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van Santen J, Dröes RM, Blanson Henkemans O, Schoone M, Valk R, Straten AV, Meiland F. Implementation of exergaming for people with dementia: facilitators, barriers, and recommendations. Aging Ment Health 2024; 28:244-253. [PMID: 37493266 DOI: 10.1080/13607863.2023.2238259] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/23/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVES To identify facilitators, barriers, and formulate recommendations for the implementation of exergames for people with dementia (PWD) in day-care centers (DCCs). METHODS Within a randomized controlled trial into the effectiveness of exergaming, 73 PWD with their informal caregivers (IC) from 11 DCCs in the Netherlands and two exergame providers participated in a process evaluation. This was a mixed-methods study using focus groups, semi-structured interviews, the Measurement Instrument for Determinants of Innovations, forms for DCC staff, and a short satisfaction questionnaire. We used descriptive statistics for the quantitative outcomes, and thematic analysis for qualitative data. The Medical Research Council guidance for process evaluation was used to identify facilitators and barriers to the implementation, mechanisms of impact, and context. RESULTS Implementation-related facilitators and barriers were the availability of budget, staff, equipment, instructions, location, and supervision. Mechanisms of impact-related facilitators were experienced positive effects on physical functioning and mobility, cognitive, emotional, and social functioning, and quality of life. Barriers were mainly linked to the need to customize the intervention for each participant. Contextual facilitators were support and enthusiasm from others; barriers were costs and planning. Recommendations by DCC staff involved technical support, instructions, responsibility, location, supervision, planning, and exergaming as a group or individually. CONCLUSION Users, IC, and staff positively valued exergaming. We found various facilitators and barriers leading to recommendations for successful implementation. We recommend further research into tailoring exergaming to specific users and contexts, and into usability and cost-effectiveness. This may contribute to further dissemination and implementation of exergaming for PWD.
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Affiliation(s)
- Joeke van Santen
- Department of Psychiatry, Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | | | | | - Ronald Valk
- HilverZorg-Day-Care Center Zonnehoeve, Hilversum, Netherlands
| | - Annemieke van Straten
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Department of Clinical- Neuro- and Developmental Psychology, Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, Netherlands
| | - Franka Meiland
- Department of Psychiatry, Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Department of Medicine for Older People, Gerion, Amsterdam, Netherlands
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Budak KB, Atefi G, Hoel V, Laporte Uribe F, Meiland F, Teupen S, Felding SA, Roes M. Can technology impact loneliness in dementia? A scoping review on the role of assistive technologies in delivering psychosocial interventions in long-term care. Disabil Rehabil Assist Technol 2023; 18:1107-1119. [PMID: 34752177 DOI: 10.1080/17483107.2021.1984594] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/17/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE We aimed to identify assistive technologies that are promising for addressing loneliness in people living with dementia in long-term care. MATERIALS AND METHODS A scoping review was conducted. EBSCO, PubMed, Cochrane Library, and ProQuest were searched from 2000 to 2020. The included studies were selected by three independent researchers and summarised, compared, and categorized according to technology type. Publications were eligible for inclusion when they reported on psychosocial interventions aiming to reduce loneliness and/or social isolation in people with dementia in long-term care settings. RESULTS Twenty-four papers were included (20 original research papers and four reviews). Most studies were conducted in Australia and Europe. The studies aimed to investigate two different types of assistive technology: social robots, and multimedia computer systems. Most studies focussed on behaviour, engagement, and mood as primary outcomes. Only one study directly aimed to alleviate loneliness. CONCLUSIONS Even though only one study addressed loneliness directly, it became clear that assistive technologies used to apply psychosocial interventions have the potential to impact loneliness in people with dementia in long-term care. However, it remains unclear why loneliness was not included as an outcome and how loneliness could become a key outcome in evaluating assistive technologies.IMPLICATIONS FOR REHABILITATIONLoneliness among older adults is associated with health risks, such as the development of dementia, depression, and increased mortality.Ambient Assisted Living (AAL) technologies have been studied to address loneliness for older adults; however people with dementia are often excluded from such studies.This diverse group of technologies is shown to have a promising impact on outcomes, such as social engagement, quality of life, and mood, but loneliness was studied less often.More research is needed to discover the potential of assistive technologies for people with dementia living in long-term care.
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Affiliation(s)
- Kübra Beliz Budak
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE) site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Golnaz Atefi
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Viktoria Hoel
- Institute for Public Health and Nursing Science, University of Bremen, Bremen, Germany
| | - Franziska Laporte Uribe
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE) site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Franka Meiland
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE) site Witten, Witten, Germany
- Department of Medicine for Older People Amsterdam UMC, Amsterdam, The Netherlands
| | - Sonja Teupen
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE) site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Simone Anna Felding
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE) site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Martina Roes
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE) site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
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Budak KB, Laporte Uribe F, Meiland F, Felding SA, Teupen S, Bergmann JM, Mueller-Widmer R, Roes M. Implementing Active Assisted Living Technology in the Long-term Care of People Living With Dementia to Address Loneliness: European Survey. JMIR Aging 2023; 6:e45231. [PMID: 37314840 DOI: 10.2196/45231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/21/2023] [Accepted: 05/12/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND In the lives of people with dementia, loneliness is an important issue with psychological and physical consequences. Active assisted living (AAL) technology has been gaining visibility in the care of persons living with dementia, including addressing loneliness. However, to the best of our knowledge, there is a lack of evidence concerning the factors influencing the implementation of AAL technology within the context of dementia, loneliness, and long-term care (LTC). OBJECTIVE We aimed to identify the familiarity with AAL technology that is promising for addressing loneliness in persons living with dementia in LTC in Europe and the factors influencing AAL technology implementation. METHODS A web-based survey was developed based on findings from our previous literature review. The Consolidated Framework for Implementation Research guided the development and analysis of the survey. Participants included 24 representatives of Alzheimer Europe member associations from 15 European countries. The data were analyzed using basic statistical methods (descriptive statistics). RESULTS The baby seal robot Paro was reported to be the most familiar AAL technology by 19 of 24 participants addressing loneliness in people with dementia living in LTC. Participants from Norway (n=2) reported familiarity with 14 AAL technologies, and participants from Serbia (n=1) reported zero familiarity. It seems that countries that invest less in LTC facilities are familiar with fewer AAL technologies. At the same time, these countries report a more positive attitude toward AAL technology, express a higher need for it, and see more advantages than disadvantages than those countries that invest more in LTC. However, a country's investment in LTC facilities does not seem to be linked to other implementation aspects such as costs, planning, and the impact of infrastructure. CONCLUSIONS Implementation of AAL technology to address loneliness in dementia seems to be linked to familiarity with the technology in a country as well as national investment in LTC facilities. This survey confirms the literature on higher investment countries' critical stance in regard to AAL technology implementation to address loneliness in persons living with dementia living in LTC. Further research is needed to clarify the potential reasons why familiarity with more AAL technology does not seem to be directly linked with acceptance, positive attitude, or satisfaction with AAL technology addressing loneliness in persons living with dementia.
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Affiliation(s)
- Kübra Beliz Budak
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V., site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Franziska Laporte Uribe
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V., site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Franka Meiland
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Vrije Universiteit Medical Center, Amsterdam, Netherlands
| | - Simone Anna Felding
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V., site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Sonja Teupen
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V., site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Johannes Michael Bergmann
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V., site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Rene Mueller-Widmer
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V., site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Martina Roes
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V., site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
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Henderson C, Rehill A, Brooker D, Evans SC, Evans SB, Bray J, Saibene FL, Scorolli C, Szcześniak D, d'Arma A, Lion K, Atkinson T, Farina E, Rymaszewska J, Chattat R, Meiland F, Dröes RM, Knapp M. Costs and cost-effectiveness of the meeting centres support programme for people living with dementia and carers in Italy, Poland and the UK: The MEETINGDEM study. Health Soc Care Community 2021; 29:1756-1768. [PMID: 33506538 DOI: 10.1111/hsc.13281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 11/08/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
We examined the costs and cost-effectiveness of the Meeting Centre Support Programme (MCSP) implemented and piloted in the UK, Poland and Italy, replicating the Dutch Meeting Centre model. Dutch Meeting Centres combine day services for people with dementia with carer support. Data were collected over 2015-2016 from MCSP and usual care (UC) participants (people with dementia-carer dyads) at baseline and 6 months. We examined participants' health and social care (HSC), and societal costs, including Meeting Centre (MC) attendances. Costs and outcomes in MCSP and UC groups were compared. Primary outcomes: Persons with dementia: quality-adjusted life years (EQ-5D-5L-derived); QOL-AD. DQoL was examined as a secondary outcome. Carers: Short Sense of Competence Questionnaire (SSCQ). Incremental cost-effectiveness ratios (ICER) and cost-effectiveness acceptability curves were obtained by bootstrapping outcome and cost regression estimates. Eighty-three MCSP and 69 UC dyads were analysed. The 6-month cost of providing MCSP was €4,703; participants with dementia attended MC a mean of 45 times and carers 15 times. Including intervention costs, adjusted 6-month HSC costs were €5,941higher in MCSP than in UC. From the HSC perspective: in terms of QALY, the probability of cost-effectiveness was zero over willingness-to-pay (WTP) ranging from €0 to €350,000. On QOL-AD, the probability of cost-effectiveness of MCSP was 50% at WTP of €5,000 for a one-point increase. A one-point gain in the DQoL positive affect subscale had a probability of cost-effectiveness of 99% at WTP over €8,000. On SSCQ, no significant difference was found between MCSP and UC. Evidence for cost-effectiveness of MCSP was mixed but suggests that it may be cost-effective in relation to gains in dementia-specific quality of life measures. MCs offer effective tailored post-diagnostic support services to both people with dementia and carers in a context where few evidence-based alternatives to formal home-based social services may be available.
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Affiliation(s)
- Catherine Henderson
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Amritpal Rehill
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Dawn Brooker
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Simon C Evans
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Shirley B Evans
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Jennifer Bray
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | | | | | | | | | | | - Teresa Atkinson
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | | | | | | | - Franka Meiland
- Amsterdam University Medical Centres, VU University Medical Centre, Amsterdam, The Netherlands
| | - Rose-Marie Dröes
- Amsterdam University Medical Centres, VU University Medical Centre, Amsterdam, The Netherlands
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
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Ronde B, Broulikova H, Bosmans J, Meiland F. [Five years University Practice of Elderly Care: users, care provided, costs and experiences]. Tijdschr Gerontol Geriatr 2021; 52. [PMID: 34498438 DOI: 10.36613/tgg.1875-6832/2021.02.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The increasing number of elderly people living at home demands a strengthening of primary care for (vulnerable) older adults. Therefore, in 2015 the VU University Medical Centre in Amsterdam founded the Universitaire Praktijk Ouderengeneeskunde (UPO) (University Practice for Elderly Care). This practice makes the expertise of the Elderly Care physician (SO) available in primary care through a close and easy accessible collaboration between the SO and the General Practitioner. The aim of this research is an evaluation of the UPO, in order to determine the added value of this care innovation and to identify areas for improvement. This research consists of a quantitative part in which the characteristics of the 190 treated UPO patients have been assessed. Also, costs have been estimated of UPO care compared to expected usual care. The qualitative part of this study consists of 22 interviews with the most important UPO stakeholders. The results of this study show that 1) the UPO seems to meet a demand from general practitioners to support them in the care of vulnerable elderly people with mostly cognitive disorders, 2) this care seems to save costs and 3) the UPO was appreciated by most of those involved. The current results call for applying this care innovation in other regions and to evaluate it on a larger scale.
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Affiliation(s)
- Brigit Ronde
- Amsterdam UMC, Locatie VUmc, Afdeling Ouderengeneeskunde, Amsterdam
| | - Hana Broulikova
- Vrije Universiteit Amsterdam, Faculteit der Bètawetenschappen, Afdeling Gezondheidswetenschappen Amsterdam
| | - Judith Bosmans
- Vrije Universiteit Amsterdam, Faculteit der Bètawetenschappen, Afdeling Gezondheidswetenschappen Amsterdam
| | - Franka Meiland
- Amsterdam UMC, Locatie VUmc, Afdeling Ouderengeneeskunde/ Gerion, Amsterdam
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6
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Lion K, Szcześniak D, Evans S, Evans S, Farina E, Brooker D, Chattat R, Meiland F, Droes RM, Rymaszewska J. Can we reduce the stigmatisation experience with psychosocial interventions? An investigation of the meeting centre support programme impact on people with cognitive impairments. Eur Psychiatry 2021. [PMCID: PMC9471906 DOI: 10.1192/j.eurpsy.2021.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionPeople living with dementia or mild cognitive impairment (MCI) experience stigmatisation and there are not many specific psychosocial interventions dedicated to help them coping with this issue, reducing its impact on their lives.ObjectivesThis study aimed to a) investigate the stigmatisation level among people with dementia and MCI in Poland, Italy and the United Kingdom and b) assess the role of the Meeting Centre Support Programme (MCSP) in decreasing stigmatisation.MethodsWe investigated outcomes for 114 people with dementia and MCI living in Italy, Poland and the UK who participated 6 months in MCSP or usual care (UC) using a pre/post-test control group study design. Level of stigmatisation was assessed with the Stigma Impact Scale: neurological impairment (SIS).ResultsStigmatisation level (SIS) among participants varied from 2 to 65 (median=33.5; Q1=27; Q3=41) with people from the UK experiencing a statistically significantly higher level of stigmatisation than people in Italy and Poland. In Italy, stigmatisation was lower (p=0.02) in the MCSP group following the intervention. In Poland, the social isolation level did not significantly change in MCSP, but increased (p=0.05) in UC. In the UK, the social rejection level raised (p=0.03) in MCSP. Overall, the combined data of the three countries did not show statistically significant differences in SIS between MCSP and UC.ConclusionsStigmatisation among people with dementia and MCI is complex and seems culturally dependent. There is a great opportunity in psychosocial interventions to reduce the burden of stigma among people with dementia which requires further investigation.DisclosureNo significant relationships.
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Vernooij-Dassen M, Moniz-Cook E, Verhey F, Chattat R, Woods B, Meiland F, Franco M, Holmerova I, Orrell M, de Vugt M. Bridging the divide between biomedical and psychosocial approaches in dementia research: the 2019 INTERDEM manifesto. Aging Ment Health 2021; 25:206-212. [PMID: 31771338 DOI: 10.1080/13607863.2019.1693968] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To provide a new perspective on integrated biomedical and psychosocial dementia research. BACKGROUND Dementia is being recognized as a multifactorial syndrome, but there is little interaction between biomedical and psychosocial approaches. A way to improve scientific knowledge is to seek better understanding of the mechanisms underlying the interaction between biomedical and psychosocial paradigms. One rationale for integrating biomedical and psychosocial research is the discordance between neuropathology and cognitive functioning. The concept of social health might bridge the two paradigms. It relates to how social resources influence the dynamic balance between capacities and limitations. HYPOTHESES Social health can act as the driver for accessing cognitive reserve, in people with dementia through active facilitation and utilization of social and environmental resources. Thereby we link lifestyle social and opportunities to the brain reserve hypothesis. MANIFESTO We provide a Manifesto on how to significantly move forward the dementia research agenda.
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Affiliation(s)
- Myrra Vernooij-Dassen
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Esme Moniz-Cook
- Faculty of Health Sciences, School of Health & Social Work, University of Hull, Hull, UK
| | - Frans Verhey
- Alzheimer Centrum Limburg, School of Mental Health & Neurosciences/Psychiatry and Psychology/MUMC, Maastricht, The Netherlands
| | - Rabih Chattat
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Bob Woods
- Dementia Services Development Centre, DSDC Wales, Bangor University, Ardudwy, Bangor, UK
| | - Franka Meiland
- Department of Psychiatry, Amsterdam University Medical Centers, Location VUmc, APH Research Institute, Amsterdam, the Netherlands
| | - Manuel Franco
- Department Psychiatry, University Rio Hortega Hospital (Valladolid) and Zamora Hospital (Zamora), Spain.,Psychiatric and Mental Health Department, University Rio Hortega Hospital and Zamora Hospital, Zamora, Spain
| | - Iva Holmerova
- Charles University FHS CELLO and Gerontologicke Centrum, Kobylisy, Czechia
| | - Martin Orrell
- The Institute of Mental Health, University of Nottingham Innovation Park, Nottingham, UK
| | - Marjolein de Vugt
- Alzheimer Center Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands
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Szcześniak D, Rymaszewska J, Saibene FL, Lion KM, D'arma A, Brooker D, Evans SB, Evans SC, Chattat R, Scorolli C, Meiland F, Hendriks I, Dröes RM, Farina E. Meeting centres support programme highly appreciated by people with dementia and carers: a European cross-country evaluation. Aging Ment Health 2021; 25:149-159. [PMID: 31684754 DOI: 10.1080/13607863.2019.1683814] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The Meeting Centres Support Programme (MCSP) offers a combined approach to providing practical, emotional and social support to people living with mild to moderately severe dementia and their family carers in the community. METHODS A mixed methods explanatory design was used. The evaluation took place within the framework of the international Joint Programme - Neurodegenerative Disease Research (JPND) - MEETINGDEM study in nine Meeting Centres in Italy, Poland and the United Kingdom. Eighty-seven people with dementia and 81 family carers completed a user evaluation survey after three months and 83 people with dementia and 84 carers after 6 months of participation in MCSP. Thirty-two people with dementia and 30 carers took part in focus groups after nine months. RESULTS The percentage of people with dementia who were very satisfied with the programme increased significantly over time (p = 0.05). The majority of carers reported that they felt less burdened after three months of participation in MCSP (48.1% much less; 35.4% a little less). After six months, this percentage increased significantly to 91% (p = 0.04, 57.7% much less; 33.3% little less). Focus group analysis showed that people with dementia and carers in all countries/centres improved their ability to maintain emotional balance. CONCLUSIONS The MCSP is highly appreciated by people with dementia and carers in all countries and it confirms the results of previous research into MCSP in the Netherlands. Our findings indicate that MCSP is a model that can help its users to increase their capacity to deal with the challenges caused by dementia and can promote emotional balance.
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Affiliation(s)
- Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | | | | | | | | | - Dawn Brooker
- Association for Dementia Studies, University of Worcester, United Kingdom
| | - Shirley B Evans
- Association for Dementia Studies, University of Worcester, United Kingdom
| | - Simon C Evans
- Association for Dementia Studies, University of Worcester, United Kingdom
| | - Rabih Chattat
- Department of Philosophy and Communication Studies, University of Bologna, Bologna, Italy
| | - Claudia Scorolli
- Department of Philosophy and Communication Studies, University of Bologna, Bologna, Italy
| | - Franka Meiland
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Iris Hendriks
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands
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Szcześniak D, Lion K, Meiland F, Brooker D, Farina E, Chattat R, Dröes RM, Rymaszewska J. The Meeting Centre Support Programme: International Evaluation of a Dyadic Intervention in Dementia. Innov Aging 2020. [PMCID: PMC7742294 DOI: 10.1093/geroni/igaa057.2735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
In Europe, 10 million people are living with dementia. Most of them reside in their own home, cared for by their loved ones. As a consequence, there is a great need to provide both, people with dementia and their carers, tailored support. The Dutch Meeting Centres Support Programme (MCSP), adaptively implemented in three European countries within the JPND-MEETINGDEM project, is an excellent example of an effective dyadic psychosocial intervention, which seems to have no cultural barriers. The mixed-methods analysis showed that participant-dyads reported great satisfaction with MCSP. People with dementia experienced improvement of their quality of life, motivation and ability to participate in everyday activities, as well as improvement in their relationship with family members. Carers felt less burdened and highly appreciated the emotional and social support they received. Repeated user evaluation shows that this dyadic support effectively helps people with dementia and their families better deal with dementia.
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Affiliation(s)
| | - Katarzyna Lion
- Menzies Health Institute Queensland Griffith University, Nathan, Queensland, Australia
| | - Franka Meiland
- University Medical Centers, VU University Medical Center, Amsterdam, Noord-Holland, Netherlands
| | - Dawn Brooker
- Association for Dementia Studies, University of Worcester, Worcester, England, United Kingdom
| | | | - Rabih Chattat
- University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Rose-Marie Dröes
- Amsterdam Public Health research institute, Amsterdam, Noord-Holland, Netherlands
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Beentjes KM, Kerkhof YJF, Neal DP, Ettema TP, Koppelle MA, Meiland F, Graff M, Dröes R. Process evaluation of the FindMyApps program trial: A tablet computer‐based intervention for self‐management and meaningful activities for people with dementia. Alzheimers Dement 2020. [DOI: 10.1002/alz.040219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - Yvonne JF Kerkhof
- Amsterdam University Medical Centres Amsterdam Netherlands
- Saxion University of Applied Sciences Deventer Netherlands
| | | | - Teake P Ettema
- Amsterdam University Medical Centres Amsterdam Netherlands
| | - Mylène Anouk Koppelle
- Amsterdam University Medical Centres Amsterdam Netherlands
- Vrije Universiteit Amsterdam Amsterdam Netherlands
| | - Franka Meiland
- Amsterdam University Medical Centres Amsterdam Netherlands
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11
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Lauriks S, Meiland F, Osté JP, Hertogh C, Dröes RM. Effects of Assistive Home Technology on quality of life and falls of people with dementia and job satisfaction of caregivers: Results from a pilot randomized controlled trial. Assist Technol 2020; 32:243-250. [PMID: 30592439 DOI: 10.1080/10400435.2018.1531952] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Determine the effects of the implementation of Assistive Home Technology (AHT) in group homes on the quality of life (QoL) of people with dementia and on job satisfaction of caregivers. METHOD Pilot randomized controlled trial in nine in-patient care group homes (group homes with vs. without AHT). Participants were 54 people with dementia and 25 professionals. Outcome measurements were QoL, fall incidents, needs, use of restraints, job satisfaction, workload, and general health. RESULTS Living in a group home with AHT had a positive effect on four QoL domains: 'social isolation', 'having things to do', 'esthetics', and 'quality of life appreciation'. No effects were found on 12 other QoL domains. Fall incidents during bathroom visits were significantly reduced by the application of AHT. During this implementation phase, in the AHT group home, a moderate negative effect was found on caregiver's appreciation of work circumstances. No effects on other outcome measures were found. CONCLUSION Positive effects were found on aspects of QoL and fall incidents in the bathroom. The lower caregiver appreciation of work circumstances in the AHT group confirms the importance of intensive support and guidance of personnel during the implementation of AHT.
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Affiliation(s)
- Steve Lauriks
- Amsterdam Public Health Service (GGD Amsterdam), Department of Epidemiology, Health promotion and Care innovation, Amsterdam , The Netherlands
| | - Franka Meiland
- Amsterdam University Medical Centers, location VUmc, Department of Psychiatry, Amsterdam Public Health Research Institute , Amsterdam, The Netherlands
| | - Johan P Osté
- Amsterdam Public Health Service (GGD Amsterdam), Department of Epidemiology, Health promotion and Care innovation, Amsterdam , The Netherlands
| | - Cees Hertogh
- Amsterdam University Medical Centers, location VUmc, Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute , Amsterdam, The Netherlands
| | - Rose-Marie Dröes
- Amsterdam University Medical Centers, location VUmc, Department of Psychiatry, Amsterdam Public Health Research Institute , Amsterdam, The Netherlands
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12
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van Rijn A, Meiland F, Dröes RM. Linking two new E-health caregiver interventions to meeting centres for people with dementia and their carers; a process evaluation. Aging Ment Health 2020; 24:1316-1325. [PMID: 31119946 DOI: 10.1080/13607863.2019.1617243] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Research shows that carers of people with dementia experience worse physical and psychological functioning than non-caregivers or than caregivers of people with a different chronic illness. This study investigated the implementation of two new e-health interventions for carers of people with dementia, Dementelcoach (telephone coaching) and STAR e-learning (online platform to learn about dementia). The interventions were linked to existing Meeting Centres for people with dementia and their carers.Method: We conducted a qualitative multiple case study. Semi-structured interviews regarding experienced influencing factors were conducted with 15 key figures/stakeholders (14 interviews) in eight Meeting Centres during the preparation, starting and continuation phases of the implementation of Dementelcoach and STAR e-learning.Results: Several influencing factors were found on micro level (e.g. PR, training, qualified personnel), meso level (e.g. finances, division of tasks) and macro level (e.g. laws and regulations, national and regional policy) during the different phases of the implementation process. Factors mentioned by most stakeholders were human and financial resources. Another important factor found was the fit between the interventions and region.Conclusion: Insight into facilitators and barriers in the implementation of Dementelcoach and STAR e-learning provided by this study will inform and enable other Meeting Centres to adopt a fitting strategy to implement these interventions in their own centre. This is expected to help disseminate the intervention further, and will result in better-informed and supported carers. This will contribute to the prevention of overburdening in carers and will potentially enable carers to provide better care for their relatives with dementia.
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Affiliation(s)
- Annelies van Rijn
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Franka Meiland
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Gerion, Department of General Practice and Elderly Care Medicine, Amsterdam University Medical Centers, location VUmc, Amsterdam, The Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of Research and Innovation, Regional mental health organization GGZinGeest, Amsterdam, The Netherlands
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13
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Evans S, Evans S, Brooker D, Henderson C, Szcześniak D, Atkinson T, Bray J, Amritpal R, Saibene FL, d'Arma A, Scorolli C, Chattat R, Farina E, Urbańska K, Rymaszewska J, Meiland F, Dröes RM. The impact of the implementation of the Dutch combined Meeting Centres Support Programme for family caregivers of people with dementia in Italy, Poland and UK. Aging Ment Health 2020; 24:280-290. [PMID: 30520312 DOI: 10.1080/13607863.2018.1544207] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: The MEETINGDEM research project aimed to implement the combined Dutch Meeting Centre Support Programme (MCSP) for community-dwelling people with dementia and caregivers within Italy, Poland and UK and to assess whether comparable benefits were found in these countries as in the Netherlands.Method: Nine pilot Meeting Centres (MCs) participated (Italy-5, Poland-2, UK-2). Effectiveness of MCSP was compared to usual care (UC) on caregiver outcomes measuring competence (SSCQ), mental health (GHQ-12), emotional distress (NPI-Q) and loneliness (UCLA) analysed by ANCOVAs in a 6-month pre-test/post-test controlled trial. Interviews using standardised measures were completed with caregivers.Results: Pre/post data were collected for 93 caregivers receiving MCSP and 74 receiving UC. No statistically significant differences on the outcome measures were found overall. At a country level MC caregivers in Italy showed significant better general mental health (p = 0.04, d = 0.55) and less caregiver distress (p = 0.02, d = 0.62) at post-test than the UC group. Caregiver satisfaction was rated on a sample at 3 months (n = 81) and 6 months (n = 84). The majority of caregivers reported feeling less burdened and more supported by participating in MCSP.Conclusion: The moderate positive effect on sense of competence and the greater mental health benefit for lonely caregivers using the MCSP compared to UC as found in the original Dutch studies were not replicated. However, subject to study limitations, caregivers in Italy using MCSP benefitted more regarding their mental health and emotional distress than caregivers using UC. Further evaluation of the benefits of MCSP within these countries in larger study samples is recommended.
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Affiliation(s)
- Shirley Evans
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Simon Evans
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Dawn Brooker
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Cate Henderson
- London School of Economics, United Kingdom London School of Economics and Political Science, London, UK
| | - Dorota Szcześniak
- Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Teresa Atkinson
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Jennifer Bray
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Rehill Amritpal
- London School of Economics and Political Science, London, UK
| | | | | | | | - Rabih Chattat
- Department of Philosophy and Communication Studies, University of Bologna, Bologna, Italy
| | | | | | - Joanna Rymaszewska
- Department of Psychology, University of Bologna, Bologna, Italy.,Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Franka Meiland
- Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands
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14
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Dröes RM, van Rijn A, Rus E, Dacier S, Meiland F. Utilization, effect, and benefit of the individualized Meeting Centers Support Program for people with dementia and caregivers. Clin Interv Aging 2019; 14:1527-1553. [PMID: 31692559 PMCID: PMC6717152 DOI: 10.2147/cia.s212852] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 07/04/2019] [Indexed: 12/18/2022] Open
Abstract
PURPOSE There are few interventions on an individual basis to support community-dwelling people with dementia to continue to fulfill their potential in society and to support their informal caregivers via e-Health. This study explored the effectiveness of the individualized Meeting Centers Support Program (iMCSP) consisting of DemenTalent (people with dementia work as volunteers in a society based on their talents), Dementelcoach (telephone coaching), and STAR e-Learning for caregivers, compared to regular MCSP and No day care support. METHOD An explorative randomized controlled trial with pre/post measurements (M0-M6) and two groups (iMCSP and regular MCSP). In addition, a comparison was made between iMCSP and a reference No day care control group. Standardized questionnaires were administered on self-esteem, neuropsychiatric symptoms, experienced autonomy and quality of life of the person with dementia, and on caregiver's sense of competence, quality of life, and happiness. RESULTS The iMCSP interventions resulted in a broader group of participants utilizing the Meeting Centers. Compared to regular MCSP, DemenTalent had a moderate positive effect on neuropsychiatric symptoms, which also proved less severe. Positive affect of participants improved within the DemenTalent and regular MCSP group after six months. Caregivers of DemenTalent participants experienced less emotional impact of neuropsychiatric symptoms. No differences were found in experienced burden, sense of competence, or quality of life in caregivers using iMCSP or regular MCSP. Compared to those receiving No day care support, caregivers of DemenTalent participants and caregivers using Dementelcoach or STAR e-Learning proved happier. Post-hoc analyses, accounting for potential between-group differences in outcome measures at baseline, generally showed results in the same direction. People with dementia and caregivers highly appreciated iMCSP and regular MCSP. CONCLUSION iMCSP can be effectively applied as alternative or additional support via regular Meeting Centers for people with dementia and caregivers who prefer individualized activities/support. DemenTalent decreased the severity of neuropsychiatric symptoms of people with dementia and emotional burden of caregivers. All iMCSP interventions tended to result in caregivers being happier compared to those receiving no support. Larger-scale studies are needed to investigate the effect of iMCSP on other domains of quality of life of participants.
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Affiliation(s)
- Rose-Marie Dröes
- Department of Psychiatry, Amsterdam University Medical Centers, Location Vumc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Research and Innovation, Regional Mental Health Organization Ggzingeest, Amsterdam, The Netherlands
| | - Annelies van Rijn
- Department of Psychiatry, Amsterdam University Medical Centers, Location Vumc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Eline Rus
- Department of Clinical Pyschology, Faculty of Behavior and Movement Sciences, VU University, Amsterdam, The Netherlands
| | - Seghoslène Dacier
- Department of Neuropsychology, Faculty of Behavior and Movement Sciences, VU University, Amsterdam, The Netherlands
| | - Franka Meiland
- Department of Psychiatry, Amsterdam University Medical Centers, Location Vumc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Neuropsychology, Faculty of Behavior and Movement Sciences, VU University, Amsterdam, The Netherlands
- Gerion, Department of General Practice and Elderly Care Medicine, Amsterdam University Medical Centers, Location Vumc, Amsterdam, The Netherlands
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15
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van Santen J, Dröes RM, Holstege M, Henkemans OB, van Rijn A, de Vries R, van Straten A, Meiland F. Effects of Exergaming in People with Dementia: Results of a Systematic Literature Review. J Alzheimers Dis 2019; 63:741-760. [PMID: 29689716 PMCID: PMC5929299 DOI: 10.3233/jad-170667] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Physical exercise benefits functioning, health, and well-being. However, people living with dementia in particular hardly engage in exercise. Exergaming (exercise and gaming) is an innovative, fun, and relatively safe way of exercising in a virtual reality or gaming environment. It may help people living with dementia overcome barriers they can experience regarding regular exercise activities. Objective: This systematic literature review aims to provide an overview of the cost-effectiveness of exergaming and its effects on physical, cognitive, emotional, and social functioning, as well as the quality of life in people living with dementia. Methods: PubMed, Embase, Cinahl, PsycINFO, the Cochrane Library, and the Web of Science Core Collection were searched. Selection of studies was carried out by at least two independent researchers. Results: Three studies were found to be eligible and were included in this review. Two of these showed some statistically significant effects of exergaming on physical, cognitive, and emotional functioning in people living with dementia, although based on a very small sample. No articles were found about the cost-effectiveness of exergaming. Conclusions: Only a few controlled studies have been conducted into the effectiveness of exergaming, and these show very little significant benefits. More well-designed studies are necessary to examine the effects of exergaming.
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Affiliation(s)
- Joeke van Santen
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Marije Holstege
- Department of Research and Development Evean, Espria, Purmerend, The Netherlands
| | | | - Annelies van Rijn
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Ralph de Vries
- Medical Library, VU University Amsterdam, Amsterdam, The Netherlands
| | - Annemieke van Straten
- Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Franka Meiland
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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16
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Brooker D, Dröes R, Chattat R, Farina E, Rymaszewska J, Meiland F, Evans S, Henderson C. ENABLING PARTICIPATION IN SOCIAL ACTIVITY: THE MEETING CENTRES SUPPORT PROGRAMME. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Brooker
- University of Worcester, UK, Worcester, England, United Kingdom
| | - R Dröes
- VU University Medical Center, Amsterdam, Netherlands
| | - R Chattat
- University of Bologna, Bologna, Italy
| | - E Farina
- Fondazione Don Gnocchi, Milan, Italy
| | | | - F Meiland
- VU University Medical Center, Amsterdam 1070 BB, Netherlands
| | | | - C Henderson
- London School of Economics, London, United Kingdom
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17
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Brooker D, Evans S, Evans S, Bray J, Saibene FL, Scorolli C, Szcześniak D, d'Arma A, Urbańska KM, Atkinson T, Farina E, Rymaszewska J, Chattat R, Henderson C, Rehill A, Hendriks I, Meiland F, Dröes RM. Evaluation of the implementation of the Meeting Centres Support Program in Italy, Poland, and the UK; exploration of the effects on people with dementia. Int J Geriatr Psychiatry 2018. [PMID: 29513909 DOI: 10.1002/gps.4865] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES MEETINGDEM investigated whether the Dutch Meeting Centres Support Programme (MCSP) could be implemented in Italy, Poland, and the UK with comparable benefits. This paper reports on the impact on people living with dementia attending pilot Meeting Centres in the 3 countries. METHODS Nine pilot Meeting Centres (MCs) participated (Italy-5, Poland-2, UK-2). Effectiveness of MCSP was compared with Usual Care (UC) on outcomes measuring behavioural and psychological symptoms (NPI), depression (CSDD), and quality of life (DQoL, QOL-AD), analysed by ANCOVAs in a 6-month pre-test/post-test controlled trial. RESULTS Pre/post data were collected for 85 people with dementia and 93 carers (MCSP) and 74 people with dementia /carer dyads' receiving UC. MCSP showed significant positive effects for DQoL [Self-esteem (F = 4.8, P = 0.03); Positive Affect (F = 14.93, P < 0.00); Feelings of Belonging (F = 7.77, P = 0.01)] with medium and large effect sizes. Higher attendance levels correlated with greater neuropsychiatric symptom reduction (rho = 0.24, P = 0.03) and a greater increase in feelings of support (rho = 0.36, P = 0.001). CONCLUSIONS MCSPs showed significant wellbeing and health benefits compared with UC, building on the evidence of effectiveness from the Netherlands. In addition to the previously reported successful implementation of MCSP in Italy, Poland, and the UK, these findings suggest that further international dissemination of MCSP is recommended.
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Affiliation(s)
- Dawn Brooker
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Simon Evans
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Shirley Evans
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Jennifer Bray
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | | | - Claudia Scorolli
- Department of Psychology, University of Bologna (UNIBO), Bologna, Italy
| | - Dorota Szcześniak
- Uniwersytet Medyczny im Piastow Slaskich we Wroclawiu, Wroclaw, Dolnoslaskie, Poland
| | | | - Katarzyna M Urbańska
- Uniwersytet Medyczny im Piastow Slaskich we Wroclawiu, Wroclaw, Dolnoslaskie, Poland
| | - Teresa Atkinson
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | | | - Joanna Rymaszewska
- Uniwersytet Medyczny im Piastow Slaskich we Wroclawiu, Wroclaw, Dolnoslaskie, Poland
| | - Rabih Chattat
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Catherine Henderson
- PSSRU, Health Policy, London School of Economics and Political Science, London, UK
| | - Amritpal Rehill
- PSSRU, Health Policy, London School of Economics and Political Science, London, UK
| | - Iris Hendriks
- Department of Psychiatry, VU University Medical center/Amsterdam Public Health Research Institute, Netherlands
| | - Franka Meiland
- Department of Psychiatry and Department of General Practice and Elderly Care Medicine VU University Medical center/ Amsterdam Public Health Research Institute, Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, VU University Medical center/Amsterdam Public Health Research Institute, Netherlands
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18
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Joling KJ, Windle G, Dröes RM, Meiland F, van Hout HPJ, MacNeil Vroomen J, van de Ven PM, Moniz-Cook E, Woods B. Factors of Resilience in Informal Caregivers of People with Dementia from Integrative International Data Analysis. Dement Geriatr Cogn Disord 2018; 42:198-214. [PMID: 27669054 DOI: 10.1159/000449131] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 08/10/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Although caring for a person with dementia can be stressful, some caregivers appear to experience few negative consequences to their well-being. This study aimed to examine what proportion of caregivers demonstrates resilience under different challenging circumstances and to identify factors related to their resilience. METHODS Baseline data from 4 studies from the Netherlands and UK among informal caregivers of people with dementia were harmonized and integrated. Caregiver resilience was defined as high levels of psychological well-being despite different types of high caregiving demands. Multivariate regression analyses identified factors significantly related to caregiver resilience. RESULTS The integrated data set included 15 harmonized variables with data from 1,048 caregivers facing a high care demand. The prevalence of resilience varied between 35 and 43%, depending on the demand for high care. Being a male caregiver, caring for a female, living apart from your relative, and low caregiver burden were positively related to caregiver resilience. CONCLUSION Caregivers have the capacity to demonstrate resilience despite significant challenges. This study demonstrates how harmonization of data from multiple existing studies can be used to increase power and explore the consistency of findings. This contributes to a better understanding of which factors are likely to facilitate caregiver resilience and offers insights for developing services.
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Affiliation(s)
- Karlijn J Joling
- Bangor University, Bangor, UK; VU University Medical Centre, Amsterdam, The Netherlands
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19
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Rymaszewska J, Dorota S, Urbańska K, Meiland F, Evans SB, Lea Saibene F, d'Arma A, Scorolli C, Hendriks I, Chattat R, Farina E, Brooker D, Dröes R. [P3–515]: USERS’ SATISFACTION OF THE MEETING CENTRE SUPPORT PROGRAMME IN ITALY, POLAND AND THE U.K. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Brooker D, Chattat R, Evans S, Evans SC, Farina E, Henderson C, Meiland F, Rymaszewska J, Dorota S, Urbańska K, Atkinson T, Bray J, d'Arma A, Gamberini G, Hendriks I, Rehill A, Lea Saibene F, Scorolli C, Orrell M, John Knapp MR, Dröes R. [P4–544]: MEETINGDEM REPORTING ON THE IMPLEMENTATION, EFFECTIVENESS AND COST‐EFFECTIVENESS OF THE DUTCH MEETING CENTRES SUPPORTS PROGRAMME FOR PEOPLE LIVING WITH DEMENTIA AND FAMILY CARERS IN THREE EUROPEAN COUNTRIES. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.07.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Joanna Rymaszewska
- Institute of Mental Health, Faculty of Medicine & Health Sciences, University of NottinghamNottinghamUnited Kingdom
| | | | | | | | | | | | | | - Iris Hendriks
- London School of Economics and Political ScienceLondonUnited Kingdom
| | - Amritpal Rehill
- London School of Economics and Political ScienceLondonUnited Kingdom
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21
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Evans S, Brooker D, Droes R, Meiland F, Rymaszewska J, Szczesniak D, Chattat R, Farina E. EVALUATION OF THE MEETING CENTER SUPPORT PROGRAMME FOR PEOPLE WITH DEMENTIA AND THEIR FAMILY CARERS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S. Evans
- University of Worcester, Worcester, United Kingdom
| | - D. Brooker
- University of Worcester, Worcester, United Kingdom
| | - R. Droes
- VU University Medical Center, Amsterdam, Netherlands,
| | - F. Meiland
- VU University Medical Center, Amsterdam, Netherlands,
| | | | | | | | - E. Farina
- Fondazione Don Carlo Gnocchi, Milan, Italy,
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22
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Meiland F, Innes A, Mountain G, Robinson L, van der Roest H, García-Casal JA, Gove D, Thyrian JR, Evans S, Dröes RM, Kelly F, Kurz A, Casey D, Szcześniak D, Dening T, Craven MP, Span M, Felzmann H, Tsolaki M, Franco-Martin M. Technologies to Support Community-Dwelling Persons With Dementia: A Position Paper on Issues Regarding Development, Usability, Effectiveness and Cost-Effectiveness, Deployment, and Ethics. JMIR Rehabil Assist Technol 2017; 4:e1. [PMID: 28582262 PMCID: PMC5454557 DOI: 10.2196/rehab.6376] [Citation(s) in RCA: 147] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/16/2016] [Accepted: 10/24/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND With the expected increase in the numbers of persons with dementia, providing timely, adequate, and affordable care and support is challenging. Assistive and health technologies may be a valuable contribution in dementia care, but new challenges may emerge. OBJECTIVE The aim of our study was to review the state of the art of technologies for persons with dementia regarding issues on development, usability, effectiveness and cost-effectiveness, deployment, and ethics in 3 fields of application of technologies: (1) support with managing everyday life, (2) support with participating in pleasurable and meaningful activities, and (3) support with dementia health and social care provision. The study also aimed to identify gaps in the evidence and challenges for future research. METHODS Reviews of literature and expert opinions were used in our study. Literature searches were conducted on usability, effectiveness and cost-effectiveness, and ethics using PubMed, Embase, CINAHL, and PsycINFO databases with no time limit. Selection criteria in our selected technology fields were reviews in English for community-dwelling persons with dementia. Regarding deployment issues, searches were done in Health Technology Assessment databases. RESULTS According to our results, persons with dementia want to be included in the development of technologies; there is little research on the usability of assistive technologies; various benefits are reported but are mainly based on low-quality studies; barriers to deployment of technologies in dementia care were identified, and ethical issues were raised by researchers but often not studied. Many challenges remain such as including the target group more often in development, performing more high-quality studies on usability and effectiveness and cost-effectiveness, creating and having access to high-quality datasets on existing technologies to enable adequate deployment of technologies in dementia care, and ensuring that ethical issues are considered an important topic for researchers to include in their evaluation of assistive technologies. CONCLUSIONS Based on these findings, various actions are recommended for development, usability, effectiveness and cost-effectiveness, deployment, and ethics of assistive and health technologies across Europe. These include avoiding replication of technology development that is unhelpful or ineffective and focusing on how technologies succeed in addressing individual needs of persons with dementia. Furthermore, it is suggested to include these recommendations in national and international calls for funding and assistive technology research programs. Finally, practitioners, policy makers, care insurers, and care providers should work together with technology enterprises and researchers to prepare strategies for the implementation of assistive technologies in different care settings. This may help future generations of persons with dementia to utilize available and affordable technologies and, ultimately, to benefit from them.
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Affiliation(s)
- Franka Meiland
- Department of Psychiatry, VU University medical centre, Amsterdam, Netherlands
| | - Anthea Innes
- Universities of Salford and Stirling UK, Manchester, Stirling, United Kingdom
| | - Gail Mountain
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom
| | - Louise Robinson
- Institute for Ageing, Newcastle University, Newcastle, United Kingdom
| | - Henriëtte van der Roest
- Department of General Practice and Elderly Care Medicine, VU university medical centre, Amsterdam, Netherlands
| | - J Antonio García-Casal
- Iberian Research Psychosciences Institute, Psychosocial Rehabilitation Centre, Intras Foundation, Zamora, Spain
| | | | - Jochen René Thyrian
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock, Greifswald, Germany
| | - Shirley Evans
- Association for Dementia Studies, University of Worcester, Worcester, United Kingdom
| | - Rose-Marie Dröes
- Department of Psychiatry, VU University medical centre, Amsterdam, Netherlands
| | - Fiona Kelly
- Centre for Person-centred Practice Research, Queen Margaret University, Edinburgh, United Kingdom
| | | | - Dympna Casey
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Tom Dening
- Division of Psychiatry & Applied Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Michael P Craven
- NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health, University of Nottingham Innovation Park, Nottingham, United Kingdom
- Bioengineering Research Group, Faculty of Engineering, University of Nottingham, Nottingham, United Kingdom
| | - Marijke Span
- Windesheim University of Applied Sciences, Zwolle, Netherlands
| | | | - Magda Tsolaki
- Memory and dementia outpatient clinic, 3rd Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Manuel Franco-Martin
- Iberian Research Psychosciences Institute, Psychiatric Department in Zamora Hospital, Salamanca University, Zamora, Spain
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Hattink B, Meiland F, van der Roest H, Kevern P, Abiuso F, Bengtsson J, Giuliano A, Duca A, Sanders J, Basnett F, Nugent C, Kingston P, Dröes RM. Web-Based STAR E-Learning Course Increases Empathy and Understanding in Dementia Caregivers: Results from a Randomized Controlled Trial in the Netherlands and the United Kingdom. J Med Internet Res 2015; 17:e241. [PMID: 26519106 PMCID: PMC4642792 DOI: 10.2196/jmir.4025] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 04/07/2015] [Accepted: 06/21/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The doubling of the number of people with dementia in the coming decades coupled with the rapid decline in the working population in our graying society is expected to result in a large decrease in the number of professionals available to provide care to people with dementia. As a result, care will be supplied increasingly by untrained informal caregivers and volunteers. To promote effective care and avoid overburdening of untrained and trained caregivers, they must become properly skilled. To this end, the European Skills Training and Reskilling (STAR) project, which comprised experts from the domains of education, technology, and dementia care from 6 countries (the Netherlands, Sweden, Italy, Malta, Romania, and the United Kingdom), worked together to create and evaluate a multilingual e-learning tool. The STAR training portal provides dementia care training both for informal and formal caregivers. OBJECTIVE The objective of the current study was to evaluate the user friendliness, usefulness, and impact of STAR with informal caregivers, volunteers, and professional caregivers. METHODS For 2 to 4 months, the experimental group had access to the STAR training portal, a Web-based portal consisting of 8 modules, 2 of which had a basic level and 6 additional modules at intermediate and advanced levels. The experimental group also had access to online peer and expert communities for support and information exchange. The control group received free access to STAR after the research had ended. The STAR training portal was evaluated in a randomized controlled trial among informal caregivers and volunteers in addition to professional caregivers (N=142) in the Netherlands and the United Kingdom. Assessments were performed with self-assessed, online, standardized questionnaires at baseline and after 2 to 4 months. Primary outcome measures were user friendliness, usefulness, and impact of STAR on knowledge, attitudes, and approaches of caregivers regarding dementia. Secondary outcome measures were empathy, quality of life, burden, and caregivers' sense of competence. RESULTS STAR was rated positively by all user groups on both usefulness and user friendliness. Significant effects were found on a person-centered care approach and on the total score on positive attitudes to dementia; both the experimental and the control group increased in score. Regarding empathy, significant improvements were found in the STAR training group on distress, empathic concern, and taking the perspective of the person with dementia. In the experimental group, however, there was a significant reduction in self-reported sense of competence. CONCLUSIONS The STAR training portal is a useful and user-friendly e-learning method, which has demonstrated its ability to provide significant positive effects on caregiver attitudes and empathy.
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Affiliation(s)
- Bart Hattink
- VU University medical center Amsterdam, Department of Psychiatry, Amsterdam, Netherlands.
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Joling K, Windle G, Dröes RM, Meiland F, Van Hout H, MacNeil Vroomen J, van de Ven P, Moniz-Cook E, Woods B. P-073: The prevalence, determinants and long term effects of resilience in family caregivers of persons with dementia. A longitudinal analysis of multiple studies. Eur Geriatr Med 2015. [DOI: 10.1016/s1878-7649(15)30176-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Nugent CD, Davies RJ, Donnelly MP, Hallberg J, Hariz M, Craig D, Meiland F, Moelaert F, Bengtsson JE, Savenstedt S, Mulvenna M, Dröes RM. The development of personalised cognitive prosthetics. Annu Int Conf IEEE Eng Med Biol Soc 2009; 2008:787-90. [PMID: 19162773 DOI: 10.1109/iembs.2008.4649270] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Persons suffering from mild dementia can benefit from a form of cognitive prosthetic which can be used to assist them with their day to day activities. Within our current work we are aiming to develop a successful user-validated cognitive prosthetic for persons with mild dementia. We have devised a three phased waterfall methodology to support our developments. Based on the evaluation of the first of these phases which involved the processes of user requirements gathering, prototype development and evaluation of in situ deployment of the technology we have been able to guide the technical development within the second phase of our work. Within this paper we provide an overview of the first phase of our methodology and demonstrate how we have used the results from this to guide the second phase of our work, especially with regards to the notion of personalisation.
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Affiliation(s)
- Chris D Nugent
- School of Computing and Mathematics and Computer Science Research Institute, University of Ulster, Belfast, Northern Ireland.
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Smits CHM, de Lange J, Dröes RM, Meiland F, Vernooij-Dassen M, Pot AM. Effects of combined intervention programmes for people with dementia living at home and their caregivers: a systematic review. Int J Geriatr Psychiatry 2007; 22:1181-93. [PMID: 17457793 DOI: 10.1002/gps.1805] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This study reviews the evidence for effects of combined intervention programmes for both the informal caregiver and the person with dementia. METHOD Systematic review. Electronic databases and key articles were searched for effect studies of combined programmes, published between January 1992 and February 2005. The resulting 52 reports were scored according to set inclusion criteria. RESULTS Twenty five reports relating to 22 programmes met the inclusion criteria. Various aspects of caregivers' mental health and burden were studied. Best results were obtained regarding general mental health. Other aspects often showed modest and varying results. Caregivers' competence was less often addressed. The effects on the cognitive and physical functioning, behavioural problems and survival of the persons with dementia were modest and inconsistent, whereas their mental health is positively affected and admittance to long stay care is often delayed. CONCLUSION Combined programmes may improve some, not all, aspects of functioning for caregiver and person with dementia. Care professionals must define their programme goals and target groups before advising their clients on a combined programme. Research may focus on the effects of programmes that were introduced fairly recently and on subgroups of caregivers (female caregivers, depressed caregivers and people with dementia, and minorities).
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Affiliation(s)
- Carolien H M Smits
- Trimbos-institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
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27
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Dröes RM, Meiland F, Schmitz M, van Tilburg W. Effect of combined support for people with dementia and carers versus regular day care on behaviour and mood of persons with dementia: results from a multi-centre implementation study. Int J Geriatr Psychiatry 2004; 19:673-84. [PMID: 15254924 DOI: 10.1002/gps.1142] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND A previous study in Amsterdam showed that combined family support in the Meeting Centres Support Programme, in which dementia patients and their carers are both supported by one professional staff member, is more effective in influencing behaviour problems and mood of dementia patients living in the community than non-integrated support, such as day care only. OBJECTIVE A multi-centre implementation study tests if similar effects are achieved in other regions of The Netherlands. METHODS A pretest-posttest control group design was applied. 112 dementia patients who visited psychogeriatric day care in eight community centres across the country and in three nursing homes, and their carers participated in the study. The patients in the experimental group (n = 89) received support from the Meeting Centres Support Programme together with their carers, while the control group (n = 23) received day care only. Behaviour problems (agressive behaviour, inactivity, non-social behaviour) and mood (dissatisfaction, depressive behaviour) were assessed using standardized observation scales. Quality of life was assessed by interviewing the patients. RESULTS After 7 months the Meeting Centres Support Programme, compared to regular day care, showed a moderately positive effect on the degree of total behaviour problems (effect size = 0.52), especially on inactivity (effect size = 0.37) and non-social behaviour (effect size = 0.60), a large effect on depressive behaviour (effect size = 0.92) and a moderate effect on self-esteem (effect size = 0.43). CONCLUSIONS The Meeting Centres Support Programme proves to be more effective than regular day care in influencing behaviour problems, especially inactivity and non-social behaviour, and depressed mood. Participation in the programme also seems to have a positive effect on self-esteem, an important aspect of quality of life. These findings surpass the results of the Amsterdam study and confirm the surplus value of the combined family support in the Meeting Centres Support Programme as compared to regular day care for people with mild to severe dementia.
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Affiliation(s)
- Rose-Marie Dröes
- Department of Psychiatry, Alzheimer Centre, Vrije Universiteit medical centre and Regional Mental Health Care Organisation 'GGZ Buitenamstel', Amsterdam, The Netherlands.
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Meiland F. [Waiting list for nursing home admission gives limited insight of the problems. Study in handling of the waiting list and the consequences for the patients]. Tijdschr Gerontol Geriatr 2002; 33:53-5. [PMID: 12012942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
The waiting list for nursing home admission is expected to remain unacceptably long. A study of the use and of possibly problematic consequences of the waiting list was described in a thesis. Despite long mean waiting periods and many problems (depressive symptoms, experiences of burden) already at the start of the waiting period, the majority of the informal caregivers were satisfied with the waiting times. This may be explained by a reticence to nursing home admission and by enlistment to the waiting list "out of precaution". Both a long and a short waiting period could be experienced as too long. Waiting list figures give insufficient insight in the "real" demand for nursing home care and in problematic waiting periods.
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Affiliation(s)
- Franka Meiland
- VU medisch centrum, afdeling psychiatrie/EMGO, Valeriuskliniek, Valeriusplein 9, 1075 BG Amsterdam.
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