The development of a multi‐sensory intervention for people with dementia living in care homes

Objectives. People with dementia are susceptible to adverse effects of medicines. However, they are not always closely monitored. We explored (1) feasibility and (2) clinical impact of nurse-led medication monitoring.Design. Feasibility “before-and-after” intervention study.Setting. Three care homes in Wales.Participants. Eleven service users diagnosed with dementia, taking at least one antipsychotic, antidepressant, or antiepileptic medicine.Intervention. West Wales Adverse Drug Reaction (ADR) Profile for Mental Health Medicines.Outcome Measures. (1) Feasibility: recruitment, retention, and implementation. (2) Clinical impact: previously undocumented problems identified and ameliorated, as recorded in participants’ records before and after introduction of the profile, and one month later.Results. Nurses recruited and retained 11 of 29 eligible service users. The profile took 20–25 minutes to implement, caused no harm, and supplemented usual care. Initially, the profile identified previously undocumented problems for all participants (mean 12.7 (SD 4.7)). One month later, some problems had been ameliorated (mean 4.9 (3.6)). Clinical gains included new prescriptions to manage pain (2 participants), psoriasis (1), Parkinsonian symptoms (1), rash (1), dose reduction of benzodiazepines (1), new care plans for oral hygiene, skin problems, and constipation.Conclusions. Participants benefited from structured nurse-led medication monitoring. Clinical trials of our ADR Profile are feasible and necessary.

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409 - Trends in Involvement, Perceived Role, Role Overload and Self-efficacy of Family Carers of People with Dementia in Care Homes

International Psychogeriatrics ◽

10.1017/s1041610220002628 ◽

2020 ◽

Vol 32 (S1) ◽

pp. 125-125

Author(s):

Marleen Prins ◽

Bernadette Willemse ◽

Marlous Tuithof ◽

Henriëtte van der Roest ◽

Anne Margriet Pot

Keyword(s):

Self Efficacy ◽

Care Home ◽

Care Homes ◽

Role Overload ◽

Family Carers ◽

Change Over Time ◽

Person Centered Care ◽

People With Dementia ◽

Centered Care ◽

Over Time

IntroductionThe quality of long-term care provided to people with dementia (PwD) in care homes can be improved by implementing person-centered care. Family carers of PwD living in care homes are an important part of person-centered care. However, they often experience high levels of burden, even when a family member with dementia lives in a care home. This study examines trends in the involvement of family carers and their perceived role, role overload and self-efficacy.MethodsData from the Living Arrangements for People with Dementia study, a cross-sectional monitoring study that evaluates developments in care for PwD in care homes in the Netherlands, with four measurement cycles between 2008-2017 was used. Data from the three most current measurement cycles were used, with respectively 144, 47 and 49 participating care homes and 888, 392 and 401 participating family carers. Family involvement was measured by the number of hours per week that family carers visited the PwD and the type of activities they undertook. Perceived caregiving role was measured with the Family Perceptions of Caregiving Role instrument. We used the Self-Perceived Pressure by Informal Care to measure role overload and a 37-item questionnaire was used to measure self-efficacy. We investigated the changes over time (e.g., measurement cycles) of these measures.ResultsThe number of hours that family carers visited the PwD did not change over time. However, there was a trend towards an increase in the variety of activities they undertook. Their perceived caregiving role did not change over time. Self-efficacy of family carers increased over time and they reported more feelings of role overload.ConclusionsDuring the past decade, there has been an increasing trend towards family carers doing more diverse activities with PwD in carer homes. Family carers did feel more competent in their caring role, although their feelings of role overload also increased. Continuing attention is therefore needed for the psychological well-being of family carers after a person with dementia moves to a care home.

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Communication And Respect for people with Dementia: Student learning – A novel practical experience of undergraduate students interacting with people with dementia in care homes (innovative practice)

Dementia ◽

10.1177/1471301216634531 ◽

2016 ◽

Vol 16 (2) ◽

pp. 243-248 ◽

Cited By ~ 2

Author(s):

Julia Helen Wood ◽

Ledia Alushi ◽

John A Hammond

Keyword(s):

Student Learning ◽

Undergraduate Students ◽

Practical Experience ◽

Educational Programme ◽

Care Homes ◽

Healthcare Students ◽

Innovative Practice ◽

People With Dementia

We designed an educational programme for multiple disciplines to improve healthcare students’ preparedness to work with people with dementia. It consisted of class-based sessions followed by a volunteer experience interacting with persons with dementia in care homes. This paper discusses the value and impact of this innovative experience.

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Systematic review of the effectiveness of non-pharmacological interventions to improve quality of life of people with dementia

International Psychogeriatrics ◽

10.1017/s1041610211002614 ◽

2012 ◽

Vol 24 (6) ◽

pp. 856-870 ◽

Cited By ~ 116

Author(s):

Claudia Cooper ◽

Naaheed Mukadam ◽

Cornelius Katona ◽

Constantine G. Lyketsos ◽

David Ames ◽

...

Keyword(s):

Quality Of Life ◽

Coping Strategy ◽

Cognitive Stimulation ◽

Care Homes ◽

Improve Quality ◽

Family Carer ◽

Pharmacological Interventions ◽

People With Dementia ◽

At Home

ABSTRACTBackground: People with dementia report lower quality of life, but we know little about what interventions might improve it.Methods: We systematically reviewed 20 randomized controlled trials reporting the effectiveness of non-pharmacological interventions in improving quality of life or well-being of people with dementia meeting predetermined criteria. We rated study validity with a checklist. We contacted authors for additional data. We calculated standardized mean differences (SMD) and, for studies reporting similar interventions, pooled standardized effect sizes (SES).Results: Pooled analyses found that family carer coping strategy-based interventions (four studies, which did not individually achieve significance; n = 420; SES 0.24 (range 0.03–0.45)) and combined patient activity and family carer coping interventions (two studies, not individually significant; n = 191; SES 0.84 (range 0.54–1.14)) might improve quality of life. In one high-quality study, a care management system improved quality of life of people with dementia living at home. Group Cognitive Stimulation Therapy (GCST) improved quality of life of people with dementia in care homes.Conclusion: Preliminary evidence indicated that coping strategy-based family carer therapy with or without a patient activity intervention improved quality of life of people with dementia living at home. GCST was the only effective intervention in a higher quality trial for those in care homes, but we did not find such evidence in the community. Few studies explored whether effects continued after the intervention stopped. Future research should explore the longer-term impact of interventions on, and devise strategies to increase, life quality of people with dementia living in care homes or at home without a family carer.

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The needs of people with dementia in care homes: the perspectives of users, staff and family caregivers

International Psychogeriatrics ◽

10.1017/s1041610208007266 ◽

2008 ◽

Vol 20 (05) ◽

Cited By ~ 57

Author(s):

Martin Orrell ◽

Geraldine A. Hancock ◽

Kumari C. Galboda Liyanage ◽

Bob Woods ◽

David Challis ◽

...

Keyword(s):

Family Caregivers ◽

Care Homes ◽

People With Dementia

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The assessment and management of pain in people with dementia in care homes

Nursing Older People ◽

10.7748/nop2010.09.22.7.29.c7947 ◽

2010 ◽

Vol 22 (7) ◽

pp. 29-35 ◽

Cited By ~ 6

Author(s):

Colm Cunningham ◽

William McClean ◽

Fiona Kelly

Keyword(s):

Care Homes ◽

People With Dementia

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P4-243: A Systematic Review and Meta-Analysis Comparing Quality-Of-Life Ratings from Family and Paid Caregivers of People With Dementia Residing in Care Homes

Alzheimer s & Dementia ◽

10.1016/j.jalz.2016.06.2335 ◽

2016 ◽

Vol 12 ◽

pp. P1123-P1124

Author(s):

Sarah Robertson ◽

Claudia Cooper ◽

Juanita Hoe ◽

Gill Livingston

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Meta Analysis ◽

Care Homes ◽

People With Dementia ◽

Paid Caregivers

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Non-pharmacological interventions in care homes, with particular emphasis on the treatment of people with dementia

Oxford Textbook of Old Age Psychiatry ◽

10.1093/med/9780198807292.003.0019 ◽

2020 ◽

pp. 265-280

Author(s):

Ian A. James ◽

Alan Howarth

Keyword(s):

Psychosocial Interventions ◽

Care Homes ◽

Future Research ◽

Pharmacological Interventions ◽

Cognitive Health ◽

Care Plans ◽

People With Dementia ◽

The Individual ◽

The Uk ◽

Preventative Interventions

In the UK there are over 22,000 care homes, largely run by the private and charitable sectors, caring for 416,000 people. The residents in care homes present with a range of needs linked to physical health, cognitive health, and mental health. A large proportion of residents in care homes have dementia and many of them exhibit Behaviours that Challenge (BtC). This chapter focuses on the non-pharmacological interventions available in care homes to help treat BtC that occur in the context of dementia. It discusses preventative interventions designed to promote the wellbeing of people with dementia, and reviews the evidence. Formulation-led interventions identify the needs of the individual and lead to the development of person-centred care plans and the evidence strongly supports that these are needed to deliver effective psychosocial interventions in care homes. Finally, the chapter discusses the implications for future research.

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