Quality of Life for People With Dementia Living in Residential and Nursing Home Care: The Impact of Performance on Activities of Daily Living, Behavioral and Psychological Symptoms, Language Skills, and Psychotropic Drugs

2001 ◽  
Vol 13 (1) ◽  
pp. 93-106 ◽  
Author(s):  
Clive Ballard ◽  
John O'Brien ◽  
Ian James ◽  
Pat Mynt ◽  
Marisa Lana ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Activities Of Daily Living ◽  
Psychotropic Drugs ◽  
Daily Living ◽  
Psychological Symptoms ◽  
Well Being ◽  
Nursing Home Care ◽  
People With Dementia ◽  
The Impact

Many people with dementia reside in care facilities. Little is known about how key parameters impact upon their quality of life (QOL). All 209 people with dementia in six facilities received a standardized assessment (Neuropsychiatric Inventory [NPI], Barthel Scale, psychotropic drugs). One hundred twelve residents were assessed using Dementia Care Mapping, an observational method for QOL indices. Lower performance on activities of daily living (reduced well-being [WB] r = +0.39, p < .0001; social withdrawal [SW] r = +0.42, p < .0001; engagement in activities [EA] r = +0.31, p = .001) and taking psychotropics (WB 2.5 vs. 3.2, t = .2.3, p = .02; SW 11.4% vs. 2.7%, t = 3.0, p = .004; EA 56.5% vs. 71.9%; t = 3.5, p = .001) were associated with reduced QOL, but symptoms from the NPI were not. More focused prescribing of psychotropics and better staff training are essential.

TOP CITED PAPERS IN INTERNATIONAL PSYCHOGERIATRICS: 6a. QUALITY OF LIFE FOR PEOPLE WITH DEMENTIA LIVING IN RESIDENTIAL AND NURSING HOME CARE: THE IMPACT OF PERFORMANCE ON ACTIVITIES OF DAILY LIVING, BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS, LANGUAGE SKILLS, AND PSYCHOTROPIC DRUGS

2009 ◽  
Vol 21 (6) ◽  
pp. 1026-1030 ◽  
Author(s):  
C. Ballard ◽  
M. Margallo-Lana ◽  
J. T. O'Brien ◽  
I. James ◽  
R. Howard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychological Symptoms ◽  
Social Withdrawal ◽  
Care Home ◽  
Well Being ◽  
Nursing Home Care ◽  
People With Dementia ◽  
The Impact ◽  
Behavioral And Psychological Symptoms

The majority of people with dementia develop behavioral and psychological symptoms of dementia (BPSD) at some point during their illness (Jeste et al., 2008). These symptoms, which are especially common among care home residents, are frequently distressing for the patients who experience them (Gilley et al., 2006; Jeste et al., 2008) and problematic for their professional and/or family caregivers. The starting point for our paper “Quality of life for people with dementia living in residential and nursing home care: the impact of performance on activities of daily living, behavioral and psychological symptoms, language skills, and psychotropic drugs” (Ballard et al., 2001) was to try and understand the impact of BPSD, function and language skills on quality of life in care home residents with dementia. Although there were frequent statements in previous work referring to the capacity of psychiatric and behavioral symptoms to reduce quality of life, we had been unable to identify any empirical evidence to support this clinical impression in a thorough literature review. The parallel validation of Dementia Care Mapping (DCM), predominantly a practice development tool, as an observational measure of well-being/quality of life (Kitwood and Bredin, 1997; Fossey et al., 2002) provided an excellent opportunity to examine this issue in a care home setting. The study focused on 209 people with dementia living in residential and nursing home care in north-east England in the U.K., who received a detailed assessment of BPSD, function and cognition. A DCM evaluation was completed for 112 of these individuals, providing a detailed observational measure of well-being, activities and social withdrawal as indices of quality of life over a six-hour daytime period. To our surprise, there was actually no association between well-being, social withdrawal or activities and BPSD. In contrast, there was a significant association between antipsychotic medication and reduced well-being, social withdrawal and activities respectively, even after controlling for the severity of behavioral disturbance. Using an arbitrary definition of “ill-being”, defined as a well-being score of less than zero, 5% of people not taking antipsychotics, 10% of people taking atypical antipsychotics and 22% of people taking typical antipsychotics were defined as having ill-being. Lower levels of functional ability were also associated with significantly lower well-being, less activities and more social withdrawal. At first this latter finding appears to be contrary to one of the central principles of DCM – namely, that the assessment should be independent of dementia severity. Although high levels of well-being and engagement are possible for people with severe dementia, this probably requires higher staff numbers and a workforce with more specialized skills in order to achieve this.

scholarly journals Understanding the Link between Family Caregiver Quality of Life and the Care Provided to Older People With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 153-154
Author(s):  
Afeez Hazzan
Keyword(s):  
Quality Of Life ◽  
Quality Of Care ◽  
Older People ◽  
Family Caregivers ◽  
Family Caregiver ◽  
Well Being ◽  
The United States ◽  
People With Dementia ◽  
The Impact

Abstract Dementia is one of the most rapidly growing diseases in the United States. In 2018, the direct costs to American society of caring for older people with dementia was approximately $277 billion. Primary informal caregivers are mainly responsible for the care of older people with dementia including Alzheimer’s disease. Caregivers perform a myriad of duties ranging from shopping for their loved ones’ groceries, helping with medications, and managing finances. The caregiving role becomes more demanding as the disease progresses over time, and studies have shown that the quality-of-life (QoL) experienced by caregivers of older adults who have dementia is lower than the QoL of caregivers for older people who do not have dementia. To the best of our knowledge, there has been no research conducted to investigate whether lower caregiver QoL affects the level or quality of care that caregivers provide to persons with dementia. In the current study, we interviewed family caregivers living in Rochester, New York to inquire about their quality of life and the care provided to older people living with dementia. Further, caregivers completed the 36-item Short Form Health Survey (SF-36) as well as a draft questionnaire for measuring the quality of care provided to older people living with dementia. Both quantitative and qualitative findings from this study reveals important relationships between family caregiver QoL and the care provided, including the impact of social support and financial well-being. The study findings could have significant impact, particularly for the provision of much needed support for family caregivers.

Deterioration of basic activities of daily living and their impact on quality of life across different cognitive stages of dementia: a European study

2014 ◽  
Vol 26 (8) ◽  
pp. 1283-1293 ◽  
Author(s):  
Clarissa M. Giebel ◽  
Caroline Sutcliffe ◽  
Minna Stolt ◽  
Staffan Karlsson ◽  
Anna Renom-Guiteras ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Large Scale ◽  
Depressive Symptomatology ◽  
European Study ◽  
Severe Dementia ◽  
People With Dementia ◽  
Adl Performance

ABSTRACTBackground:Performing basic activities of daily living (ADLs) is one of the major difficulties encountered in dementia, which can have considerable negative impacts on the quality of life (QoL) of people with dementia (PwD). However, the extent to which basic ADL performance deteriorates across mild, moderate, and severe dementia is little examined and its impact, together with depression and neuropsychiatric behavior, upon QoL, is of considerable relevance across European countries.Methods:Data were drawn from people living in the community who were participants in a large-scale European study on transition from community living to care homes of PwD. PwD completed measures on cognitive functioning and QoL, and informal carers reported upon QoL, depressive symptomatology, psychopathology, and functional ability of the PwD.Results:ADL performance deteriorated differently for each activity. In particular, toileting, transfer, and feeding remained relatively intact throughout, whereas performance on bathing and dressing deteriorated to a greater extent from mild to severe dementia. It appears that continence was not affected by the stage of dementia with similar levels of impairment. Basic ADL performance impacted to different degrees on QoL across dementia stages and countries.Conclusions:Interventions aimed at maintaining independence or QoL need to target different ADLs across different dementia stages and perhaps also tailor interventions to the context of different countries. Findings contribute to the development of non-pharmaceutical interventions and governmental pledges to promote independence in dementia.

scholarly journals Level of asthma control and its impact on activities of daily living in asthma patients in Brazil

2013 ◽  
Vol 39 (5) ◽  
pp. 532-538 ◽  
Author(s):  
Mariana Rodrigues Gazzotti ◽  
Oliver Augusto Nascimento ◽  
Federico Montealegre ◽  
James Fish ◽  
Jose Roberto Jardim
Keyword(s):  
Quality Of Life ◽  
Activities Of Daily Living ◽  
Emergency Room ◽  
Asthma Control ◽  
Daily Living ◽  
Negative Impact ◽  
Uncontrolled Asthma ◽  
School Work ◽  
The Impact

OBJECTIVE: To evaluate the impact of asthma on activities of daily living and on health status in patients with controlled, partially controlled, or uncontrolled asthma in Brazil. METHODS: We used data related to 400 patients in four Brazilian cities (São Paulo, Rio de Janeiro, Salvador, and Curitiba), obtained in a survey conducted throughout Latin America in 2011. All study subjects were > 12 years of age and completed a standardized questionnaire in face-to-face interviews. The questions addressed asthma control, hospitalizations, emergency room visits, and school/work absenteeism, as well as the impact of asthma on the quality of life, sleep, and leisure. The level of asthma control was determined in accordance with the Global Initiative for Asthma criteria. RESULTS: Among the 400 respondents, asthma was controlled in 37 (9.3%), partially controlled in 226 (56.5%), and uncontrolled in 137 (34.2%). The numbers of patients with uncontrolled or partially controlled asthma who visited the emergency room, who were hospitalized, and who missed school/work were higher than were those of patients with controlled asthma (p = 0.001, p = 0.05, and p = 0.01, respectively). Among those with uncontrolled asthma, the impact of the disease on activities of daily living, sleep, social activities, and normal physical exertion was greater than it was among those with controlled or partially controlled asthma (p < 0.001). CONCLUSIONS: In Brazil, asthma treatment should be monitored more closely in order to increase treatment adherence and, consequently, the level of asthma control, which can improve patient quality of life and minimize the negative impact of the disease.

[P1-630]: THE IMPACT OF PAIN ON QUALITY OF LIFE AND THE MEDIATING ROLE OF ACTIVITIES OF DAILY LIVING AND DEPRESSIVE SYMPTOMS IN SEVERE DEMENTIA

2017 ◽  
Vol 13 (7S_Part_10) ◽  
pp. P540-P540
Author(s):  
Hanne Marie Rostad ◽  
Martine Puts ◽  
Milada Cvancarova Småstuen ◽  
Inger Utne ◽  
Ellen Karine Grov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Severe Dementia ◽  
Mediating Role ◽  
The Impact

Quality of life in poor prognosis patients with locally advanced non-small cell lung cancer (LA-NSCLC) undergoing a phase II study of concurrent cetuximab and definitive thoracic radiotherapy followed by docetaxel and cetuximab.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e17559-e17559
Author(s):  
Lora Thompson ◽  
Martine Extermann ◽  
Thomas J. Dilling ◽  
Jongphil Kim ◽  
Binglin Yue ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Locally Advanced ◽  
Well Being ◽  
Thoracic Radiotherapy ◽  
Significant Difference ◽  
Specific Symptoms

e17559 Background: A single institution prospective clinical trial was conducted to examine the safety and efficacy of concurrent cetuximab and definitive thoracic radiotherapy followed by docetaxel plus cetuximab. Quality of life (QOL) was assessed as a secondary endpoint. Survival and toxicity data are presented separately. Methods: Eligible pts with unresectable stage IIA or IIIB LA-NSCLC, who also had ECOG PS 2 OR weight loss ≥5% in 3 months OR age >70, completed QOL measures at baseline, after concurrent cetuximab/radiotherapy (recovery), and after docetaxol/cetuximab (consolidation). Scores were calculated for Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Fatigue Symptom Inventory (FSI) worst fatigue, FSI fatigue interference, and Functional Assessment of Cancer Therapy – Lung Trial Outcome Index (FACT-L TOI). FACT-L TOI assessed physical (e.g., nausea) and functional (e.g., difficulty sleeping) well-being as well as lung cancer specific symptoms (e.g., shortness of breath, cough). Descriptive and t-test results are presented. Results: Pts (N = 27) were primarily male (67%) and non-Hispanic Caucasian (96%) with mean age of 73 years. High attrition between recovery (N = 22) and consolidation (N = 10) occurred. Compared to baseline, pts reported higher levels of worst fatigue (p < .03) and fatigue interference (p = .01) at recovery. There was a decline in IADLs (p = .01) but no significant difference in ADLs or FACT-L TOI. Further examination of FACT subscales revealed declines in physical (p < .0001) and functional (p = .02) well-being but improvement in lung cancer specific symptoms (p < .0001). A similar pattern is found for comparisons between baseline and consolidation (ps < .05). There were no significant differences between recovery and consolidation. Conclusions: Although pts experienced declines in QOL across most domains after concurrent cetuximab and radiotherapy, there was improvement in lung cancer specific symptoms. Pts were also able to maintain their ability to perform ADLs. High attrition after recovery is a notable limitation.

scholarly journals Impact of the Severity of Alzheimer’s Disease on the Quality of Life, Activities of Daily Living, and Caregiving Costs for Institutionalized Patients on Anti-Alzheimer Medications in Japan

2021 ◽  
pp. 1-8
Author(s):  
Takumi Ashizawa ◽  
Ataru Igarashi ◽  
Yukinori Sakata ◽  
Mie Azuma ◽  
Kenichi Fujimoto ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
The Elderly ◽  
The Mean ◽  
Institutionalized Patients ◽  
The Impact

Background: Alzheimer’s disease (AD) increases societal costs and decreases the activities of daily living (ADL) and quality of life (QoL) of the affected individuals. Objective: We assess the impact of AD severity on ADL, QoL, and caregiving costs in Japanese facilities for the elderly. Methods: Patients with AD in facilities for the elderly were included (47 facilities, N = 3,461). The QoL, ADL, and disease severity of patients were assessed using Barthel Index (BI), EuroQoL-5D-5L (EQ-5D-5L), and Mini-Mental State Examination (MMSE), respectively. Annual caregiving costs were estimated using patients’ claims data. The patients were subcategorized into the following three groups according to the MMSE score: mild (21≤MMSE≤30), moderate (11≤MMSE≤20), and severe (0≤MMSE≤10). Changes among the three groups were evaluated using the Jonckheere-Terpstra test. Results: Four hundred and one participants were on anti-AD medicines, of whom 287 (age: 86.1±6.4 years, 76.7% women) in the mild (n = 53, 84.0±6.9 years, 71.7%), moderate (n = 118, 86.6±5.9 years, 76.3%), and severe (n = 116, 86.6±6.5 years, 79.3%) groups completed the study questionnaires. The mean BI and EQ-5D-5L scores for each group were 83.6, 65.1, and 32.8 and 0.801, 0.662, and 0.436, respectively. The mean annual caregiving costs were 2.111, 2.470, and 2.809 million JPY, respectively. As AD worsened, the BI and EQ-5D-5L scores decreased and annual caregiving costs increased significantly. Conclusion: AD severity has an impact on QoL, ADL, and caregiving costs.

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