McAiney
- University of Waterloo, Waterloo, ON.,Schlegel-University of Waterloo Research Institute for Aging, Waterloo, ON, Canada
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Karacsony S, Abela MRL. Stimulating sense memories for people living with dementia using the Namaste Care programme: What works, how and why? J Clin Nurs 2021; 31:1921-1932. [PMID: 33462888 DOI: 10.1111/jocn.15665] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/18/2020] [Accepted: 12/31/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Sensory-based program for people with advanced dementia aim to address unmet needs and to improve behaviours, mood or cognition. Pleasurable, involuntary sense memories stimulated by sensory-based program are difficult to evaluate because it is not possible to ask what people with dementia remember about their past, or what sense memories are being evoked. Notwithstanding the challenges in identifying what sense memories people with dementia experience, nurses and caregivers should recognise the potential value of sense memories for pleasure and happiness and provide optimum conditions to stimulate the senses. AIMS AND OBJECTIVES To examine the potential for involuntary sense memories to be activated by sensory stimulation, with a focus on the effects of the Namaste Care programme. DESIGN This is a discursive paper applying a content analysis to the qualitative findings of studies reporting on the Namaste Care programme to critically evaluate the topic of involuntary sense memories for people living with advanced dementia. METHODS A literature review and content analysis of qualitative findings on the Namaste Care programme was performed. Findings are reported in line with the COREQ checklist. RESULTS Eleven studies met the inclusion criteria. Codes were grouped into four categories representing enhanced mood, pleasure, happiness and comfort capturing the effects of the sensory stimulation observed or perceived by nurses and family caregivers. Descriptions provide some evidence of sensory memories activated by stimulation of some senses but not all. CONCLUSION Involuntary sense memories contribute to well-being of people living with advanced dementia. Caregivers, including nurses, need to be aware that involuntary sense memories that do not rely on cognitive processes can be triggered by sensory stimulation and have the potential to enhance mood and bestow pleasure, happiness and comfort over and above the "activity" of the sensory programme. RELEVANCE TO CLINICAL PRACTICE By integrating the documented experiential findings and conceptual understandings of sense memory, this paper contributes to advancing the understanding of the value of involuntary sense memories for people living with dementia that nurses and caregivers need to be aware of and, in turn, provide the optimum conditions for memory of the senses to be activated. A sensory-based programme, such as Namaste Care, provides optimum conditions at low cost to activate sense memories.
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Affiliation(s)
- Sara Karacsony
- School of Nursing, College of Health and Medicine, University of Tasmania, Sydney, Australia
| | - Melissa R L Abela
- Wicking Dementia Research & Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Australia
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The Impact of Implementing a Namaste Care Intervention in UK Care Homes for People Living with Advanced Dementia, Staff and Families. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17166004. [PMID: 32824847 PMCID: PMC7459821 DOI: 10.3390/ijerph17166004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/14/2020] [Accepted: 08/14/2020] [Indexed: 11/16/2022]
Abstract
Care homes can struggle to provide optimal care for residents with advanced dementia. Namaste Care provides a structured daily programme of physical, sensory and emotional care delivered by regular care workers. A three-year, mixed method process study of implementation and impact created a manualised Namaste Care Intervention for UK care homes (NCI-UK). This article reports on the impact of NCI-UK delivered consistently in five care homes for 12–24 weeks. Impact for residents was assessed using, pre-post data, showing significant positive effects for QUALID (t = 2.92, p = 0.01, n = 31) and CMAI (t = 3.31, p = 0.002, n = 32), alongside many qualitative examples of positive impacts on wellbeing, responsiveness and communication. Pre-post staff questionnaire data (n = 20) were not significant. Qualitative data indicated that NCI-UK is a positive staff experience, providing sense of purpose, improved wellbeing and relationships. The care homes reported benefiting from implementing NCI-UK in terms of reputation and quality improvement. Family interviews were also positive, relating to seeing the difference, improving relationships and being involved. NCI-UK can therefore be recommended as an impactful intervention for residents, staff and families.
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