Group activity with Paro in nursing homes: systematic investigation of behaviors in participants

ABSTRACTBackground:A variety of group activities is promoted for nursing home (NH) residents with dementia with the aim to reduce apathy and to increase engagement and social interaction. Investigating behaviors related to these outcomes could produce insights into how the activities work. The aim of this study was to systematically investigate behaviors seen in people with dementia during group activity with the seal robot Paro, differences in behaviors related to severity of dementia, and to explore changes in behaviors.Methods:Thirty participants from five NHs formed groups of five to six participants at each NH. Group sessions with Paro lasted for 30 minutes twice a week during 12 weeks of intervention. Video recordings were conducted in the second and tenth week. An ethogram, containing 18 accurately defined and described behaviors, mapped the participants’ behaviors. Duration of behaviors, such as “Observing Paro,” “Conversation with Paro on the lap,” “Smile/laughter toward other participants,” were converted to percentage of total session time and analyzed statistically.Results:“Observing Paro” was observed more often in participants with mild to moderate dementia (p = 0.019), while the variable “Observing other things” occurred more in the group of severe dementia (p = 0.042). “Smile/laughter toward other participants” showed an increase (p = 0.011), and “Conversations with Paro on the lap” showed a decrease (p = 0.014) during the intervention period.Conclusions:Participants with severe dementia seemed to have difficulty in maintaining attention toward Paro during the group session. In the group as a whole, Paro seemed to be a mediator for increased social interactions and created engagement.

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Impact of Social Isolation on People with Dementia and Their Family Caregivers

Journal of Alzheimer s Disease ◽

10.3233/jad-201580 ◽

2021 ◽

pp. 1-11

Author(s):

Lílian Viana dos Santos Azevedo ◽

Ismael Luis Calandri ◽

Andrea Slachevsky ◽

Héctor Gastón Graviotto ◽

Maria Carolina Santos Vieira ◽

...

Keyword(s):

Family Caregivers ◽

Social Isolation ◽

Clinical Symptoms ◽

Memory Function ◽

South American ◽

Severe Dementia ◽

Dementia Caregivers ◽

People With Dementia ◽

Moderate Dementia ◽

Severity Of Dementia

Background: People with dementia and their family caregivers may face a great burden through social isolation due to the COVID-19 pandemic, which can be manifested as various behavioral and clinical symptoms. Objective: To investigate the impacts of social isolation due to the COVID-19 pandemic on individuals with dementia and their family caregivers. Methods: Two semi-structured questionnaires were applied via telephone to family caregivers of people diagnosed with dementia in three cities in Argentina, Brazil, and Chile, in order to assess clinical and behavioral changes in people with dementia and in their caregivers. Results: In general, 321 interviews were conducted. A significant decline in memory function has been reported among 53.0%of people with dementia. In addition, 31.2%of individuals with dementia felt sadder and 37.4%had increased anxiety symptoms. These symptoms of anxiety were greater in individuals with mild to moderate dementia, while symptoms of agitation were greater in individuals with severe dementia. Moreover, compulsive-obsessive behavior, hallucinations, increased forgetfulness, altered appetite, and increased difficulty in activities of daily living were reported more frequently among individuals with moderate to severe dementia. Caregivers reported feeling more tired and overwhelmed during this period and these symptoms were also influenced by the severity of dementia. Conclusion: Social isolation during the COVID-19 pandemic triggered a series of negative behavioral repercussions, both for people with dementia and for their family caregivers in these three South American countries.

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Music Connects Us: Development of a Music-Based Group Activity Intervention to Engage People Living with Dementia and Address Loneliness

Healthcare ◽

10.3390/healthcare9050570 ◽

2021 ◽

Vol 9 (5) ◽

pp. 570

Author(s):

Hannah M. O’Rourke ◽

Tammy Hopper ◽

Lee Bartel ◽

Mandy Archibald ◽

Matthias Hoben ◽

...

Keyword(s):

Social Interactions ◽

Social Connectedness ◽

Care Home ◽

Intervention Mapping ◽

Group Activity ◽

Relationship Building ◽

Care Staff ◽

Future Research ◽

Engaged Scholarship ◽

Severe Dementia

There is a need for intervention research to understand how music-based group activities foster engagement in social interactions and relationship-building among care home residents living with moderate to severe dementia. The purpose of this conceptual paper is to describe the design of ‘Music Connects Us’, a music-based group activity intervention. Music Connects Us primarily aims to promote social connectedness and quality of life among care home residents living with moderate to severe dementia through engagement in music-making, supporting positive social interactions to develop intimate connections with others. To develop Music Connects Us, we adapted the ‘Music for Life’ program offered by Wigmore Hall in the United Kingdom, applying an intervention mapping framework and principles of engaged scholarship. This paper describes in detail the Music Connects Us program, our adaptation approach, and key adaptations made, which included: framing the project to focus on the engagement of the person living with dementia to ameliorate loneliness; inclusion of student and other community-based musicians; reduced requirements for care staff participation; and the development of a detailed musician training approach to prepare musicians to deliver the program in Canada. Description of the development, features, and rationale for Music Connects Us will support its replication in future research aimed to tests its effects and its use in clinical practice.

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Effects of multisensory and motor stimulation on the behavior of people with dementia

Dementia ◽

10.1177/1471301215592080 ◽

2016 ◽

Vol 16 (3) ◽

pp. 344-359 ◽

Cited By ~ 3

Author(s):

Giovana Sposito ◽

Ana Barbosa ◽

Daniela Figueiredo ◽

Mônica Sanches Yassuda ◽

Alda Marques

Keyword(s):

Aged Care ◽

Direct Care ◽

Direct Care Workers ◽

Severe Dementia ◽

Video Recordings ◽

People With Dementia ◽

Care Workers ◽

Care Facilities ◽

Aged Care Facilities ◽

Quasi Experimental

A quasi-experimental study using a pre–posttest design was conducted in four aged care facilities to assess the effects of a person-centred care (PCC) multisensory stimulation (MSS) and motor stimulation (MS) program, implemented by direct care workers, on the behaviors of residents with dementia. Data were collected at baseline and after the intervention through video recordings of morning care routines. Forty-five residents with moderate and severe dementia participated in the study. A total of 266 morning care routines were recorded. The frequency and duration of a list of behaviors were analyzed. The frequency of engagement in task decreased significantly ( p = .002) however, its duration increased ( p = .039). The duration of gaze directed at direct care workers improved significantly ( p = .014) and the frequency of closed eyes decreased ( p = .046). There was a significant decrease in the frequency of the expression of sadness. These results support the implementation of PCC–MSS and MS programs as they may stimulate residents’ behaviors.

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Common behavioral problems among patients with dementia attending in tertiary care hospitals in Dhaka city

Bangladesh Journal of Psychiatry ◽

10.3329/bjpsy.v28i2.32736 ◽

2017 ◽

Vol 28 (2) ◽

pp. 50-52

Author(s):

Sadya Tarannum ◽

Bushra Sultana ◽

Sultana Algin ◽

Atiqul Haq Majumder

Keyword(s):

Behavioral Problems ◽

Tertiary Care ◽

Behavioral Problem ◽

Cross Sectional Study ◽

Severe Dementia ◽

Cross Sectional ◽

Developed Country ◽

Moderate Dementia ◽

New Treatment ◽

Severity Of Dementia

Elderly people are increasing day by day both in developing and developed country due to development of new treatment, increased awareness of people and improved health facilities. This present study was conducted with the aim to identify behavioral problems according to severity of dementia. This descriptive cross sectional study was conducted in the Department of Psychiatry and Department of Neuro-medicine of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh and in National Institute of Mental Health (NIMH), Sher-E-Bangla Nagar, Dhaka, Bangladesh from September 2013 to March 2015. A total 150 patients were selected purposefully; severity of dementia was graded according to Mini Mental State Examination (MMSE) and another questionnaire was applied to detect behavioral problems of patients. In this study mild dementia was found as the most frequent (38%), followed by severe dementia (35.3%) and moderate dementia (26.7%). The results indicated that behavioral problem was more common in severe dementia. Behavioral problem was more common in severe dementia than in mild and moderate dementia. Among behavioral problems sleep disturbance and sexual disturbance were statistically significant This study provides information about pattern of behavioral problems among patients with dementia. Liaison approach with other discipline may improve quality of life of these patients treatable.Bang J Psychiatry Dec 2014; 28(2): 50-52

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Value of Personalized Dementia-Specific Quality of Life Scales: An Explorative Study in 3 European Countries

American Journal of Alzheimer s Disease & Other Dementias® ◽

10.1177/15333175211033721 ◽

2021 ◽

Vol 36 ◽

pp. 153331752110337

Author(s):

Iris Hendriks ◽

Raquel Demetrio ◽

Franka J. M. Meiland ◽

Rabih Chattat ◽

Dorota Szcześniak ◽

...

Keyword(s):

Quality Of Life ◽

Care Practice ◽

Support Programme ◽

People With Dementia ◽

Individual Character ◽

Moderate Dementia ◽

The Uk ◽

Severity Of Dementia ◽

The Relationship

Measuring Quality of Life (QOL) can be difficult due to its individual character. To explore the value of personalized QOL measurement for people with dementia, personalized versions of two dementia-specific QOL scales (Dementia quality of Life (DQoL) and Quaility of Life in Alzheimer's Disease (QoL-AD)) were constructed. This study investigated whether the personalized measures are more valid to detect variations in QOL than their standard versions for people with mild to moderate dementia, with sufficient internal consistency. Moreover, the relationship between the personalized QOL measures and severity of dementia was investigated. Finally, the study explored the differences between countries regarding the personalized overall QOL and differences in the importance of QOL domains. This explorative one-group design study used baseline data from the MEETINGDEM study into the implementation of the Meeting Centres Support Programme in Italy, Poland and the UK. The personalized versions of the DQoL and QoL-AD were reliable, but not more valid than their standard versions. No relationship between severity of dementia and personalized QOL was found. While no differences were found between countries for the overall QOL score, some QOL domains were valued differently: people with dementia from the UK rated self-esteem, mood, physical health, energy level and the ability to do chores around the house significantly less important than people from Italy and Poland. The personalized versions of the DQoL and QoL-AD may offer dementia care practice important insights into what domains contribute most to an individual’s QOL.

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Maintaining Social Connections in Dementia: A Qualitative Synthesis

Qualitative Health Research ◽

10.1177/1049732319874782 ◽

2019 ◽

Vol 30 (1) ◽

pp. 23-42 ◽

Cited By ~ 3

Author(s):

Linda Birt ◽

Rebecca Griffiths ◽

Georgina Charlesworth ◽

Paul Higgs ◽

Martin Orrell ◽

...

Keyword(s):

Social Interactions ◽

Impression Management ◽

Short Term Memory ◽

Clinical Symptoms ◽

Social Connections ◽

Social Self ◽

Qualitative Synthesis ◽

People With Dementia ◽

Moderate Dementia ◽

Person With Dementia

The clinical symptoms of dementia include difficulty with speech, poor short-term memory, and changes in behavior. These symptoms can affect how the person with dementia understands and performs in social interactions. This qualitative review investigated how people with mild to moderate dementia managed social connections. A systematic search of social science databases retrieved 13 articles; data were synthesized using thematic analysis. Results established the work undertaken by people with dementia to maintain and present a social persona seen as socially acceptable. Interpretations are contextualized within Goffman and Sabat’s theories on “self.” People with dementia were agentic in impression management: undertaking work to maintain recognized social roles, while being aware of when their illness led to others discrediting them. Wider recognition of strategies used to maintain a social self could inform interventions designed to increase capability and confidence in co-managing social connections following dementia diagnosis.

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Classification of Dementia Severity in Taiwan Based on History-Based Clinical Diagnosis System

American Journal of Alzheimer s Disease & Other Dementias® ◽

10.1177/1533317520970788 ◽

2020 ◽

Vol 35 ◽

pp. 153331752097078

Author(s):

Yun Fah Chang ◽

Woan Yee Loi ◽

Pai-Yi Chiu ◽

Huang-Nan Huang

Keyword(s):

Rating Scale ◽

Clinical Dementia Rating ◽

Severe Dementia ◽

Dementia Patients ◽

Moderate Dementia ◽

Solid Foundation ◽

Severity Levels ◽

Diagnosis Tool ◽

Severity Of Dementia

Background/Aims: This study used HAICDDS screening questionnaire to classify the severity of dementia in Taiwan based on the clinical dementia rating scale. Methods: LDA was applied to 6,328 Taiwanese clinical patients for classification purposes. Clustering method was used to identify the associated influential symptoms for each severity level. Result: LDA shows only 36 HAICDDS questions are significant to distinguish the 5 severity levels with 80% overall accuracy and it increased to 85.83% when combining normal and MCI groups. Severe dementia patients have the most serious declination in most cognitive and functionality domains, follows by moderate dementia, mild dementia, MCI and normal patients. Conclusion: HAICDDS is a reliable and time-saved diagnosis tool in classifying the severity of dementia before undergoing a more in-depth clinical examination. The modified CDR may be indicated for epidemiological study and provide a solid foundation to develop a machine-learning derived screening instrument to detect dementia symptoms.

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Prevalence and Severity of Dementia in Nursing Home Residents

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000433525 ◽

2015 ◽

Vol 40 (3-4) ◽

pp. 166-177 ◽

Cited By ~ 43

Author(s):

Anne-Sofie Helvik ◽

Knut Engedal ◽

Jūratė Šaltytė Benth ◽

Geir Selbæk

Keyword(s):

Nursing Home ◽

Rating Scale ◽

Unit Length ◽

Nursing Home Residents ◽

Linear Regression Models ◽

Clinical Dementia Rating ◽

Severe Dementia ◽

People With Dementia ◽

Severity Of Dementia ◽

Single Men

Background/Aims: The aim of this study was to compare the presence and severity of dementia in two large cross-sectional samples of nursing home residents from 2004/2005 and 2010/2011. Methods: Demographic information as well as data on the type of nursing home unit, length of stay before assessment, physical health, regularly used prescribed drugs and Clinical Dementia Rating scale scores were used in the analyses. Logistic and linear regression models for hierarchical data were estimated. Results: The odds of the occurrence and of a greater severity of dementia were higher in 2010/2011 than in 2004/2005. Independent of the time of study, married men had more severe dementia than single men, and single women had more severe dementia than single men. Conclusion: The findings may reflect the increase in the need for more nursing home beds designed for people with dementia between 2004/2005 and 2010/2011.

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Effects of a culturally adapted group based Montessori based activities on engagement and affect in Chinese older people with dementia: a randomized controlled trial

BMC Geriatrics ◽

10.1186/s12877-020-01967-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Helen Yue-lai Chan ◽

Yee-man Yau ◽

Si-fan. Li ◽

Ka-shi Kwong ◽

Yuen-yu Chong ◽

...

Keyword(s):

Controlled Trial ◽

Intervention Group ◽

Community Dwelling ◽

Group Activities ◽

People With Dementia ◽

Culturally Adapted ◽

Moderate Dementia ◽

Montessori Method ◽

Chinese Older People ◽

To Receive

Abstract Background The Montessori Method underpinned by the principle of person-centered care has been widely adopted to design activities for people with dementia. However, the methodological quality of the existing evidence is fair. The objectives of this study are to examine the feasibility and effects of a culturally adapted group-based Montessori Method for Dementia program in Chinese community on engagement and affect in community-dwelling people with dementia. Methods This was a two-arm randomized controlled trial. People who were aged 60 years or over and with mild to moderate dementia were recruited and randomly assigned to the intervention group to receive Montessori-based activities or the comparison group to receive conventional group activities over eight weeks. The attendance rates were recorded for evaluating the feasibility. The Menorah Park Engagement Scale and the Apparent Affect Rating Scale were used to assess the engagement and affect during the activities based on observations. Generalized Estimating Equation model was used to examine the intervention effect on the outcomes across the sessions. Results A total of 108 people with dementia were recruited. The average attendance rate of the intervention group (81.5%) was higher than that of the comparison group (76.3%). There was a significant time-by-group intervention effect on constructive engagement in the first 10 minutes of the sessions (Wald χ2 = 15.21–19.93, ps = 0.006–0.033), as well as on pleasure (Wald χ2 = 25.37–25.73, ps ≤ 0.001) and interest (Wald χ2 = 19.14–21.11, ps = 0.004–0.008) in the first and the middle 10 minutes of the sessions, adjusted for cognitive functioning. Conclusions This study provide evidence that Montessori-based group activities adapted to the local cultural context could effectively engage community-dwelling Chinese older people with mild to moderate dementia in social interactions and meaningful activities and significantly increase their positive affect. Trial registration ClinicalTrials.gov, NCT04352387. Registered 20 April 2020. Retrospectively registered.

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312 - Level of engagement during an innovative therapy program in people with dementia – implementing Serious Traditional Multidimensional Games

International Psychogeriatrics ◽

10.1017/s1041610220002124 ◽

2020 ◽

Vol 32 (S1) ◽

pp. 70-70

Author(s):

Marlene C. Neves Rosa ◽

Raul Antunes ◽

Rui Matos ◽

Nuno Amaro ◽

Marta Duarte

Keyword(s):

Cognitive Therapy ◽

Specific Activity ◽

Positive Impact ◽

Index Number ◽

Severe Dementia ◽

Innovative Therapy ◽

Therapy Program ◽

People With Dementia ◽

Moderate Dementia ◽

Success Index

Background:There is a significant difficulty in the engagement of people with dementia in therapeutic activities. Considering that stimulus attributes (e.g., content of a specific activity) seem to be determinant to achieve an expected engagement, innovative approaches are required.Aim:characterise the engagement of people with dementia in serious traditional multidimensional games (sTMG), comparing with conventional therapy (CT) sessions.Methods:Subjects with dementia were recruited in Alzheimer’s Portugal Foundation. Sociodemographic and clinical participants’ characteristics were collected, including classification of dementia severity using Mini-mental State Examination (MSE) and walking independence classification (dependent - someone needs supervision or human support to walk). Gerontologist, psychologist, occupational therapist and physiotherapist were invited to classify patients’ engagement in routine CT (i.e., cognitive therapy and exercise classes), according to 0 -10 scale (10 – successful engagement). Serious adaptations in TMG were implemented in 3 consecutive sessions (1 per week/ 45 min./session) and patient s engagement was rated in each session. Success index (number of subjects showing higher engagement in TMG/total participants) was calculated.Results:Thirteen participants (5 males; 79.23±8.39yrs; 15.76±9.22 MSE; 9 walk independently) were enrolled. Success index was 38%; comparing TMG with cognitive therapy and 31%, comparing to movement classes. Two patients with severe dementia and walking independency were more engaged in sTMG sessions (sTMG - 4;4; Cognitive therapy - 2;1; Exercises Classes). Four patients with moderate dementia and walking independency obtained worse engagement (sTMG –3;6;2;7; Cognitive therapy – 6;7;8;8 Exercises Classes – 4;6;7;9).Discussion:Our results showed that sTMG sessions had a positive impact in people with dementia, specifically in advanced/severe cases. In this respect, a previous study of Natalie et al., (2017) concluded that engagement was lower in cognitive activities for people with severe dementia, which can explain the higher engagement in sTMG sessions. Furthermore, Bier et al. (2008) enlightened that people with dementia in a moderate stage are characterised by emergent behavioural changes, which might difficult patients’ integration in new activities.Conclusion:sTMG had a positive impact in the engagement of people with dementia. Specifically, for patients at middle stage of dementia, future studies include longer sTMG protocols, possibly providing better patients’ integration.

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