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Sultana M, Campbell K, Jennings M, Montero-Odasso M, Orange JB, Knowlton J, St George A, Bryant D. Virtual Reality Experience Intervention May Reduce Responsive Behaviors in Nursing Home Residents with Dementia: A Case Series. J Alzheimers Dis 2021; 84:883-893. [PMID: 34602467 DOI: 10.3233/jad-210010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND People with advanced dementia often exhibit responsive behaviors such as apathy, depression, agitation, aggression, and psychosis. Non-pharmacological approaches (e.g., listening to music, watching television, doing arts and crafts) are now considered as a first-line strategy to manage responsive behaviors in clinical practice due to the potential risks associated with the antipsychotic medications. To date, no evaluations of immersive non-head mounted virtual reality (VR) experience as a non-pharmacologic approach for people with advanced dementia living in nursing homes have been reported. OBJECTIVE To evaluate the feasibility (acceptance and safety) of VR experience. METHODS A single site case series (nonrandomized and unblinded) with a convenience sample (N = 24; age = 85.8±8.6 years; Cognitive Performance Scale score = 3.4±0.6) measuring depression and agitation before and after the intervention. The intervention was a 30-min long research coordinator- facilitated VR experience for two weeks (10 sessions). RESULTS The intervention was feasible (attrition rate = 0% ; adverse events = 0). A reduction in depression and in agitation was observed after the intervention. However, we suggest extreme caution in interpreting this result considering the study design and small sample size. CONCLUSION This study provides the basis for conducting a randomized controlled trial to evaluate the effect of VR experience on responsive behaviors in nursing homes. Since our intervention uses a smart remote-controlled projector without a headset, infectious exposure can be avoided following the COVID-19 pandemic-induced physical distancing policy in care homes.
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Affiliation(s)
- Munira Sultana
- Health and Rehabilitation Sciences, Western University, London, ON, Canada.,Gait & Brain Lab, Parkwood Institute, London, ON, Canada
| | - Karen Campbell
- International Skin Tear Advisory Panel, Ottawa, ON, Canada.,Primacare Living Solutions Inc.TM, Toronto, ON, Canada.,Master of Clinical Science - Advanced Health Care Practice, Western University, London, ON, Canada
| | - Morgan Jennings
- Health and Rehabilitation Sciences, Western University, London, ON, Canada
| | - Manuel Montero-Odasso
- Gait & Brain Lab, Parkwood Institute, London, ON, Canada.,Department of Medicine and Department of Epidemiology & Biostatistics, Western University, London, ON, Canada.,Geriatric Medicine, St. Joseph's Health Care, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - J B Orange
- Lawson Health Research Institute, London, ON, Canada
| | - Jill Knowlton
- Primacare Living Solutions Inc.TM, Toronto, ON, Canada
| | | | - Dianne Bryant
- Lawson Health Research Institute, London, ON, Canada.,School of Physical Therapy and Schulich School of Medicine & Dentistry (Orthopaedic Surgery), Western University, London, ON, Canada.,Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
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Knowlton J, Clauser S, Fatula J. Nursing home pre- admission screening: a review of state programs. Health Care Financ Rev 1982; 3:75-87. [PMID: 10309603 PMCID: PMC4191261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
From January through March of 1981, the Health Care Financing Administration (HCFA) surveyed the agencies of 49 States and the District of Columbia responsible for the administration of the Medicaid program. The purpose of the survey was to determine if the agencies had a nursing home pre-admission screening program for Medicaid patients. Twenty-eight States and the District of Columbia responded that there was a state-wide, pre-admission screening program for Medicaid patients prior to their entry into a nursing home, or that there was a program operating in a portion of the State. HCFA collected information on the scope of the programs, the agencies responsible for conducting pre-admission screening, the composition of the screening teams, and the characteristics of the client assessment instruments. Two States, Virginia and Massachusetts, provided information on program impact. This article presents the findings of the survey and explores several aspects of the Medicaid program influencing the effectiveness of pre-admission screening. It begins with an overview of the policy issues which have influenced the development of pre-admission screening and defines the core components of these programs.
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