How do staff influence the quality of long-term dementia care and the lives of residents? A systematic review of the evidence

2016 ◽  
Vol 28 (8) ◽  
pp. 1263-1281 ◽  
Author(s):  
Katrina Anderson ◽  
Mike Bird ◽  
Sarah MacPherson ◽  
Annaliese Blair
Keyword(s):  
Systematic Review ◽  
Functional Dependence ◽  
Dementia Care ◽  
Cross Sectional ◽  
Search Terms ◽  
People With Dementia ◽  
Comprehensive Search ◽  
Prospective Longitudinal

ABSTRACTBackground:Research suggests and common sense indicates that there are relationships between staff variables in residential dementia care and the quality of life (QOL) of residents, with poor care due to staff factors increasing resident suffering. Despite these indications, we do not have a coherent picture of these relationships, which variables are important, and where to intervene in order to minimize suffering for people with dementia.Methods:This systematic review examined associations between staff variables, quality of care (QOC), and QOL for residents, using published peer-reviewed literature from the last 20 years. A comprehensive search was conducted using an exhaustive list of search terms, leading to the identification of 33,204 unique papers, which was reduced to 35 on-topic papers.Results:In the main, we were able to provide collective evidence to suggest there are relationships between potentially adjustable staff variables and QOC on to QOL. When staff treat and interact empathetically and humanely in care, there is a relationship with better mood for residents, delayed functional dependence and better food intake. Where staff are more skilled and educated, there is less psychotropic medication use. Unlimited empathy about the risk of residents falling or being in pain is not enough; staff need to know about the dangers of restraint.Conclusions:Confidence in these indicative links is weakened by a lack of high-quality prospective longitudinal studies focusing on potentially adjustable staff variables, with a bias towards cross-sectional studies including only variables that are fixed or unlikely to change. (Review registration no. PROSPERO 2014:CRD42014015224).

Baduanjin Exercise for Adults Aged 65 Years and Older: A Systematic Review and Meta-Analysis of Randomized Controlled Studies

2021 ◽  
pp. 073346482110593
Author(s):  
Cindy Jones ◽  
Meiling Qi ◽  
Zihui Xie ◽  
Wendy Moyle ◽  
Benjamin Weeks ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Mainland China ◽  
Walking Ability ◽  
Search Terms ◽  
Randomized Controlled Studies ◽  
Chinese Studies ◽  
Older Chinese

This study performed a systematic review and meta-analysis to evaluate the health effects of Baduanjin exercise on adults aged 65 years and older. Chinese and English databases were electronically searched using search terms related to the PICO model from inception through June 2021. The study quality assessment and meta-analysis were conducted using the PEDro scale and RevMan 5.4 software. Eleven included Chinese studies, published between 2015 and 2021, recruited participants from the mainland of China. The aggregated results showed significant benefits of Baduanjin on physical function, walking ability, balance, and anxiety. A long-term Baduanjin intervention could also improve quality of life and reduce falls and pain. Baduanjin appears to have the potential to improve the health of older adults, but conclusions are limited due to the lack of rigorous and robust studies within and outside of mainland China. Larger, well-designed RCTs are needed to confirm these findings.

scholarly journals Osteoarthritis and the Mediterranean Diet: A Systematic Review

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 1030 ◽  
Author(s):  
Isabel Morales-Ivorra ◽  
Montserrat Romera-Baures ◽  
Blanca Roman-Viñas ◽  
Lluis Serra-Majem
Keyword(s):  
Systematic Review ◽  
Mediterranean Diet ◽  
Positive Association ◽  
Cartilage Degradation ◽  
Epidemiological Evidence ◽  
Cross Sectional ◽  
The Mediterranean ◽  
The Relationship

Osteoarthritis (OA) affects 240 million people globally. Few studies have examined the links between osteoarthritis and the Mediterranean diet (MD). The aim of this paper was to systematically review and analyze the epidemiological evidence in humans on the MD and its association with OA. A systematic search of EMBASE identified three studies that explored the association between MD and OA. Two of them were cross-sectional and the third one was a 16-week randomized clinical trial. Prisma declaration was followed to carry out this review. These studies described a positive association between a higher adherence to a MD and the quality of life of participants suffering OA. The prevalence of OA was lower in participants with a higher adherence to a Mediterranean diet. Biomarkers of inflammation and cartilage degradation related to OA were also analyzed and significant differences were detected only for IL1-α, which decreased in the MD group. Exploring the relationship between MD and OA is complex, moreover, the limited evidence and methodological differences in such studies makes it difficult to compare results. In conclusion, the three studies included in this systematic review demonstrated some relation between osteoarthritis and a Mediterranean diet. However, prospective and longer interventions are required to evaluate the long-term efficacy of the Mediterranean diet to improve symptomatology and preventing osteoarthritis.

scholarly journals Interventions in Foster Family Care: A Systematic Review

2019 ◽  
Vol 30 (1) ◽  
pp. 3-18 ◽  
Author(s):  
Martin Bergström ◽  
Marianne Cederblad ◽  
Kickan Håkansson ◽  
Ann Kristine Jonsson ◽  
Christian Munthe ◽  
...  
Keyword(s):  
Systematic Review ◽  
Experimental Studies ◽  
Family Care ◽  
Foster Family ◽  
Parent Selection ◽  
Quasi Experimental ◽  
Comprehensive Search ◽  
Short And Long Term

Objective: Foster family care is associated with adverse short- and long-term consequences for the child. A systematic review was conducted on interventions for foster children and foster careers. Method: A comprehensive search process was used to find eligible interventions evaluated in randomized controlled trials or quasi-experimental studies. The quality of studies was assessed with GRADE, and effects were synthesized using meta-analytic methods. Results: In all, 28 publications of 18 interventions, including 5,357 children, were identified. Only three specific interventions had sufficient confidence of evidence. No study had examined tools for foster parent selection nor had evaluated preservice programs related to outcomes. Discussion: These analyses provide new insights and hope into the field of systematic interventions in foster care. The overall results indicate that it is possible to improve eight outcomes but cannot point out which programs are superior. Ethically, social care organizations should systematically collect knowledge about effects and side effects.

scholarly journals Dementia Care and the Role of Guideline Adherence in Primary Care: Cross-Sectional Findings From the DemTab Study

2021 ◽  
Author(s):  
Sonia Lech ◽  
Julie Lorraine O'Sullivan ◽  
Johanna Drewelies ◽  
Wolfram Herrmann ◽  
Robert Spang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Dementia Care ◽  
Perceived Usefulness ◽  
Trial Registration ◽  
Cross Sectional ◽  
People With Dementia ◽  
Number Of Patients

Abstract Background: General practitioners (GPs) play a key role in the care of people with dementia (PwD). However, the role of the German Dementia Guideline in primary care remains unclear. The main objective of the present study was to examine the role of guideline-based dementia care in general practices.Methods: A cross-sectional analysis of data obtained from the DemTab study was conducted. Descriptive analyses of sociodemographic and clinical characteristics for GPs (N = 28) and PwD (N = 91) were conducted. Adherence to the German Dementia Guideline of GPs was measured at the level of PwD. Linear Mixed Models were used to analyze the associations between adherence to the German Dementia Guideline and GP factors at individual (age, years of experience as a GP, frequency of utilization of guideline, perceived usefulness of guideline) and structural (type of practice, total number of patients seen by a participating GP, and total number of PwD seen by a participating GP) levels as well as between adherence to the German Dementia Guideline and PwD’s quality of life. Results: Self-reported overall adherence of GPs was on average 71% (SD = 19.4, range: 25 – 100). Adherence to specific recommendations varied widely (from 19.2% to 95.3%) and the majority of GPs (79.1%) reported the guideline as only partially or somewhat helpful. Further, we found lower adherence to be significantly associated with higher numbers of patients (γ10 = -5.58, CI = -10.97, -0.19, p = .04). No association between adherence to the guideline and PwD’s quality of life was found (γ10 = -.86, CI = -4.18, 2.47, p = .61). Conclusion: The present study examined the role of adherence to the German Dementia Guideline recommendations in primary care. Overall, GPs reported high levels of adherence. However, major differences across guideline recommendations were found. Findings highlight the importance of guidelines for the provision of care. Dementia guidelines for GPs need to be better tailored and addressed. Further, structural changes such as more time for PwD may contribute to a sustainable change of dementia care in primary care.Trial registration: The DemTab trial was prospectively registered with the ISRCTN registry (Trial registration number: ISRCTN15854413). Registered 01 April 2019, https://doi.org/10.1186/ISRCTN15854413

scholarly journals Stigma of Dementia During COVID-19: First Insights From a Twitter Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 961-962
Author(s):  
Juanita-Dawne Bacsu ◽  
Megan O'Connell ◽  
Alison Chasteen ◽  
Keyword(s):  
Critical Issue ◽  
Public Healthcare ◽  
Contributing Factors ◽  
Term Care ◽  
Search Terms ◽  
People With Dementia ◽  
Care Partners ◽  
Education And Awareness

Abstract Stigma is a critical issue that reduces the quality of life for people living with dementia and their care partners. Despite this knowledge, little research examines stigma of dementia, especially within the context of the COVID-19 pandemic. This presentation aims to: 1) identify the contributing factors of stigma against dementia during the COVID-19 pandemic; and 2) describe actions to challenge stigma of dementia. Using Twitter data, tweets were compiled with Python’s GetOldTweets application from February to September 2020. Search terms included keywords for dementia (e.g., Alzheimer’s) and COVID-19 (e.g., coronavirus). From the 20,800 tweets, filters were used to exclude irrelevant tweets. The remaining 5,063 tweets were analyzed by a group of coders with 1,743 tweets identified for further stigma-related coding. The 1,743 tweets were exported to Excel for thematic analysis and divided among 13 coders. Each tweet was coded independently by two reviewers to ensure intercoder reliability (e.g., 86%). Contributing factors of stigma of dementia included: ageism and devaluing the lives of people with dementia (e.g., ‘old and dying anyways’); misinformation and false beliefs (e.g., ‘COVID-19 vaccine causes dementia’); political dementia-related slander and ridicule (e.g., ‘dementia Joe’); and stigma within healthcare and long-term care organizations (e.g., pushing DNR orders). Globally, there is an urgent need for more dementia education and awareness targeted towards the general public, healthcare workers, and policymakers to reduce stigma against people living with dementia. Further research is necessary to explore the contributing factors and interventions to reduce stigma of dementia during the COVID-19 pandemic and beyond.

scholarly journals Supportive care for older people with dementia: socio-organisational implications

2020 ◽  
pp. 1-33
Author(s):  
Francesco Miele ◽  
Federico Neresini ◽  
Giovanni Boniolo ◽  
Omar Paccagnella
Keyword(s):  
Supportive Care ◽  
Dementia Care ◽  
Future Research ◽  
Cultural Backgrounds ◽  
Term Care ◽  
Care Givers ◽  
People With Dementia ◽  
Depth Analysis

Abstract For many years, dementia care has been dominated by the standard medical approach, in which dementia is treated mainly with drugs, such as anti-anxiety, antidepressant and anti-psychotic medications. With the aim of seeking effective treatments for patients with dementia, over the last years, several contributions have criticised the pervasive use of drugs for the management of behavioural and physiological symptoms related to dementia, proposing personalised interventions aimed at supporting patients and their relatives from diagnosis until death. With particular reference to long-term settings, in this work, we aim at understanding the organisational implications of three types of interventions (labelled supportive care interventions – SCIs) that have characterised this shift in dementia care: person-centred, palliative and multi-disciplinary care. Conducted by following the integrative review method, our review underlines how SCIs have controversial consequences on the quality of care, the care-givers’ quality of life and cultural backgrounds. After an in-depth analysis of selected papers, we offer some considerations about the implications of SCIs for long-term care organisations and future research directions.

scholarly journals Dementia Care Mapping in long-term care settings: a systematic review of the evidence

2017 ◽  
Vol 29 (10) ◽  
pp. 1609-1618 ◽  
Author(s):  
Ana Barbosa ◽  
Kathryn Lord ◽  
Alan Blighe ◽  
Gail Mountain
Keyword(s):  
Systematic Review ◽  
Neuropsychiatric Symptoms ◽  
Dementia Care ◽  
Future Research ◽  
Term Care ◽  
People With Dementia ◽  
Care Workers ◽  
Care Mapping ◽  
Dementia Care Mapping

ABSTRACTBackground:This systematic review identifies and reports the extent and nature of evidence to support the use of Dementia Care Mapping as an intervention in care settings.Methods:The review was limited to studies that used Dementia Care Mapping as an intervention and included outcomes involving either care workers and/or people living with dementia. Searches were conducted in PubMed, Web of Knowledge, CINAHL, PsychINFO, EBSCO, and Scopus and manually from identified articles reference lists. Studies published up to January 2017 were included. Initial screening of identified papers was based on abstracts read by one author; full-text papers were further evaluated by a second author. The quality of the identified papers was assessed independently by two authors using the Cochrane Risk of Bias Tool. A narrative synthesis of quantitative findings was conducted.Results:We identified six papers fulfilling predefined criteria. Studies consist of recent, large scale, good quality trials that had some positive impacts upon care workers’ stress and burnout and benefit people with dementia in terms of agitated behaviors, neuropsychiatric symptoms, falls, and quality of life.Conclusion:Available research provides preliminary evidence that Dementia Care Mapping may benefit care workers and people living with dementia in care settings. Future research should build on the successful studies to date and use other outcomes to better understand the benefits of this intervention.

scholarly journals 506 - Methodologies used to study the feasibility, usability and effectiveness of social robots in clinical and social care settings for elderly adults

2021 ◽  
Vol 33 (S1) ◽  
pp. 59-59
Author(s):  
Aysan Mahmoudi ◽  
Mauricio Molinari ◽  
Henriette Van Der Roest ◽  
Manuel Franco
Keyword(s):  
Social Robots ◽  
Elderly Adults ◽  
Cross Sectional ◽  
Research Fields ◽  
Private Households ◽  
People With Dementia ◽  
Long Term Impact ◽  
Physiological Tests

Background:In a search for innovative dementia care strategies, a new research fields have been dedicated to design social robots for older adults with cognitive impairments and dementia in order to promote their quality of life through communication and social interactions. Although the results are promising, the quality of studies on effectiveness of social robots in elderly adults is still low due to several methodological limitations (1). Then, we aim to review the methodologies used so far for conducting studies with social robots in clinical and social settings with people with dementia and elderly adults.Method:Searches in Medline (PubMed), Web of Science, PsycInfo, and Cinahl yielded 33 studies included in the final review after applying inclusion and exclusion criteria. Reviews were conducted by two authors independently.Result:Across 33 papers, 23 different social robots were examined on elderly adults and PwD, investigating feasibility, usability and effectiveness. A variety of study designs such as RCTs, mixed methods, cross-sectional and cohort were employed. Individual and group-based interventions took place in private households, LTCFs and labs within a single session or multiple sessions. Data were collected through observation, questionnaires, interview and physiological tests. Most revealed improvements were found in mood, engagement and participation. However, improvements in QoL, depression and cognition were not significant.Conclusion:Despite the promising results, due to the insufficient methodology, failures and ambitious findings remain within the many aspects of the enquiry. Appropriate RCT designs with large sample sizes and individual intervention sessions might be established for effectiveness studies. For feasibility/usability studies, a cohort design with long-term intervention would serve best. We also recommend a mixed method of data collection for any of three effectiveness, feasibility and usability study aims. Multiple interaction sessions running for more than one month might help researches to draw significant results and reveal the long-term impact of the robots.

Do interventions with staff in long-term residential facilities improve quality of care or quality of life for people with dementia? A systematic review of the evidence

2016 ◽  
Vol 28 (12) ◽  
pp. 1935-1936 ◽  
Author(s):  
Nancy A. Hodgson
Keyword(s):  
Patient Outcomes ◽  
Dementia Care ◽  
Dementia Patient ◽  
Dyadic Relationship ◽  
Quality Outcomes ◽  
Formal Caregivers ◽  
Institutional Settings ◽  
People With Dementia

The review by Bird and colleagues (2016), published in this issue of International Psychogeriatrics, is notable for jointly examining the effect of dementia care interventions on both staff and resident quality outcomes. This is an important contribution to improving dementia care because it recognizes the dynamic and dyadic relationship between residents and their caregivers in residential settings. While evidence exists on the dyadic effect of family caregiver intervention on dementia patient outcomes (Gitlin and Hodgson, 2015), less attention has been given to formal caregivers in institutional settings (Dellefield et al., 2015).

scholarly journals Health and long-term care of the elderly with dementia in rural Thailand: a cross-sectional survey through their caregivers

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e032637
Author(s):  
Nalinee N Chuakhamfoo ◽  
Pudtan Phanthunane ◽  
Sirintorn Chansirikarn ◽  
Supasit Pannarunothai
Keyword(s):  
Long Term Care ◽  
Informal Caregivers ◽  
The Elderly ◽  
Dementia Care ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Term Care ◽  
Dementia Severity ◽  
People With Dementia

ObjectiveTo describe the circumstances of the elderly with dementia and their caregivers’ characteristics in order to examine factors related to activities of daily living (ADL) and household income to propose a long-term care policy for rural areas of Thailand.SettingA cross-sectional study at the household level in three rural regions of Thailand where there were initiatives relating to community care for people with dementia.ParticipantsCaregivers of 140 people with dementia were recruited for the study.Primary and secondary outcome measuresSocioeconomic characteristics including data from assessment of ADL and instrumental ADL and the Thai version of Resource Utilisation in Dementia were collected. Descriptive statistics were used to explain the characteristics of the elderly with dementia and the caregivers while inferential statistics were used to examine the associations between different factors of elderly patients with dementia with their dependency level and household socioeconomic status.ResultsEighty-six per cent of the dementia caregivers were household informal caregivers as half of them also had to work outside the home. Half of the primary caregivers had no support and no minor caregivers. The elderly with dementia with high dependency levels were found to have a significant association with age, dementia severity, chance of hospitalisation and number of hospitalisations. Though most of these rural samples had low household incomes, the patients in the lower-income households had significantly lower dementia severity, but, with the health benefit coverage had significantly higher chances of hospitalisation.ConclusionAs the informal caregivers are the principal human resources for dementia care and services in rural area, policymakers should consider informal care for the Thai elderly with dementia and promote it as the dominant pattern of dementia care in Thailand.

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