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Tam MT, Martin S, Jiang YF, Machado A, Robillard JM. "Dementia Doesn't Mean That Life Doesn't Have More Wonderful Things Ahead": A Qualitative Study Evaluating a Canadian Dementia Support Services Program. Can Geriatr J 2024; 27:116-125. [PMID: 38827428 PMCID: PMC11100986 DOI: 10.5770/cgj.27.698] [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: 06/04/2024] Open
Abstract
Background Community support programs can improve quality of life for people living with dementia and their care partners. Important to the successful implementation of such programs is close engagement with end-users to gain a better understanding of their needs. This study describes the perspectives of people living with dementia, care partners, and health-care providers on the First Link® dementia support program provided by the Alzheimer Society of British Columbia (ASBC). Methods Following a large-scale survey (N=1,164), semi-structured interviews were conducted with participants to explore in greater detail the different needs and themes that emerged from the first phase of the study. The interviews explored: 1) experiences with the program; 2) future planning; 3) meaning of independence; and 4) impact of the program on emotional and physical well-being. Results A total of 48 participants were interviewed in this study. Knowledge and education were key factors that helped participants manage the impact of dementia. Learning about dementia, the experiences of others, strategies on how to manage symptoms, what to plan for in the future, and how to access different services in the community, was tied to increased feelings of confidence and comfort, and decreased stress. Participants also provided suggestions for improvement of the First Link® dementia program such as further embedding the program into the patient journey, providing more services in remote areas, providing education for health-care providers, and increasing awareness of the program. Conclusion By emphasizing the lived experiences and needs of those living with dementia and their caregivers, this work will inform future research-based program evaluations globally and, in turn, improve the existing services to support people living with-and impacted by-dementia.
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Affiliation(s)
- Mallorie T. Tam
- Department of Medicine, Division of Neurology, The University of British Columbia, Vancouver, BC,
Canada
- British Columbia Children’s & Women’s Hospital, Vancouver, BC,
Canada
| | - Susanna Martin
- Department of Medicine, Division of Neurology, The University of British Columbia, Vancouver, BC,
Canada
- British Columbia Children’s & Women’s Hospital, Vancouver, BC,
Canada
| | - Yu Fei Jiang
- Department of Medicine, Division of Neurology, The University of British Columbia, Vancouver, BC,
Canada
- British Columbia Children’s & Women’s Hospital, Vancouver, BC,
Canada
| | - Angela Machado
- Department of Medicine, Division of Neurology, The University of British Columbia, Vancouver, BC,
Canada
- British Columbia Children’s & Women’s Hospital, Vancouver, BC,
Canada
| | - Julie M. Robillard
- Department of Medicine, Division of Neurology, The University of British Columbia, Vancouver, BC,
Canada
- British Columbia Children’s & Women’s Hospital, Vancouver, BC,
Canada
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Barbosa A, Ferreira AR, Smits C, Hegerath FM, Vollmar HC, Fernandes L, Craven MP, Innes A, Casey D, Sezgin D, Hopper L, Øksnebjerg L. Use and uptake of technology by people with dementia and their supporters during the COVID-19 pandemic. Aging Ment Health 2024; 28:83-94. [PMID: 36650751 DOI: 10.1080/13607863.2022.2163375] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 12/19/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This rapid review aims to identify the types of technologies used by people with dementia and their supporters during the COVID-19 pandemic, and the issues which influenced technology adoption within their usual care routines. METHODS PubMed, PsychInfo, Scopus, and Cochrane COVID reviews were searched to identify peer-review studies published since 2020. A total of 18 studies were included and synthesised thematically. RESULTS Of these, most were conducted in the community (n = 15) with people with dementia only (n = 11) and involved qualitative methods (n = 11). The majority (n = 12) focused on digital off-the-shelf and low-cost solutions, such as free video conferencing platforms, to access care, socialise or take part in interventions. Whilst often well-accepted and associated with positive outcomes (such as improved social connectedness), lack of digital literacy or support to use technologies, limited access to appropriate technology, individuals' physical, cognitive, or sensory difficulties, were highlighted and likely to threaten the adoption of these solutions. The quality of the evidence was mixed, neither very robust nor easily generalisable which may be attributed to the challenges of conducting research during the pandemic or the need to rapidly adapt to a new reality. CONCLUSION While COVID-19 has fast-tracked the adoption of technology, its use is likely to continue beyond the pandemic. We need to ensure this technology can leverage dementia support and care and that people with dementia are enabled and empowered to use it.
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Affiliation(s)
- Ana Barbosa
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Ana Rita Ferreira
- CINTESIS@RISE, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Carolien Smits
- Dutch Centre of Expertise on Health Disparities, Pharos Expertise Centre on Health Disparities, Utrecht, Netherlands
| | - Flora-Marie Hegerath
- Institute of General Practice and Family Medicine, Medical Faculty, Ruhr University Bochum, Bochum, Germany
| | - Horst Christian Vollmar
- Institute of General Practice and Family Medicine, Medical Faculty, Ruhr University Bochum, Bochum, Germany
| | - Lia Fernandes
- CINTESIS@RISE, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Michael P Craven
- Human Factors Research Group, Faculty of Engineering, University of Nottingham, Nottingham, UK
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Anthea Innes
- Department Health, Aging and Society, Faculty of Social Science, McMaster University, Hamilton, Canada
| | - Dympna Casey
- School of Nursing and Midwifery, College of Medicine, Nursing, and Health Sciences, National University of Ireland, Galway, Ireland
| | - Duygu Sezgin
- School of Nursing and Midwifery, College of Medicine, Nursing, and Health Sciences, National University of Ireland, Galway, Ireland
| | - Louise Hopper
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Laila Øksnebjerg
- Department of Neurology, Danish Dementia Research Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
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Henderson J, Reid C. Virtual collaborative creative engagement in a pandemic world: creative connection for older adults with lived experience of dementia. FRONTIERS IN HEALTH SERVICES 2023; 3:1223337. [PMID: 38162191 PMCID: PMC10754963 DOI: 10.3389/frhs.2023.1223337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024]
Abstract
Introduction Older adults were disproportionately affected by COVID-19, and isolation and loneliness became key risk factors for mental illness and decreased quality of life. Older adults with lived experience of dementia and their care partners experienced isolation, loneliness, anxiety and depression, already heightened due to social stigma. Reduced access to resources was a notable problem. Objective This Canadian qualitative study investigates the Raising the Curtain on the Lived Experience of Dementia (RTC) Project's virtual turn in program delivery during the pandemic, asking "How did virtual collaborative creative engagement (CCE) impact well-being for people living with dementia and their care partners?"; and "What are key elements of RTC's unique virtual CCE approach?" Methods The study employs reflexive thematic analysis to analyse interviews and focus groups with the project's artist facilitators, researchers, peer collaborators living with dementia, and their care partners. Findings: Themes describe key elements of RTC's unique approach to virtual CCE and include: "Adjusting Expectations and Adapting to Technology"; "Re-imagining Creative Engagement in Virtual Space"; "Sustaining Reciprocal Caring, Learning, and Support"; "Disrupting Stigma and Welcoming a Wider Audience"; and "Supporting Well-being through Empowerment, Community, and Creativity." Discussion Findings offer new perspectives on how virtual CCE not only has the potential to decrease loneliness and isolation and associated mental health risks for older adults living with dementia and their care partners, but also can work to disrupt stigmatizing representations of dementia, promote inclusion, and enhance citizenship.
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Affiliation(s)
- Julia Henderson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Colleen Reid
- Department of Therapeutic Recreation, Douglas College, Coquitlam, BC, Canada
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Conway A, Ryan A, Harkin D, Mc Cauley C. "It's Another Feather in My Hat"-Exploring Factors Influencing the Adoption of Apps With People Living With Dementia. DEMENTIA 2023; 22:1487-1513. [PMID: 37365816 PMCID: PMC10521156 DOI: 10.1177/14713012231185283] [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: 06/28/2023]
Abstract
INTRODUCTION With the growing interest and availability of mobile applications (apps) for people living with dementia, it is desirable to have a broader insight into how technology adoption may be further improved. This paper aims to explore the factors influencing adoption of mobile applications for people living with dementia. METHODS The recruitment of participants was facilitated through a dementia advocacy group of people living with dementia. A focus group design was applied to elicit discussion and to explore divergent views on the topic. The data was analysed using thematic analysis. FINDINGS The 15 individuals who participated in this study comprised of seven women and eight men within the age range of 60-90 years. This study reports key findings pertaining to the views and experiences of using mobile apps. Data analysis revealed the following four distinct themes; (Theme 1: Living with dementia)-"That's the difficulty there even with apps or anything else." (Theme 2: Motivation)- "It makes me feel good. I feel a little with it [laughs], that its not all gone in there" (Theme 3: Fears and Concerns)- "Can somebody else get into your personal memories?" (Theme 4- Support)- "So it's important that we have that support". Together these themes encapsulate the most influential aspects, as highlighted by the participants influencing the acceptance and adoption of apps. CONCLUSION This paper explores the barriers and facilitators to app acceptance and adoption. This includes the importance of "feel good moments" and positive experiences, challenges associated with living with dementia, the importance of ongoing support, and security of the user's information. This study adds to what is already known by capturing the views and experiences of people living with dementia in relation to the factors influencing the adoption of apps.
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Affiliation(s)
- Aoife Conway
- School of Nursing and Paramedic Science, Ulster University, Co Londonderry, NI, UK
| | - Assumpta Ryan
- School of Nursing and Paramedic Science, Ulster University, Co Londonderry, NI, UK
| | - Deirdre Harkin
- School of Nursing and Paramedic Science, Ulster University, Co Londonderry, NI, UK
| | - Claire Mc Cauley
- School of Nursing and Paramedic Science, Ulster University, Co Londonderry, NI, UK
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Yuk JS, Lee JS, Park JH. Menopausal hormone therapy and risk of dementia: health insurance database in South Korea-based retrospective cohort study. Front Aging Neurosci 2023; 15:1213481. [PMID: 37744387 PMCID: PMC10512830 DOI: 10.3389/fnagi.2023.1213481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Menopausal hormone therapy (MHT) is used to alleviate the symptoms associated with menopause, despite the lack of recommendations for MHT in preventing dementia. Recent nationwide studies have explored the association between MHT and dementia risk, but the findings remain limited. This study aims to investigate the association between MHT and the incidence of Alzheimer's disease (AD) and non-AD dementia using national population data from Korea. Methods We conducted a retrospective study using data from the National Health Insurance Service in Korea between January 1, 2002, and December 31, 2019. Women over 40 years were eligible for this study and classified into the MHT or non-MHT groups. The MHT group consisted of women who used Tibolone (TIB), combined estrogen plus progestin by the manufacturer (CEPM), estrogen, combined estrogen plus progestin by a physician (CEPP), and transdermal estrogen during menopause. We compared the risk of dementia between the MHT and non-MHT groups. Results The study included 1,399,256 patients, of whom 387,477 were in the MHT group, and 1,011,779 were in the non-MHT group. The median duration of MHT was 23 months (range: 10-55 months). After adjusting for available confounders, we found that different types of MHT had varying effects on the occurrence of dementia. TIB (HR 1.041, 95% confidence interval (CI) 1.01-1.072) and oral estrogen alone (HR 1.081, 95% CI 1.03-1.134) were associated with a higher risk of AD dementia. In contrast, there was no difference in the risk of AD dementia by CEPM (HR 0.975, 95% CI 0.93-1.019), CEPP (HR 1.131, 95% CI 0.997-1.283), and transdermal estrogen (HR 0.989, 95% CI 0.757-1.292) use. The use of TIB, CEPM, and oral estrogen alone increased the risk of non-AD dementia (HR 1.335, 95% CI 1.303-1.368; HR 1.25, 95% CI 1.21-1.292; and HR 1.128, 95% CI 1.079-1.179; respectively), but there was no risk of non-AD dementia in the other MHT groups (CEPP and topical estrogen). Conclusion Our findings indicate that MHT has varying effects on the incidence of AD and non-AD dementia. Specifically, TIB, CEPM, and oral estrogen alone increase the risk of non-AD dementia, while transdermal estrogen is not associated with dementia risk. It is essential to consider the type of MHT used when assessing the risk of dementia in women.
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Affiliation(s)
- Jin-Sung Yuk
- Department of Obstetrics and Gynecology, Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, Republic of Korea
| | - Jin San Lee
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Joong Hyun Park
- Department of Neurology, Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, Republic of Korea
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Tsatali M, Moraitou D, Boza ES, Tsolaki M. Cognition and Functionality Were Not Affected Due to the COVID-19 Pandemic in People with Mild Cognitive Impairment and AD Dementia Attending Digital Non-Pharmacologic Interventions. Brain Sci 2023; 13:1044. [PMID: 37508975 PMCID: PMC10376995 DOI: 10.3390/brainsci13071044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The majority of previous studies showed that older adults with mild cognitive impairment (MCI) as well as Alzheimer's disease dementia (ADD) had impaired cognition and mood status, as well as increased behavioral disturbances after the first wave of the COVID-19 pandemic. However, there are still controversial data as regards the multifactorial impact of the restrictive measures on cognition, mood and daily function in older adults with MCI and ADD. AIM In the current study, the scope is to identify possible deterioration by means of cognitive and functional level due to mood and behavioral alterations during the second quarantine imposed in Greece between November 2020 and May 2021, as well as one year after the second quarantine, in May 2022. METHODS Participants were recruited from the two day centers of the Greek Association of Alzheimer Disease and Related Disorders (GAADRD). They underwent three yearly follow up assessments from May 2020 to May 2022 and participated in cognitive training interventions (through digital online means) during the aforementioned period. Mixed measures analyses of variance as well as path models were used for the study's purposes. RESULTS The study sample comprised 210 participants (175 people with MCI and 35 people with ADD). The mean age was 71.59 and 77.94 for people with MCI and mild ADD, respectively, whereas the average number of years of education was 12.65 for those with MCI and 9.83 for people with mild ADD. The results show that participants' deterioration rate (D), calculated by means of their performance in neuropsychological and functional assessments between 2020 and 2021 (D1) and 2021 and 2022 (D2), did not change significantly, except for the Rey Auditory Verbal Learning Test (RAVLT), since both groups displayed a larger D2 across the test conditions (immediate recall, fifth trial and delayed recall). Trail Making Test-B (TMT-B) performance, applied only in the MCI group, decreased more in relation to the deterioration rate D2. Additionally, two path models were applied to measure the direct relationships between diagnosis, performance in tests measuring mood and neuropsychiatric disturbances (NPI) and cognition, as measured by the RAVLT, in the 2020-2022 assessments. TMT-B was administered only in the MCI population, and therefore was not included in path models. The results show that participants' scores in RAVLT conditions were related to diagnosis and NPI performance, which was positively affected by diagnosis. No other relationships between RAVLT with mood tests were observed. CONCLUSIONS Our results show that after the second lockdown period, the neuropsychological performance of people with MCI and ADD, calculated by means of their D2, did not change, except from their verbal memory, as well as visual scanning and information processing, measured using the TMT-B. Therefore, it can be assumed that those who were enrolled in digital non-pharmacological interventions during the COVID-19 pandemic home restrictions did not experience increased cognitive and functional deterioration due to mood and behavioral alterations after the pandemic.
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Affiliation(s)
- Marianna Tsatali
- Greek Association of Alzheimer's Disease and Related Disorders, 54643 Thessaloniki, Greece
- Laboratory of Psychology, Department of Cognitive and Experimental Psychology, Faculty of Philosophy, School of Psychology, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece
| | - Despina Moraitou
- Laboratory of Psychology, Department of Cognitive and Experimental Psychology, Faculty of Philosophy, School of Psychology, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece
- Lab of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki (CIRI-AUTh), 54124 Thessaloniki, Greece
| | - Evgenia Sakka Boza
- Greek Association of Alzheimer's Disease and Related Disorders, 54643 Thessaloniki, Greece
| | - Magdalini Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders, 54643 Thessaloniki, Greece
- Lab of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki (CIRI-AUTh), 54124 Thessaloniki, Greece
- 1st Department of Neurology, Medical School, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece
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Bauernschmidt D, Hirt J, Langer G, Meyer G, Unverzagt S, Wilde F, Wittmann J, Bieber A. Technology-Based Counselling for People with Dementia and Their Informal Carers: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2023:JAD221194. [PMID: 37125549 DOI: 10.3233/jad-221194] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Information technology can enhance timely and individual support for people with Alzheimer's disease and other dementias and their informal carers. OBJECTIVE To review the effectiveness of technology-based counselling interventions for people with dementia and informal carers. METHODS Randomized controlled trials of remote dementia counselling interventions were included. We searched CINAHL, Cochrane Library, MEDLINE, PsycINFO, and the Web of Science Core Collection (April 2021) in combination with citation tracking and free web searching (October to November 2021). We provide meta-analyses for caregiver depression, burden, and self-efficacy/mastery and structured reporting for other outcomes. The Grading of Recommendations Assessment, Development and Evaluation approach and the Risk of Bias 2 tool were applied. RESULTS We included five randomized controlled trials involving 880 participants. Interventions were provided for carers (four studies) or dyads (one study). Carers were predominantly women and were the spouses or children of people with dementia. Counselling was delivered via telephone or videoconference with two to 23 sessions over 1 to 12 months. Control groups received educational and resource materials only, standard (helpline) services, non-directive support, or home visits. Meta-analysis for our primary outcome, depressive symptoms in carers, revealed no statistically significant effect (SMD -0.15; 95% CI -0.40 to 0.10). There were also no significant effects on burden and self-efficacy/mastery. We rated the certainty of evidence as low to very low and all outcomes at an overall high risk of bias. CONCLUSION The effectiveness of technology-based counselling interventions for people with dementia and informal carers remains uncertain. Theory-based approaches are needed for the development and evaluation of these interventions.
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Affiliation(s)
- Dorothee Bauernschmidt
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Julian Hirt
- Department of Health, Center for Dementia Care, Institute of Applied Nursing Science, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Gero Langer
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Gabriele Meyer
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Susanne Unverzagt
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Fabian Wilde
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Janina Wittmann
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anja Bieber
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Damian AC, Ciobanu AM, Anghele C, Papacocea IR, Manea MC, Iliuță FP, Ciobanu CA, Papacocea Ș. Caregiving for Dementia Patients during the Coronavirus Pandemic. J Clin Med 2023; 12:jcm12072616. [PMID: 37048700 PMCID: PMC10095033 DOI: 10.3390/jcm12072616] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/23/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
The coronavirus pandemic has had a global impact on both mental and physical health. Caregiving has become more difficult during this time due to the quick spread of this respiratory disease, dread of the unknown, congested hospitals, and many restrictions, particularly for people with multiple comorbidities. We aimed to assess the impact of this pandemic on a group of caregivers of patients with dementia and their needs during this time. The study’s findings indicate that females assumed the role of the caregiver more often than men (88.5% of the participants) and scored lower on the life quality scale. The most often issue encountered during the pandemic was difficulty in accessing health care facilities (36%). Participants with a higher education level scored better in the physical (24.67, p = 0.01 and 24.48, p = 0.01) and mental health (20.67, p = 0.002; 19,82, p = 0.008) domains of the life quality test. The fear of COVID questionnaire showed a low level of concern in the category of participants with a high education level. Overall, this pandemic emphasizes the importance of social interaction and the possibilities to improve health care services through telemedicine. Caregivers could benefit from socialization and support programs as well as the early detection of affective disorders.
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Affiliation(s)
- Ana Claudia Damian
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Adela Magdalena Ciobanu
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Cristina Anghele
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
- Correspondence: (C.A.); (C.A.C.)
| | - Ioana Raluca Papacocea
- Discipline of Physiology, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mihnea Costin Manea
- Department of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Floris Petru Iliuță
- Department of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Constantin Alexandru Ciobanu
- Faculty of Medicine, “Titu Maiorescu” University of Medicine and Pharmacy, 040441 Bucharest, Romania
- Correspondence: (C.A.); (C.A.C.)
| | - Șerban Papacocea
- Department of Neurosurgery, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Ervasti K, Kotkas T, Issakainen M, Teiska M, Mäki-Petäjä-Leinonen A. In the Shadow of COVID-19: The Well-Being and Rights of People Living with Dementia in Finland During the Pandemic. J Alzheimers Dis 2023; 92:1473-1485. [PMID: 36911938 DOI: 10.3233/jad-221096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
BACKGROUND Exceptional circumstances such as the COVID-19 pandemic increase the risk for vulnerability among people living with dementia. OBJECTIVE This article discusses the well-being and rights of people living with dementia in Finland during the pandemic and analyses the legal framework covering the restrictions of their rights during that period. METHODS The empirical research comprises a survey of persons with dementia (n = 31) and their family members (n = 168). The participants completed a total of 13 survey items involving questions about their well-being during the pandemic, restrictions on freedom, access to services, information on pandemic regulations and guidelines as well as possible problems with authorities. The survey included both multiple choice and open-ended questions. RESULTS According to people with dementia and their family members, by spring 2021, the pandemic had reduced meaningful activities available to people living with dementia in Finland and decreased the number of meetings between them and other people. Many reported a decline in their physical and/or mental well-being or greater difficulty or delays in accessing social and health services. Over a third of respondents found that the right to meet people was restricted among people with dementia, and almost half of the respondents took the view that their freedom of movement was restricted. There were also major shortcomings in terms of information on restrictions. CONCLUSION The results highlight the importance of bearing in mind the negative effects that restrictions on mobility, meeting other people and meaningful activities can have on the well-being of people living with dementia. This should be considered, for example, when reforming legislation.
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Affiliation(s)
- Kaijus Ervasti
- Law School, University of Eastern Finland, Joensuu, Finland
| | - Toomas Kotkas
- Faculty of Law, University of Helsinki, Helsinki, Finland
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Giebel C, Talbot CV, Wharton E, Lorenz-Dant K, Suárez-González A, Cannon J, Tetlow H, Lion KM, Thyrian JR. The early impacts of COVID-19 on unpaid carers of people living with dementia: part II of a mixed-methods systematic review. Aging Ment Health 2023; 27:547-562. [PMID: 35818800 DOI: 10.1080/13607863.2022.2084510] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/14/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVES With a lack of existing comprehensive reviews, the aim of this mixed-method systematic review was to synthesise the evidence on the early impacts of the pandemic on unpaid dementia carers across the globe. METHODS This review was registered on PROSPERO [CDR42021248050]. PubMed, CINAHL, Embase, Scopus and Web of Science were searched from 2020 to July 2021. Studies were included if they reported on the different impacts of the pandemic on unpaid dementia carers aged 18+, with papers published in English, German, Polish, or Spanish. A number of research team members were involved in the selection of studies following PRISMA guidance. RESULTS Thirty-six studies (43 papers) from 18 countries reported on the early impact of the pandemic on unpaid dementia carers. Impacts were noted on accessing care and support; carer burden; and well-being. Studies found that carers had limited access to care and support services, increased workload, enhanced feelings of social isolation, and reduced wellbeing. Specifically, reductions in access to care and support increased carer's unpaid caring tasks, removing any opportunities for temporary respite, and thus further increasing carer burden and reducing mental well-being in many. CONCLUSIONS The needs of unpaid dementia carers appear to have increased during the pandemic, without adequate support provided. Policy initiatives need to enable better mental health support and formal care provision for unpaid carers and their relatives with dementia, whilst future research needs to explore the long-term implications of carer needs in light of care home restrictions and care delivery.
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Affiliation(s)
- Clarissa Giebel
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- NIHR ARC NWC, Liverpool, UK
| | | | - Emily Wharton
- NIHR ARC NWC, Liverpool, UK
- School for Sport and Exercise Science, Liverpool John Moore's University, Liverpool, UK
| | - Klara Lorenz-Dant
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | | | - Hilary Tetlow
- NIHR ARC NWC, Liverpool, UK
- SURF Liverpool, Liverpool, UK
| | - Katarzyna M Lion
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Jochen René Thyrian
- German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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11
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Perach R, Read S, Hicks B, Harris PR, Rusted J, Brayne C, Dangoor M, Miles E, Dixon J, Robinson L, Thomas A, Banerjee S. Predictors of loneliness during the Covid-19 pandemic in people with dementia and their carers in England: findings from the DETERMIND-C19 study. Aging Ment Health 2023; 27:521-532. [PMID: 35658781 DOI: 10.1080/13607863.2022.2080179] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES To identify factors that predict the risk of loneliness for people with dementia and carers during a pandemic. METHODS People with dementia and their carers completed assessments before (July 2019-March 2020; 206 dyads) and after (July-October 2020) the first Covid-19 'lockdown' in England. At follow-up, the analytic sample comprised 67 people with dementia and 108 carers. We built a longitudinal path model with loneliness as an observed outcome. Carer type and social contacts at both measurements were considered. Other social resources (quality of relationship, formal day activities), wellbeing (anxiety, psychological wellbeing) and cognitive impairment were measured with initial level and change using latent growth curves. We adjusted for socio-demographic factors and health at baseline. RESULTS In carers, higher levels of loneliness were directly associated with non-spouse coresident carer type, level and increase of anxiety in carer, more formal day activities, and higher cognitive impairment in the person with dementia. In people with dementia, non-spouse coresident carer type, and higher initial levels of social resources, wellbeing, and cognitive impairment predicted the changes in these factors; this produced indirect effects on social contacts and loneliness. CONCLUSION Loneliness in the Covid-19 pandemic appears to be shaped by different mechanisms for people with dementia and their carers. The results suggest that carers of those with dementia may prioritize providing care that protects the person with dementia from loneliness at the cost of experiencing loneliness themselves. Directions for the promotion of adaptive social care during the Covid-19 pandemic and beyond are discussed.
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Affiliation(s)
- Rotem Perach
- School of Psychology, University of Sussex, Brighton, UK
| | - Sanna Read
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Ben Hicks
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Peter R Harris
- School of Psychology, University of Sussex, Brighton, UK
| | | | - Carol Brayne
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Margaret Dangoor
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Eleanor Miles
- School of Psychology, University of Sussex, Brighton, UK
| | - Josie Dixon
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | | | - Alan Thomas
- Institute for Ageing, Newcastle University, Newcastle, UK
| | - Sube Banerjee
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK.,Faculty of Health, University of Plymouth, Plymouth, UK
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12
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Giebel C, Lion KM, Lorenz-Dant K, Suárez-González A, Talbot C, Wharton E, Cannon J, Tetlow H, Thyrian JR. The early impacts of COVID-19 on people living with dementia: part I of a mixed-methods systematic review. Aging Ment Health 2023; 27:533-546. [PMID: 35763444 DOI: 10.1080/13607863.2022.2084509] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/14/2022] [Indexed: 11/01/2022]
Abstract
Objectives: The aim of this Part I systematic review was to understand the impact of the COVID-19 pandemic on the lives of people with dementia living in the community or in residential care. Part II focused on unpaid carers.Methods: This review was registered on PROSPERO [CRD42021248050]. Five data bases (PubMed, CINAHL, Embase, Scopus, Web of Science) were searched in July 2021. Studies were included if they reported on the impacts of the pandemic on people living with dementia, either in the community or residential settings, and published in English, German, Polish, or Spanish. Risk of bias was assessed using the Standard Quality Assessment QualSyst.Results: Forty papers from 33 studies reported on the effects of COVID-19 on people with dementia. Included studies were conducted across 15 countries, focusing on single-country evaluations except in one study. Three studies focused on care homes, whilst the remainder reported on the community. Studies were categorised into five impacts: Cognition; Independence and physical functioning; Behavioural symptoms; Well-being; and Access to care. All studies evidenced the negative pandemic impacts, including faster cognitive, physical, and behavioural deterioration, limited access to care, and poorer mental and social health.Conclusions: Future restrictions need to consider the need for people with dementia to stay cognitively, physically, and socially stimulated to live well, and this review provides a call for a future pandemic strategy for dementia. Longitudinal research is required on the long-term impacts of the pandemic on the lives of people with dementia, including time to care home entry.
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Affiliation(s)
- Clarissa Giebel
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- NIHR ARC NWC, Liverpool, UK
| | - Katarzyna M Lion
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Klara Lorenz-Dant
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Catherine Talbot
- Faculty of Science & Technology, Bournemouth University, Poole, UK
| | - Emily Wharton
- NIHR ARC NWC, Liverpool, UK
- School of Sport and Exercise Sciences, Liverpool John Moore's University, Liverpool, UK
| | - Jacqueline Cannon
- School of Sport and Exercise Sciences, Liverpool John Moore's University, Liverpool, UK
| | - Hilary Tetlow
- NIHR ARC NWC, Liverpool, UK
- Lewy Body Society, Wigan, UK
| | - Jochen René Thyrian
- Lewy Body Society, Wigan, UK
- SURF Liverpool, Liverpool, UK
- German Centre for Neurodegenerative Diseases (DZNE), Greifswald, Germany
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
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13
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Berridge C, Zhou Y, Robillard JM, Kaye J. Companion robots to mitigate loneliness among older adults: Perceptions of benefit and possible deception. Front Psychol 2023; 14:1106633. [PMID: 36895732 PMCID: PMC9988932 DOI: 10.3389/fpsyg.2023.1106633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/19/2023] [Indexed: 02/25/2023] Open
Abstract
Objective Given growing interest in companion robots to mitigate loneliness, large-scale studies are needed to understand peoples' perspectives on the use of robots to combat loneliness and attendant ethical issues. This study examines opinions about artificial companion (AC) robots regarding deception with dementia and impact on loneliness. Methods Data are from a survey of 825 members of the OHSU Research via Internet Technology and Experience cohort (response rate = 45%). Sixty percent (n = 496) of the age diverse sample (range = 25-88; M = 64; SD = 13.17) is over 64, allowing us to compare across age and consider current and future older adults. Ordinal logistic regressions examined relationships between age, health, and other socio-demographic characteristics and perceptions of impact on loneliness and comfort with deception. Results Most participants (68.7%) did not think an AC robot would make them feel less lonely and felt somewhat-to-very uncomfortable (69.3%) with the idea of being allowed to believe that an artificial companion is human. In adjusted models, one additional year of age was associated with lower likelihood of perceived benefit of reducing loneliness [Odds Ratio (OR) = 0.98; (0.97-0.99), p = 0.003] and lower comfort with deception [OR = 0.99; (0.97-1.00), p = 0.044]. Being female was associated with lower likelihood of comfort with deception [OR = 0.68; (0.50-0.93), p = 0.014] and high confidence using computers with greater comfort [OR = 2.18; (1.42-3.38), p < 0.001]. Discussion There was not strong support for AC robots to mitigate loneliness. Most participants were uncomfortable with this form of deception, indicating need for design solutions for those who want to avoid this possibility, as well as greater attentiveness to desirability and comfort across age and gender.
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Affiliation(s)
- Clara Berridge
- School of Social Work, University of Washington, Seattle, WA, United States
| | - Yuanjin Zhou
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, United States
| | - Julie M. Robillard
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jeffrey Kaye
- School of Medicine, Oregon Health and Science University, Portland, OR, United States
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14
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Cho E, Shin J, Seok JW, Lee H, Lee KH, Jang J, Heo SJ, Kang B. The effectiveness of non-pharmacological interventions using information and communication technologies for behavioral and psychological symptoms of dementia: A systematic review and meta-analysis. Int J Nurs Stud 2023; 138:104392. [PMID: 36434931 DOI: 10.1016/j.ijnurstu.2022.104392] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 11/01/2022] [Accepted: 11/05/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Although behavioral and psychological symptoms of dementia are a global public health challenge, non-pharmacological interventions using information and communication technologies can be an affordable, cost-effective, and innovative solution. OBJECTIVES This study aimed to examine the effectiveness of non-pharmacological interventions using information and communication technologies on the behavioral and psychological symptoms of dementia and identify potential moderators of intervention effects. DESIGN Systematic review and meta-analysis of randomized controlled trials. METHODS A systematic literature review was conducted using PubMed, CINAHL, PsycINFO, Embase, and the Cochrane Library from May 2022. Randomized controlled trials that examined the effects of non-pharmacological interventions using information and communication technologies on the behavioral and psychological symptoms of dementia were included. A meta-analysis using a random-effects model was performed to calculate the pooled standardized mean differences between overall symptoms and each type of symptom. For moderator analyses, subgroup and meta-regression analyses were performed. RESULTS Sixteen trials (15 articles) met the eligibility criteria. The interventions were grouped into activity engagement interventions using digital health that provided music and reminiscence therapy, physical exercise, social interaction interventions using social robots, and telehealth-based care aid interventions that provided coaching or counseling programs. Pooled evidence demonstrated that non-pharmacological interventions using information and communication technologies exerted a large effect on depression (SMD = -1.088, 95% CI -1.983 to -0.193, p = 0.017), a moderate effect on overall behavioral and psychological symptoms of dementia (SMD = -0.664, 95% CI -0.990 to -0.338, p < 0.001), and agitation (SMD = -0.586, 95% CI -1.130 to -0.042, p = 0.035). No effects on neuropsychiatric symptoms (SMD = -0.251, 95% CI -0.579 to 0.077, p = 0.133), anxiety (SMD = -0.541, 95% CI -1.270 to 0.188, p = 0.146), and apathy (SMD = -0.830, 95% CI -1.835 to 0.176, p = 0.106) were reported. Moderator analyses identified the mean age of the participants as a potential moderator of intervention effects. CONCLUSIONS Evidence from this systematic review and meta-analysis suggests that non-pharmacological interventions, using information and communication technologies, were an applicable approach to managing behavioral and psychological symptoms among older adults with dementia, with moderate to large effect sizes. However, evidence on anxiety and apathy is inconclusive due to the limited number of existing randomized controlled trials. Future studies with subgroup analyses are warranted to conclude the most effective types of intervention using information and communication technologies for each type of symptom. REGISTRATION CRD42021258498.
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Affiliation(s)
- Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea; Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea.
| | - Jinhee Shin
- College of Nursing, Woosuk University, Jeollabuk-do, Republic of Korea.
| | - Jo Woon Seok
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea.
| | - Hyangkyu Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea; Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea.
| | - Kyung Hee Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea; Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea.
| | - Jiyoon Jang
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea.
| | - Seok-Jae Heo
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Bada Kang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea; Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea.
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15
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Flynn A, Barry M, Qi Koh W, Reilly G, Brennan A, Redfern S, Casey D. Introducing and Familiarising Older Adults Living with Dementia and Their Caregivers to Virtual Reality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16343. [PMID: 36498417 PMCID: PMC9736737 DOI: 10.3390/ijerph192316343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
Virtual Reality (VR) is increasingly being applied in dementia care across a range of applications and domains including health and wellbeing. Despite the commercial availability of VR, informants of design are not always aware of its functionality and capabilities, to meaningfully contribute to VR design. In designing VR applications for people living with dementia, it is recommended that older adults living with dementia and their support persons be involved in the design process using participatory approaches, thereby giving them a voice on the design of technology from the outset. A VR technology probe is a useful means of familiarising older adults living with dementia and their informal caregivers with the knowledge and understanding of interactive VR to employ technology that supports them to maintain their social health. This paper charts the implementation and evaluation of a VR technology probe, VR FOUNDations. To explore their experiences, nine older adults living with dementia and their nine informal caregivers trialled VR FOUNDations and completed semi-structured interviews after its use. Overall, older adults living with dementia and their informal caregivers perceived VR FOUNDations to achieve its aim of increasing understanding and inspiring future design decisions. The findings also identified promising positive experiences using a VR technology probe which may be indicative of its applicability to social health and wellbeing domains. This paper advocates for the structured design and implementation of VR technology probes as a pre-requisite to the participatory design of VR applications for the health and wellbeing of people living with dementia. The use of such technology probes may afford older adults living with dementia and their informal caregivers the best opportunity to contribute to design decisions and participate in technology design to support their health and wellbeing.
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Affiliation(s)
- Aisling Flynn
- School of Nursing and Midwifery, University of Galway, H91 TK33 Galway, Ireland
| | - Marguerite Barry
- Information and Communication Studies, ADAPT Centre, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Wei Qi Koh
- School of Nursing and Midwifery, University of Galway, H91 TK33 Galway, Ireland
| | - Gearóid Reilly
- School of Computer Science, University of Galway, H91 TK33 Galway, Ireland
| | - Attracta Brennan
- School of Computer Science, University of Galway, H91 TK33 Galway, Ireland
| | - Sam Redfern
- School of Computer Science, University of Galway, H91 TK33 Galway, Ireland
| | - Dympna Casey
- School of Nursing and Midwifery, University of Galway, H91 TK33 Galway, Ireland
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16
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Chyu J, Cantu P, Mehta N, Markides K. Caregiving for People With Dementia or Cognitive Impairment During the COVID-19 Pandemic: A Review. Gerontol Geriatr Med 2022; 8:23337214221132369. [PMID: 36299916 PMCID: PMC9585366 DOI: 10.1177/23337214221132369] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/23/2022] [Accepted: 09/23/2022] [Indexed: 11/06/2022] Open
Abstract
The COVID-19 pandemic has been a major source of stress for informal caregivers
for people with dementia. Studies show the unique challenges caregivers face,
such as social isolation, extended work hours, and adherence to public health
guidelines. We conducted a narrative review of factors impacting well-being of
informal caregivers of older adults with dementia during the COVID-19 pandemic.
Sixty-four papers were identified as published between June 2020 and December
2021. All studies were conducted in the U.S. or other Western countries and were
cross-sectional and conducted prior to COVID-19 vaccines. Articles highlighted
increasing burdens such as financial and physical stress, as well as worsened
psychological well-being from anxiety and depression. Protective factors such as
social support and telehealth interventions also emerged. Limitations include
lack of longitudinal information to identify broader themes on caregiving during
the pandemic. Studies not only identified new, pandemic-related risk factors,
but also a heightened effect of pre-existing risk factors (e.g., income, living
situation) on caregiver burden.
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Affiliation(s)
- Joanna Chyu
- University of Texas Medical Branch,
Galveston, USA
| | - Philip Cantu
- University of Texas Medical Branch,
Galveston, USA
| | - Neil Mehta
- University of Texas Medical Branch,
Galveston, USA
| | - Kyriakos Markides
- University of Texas Medical Branch,
Galveston, USA,Kyriakos Markides, School for Public and
Population Health, University of Texas Medical Branch, Galveston, TX 77551, USA.
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17
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Koszalinski RS, Olmos B. Communication challenges in social isolation, subjective cognitive decline, and mental health status in older adults: A scoping review (2019-2021). Perspect Psychiatr Care 2022; 58:2741-2755. [PMID: 35582750 DOI: 10.1111/ppc.13115] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Through an evolutionary concept analysis, social isolation (SI) was defined as lack of social belonging and engagement with others, minimal number of social contacts, and insufficient quality relationships. This definition represents broader understanding of most contributing factors to SI and supports the concepts of reduced communication and socialization experienced during the COVID-19 pandemic. The COVID-19 pandemic served to heighten this problem, including communication challenges, and brought negative outcomes of SI to light. The overall research question examined the impact of communication challenges and SI on OAs with Alzheimer's disease, related dementias, and subjective cognitive changes (2020-2021). This scoping literature review was developed to compare the psychosocial and mental health of older adults between prepandemic and pandemic lockdown of 2020-2021. DESIGN AND METHODS This review followed the procedures for scoping review reporting as stated by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews (PRISMA-ScR). In collaboration with an expert scientific information specialist assigned to the college of nursing, the literature was queried through MEDLINE(R) and Epub Ahead of Print, In-Process, In-Data-Review & Other Non-Indexed Citations and Daily 1946 to September 02, 2021; APA PsycInfo 1806 to August Week 5 2021; and Embase Classic+Embase 1947 to 2021 September 02. Search terms included social isolation; nursing home; home for the aged; long-term care; old age homes or convalescent home or nursing home; long-term care, or long-term care; aged or elders or seniors, dementia, Alzheimer's or dementia; osteoporosis; and fragility fracture. FINDINGS Quantitative data informed outcomes through increased depression and anxiety, higher rates of depression during the pandemic than prepandemic, and increased symptomology in neuropsychiatric profiles. Further, COVID19-related restrictions, including impaired communication streams, seemed to be the origin of stress-related cognitive changes and symptomology. Communication challenges in residents with dementia may lead to feelings of social isolation. Qualitative evidence supports that dementia has a social, psychological, material, and socio-demographic impact. Further, the lockdown disrupted the existing flow of communication between all stakeholders and residents, resulting in heightened perceptions of SI and a profound sense of loss. PRACTICE IMPLICATIONS The results include a diverse and complex characterization of negative outcomes. Further, strong evidence indicates that communication and human contact can ameliorate negative outcomes.
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Affiliation(s)
- Rebecca S Koszalinski
- Fran and Earl Ziegler College of Nursing, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Brenda Olmos
- Fran and Earl Ziegler College of Nursing, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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18
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Perez H, Miguel-Cruz A, Daum C, Comeau AK, Rutledge E, King S, Liu L. Technology Acceptance of a Mobile Application to Support Family Caregivers in a Long-Term Care Facility. Appl Clin Inform 2022; 13:1181-1193. [PMID: 36257602 PMCID: PMC9771689 DOI: 10.1055/a-1962-5583] [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: 06/12/2022] [Accepted: 10/15/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Family caregivers are unpaid individuals who provide care to people with chronic conditions or disabilities. Family caregivers generally do not have formal care-related training. However, they are an essential source of care. Mobile technologies can benefit family caregivers by strengthening communication with care staff and supporting the monitoring of care recipients. OBJECTIVE We conducted a mixed-method study to evaluate the acceptance and usability of a mobile technology called the Smart Care System. METHODS Using convenience sampling, we recruited 27 family caregivers to evaluate the mobile Smart Care System (mSCS). In the quantitative phase, we administered initial and exit questionnaires based on the Unified Theory of Acceptance and Use of Technology. In the qualitative phase, we conducted focus groups to explore family caregivers' perspectives and opinions on the usability of the mSCS. With the quantitative data, we employed univariate, bivariate, and partial least squares analyses, and we used content analysis with the qualitative data. RESULTS We observed a high level of comfort using digital technologies among participants. On average, participants were caregivers for an average of 6.08 years (standard deviation [SD] = 6.63), and their mean age was 56.65 years (SD = 11.62). We observed a high level of technology acceptance among family caregivers (7.69, SD = 2.11). Behavioral intention (β = 0.509, p-value = 0.004) and facilitating conditions (β = 0.310, p-value = 0.049) were statistically significant and related to usage behavior. In terms of qualitative results, participants reported that the mobile application supported care coordination and communication with staff and provided peace of mind to family caregivers. CONCLUSION The technology showed high technology acceptance and intention to use among family caregivers in a long-term care setting. Facilitating conditions influenced acceptance. Therefore, it would be important to identify and optimize these conditions to ensure technology uptake.
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Affiliation(s)
- Hector Perez
- Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Antonio Miguel-Cruz
- Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
- Faculty of Rehabilitation Medicine, University of Alberta. Edmonton, Alberta, Canada
- Glenrose Rehabilitation Research, Innovation & Technology (GRRIT) Hub, Glenrose Rehabilitation Hospital. Edmonton, Alberta, Canada
| | - Christine Daum
- Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
- Faculty of Rehabilitation Medicine, University of Alberta. Edmonton, Alberta, Canada
| | - Aidan K. Comeau
- Faculty of Rehabilitation Medicine, University of Alberta. Edmonton, Alberta, Canada
| | - Emily Rutledge
- Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Sharla King
- Faculty of Education, University of Alberta. Edmonton, Alberta, Canada
| | - Lili Liu
- Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
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19
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The impact of social isolation due to the COVID-19 pandemic on patients with dementia and caregivers. Acta Neuropsychiatr 2022; 34:276-281. [PMID: 35369891 DOI: 10.1017/neu.2022.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Social distancing to limit COVID-19 transmission has led to extensive lifestyle changes, including for people with dementia (PWD). The aim of this study, therefore, was to assess the impact of lockdown on the mental health of PWD and their carers. METHODS Forty-five carers of PWD completed a telephone interview during the baseline assessment of the SOLITUDE study to gather information on life conditions and changes in symptoms of PWD during lockdown. Associations between changes in symptoms of PWD and carers' concerns and mental health were investigated. RESULTS About 44% of carers experienced anxiety and irritability and reported changes in behavioural and cognitive symptoms in PWD. These changes were associated with worse carers' mental health and concerns about faster disease progression (χ2 = 13.542, p < 0.001). CONCLUSION COVID-19-related social isolation has had a negative impact on patients' and carers' mental health. Potential long-term neurocognitive consequences require further investigation.
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20
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Glassner AA, Masoud SS, Mendoza MY, Rhodes S, White CL. “An animated socialization without substance:” experiences of persons living with dementia through the COVID-19 pandemic. DEMENTIA 2022; 21:2536-2552. [PMID: 36112904 PMCID: PMC9475370 DOI: 10.1177/14713012221126288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Like so many others, persons living with dementia have been greatly impacted by the COVID-19 pandemic. A Stakeholder Advisory Council set a research priority to learn more about the experiences of families living with dementia during COVID-19. Methods This study was conducted using a multi-method design. Online surveys were completed by 27 persons living with dementia to rate the impact of COVID-19 on their health and healthcare. Additionally, interviews (n = 3) and two focus groups were conducted via Zoom with eight participants to explore the experiences of persons living with dementia during COVID-19. Results Most participants in this study reported that COVID-19 had some to extreme impact on their anxiety, feelings of isolation, and quality of life. Focus groups and interviews provided context and increased understanding of the main survey findings, with participants also describing other concerns and how they were coping with all of the challenges that came with COVID-19. Five themes from the qualitative data were health, isolation, feelings about COVID-19, adapting to COVID-19, and self-refection. Discussion Although persons living with dementia described the ways that COVID-19 impacted on their quality of life, they also described strategies for coping. For those persons living with dementia who are able to utilize technology, this study highlights the ongoing need to provide virtual opportunities for socialization and support. These findings also emphasize the need to create safe opportunities for socialization such as small socially distanced activities that may allow persons living with dementia to maintain social connections through the COVID-19 pandemic and throughout the progression of their disease.
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Affiliation(s)
- Ashlie A Glassner
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Sara S Masoud
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Mayra Y Mendoza
- Caregiver and Patient Advocate, Stakeholder Advisory Council, San Antonio, TX, USA
| | - Shanae Rhodes
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Carole L White
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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21
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Wu L, Ali S, Ali H, Brock T, Xu J, Tong W. NeuroCORD: A Language Model to Facilitate COVID-19-Associated Neurological Disorder Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9974. [PMID: 36011614 PMCID: PMC9408703 DOI: 10.3390/ijerph19169974] [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: 07/14/2022] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
COVID-19 can lead to multiple severe outcomes including neurological and psychological impacts. However, it is challenging to manually scan hundreds of thousands of COVID-19 articles on a regular basis. To update our knowledge, provide sound science to the public, and communicate effectively, it is critical to have an efficient means of following the most current published data. In this study, we developed a language model to search abstracts using the most advanced artificial intelligence (AI) to accurately retrieve articles on COVID-19-associated neurological disorders. We applied this NeuroCORD model to the largest benchmark dataset of COVID-19, CORD-19. We found that the model developed on the training set yielded 94% prediction accuracy on the test set. This result was subsequently verified by two experts in the field. In addition, when applied to 96,000 non-labeled articles that were published after 2020, the NeuroCORD model accurately identified approximately 3% of them to be relevant for the study of COVID-19-associated neurological disorders, while only 0.5% were retrieved using conventional keyword searching. In conclusion, NeuroCORD provides an opportunity to profile neurological disorders resulting from COVID-19 in a rapid and efficient fashion, and its general framework could be used to study other COVID-19-related emerging health issues.
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Affiliation(s)
- Leihong Wu
- National Center for Toxicological Research, Food and Drug Administration, 3900 NCTR Rd., Jefferson, AR 72079, USA
| | - Syed Ali
- National Center for Toxicological Research, Food and Drug Administration, 3900 NCTR Rd., Jefferson, AR 72079, USA
| | - Heather Ali
- Department of Internal Medicine, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR 72205, USA
| | - Tyrone Brock
- National Center for Toxicological Research, Food and Drug Administration, 3900 NCTR Rd., Jefferson, AR 72079, USA
- Department of Mathematics and Computer Science, University of Arkansas at Pine Bluff, 1200 University Drive, Pine Bluff, AR 71601, USA
| | - Joshua Xu
- National Center for Toxicological Research, Food and Drug Administration, 3900 NCTR Rd., Jefferson, AR 72079, USA
| | - Weida Tong
- National Center for Toxicological Research, Food and Drug Administration, 3900 NCTR Rd., Jefferson, AR 72079, USA
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22
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Giosa JL, Saari M, Holyoke P, Hirdes JP, Heckman GA. Developing an evidence-informed model of long-term life care at home for older adults with medical, functional and/or social care needs in Ontario, Canada: a mixed methods study protocol. BMJ Open 2022; 12:e060339. [PMID: 35953249 PMCID: PMC9379487 DOI: 10.1136/bmjopen-2021-060339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic exacerbated existing challenges within the Canadian healthcare system and reinforced the need for long-term care (LTC) reform to prioritise building an integrated continuum of services to meet the needs of older adults. Almost all Canadians want to live, age and receive care at home, yet funding for home and community-based care and support services is limited and integration with primary care and specialised geriatric services is sparse. Optimisation of existing home and community care services would equip the healthcare system to proactively meet the needs of older Canadians and enhance capacity within the hospital and residential care sectors to facilitate access and reduce wait times for those whose needs are best served in these settings. The aim of this study is to design a model of long-term 'life care' at home (LTlifeC model) to sustainably meet the needs of a greater number of community-dwelling older adults. METHODS AND ANALYSIS An explanatory sequential mixed methods design will be applied across three phases. In the quantitative phase, secondary data analysis will be applied to historical Ontario Home Care data to develop unique groupings of patient needs according to known predictors of residential LTC home admission, and to define unique patient vignettes using dominant care needs. In the qualitative phase, a modified eDelphi process and focus groups will engage community-based clinicians, older adults and family caregivers in the development of needs-based home care packages. The third phase involves triangulation to determine initial model feasibility. ETHICS AND DISSEMINATION This study has received ethics clearance from the University of Waterloo Research Ethics Board (ORE #42182). Results of this study will be disseminated through peer-reviewed publications and local, national and international conferences. Other forms of knowledge mobilisation will include webinars, policy briefs and lay summaries to elicit support for implementation and pilot testing phases.
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Affiliation(s)
- Justine L Giosa
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- SE Research Centre, SE Health, Markham, Ontario, Canada
| | - Margaret Saari
- SE Research Centre, SE Health, Markham, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Paul Holyoke
- SE Research Centre, SE Health, Markham, Ontario, Canada
| | - John P Hirdes
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - George A Heckman
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
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23
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West E, Nair P, Aker N, Sampson EL, Moore K, Manthorpe J, Rait G, Walters K, Kupeli N, Davies N. Rapid development of a COVID-19 care planning decision-aid for family carers of people living with dementia. Health Expect 2022; 25:1954-1966. [PMID: 35716078 PMCID: PMC9327830 DOI: 10.1111/hex.13552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/29/2022] [Accepted: 05/27/2022] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION COVID-19 has disproportionately affected people living with dementia and their carers. Its effects on health and social care systems necessitated a rapid-response approach to care planning and decision-making in this population, with reflexivity and responsiveness to changing individual and system needs at its core. Considering this, a decision-aid to help families of persons with dementia was developed. OBJECTIVES To coproduce with people living with dementia, and the people who care for them, a decision-aid for family carers of people living with dementia, to support decisions during the COVID-19 pandemic and beyond. METHODS Semi-structured interviews were undertaken in 2020 with: (1) staff from two English national end-of-life and supportive care organizations; and (2) people living with dementia and family carers. Simultaneously, a rapid review of current evidence on making decisions with older people at the end of life was undertaken. Evidence from these inputs was combined to shape the decision-aid through a series of workshops with key stakeholders, including our patient and public involvement group, which consisted of a person living with dementia and family carers; a group of clinical and academic experts and a group of policy and charity leads. RESULTS The rapid review of existing evidence highlighted the need to consider both process and outcome elements of decision-making and their effects on people living with dementia and their families. The qualitative interviews discussed a wide range of topics, including trust, agency and confusion in making decisions in the context of COVID-19. The decision-aid primarily focussed on care moves, legal matters, carer wellbeing and help-seeking. CONCLUSIONS Combining different sources and forms of evidence was a robust and systematic process that proved efficient and valuable in creating a novel decision-aid for family carers within the context of COVID-19. The output from this process is an evidence-based practical decision-aid coproduced with people living with dementia, family carers, clinical and academic experts and leading national dementia and palliative care organizations. PATIENT OR PUBLIC CONTRIBUTION We worked with people living with dementia and family carers and other key stakeholders throughout this study, from study development and design to inclusion in stakeholder workshops and dissemination.
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Affiliation(s)
- Emily West
- Marie Curie Palliative Care Research DepartmentUniversity College LondonLondonUK
| | - Pushpa Nair
- Department of Primary Care and Population Health, Centre for Ageing Population Studies, Royal Free CampusUniversity College LondonLondonUK
| | - Narin Aker
- Department of Primary Care and Population Health, Centre for Ageing Population Studies, Royal Free CampusUniversity College LondonLondonUK
| | - Elizabeth L. Sampson
- Marie Curie Palliative Care Research DepartmentUniversity College LondonLondonUK
- Department of Psychological Medicine, Royal London HospitalEast London NHS Foundation TrustLondonUK
| | - Kirsten Moore
- Marie Curie Palliative Care Research DepartmentUniversity College LondonLondonUK
- National Ageing Research InstituteParkvilleVictoriaAustralia
| | - Jill Manthorpe
- NIHR Policy Research Unit in Health and Social Care WorkforceKing's College London, StrandLondonUK
- NIHR Applied Research Collaborative (ARC) South LondonKing's College London, StrandLondonUK
| | - Greta Rait
- Department of Primary Care and Population Health, Centre for Ageing Population Studies, Royal Free CampusUniversity College LondonLondonUK
| | - Kate Walters
- Department of Primary Care and Population Health, Centre for Ageing Population Studies, Royal Free CampusUniversity College LondonLondonUK
| | - Nuriye Kupeli
- Marie Curie Palliative Care Research DepartmentUniversity College LondonLondonUK
| | - Nathan Davies
- Marie Curie Palliative Care Research DepartmentUniversity College LondonLondonUK
- Department of Primary Care and Population Health, Centre for Ageing Population Studies, Royal Free CampusUniversity College LondonLondonUK
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24
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Maclagan LC, Wang X, Emdin A, Jones A, Jaakkimainen RL, Schull MJ, Sourial N, Vedel I, Swartz RH, Bronskill SE. Visits to the emergency department by community-dwelling people with dementia during the first 2 waves of the COVID-19 pandemic in Ontario: a repeated cross-sectional analysis. CMAJ Open 2022; 10:E610-E621. [PMID: 35790227 PMCID: PMC9262349 DOI: 10.9778/cmajo.20210301] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Community-dwelling people with dementia have been affected by COVID-19 pandemic health risks and control measures that resulted in worsened access to health care and service cancellation. One critical access point in health systems is the emergency department. We aimed to determine the change in weekly rates of visits to the emergency department of community-dwelling people with dementia in Ontario during the first 2 waves of the COVID-19 pandemic compared with historical patterns. METHODS We conducted a population-based repeated cross-sectional study and used health administrative databases to compare rates of visits to the emergency department among community-dwelling people with dementia who were aged 40 years and older in Ontario during the first 2 waves of the COVID-19 pandemic (March 2020-February 2021) with the rates of a historical period (March 2019-February 2020). Weekly rates of visits to the emergency department were evaluated overall, by urgency and by chapter from the International Statistical Classification of Diseases and Related Health Problems, 10th Revision. We used Poisson models to compare pandemic and historical rates at the week of the lowest rate during the pandemic period and the latest week. RESULTS We observed large immediate declines in rates of visits to the emergency department during the COVID-19 pandemic (rate ratio [RR] 0.50, 95% confidence interval [CI] 0.47-0.53), which remained below historical levels by the end of the second wave (RR 0.88, 95% CI 0.83-0.92). Rates of both nonurgent (RR 0.33, 95% CI 0.28-0.39) and urgent (RR 0.51, 95% CI 0.48-0.55) visits to the emergency department also declined and remained low (RR 0.68, 95% CI 0.59-0.79, RR 0.91, 95% CI 0.86-0.96), respectively. Visits for injuries, and circulatory, respiratory and musculoskeletal diseases declined and remained below historical levels. INTERPRETATION Prolonged reductions in visits to the emergency department among people with dementia during the first 2 pandemic waves raise concerns about patients who delay seeking acute care services. Understanding the long-term effects of these reductions requires further research.
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Affiliation(s)
- Laura C Maclagan
- ICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que
| | - Xuesong Wang
- ICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que
| | - Abby Emdin
- ICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que
| | - Aaron Jones
- ICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que
| | - R Liisa Jaakkimainen
- ICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que
| | - Michael J Schull
- ICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que
| | - Nadia Sourial
- ICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que
| | - Isabelle Vedel
- ICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que
| | - Richard H Swartz
- ICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que
| | - Susan E Bronskill
- ICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que.
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25
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Gamble LD, Parker S, Quinn C, Bennett HQ, Martyr A, Sabatini S, Pentecost C, Collins R, Dawson E, Hunt A, Allan L, Burns A, Litherland R, Victor C, Matthews FE, Clare L. A Comparison of Well-Being of Carers of People with Dementia and Their Ability to Manage Before and During the COVID-19 Pandemic: Findings from the IDEAL Study. J Alzheimers Dis 2022; 88:679-692. [PMID: 35634850 DOI: 10.3233/jad-220221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Social restriction measures imposed to curb the spread of COVID-19 in the United Kingdom impacted on carers of people with dementia, limiting access to support services and increasing perceived burden of caring. Few studies have compared data collected both during and before the pandemic to examine the effect of these changes. OBJECTIVE To explore whether the COVID-19 pandemic affected the well-being of carers of people with dementia living in the community, and their ability to cope with their caring responsibilities. METHODS Analysis was conducted on two groups of carers who were enrolled in the IDEAL programme; the 'pre-pandemic group' (n = 312), assessed at two time points prior to the pandemic, and the 'pandemic group', assessed prior to and several months into the pandemic (n = 156). For the pre-pandemic group, carers were matched 2:1 to carers in the pandemic group on certain characteristics. Differences in change over time between the two groups on self-reported well-being, quality of life, coping, perceived competence, and role captivity, was investigated using mixed effect modelling. RESULTS Compared to the pre-pandemic group, those in the pandemic group appeared to cope better and had more stable self-rated competency and role captivity. They did not differ in terms of well-being or quality of life. CONCLUSIONS Despite reports of negative impacts on carers early in the pandemic, the findings suggest the pandemic had little negative longer-term impact on carers of people with dementia, and in fact they appeared to have a more positive attitude towards coping several months into the pandemic.
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Affiliation(s)
- Laura D Gamble
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Sophie Parker
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Catherine Quinn
- Centre for Applied Dementia Studies, Bradford University, UK
| | - Holly Q Bennett
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Anthony Martyr
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Serena Sabatini
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Claire Pentecost
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Rachel Collins
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Eleanor Dawson
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Anna Hunt
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Louise Allan
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Alistair Burns
- Institute of Brain, Behaviour and Mental Health, University of Manchester, UK
| | | | - Christina Victor
- College of Health, Medicine and Life Sciences, Brunel University London, UK
| | - Fiona E Matthews
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Linda Clare
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK.,NIHR Applied Research Collaboration South-West Peninsula, UK
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26
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Howkins J, Hassiotis A, Bradley E, Levitas A, Sappok T, Sinai A, Thakur A, Shankar R. International clinician perspectives on pandemic-associated stress in supporting people with intellectual and developmental disabilities. BJPsych Open 2022; 8:e84. [PMID: 35431024 PMCID: PMC9059730 DOI: 10.1192/bjo.2022.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND People living with intellectual and developmental disabilities (IDD) have suffered disproportionately in health outcomes and general well-being during the COVID-19 pandemic. There is emerging evidence of increased psychological distress. Increased strain has also fallen on clinicians managing the psychological needs of people with IDD, in the context of learning new technologies, staff shortages, reduced services and paused training opportunities. AIMS To examine clinicians' experiences of patient care, clinical management and the impact of care delivery. METHOD A mixed fixed-response and free-text survey comprising 28 questions covering four areas (responder demographics, clinical practice, changes to local services and clinician experiences) was developed, using the STROBE guidance. It was disseminated through an exponential snowballing technique to clinicians in seven high-income countries. Quantitative data were analysed and presented with Microsoft Excel. Qualitative data were coded and thematically analysed, and presented with in-text quotations. RESULTS There were 139 respondents, mostly senior physicians (71%). Two-thirds reported over 10 years working in the field. Quantitative findings include increased clinician stress (77%), referrals (53%), patient distress presentations (>70%), patient isolation (73%) and carer burden (89%), and reduced patient participation in daily activities (86%). A third reported increased psychotropic prescribing. Qualitative analysis outlined changes to clinical practice, particularly the emergence and impact of telehealth. CONCLUSIONS In the countries surveyed, the pandemic has not only had a significant impact on people with IDD, but also their carers and clinicians. A proactive, holistic international response is needed in preparedness for future public health emergencies.
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Affiliation(s)
| | | | | | | | - Tanja Sappok
- Department for Mental Health, Charité University Hospital, Germany
| | - Amanda Sinai
- Department of Psychiatry, Mayanei Hayeshua Medical Center, Israel
| | - Anupam Thakur
- Department of Psychiatry, University of Toronto, Canada
| | - Rohit Shankar
- Cornwall Partnership NHS Foundation Trust, UK; and Cornwall Intellectual Disability Equitable Research (CIDER), University of Plymouth Peninsula School of Medicine, UK
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27
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Merrilees J, Robinson-Teran J, Allawala M, Dulaney S, Rosenbloom M, Lum HD, Sawyer RJ, Possin KL, Bernstein A. Responding to the needs of persons living with dementia and their caregivers during the COVID-19 pandemic: Lessons from the Care Ecosystem. Innov Aging 2022; 6:igac007. [PMID: 35434383 PMCID: PMC9007551 DOI: 10.1093/geroni/igac007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Objectives
The COVID-19 pandemic created challenges for persons with dementia, their caregivers, and programs that support them. The Care Ecosystem (CE) is a model of dementia care designed to support people with dementia and their family caregiver dyads through on-going contact with a care team navigator (CTN) and an expert clinical team. CTNs provide support, education and resources and help dyads manage dementia-related concerns as they evolve over the course of the disease. We aimed to understand how the Care Ecosystem responded to the needs of dyads during the initial three months of the COVID-19 pandemic.
Research Design and Methods
We conducted a survey and qualitative interviews with staff members from four established Care Ecosystem programs located in four different states to explore 1) challenges dyads voiced during the pandemic, 2) CE staff approaches to addressing the needs of dyads and 3) programmatic challenges faced and lessons learned.
Findings
Nine staff members from four Care Ecosystem programs with an active collective caseload of 379 dyads were interviewed. Themes were identified that included dyad concerns regarding fear of illness, changing attitudes towards long term care, decreased availability of services and resources, and impacts on patient and caregiver health and well-being. Programmatic challenges included maintaining effective communication with dyads and program staff, technological readiness, workflow restructuring and program sustainability.
Discussion and Implications
Approaches in supporting people with dementia and their caregivers should demonstrate flexibility, responsivity, and creativity and these findings provide insight for understanding how dementia care programs can be positioned to offer continuous support for this vulnerable population.
Translational Significance
During the pandemic, persons with dementia and their caregivers reported concerns relating to viral exposure, functional and behavioral decline of the person with dementia, difficulty accessing resources, changing attitudes towards long term care and experiences of loneliness and isolation. The Care Ecosystem, a supportive dementia care model, faced challenges relating to program sustainability and workflow. Telephone-based and scheduled contacts with dyads, along with strong organizational and community partnerships were factors in supporting dyads. Results from this study inform programs on ways to support persons with dementia and their caregivers during unexpected events that threaten public health and safety.
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Affiliation(s)
- Jennifer Merrilees
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA
| | - Joanne Robinson-Teran
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Mahnoor Allawala
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Sarah Dulaney
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Michael Rosenbloom
- Center for Memory and Aging, HealthPartners Institute, Saint Paul, Minnesota, USA
| | - Hillary D Lum
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
- VA Eastern Colorado Geriatrics Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA
| | - Robert John Sawyer
- Cognitive Disorders and Brain Health Program, Ochsner Health, New Orleans, Louisiana, USA
| | - Katherine L Possin
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA
| | - Alissa Bernstein
- Department of Humanities and Social Sciences, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, USA
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA
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Impact of Actual Use Behavior of Healthcare Wearable Devices on the Quality of Life: A Cross-Sectional Survey of People with Dementia and Their Caregivers in Ghana. Healthcare (Basel) 2022; 10:healthcare10020275. [PMID: 35206890 PMCID: PMC8872618 DOI: 10.3390/healthcare10020275] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/17/2022] [Accepted: 01/24/2022] [Indexed: 12/17/2022] Open
Abstract
The increasing prevalence of dementia has necessitated the introduction and use of healthcare wearable devices to augment the healthcare services delivered to people with dementia (PWDs). Unfortunately, evidence on user feedback and the real impact of the actual use of these devices on the quality of life of PWDs has not been fully explored, especially in the context of developing countries. This study, therefore, seeks to evaluate the impact of actual use behavior (AUB) of healthcare wearable devices on the quality of life (QoL) of PWDs in Ghana by using constructs from the extended Unified Theory of Acceptance and Use of Technology (UTAUT2) model and the SF-36 quality of life instrument. Data were collected from people with dementia and, in some cases, caregivers (acting as proxies) in three administrative regions of Ghana using structured questionnaires. Of the 420 questionnaires distributed, 356 were returned, giving a response rate of (356/420, 84.8%). Three hundred and twenty (320) responses were used for further analysis, employing the Partial Least Squares based on Structural Equation Modeling. The results showed a significant positive relationship between AUB and QoL (p < 0.001). Other predictors such as behavioral intention, facilitating conditions, effort expectancy and social influence were also found to significantly impact the actual use behavior of healthcare wearable devices among PWDs. The study also revealed that 4% (14) of patients rated their reported health transition associated with the use of healthcare wearable devices as excellent, 42.5% (136) as very good, and 39.4% (126) as good, respectively at the time of the study compared to a year ago. This study provided empirical evidence of the positive impact of the actual use of healthcare wearable devices on the quality of life of PWDs and further highlighted the factors that drive actual use behavior among PWDs in Ghana. Based on the findings of this study, stakeholders need to create the necessary conditions that will facilitate the adoption and use of healthcare wearable devices, as this will help improve the quality of life, reduce the burden of the disease on caregivers, and enable independent living of PWDs.
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Carbone EA, de Filippis R, Roberti R, Rania M, Destefano L, Russo E, De Sarro G, Segura-Garcia C, De Fazio P. The Mental Health of Caregivers and Their Patients With Dementia During the COVID-19 Pandemic: A Systematic Review. Front Psychol 2022; 12:782833. [PMID: 35002872 PMCID: PMC8740146 DOI: 10.3389/fpsyg.2021.782833] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/30/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Coronavirus Disease 2019 (COVID-19) is a worldwide public health concern. It continues to spread rapidly throughout the world causing multiple physical and psychological consequences in the population. Especially, people affected by severe psychiatric or neurological diseases are highly susceptible to serious health complications not only due to the direct effect of the infection but also to the indirect effect of COVID-19 following social distancing during lockdowns and its general social consequences. Indeed, lockdown and difficulties in using the care services produced psychological consequences in caregivers such as depression, anxiety, and worsening of the quality of life which in turn affected the ability to manage patients. Our aim was to systematically review the psychological consequences of the COVID-19 lockdown in caregivers of patients with cognitive impairment and dementia and the impact on the health of their patients. Methods: A systematic literature search was conducted by searching in MEDLINE/PubMed, Scopus, and Web of Science by two independent researchers following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Data extraction and quality assessment were also performed. Papers were screened for eligibility by abstract and then those which met inclusion criteria were included in this review. Results: The initial search returned 410 records. After the abstract screening and the inclusion/exclusion criteria were applied, 315 were excluded because they were irrelevant, 30 because they were reviews, meta-analyses, letters to editors, editorials, guidelines, or case reports, and 10 because they were duplicates. Then, 38 out of 55 abstracts/full-text articles were excluded because they did not simultaneously assess mental health of patients and caregivers. In the end, 17 papers were deemed eligible and included in the present review. Conclusion: Based on current literature, the COVID-19 pandemic and the ensuing lockdown caused severe psychological consequences for caregivers of patients with dementia, worsening their mental health, and increasing the psychological and physical burden, independently from the severity of the disease of their relatives, which resulted also independently globally worsened.
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Affiliation(s)
- Elvira Anna Carbone
- Psychiatry Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Renato de Filippis
- Psychiatry Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Roberta Roberti
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Marianna Rania
- Psychiatry Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Laura Destefano
- Psychiatry Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy.,Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Emilio Russo
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | | | - Cristina Segura-Garcia
- Psychiatry Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Pasquale De Fazio
- Psychiatry Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
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Dosso JA, Kailley JN, Guerra GK, Robillard JM. Older adult perspectives on emotion and stigma in social robots. Front Psychiatry 2022; 13:1051750. [PMID: 36713914 PMCID: PMC9878396 DOI: 10.3389/fpsyt.2022.1051750] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/20/2022] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Social robot adoption by older adults and people living with dementia is limited by several barriers, including a lack of emotional alignment with social robots and perceptions of stigma around social robot use. The goal of this work was to address these barriers by engaging end-users in discussions on factors that could affect emotional connection to a social robot and considerations around using a social robot in public. METHODS We conducted seven 90-min online workshops with older adults with (n = 2) and without dementia (n = 25) and care partners (n = 17). Older adults with and without dementia were in their 50s - 80s, and care partners were in their 30s - 70s. Seven older adults, seven care partners, and one older adult with dementia indicated that they had used a robot before. Online workshops had 4-8 participants each, and began with video demonstrations of pet-like robot MiRo and tabletop robot T-Top, as well as a live demonstration of MiRo. Participants completed the Multi-Dimensional Robot Attitude Scale before the workshops and the Psychosocial Impact of Assistive Devices Scale and two Zoom polls during the workshops. The audio and chat responses from the workshops were transcribed verbatim and content analysis was performed on the transcripts. RESULTS Our analysis revealed three broad themes and 10 subthemes. In their discussions on features and applications, participants highlighted preferred forms of communication with a robot and ways in which a robot could support connection between people. For example, robots could improve the quality of communication between care partners and the person for whom they care. While many agreed that a social robot should match their level of emotion and interactivity, participants had different preferences for social robot emotional range and display features. Finally, participants discussed considerations around showing a robot to other people; several participants suggested that a robot could help raise awareness of ageing and dementia while others shared concerns about stigma and attracting negative attention from an audience. DISCUSSION Incorporating these findings into the design and implementation of social robots will result in devices that are better-suited to the needs of older adults, people living with dementia, and care partners.
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Affiliation(s)
- Jill A Dosso
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,British Columbia Children's and Women's Hospital, Vancouver, BC, Canada
| | - Jaya N Kailley
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,British Columbia Children's and Women's Hospital, Vancouver, BC, Canada
| | - Gabriella K Guerra
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,British Columbia Children's and Women's Hospital, Vancouver, BC, Canada
| | - Julie M Robillard
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,British Columbia Children's and Women's Hospital, Vancouver, BC, Canada
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Sabatini S, Bennett HQ, Martyr A, Collins R, Gamble LD, Matthews FE, Pentecost C, Dawson E, Hunt A, Parker S, Allan L, Burns A, Litherland R, Quinn C, Clare L. Minimal Impact of COVID-19 Pandemic on the Mental Health and Wellbeing of People Living With Dementia: Analysis of Matched Longitudinal Data From the IDEAL Study. Front Psychiatry 2022; 13:849808. [PMID: 35370851 PMCID: PMC8965515 DOI: 10.3389/fpsyt.2022.849808] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/14/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Research suggests a decline in the mental health and wellbeing of people with dementia (PwD) during the COVID-19 pandemic; however few studies have compared data collected pre-pandemic and during the pandemic. Moreover, none have compared this change with what would be expected due to dementia progression. We explored whether PwD experienced changes in mental health and wellbeing by comparing pre-pandemic and pandemic data, and drew comparisons with another group of PwD questioned on two occasions prior to the pandemic. METHODS Community-dwelling PwD enrolled in the IDEAL programme were split into two groups matched for age group, sex, dementia diagnosis, and time since diagnosis. Although each group was assessed twice, one was assessed prior to and during the pandemic (pandemic group; n = 115) whereas the other was assessed prior to the pandemic (pre-pandemic group; n = 230). PwD completed measures of mood, sense of self, wellbeing, optimism, quality of life, and life satisfaction. RESULTS Compared to the pre-pandemic group, the pandemic group were less likely to report mood problems, or be pessimistic, but more likely to become dissatisfied with their lives. There were no changes in continuity in sense of self, wellbeing, and quality of life. DISCUSSION Results suggest the pandemic had little effect on the mental health and wellbeing of PwD, with any changes observed likely to be consistent with expected rates of decline due to dementia. Although personal accounts attest to the challenges experienced, PwD appear to have been resilient to the impact of lockdown and social restrictions during the pandemic.
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Affiliation(s)
- Serena Sabatini
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Holly Q Bennett
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Anthony Martyr
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Rachel Collins
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Laura D Gamble
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Fiona E Matthews
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Claire Pentecost
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Eleanor Dawson
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Anna Hunt
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Sophie Parker
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Louise Allan
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Alistair Burns
- School of Social Sciences, Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom
| | - Rachael Litherland
- Innovations in Dementia Community Interest Company (CIC), Exeter, United Kingdom
| | - Catherine Quinn
- Centre for Applied Dementia Studies, Bradford University, Bradford, United Kingdom
| | - Linda Clare
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom.,National Institute for Health Research (NIHR) Applied Research Collaboration South-West Peninsula, London, United Kingdom
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Clare L, Martyr A, Gamble LD, Pentecost C, Collins R, Dawson E, Hunt A, Parker S, Allan L, Burns A, Hillman A, Litherland R, Quinn C, Matthews FE, Victor C. Impact of COVID-19 on 'Living Well' with Mild-to-Moderate Dementia in the Community: Findings from the IDEAL Cohort. J Alzheimers Dis 2021; 85:925-940. [PMID: 34776448 DOI: 10.3233/jad-215095] [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] [Indexed: 12/13/2022]
Abstract
BACKGROUND Negative impacts of the COVID-19 pandemic on people with dementia have been widely-documented, but most studies have relied on carer reports and few have compared responses to information collected before the pandemic. OBJECTIVE We aimed to explore the impact of the pandemic on community-dwelling individuals with mild-to-moderate dementia and compare responses with pre-pandemic data. METHODS During the second wave of the pandemic, we conducted structured telephone interviews with 173 people with dementia and 242 carers acting as informants, all of whom had previously participated in the IDEAL cohort. Where possible, we benchmarked responses against pre-pandemic data. RESULTS Significant perceived negative impacts were identified in cognitive and functional skills and ability to engage in self-care and manage everyday activities, along with increased levels of loneliness and discontinuity in sense of self and a decline in perceived capability to 'live well'. Compared to pre-pandemic data, there were lower levels of pain, depression, and anxiety, higher levels of optimism, and better satisfaction with family support. There was little impact on physical health, mood, social connections and relationships, or perceptions of neighborhood characteristics. CONCLUSION Efforts to mitigate negative impacts of pandemic-related restrictions and restore quality of life could focus on reablement to address the effects on participation in everyday activities, creating opportunities for social contact to reduce loneliness, and personalized planning to reconnect people with their pre-COVID selves. Such efforts may build on the resilience demonstrated by people with dementia and carers in coping with the pandemic.
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Affiliation(s)
- Linda Clare
- College of Medicine and Health, University of Exeter, Exeter, UK.,NIHR Applied Research Collaboration South-West Peninsula, Exeter, UK
| | - Anthony Martyr
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Laura D Gamble
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Claire Pentecost
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Rachel Collins
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Eleanor Dawson
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Anna Hunt
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Sophie Parker
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Louise Allan
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Alistair Burns
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Alexandra Hillman
- Department of Public Health Policy and Social Sciences, Swansea University, Swansea, Wales, UK
| | | | - Catherine Quinn
- Centre for Applied Dementia Studies, Bradford University, Bradford, UK.,Wolfson Centre for Applied Health Research, Bradford, UK
| | - Fiona E Matthews
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Christina Victor
- College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
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Toward the Integration of Technology-Based Interventions in the Care Pathway for People with Dementia: A Cross-National Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910405. [PMID: 34639704 PMCID: PMC8508540 DOI: 10.3390/ijerph181910405] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/30/2021] [Accepted: 09/30/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The integration of technology-based interventions into health and care provision in our aging society is still a challenge especially in the care pathway for people with dementia. OBJECTIVE The study aims to: (1) identify which socio-demographic characteristics are independently associated with the use of the embodied conversational agent among subjects with dementia, (2) uncover patient cluster profiles based on these characteristics, and (3) discuss technology-based interventions challenges. METHODS A virtual agent was used for four weeks by 55 persons with dementia living in their home environment. RESULTS Participants evaluated the agent as easy-to-use and quickly learnable. They felt confident while using the system and expressed the willingness to use it frequently. Moreover, 21/55 of the patients perceived the virtual agent as a friend and assistant who they could feel close to and who would remind them of important things. CONCLUSIONS Technology-based interventions require a significant effort, such as personalized features and patient-centered care pathways, to be effective. Therefore, this study enriches the open discussion on how such virtual agents must be evidence-based related and designed by multidisciplinary teams, following patient-centered care as well as user-centered design approaches.
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Long-Term Outcomes of Patients with Coronavirus Disease 2019 at One Year after Hospital Discharge. J Clin Med 2021; 10:jcm10132945. [PMID: 34209085 PMCID: PMC8269002 DOI: 10.3390/jcm10132945] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 06/26/2021] [Accepted: 06/27/2021] [Indexed: 12/29/2022] Open
Abstract
Background: The long-term effects of COVID-19 remain largely unclear. This study aims to investigate post-acute health consequences and mortality one year after hospital discharge. Methods: All surviving adult patients who were discharged after hospital admission due to acute COVID-19 in the first wave of the pandemic underwent a comprehensive interview. Functional assessment was performed in patients aged over 65. Clinical and hospital records were reviewed and mortality causes assessed. Results: A total of 587 patients with COVID-19 were discharged from hospital, including 266 after hospital admission and 321 from the emergency room. Mortality within the following year occurred in 34/266 (12.8%) and 10/321 (3.1%), respectively, due to causes directly or possibly related to COVID-19 in 20.5% and 25% of patients. Post-COVID-19 syndrome was assessed in 543 patients at one year from discharge. Any clinical complaint was reported by 90.1% of patients who needed hospitalization and 80.4% of those discharged from the emergency room (p = 0.002), with breathlessness (41.6%), tiredness (35.4%), ageusia (30.2%), and anosmia (26.3%) being the most common complaints. Ongoing symptoms attributed to COVID-19 were reported by 66.8% and 49.5% of patients, respectively (p < 0.001). Newly developed COPD, asthma, diabetes, heart failure, and arthritis—as well as worsening of preexisting comorbidities—were found. Conclusions: One-year mortality among survivors of acute COVID-19 was 7.5%. A significant proportion of COVID-19 patients experienced ongoing symptoms at 1 year from onset of the disease.
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