A pragmatic trial testing a tailored non pharmacologic therapies on nocturnal behavioral and psychological symptoms associated with dementia

2022 ◽  
Vol 43 ◽  
pp. 85-90
Author(s):  
Thierry Bautrant ◽  
Caroline Franqui ◽  
Hossein Clément ◽  
Maurice Rabault ◽  
Faima Masseboeuf ◽  
...  
Keyword(s):  
Psychological Symptoms ◽  
Pragmatic Trial ◽  
Trial Testing ◽  
Behavioral And Psychological Symptoms ◽  
Pharmacologic Therapies

scholarly journals Effectiveness of the Care of Persons With Dementia in Their Environments Intervention When Embedded in a Publicly Funded Home- and Community-Based Service Program

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Richard H Fortinsky ◽  
Laura N Gitlin ◽  
Laura T Pizzi ◽  
Catherine Verrier Piersol ◽  
James Grady ◽  
...  
Keyword(s):  
Psychological Symptoms ◽  
Pragmatic Trial ◽  
Well Being ◽  
Functional Independence ◽  
Evidence Based ◽  
Publicly Funded ◽  
Long Term Effects ◽  
Community Based ◽  
Activity Engagement ◽  
Behavioral And Psychological Symptoms

Abstract Background and Objectives In the absence of effective pharmacotherapy, there is an urgent need to test evidence-based dementia care interventions using pragmatic trial approaches. We present results from a study in which an evidence-based, nonpharmacologic intervention for persons living with Alzheimer’s disease and related dementia (ADRD) and their informal caregivers, Care of Persons with Dementia in their Environments (COPE), was tested in a Medicaid and state revenue-funded home and community-based service (HCBS) program. Research Design and Methods Using pragmatic trial design strategies, persons living with ADRD and their caregivers were randomly assigned as dyads to receive COPE plus usual HCBS (COPE; n = 145 dyads) or usual HCBS only (Usual Care or UC; n = 146 dyads). Outcomes were measured prerandomization, and 4 and 12 months postrandomization. Outcomes for persons living with ADRD included functional independence, activity engagement, self-reported quality of life, and behavioral and psychological symptoms. Caregiver outcomes included perceived well-being, confidence using dementia management strategies, and degree of distress caused by behavioral and psychological symptoms. Results After 4 months, caregivers receiving COPE reported greater perceived well-being (least squares mean = 3.2; 95% CI: 3.1–3.3) than caregivers receiving UC (3.0; 2.9–3.0; p < .001), and persons living with ADRD receiving COPE, compared to those receiving UC, showed a strong trend toward experiencing less frequent and less severe behavioral and psychological symptoms (9.7; 5.2–14.2 vs 12.7; 8.3–17.1; p = .07). After 12 months, persons living with ADRD receiving COPE were more engaged in meaningful activities (2.1; 2.0–2.1 vs 1.9; 1.9–2.0; p = .02) than those receiving UC. Discussion and Implications Embedding COPE in a publicly funded HCBS program yielded positive immediate effects on caregivers’ well-being, marginal positive immediate effects on behavioral and psychological symptoms, and long-term effects on meaningful activity engagement among persons living with ADRD. Findings suggest that COPE can be effectively integrated into this service system, an important step towards widespread adoption. Clinical Trials Registration Number NCT02365051.

scholarly journals INTEREST GROUP SESSION—NURSING CARE OF OLDER ADULTS: MAKING IT HAPPEN: PERSON-CENTERED DEMENTIA CARE FOR BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S557-S558
Author(s):  
Ann M Kolanowski ◽  
Barbara Bowers
Keyword(s):  
Psychological Symptoms ◽  
Pragmatic Trial ◽  
Direct Care ◽  
High Rate ◽  
Care Staff ◽  
Future Research ◽  
Prescribing Practices ◽  
Person Centered Care ◽  
Centered Care ◽  
Behavioral And Psychological Symptoms

Abstract Person-centered care is the standard of practice in communal living sites, yet many facilities struggle to make this a reality. Both direct care staff and administrators find residents’ behavioral and psychological symptoms of dementia (BPSD) particularly challenging. Our research team is conducting a pragmatic trial, the goal of which is to help staff use person-centered, non-pharmacological approaches for these symptoms. During the past three years we have gained insights into what may affect the ability of staff to deliver high quality person-centered care. We share these insights in this symposium. In the first paper, the investigators present data indicating that a high rate of psychotropic drug use among residents with dementia persists despite little association to BPSD, and bring into question the need for education around de-prescribing practices. In the second paper, the investigators discuss the conceptual basis and empirical evidence for using affect balance, in addition to symptom reduction, as an important and meaningful outcome for residents. The third paper examines gender differences in the expression of BPSD and how these differences may work to limit staff ability to identify treatment approaches for women who, nonetheless, have significant symptoms. In the final paper the psychometric properties and results of a new Knowledge of Person-centered Approaches for BPSD Test, that was developed by the team and given to staff, are examined and the implications of the findings for the delivery of person-centered care are considered. The discussant will reflect on these findings and provide direction for future research and practice.

scholarly journals Acupuncture and Acupressure for Dementia Behavioral and Psychological Symptoms: A Scoping Review

2019 ◽  
Vol 42 (10) ◽  
pp. 867-880 ◽  
Author(s):  
Melissa L. Harris ◽  
Marita G. Titler ◽  
Laura M. Struble
Keyword(s):  
Scoping Review ◽  
Daily Living ◽  
Sleep Disturbances ◽  
Psychological Symptoms ◽  
Psychotropic Medications ◽  
Controlled Trials ◽  
Exclusion Criteria ◽  
Randomized Controlled ◽  
Behavioral And Psychological Symptoms ◽  
Pharmacologic Therapies

Due to the dangers associated with psychotropic medications, there is an urgent need for non-pharmacologic therapies to treat behavioral and psychological symptoms of dementia (BPSD). Acupuncture and acupressure are safe and well-tolerated non-pharmacologic therapies for this population, but currently no review has explored acutherapy for management of distressing dementia symptoms. This review synthesizes research on acupuncture and acupressure for BPSD. Upon searching five databases, 15 studies met inclusion/exclusion criteria. Nine examined acupressure, six acupuncture, and eight were randomized controlled trials. The percent of studies demonstrating statistically significant improvements in symptoms were: activities of daily living (ADLs; 75%), agitation (100%), anxiety (67%), depression (100%), mood (100%), neuropsychological disturbances (67%), and sleep disturbances (100%). Variations in study design, intervention procedures, and outcomes limit interpretations about effectiveness. It is recommended that further research be done to examine the efficacy of these therapies and promote generalizability.

scholarly journals Developing a virtual reality for people with dementia in nursing homes based on their psychological needs: a feasibility study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jung-Hee Kim ◽  
Seonmin Park ◽  
Hyeongji Lim
Keyword(s):  
Virtual Reality ◽  
Nursing Homes ◽  
Intervention Program ◽  
Psychological Symptoms ◽  
Likert Scale ◽  
Psychological Needs ◽  
Second Phase ◽  
People With Dementia ◽  
The Mean ◽  
Behavioral And Psychological Symptoms

Abstract Background The purpose of this study was (1) to develop a virtual reality (VR) intervention program based on the psychological needs of patients residing in nursing facilities in South Korea to alleviate their behavioral and psychological symptoms and (2) to confirm the possibility of utilizing VR in patients with dementia. Methods In the first phase, patients with dementia residing in nursing homes and experiencing behavioral and psychological symptoms were recruited. Surveys and questionnaires were used to identify activities that alleviated the behavioral and psychological symptoms of dementia (BPSD) among the patients. These activities were classified into five types of psychological needs. In the second phase, a fully immersive, interactive, easy-to-use VR platform was developed that reflected these psychological needs. Patients with dementia experienced the VR content. The researchers assessed the level of the participants’ immersion, preference, and interaction with the VR using a 5-point Likert scale. Results In the feasibility test, 10 nursing home residents were recruited. The mean immersion score was 4.93 ± 0.16 points, the mean preference score was 4.35 ± 0.41 points, and the mean interaction score was 3.84 ± 0.43 points using a 5-point Likert scale. Higher mean scores indicated a more positive outcome. Six of the 10 participants required assistance while using the VR. The mean VR experience duration was 10.00 ± 3.46 min. Conclusions The VR-based intervention program that was developed to reduce BPSD was feasible for the participants and provided them with a high degree of satisfaction and immersion. Furthermore, this study also confirmed the convenience and safety of the program. These findings support the potential use of VR-based BPSD intervention programs to treat patients with dementia.

scholarly journals 404 - Effect of Psychoeducation Modul on the Administration of Psychotropic Drugs for Patients with Behavioral and Psychological Symptoms of Dementia at the RS Dr. H. Marzoeki Mahdi Bogor on Caregivers

2020 ◽  
Vol 32 (S1) ◽  
pp. 120-120
Keyword(s):  
Psychotropic Drugs ◽  
Cognitive Abilities ◽  
Health Workers ◽  
Psychological Symptoms ◽  
Clinical Syndrome ◽  
List Type ◽  
Study Program ◽  
Dementia Patients ◽  
Patients Experience ◽  
Behavioral And Psychological Symptoms

Name : Yuniar Pukuk KesumaStudy program : Psychiatry, Specialist II Geriatric PsychiatryCounsellor : Dr.dr. Martina Wiwie S. Nasrun, Sp.KJ(K)Background:Dementia is a clinical syndrome characterized by a decline in cognitive abilities and memory deficits globally. About 90% of patients experience behavioral and psychological symptoms. The use of psychotropic drugs is influenced by the patient symptoms, burden of the caregiver, and the habit of health workers.Objective:To determine the effect of psychoeducation modules to caregivers to increase knowledge, decrease of psychotropic drugs, reduce symptoms and burden of caregivers.Methods:There are 2 steps of studies. The first was a qualitative study to create psychoeducation module and the second was to conduct a pre-experimental study (one group pretest-posttest study). Psychoeducation is given in 2 consecutive weeks.Results:Fourty caregivers of dementia patients aged 41.3 (± 9.72) years. The psychoeducation modules is associated with decreasing symptoms and the use of psychotropic drugs, increasing knowledge and decreasing the burden of caregivers. At the end, 23% of patients were able to stop using psychotropic drugs and 62% of patients reduced their dose and/or the amount of psychotropic drugs.Conclusion:The psychoeducation modules to caregivers is associated with a decrease of patient symptoms and the use of psychotropic drugs. Psychoeducation also increases the knowledge of the caregiver and decreases the burden of the caregiver so that this psychoeducation module can be an additional therapy for patients with dementia.

scholarly journals The Holistic Impact of Using Arts-Based Intervention for Elderly With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 567-567
Author(s):  
Rainbow Tin Hun Ho
Keyword(s):  
Motor Behavior ◽  
Psychological Symptoms ◽  
Controlled Trial ◽  
Negative Mood ◽  
Community Dwelling ◽  
Creative Arts ◽  
Dance Movement ◽  
Moderate Dementia ◽  
Practical Experiences ◽  
Behavioral And Psychological Symptoms

Abstract The use of creative arts on supporting elderly with dementia has been becoming popular due to its safe and engaging process. This non-pharmacological approach can complement with other treatment methods to support elderly with dementia on various aspects, including physical, cognitive and social functioning. In our randomized controlled trial on dance movement therapy (DMT) for 204 community dwelling elders with mild dementia, we found DMT could significantly reduce the level of depression, loneliness and negative mood (β=0.33-0.42, p<.01), and also the diurnal cortisol slope (β =0.30, p<.01); while in another trial on 73 elderly with moderate dementia, we found music and movement could help reduce the behavioral and psychological symptoms such as agitation (β = -0.41, p<.01), aberrant motor behavior (β=-1.02, p<.01), and dysphonia (β=-0.61, p<.05). The present presentation aims to share with the audience our practical experiences, the research procedures as well as the findings of the projects.

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