Using Spaced Retrieval Training to Teach People With Dementia to Independently Use Their Walking Aids: Two Case Studies

2014 ◽  
Vol 38 (2) ◽  
pp. 170-178 ◽  
Author(s):  
Alexandra S. Creighton ◽  
Tanya E. Davison ◽  
Eva S. van der Ploeg ◽  
Cameron J. Camp ◽  
Daniel W. O’Connor
Keyword(s):  
Case Studies ◽  
Spaced Retrieval ◽  
People With Dementia ◽  
Walking Aids

scholarly journals BBusiness Models of eHealth Interventions to Support Informal Caregivers of People with Dementia in the Netherlands: Case Study Analysis (Preprint)

2020 ◽  
Author(s):  
Hannah Liane Christie ◽  
Lizzy Mitzy Maria Boots ◽  
Ivo Hermans ◽  
Mark Govers ◽  
Huibert Johannes Tange ◽  
...  
Keyword(s):  
The Netherlands ◽  
Case Studies ◽  
Business Models ◽  
Informal Caregivers ◽  
Academic Research ◽  
Study Analysis ◽  
Case Study Methodology ◽  
Case Study Analysis ◽  
People With Dementia

BACKGROUND In academic research contexts, eHealth interventions for caregivers of people with dementia have shown ample evidence of effectiveness. However, they are rarely implemented into practice and much can be learned from their counterparts (from commercial, governmental, or other origins) that are already being used in practice. OBJECTIVE This study aimed to (1.) examine a sample of case studies of eHealth interventions to support informal caregivers of people with dementia, that are currently used in the Netherlands; (2.) investigate what strategies are used to ensure the desirability, feasibility, viability, and sustainability of the interventions, and (3.) apply the lessons learned from this practical, commercial implementation perspective to academically developed eHealth interventions for caregivers of people with dementia. METHODS In step one, experts (N=483) in the fields of dementia and eHealth were contacted and asked to recommend interventions that met the following criteria: (1.) delivered via the internet, (2.) suitable for informal caregivers of people with dementia, (3.) accessible in the Netherlands, either in Dutch or in English, and (4.) used in practice. The contacted experts were academics working on dementia and/or psychosocial innovations, industry professionals from eHealth software companies, clinicians, patient organisations, and people with dementia and their caregivers. In step two, contact persons from the suggested eHealth interventions participated in a semi-structured telephone interview. The results were analysed using multiple-case study methodology. RESULTS Twenty-one eHealth interventions for caregivers of people with dementia were suggested by experts. Nine of these 21 interventions met all four criteria and were included in the sample for case study analysis. Four cases were found to have developed sustainable business models. Five cases were implemented in a more exploratory manner and relied on research grants to varying extents, though some had also developed preliminary business models. CONCLUSIONS These findings suggest that the desirability, feasibility, and viability of eHealth interventions for caregivers of people with dementia are linked to their integration into larger structures, their ownership and support of content internally, their development of information and communication technology (ICT) services externally, and offering fixed, low-level pricing. The origin of the case studies was also important, as eHealth interventions that had originated in an academic research context less reliably found their way to sustainable implementation. In addition, careful selection of digital transformation strategies, more intersectoral cooperation, and more funding for implementation and business modelling research are recommended to help future developers bring eHealth interventions for caregivers of people with dementia into practice.

scholarly journals A mixed methods systematic review of multimodal non-pharmacological interventions to improve cognition for people with dementia

Dementia ◽  
2018 ◽  
Vol 19 (4) ◽  
pp. 1086-1130 ◽  
Author(s):  
Garuth Chalfont ◽  
Christine Milligan ◽  
Jane Simpson
Keyword(s):  
Case Studies ◽  
Stress Reduction ◽  
Grey Literature ◽  
Individual Case ◽  
Primary Diagnosis ◽  
Cognitive Outcome ◽  
Patient Treatment ◽  
Gut Health ◽  
Pharmacological Interventions ◽  
People With Dementia

Objective Multimodal non-pharmacological interventions have been argued to have the potential to complement current pharmacological approaches to improving quality of life for people living with dementia. The aim of this review was to identify, synthesise and appraise the evidence for the effectiveness of multimodal non-pharmacological interventions for improving cognitive function specifically. Method After a comprehensive search strategy including grey literature, 26 studies were reviewed. The inclusion criteria concerned adults with a primary diagnosis of dementia. Studies used two or more different modes of intervention, and measured a cognitive outcome. Due to differences in the conceptualisations of the term ‘multimodal’, a typology of modes and methods was developed to facilitate classification of candidate studies. Results Twenty-one group studies and five case studies were found. Group studies used two or three modes of intervention and multiple methods to implement them. Interventions utilised were cognitive, physical, psychological and psychosocial, nutrition, fasting, gut health, sleep hygiene, stress reduction, detoxification, hormonal health and oxygen therapy. Five individual case studies were found in two separate papers. Each personalised patient treatment utilised in-depth assessments and prescribed up to nine different modes. In 19 (90%) of the 21 group comparisons, participants were reported to have cognitive improvements, stability with their dementia or a delay in their decline. The extent of these improvements in terms of meaningful clinical change was variable. Conclusion Multimodal non-pharmacological interventions have the potential to complement singular therapeutic approaches by addressing multiple modifiable risk factors currently understood to contribute towards cognitive decline.

A COMPARISON OF SPACED RETRIEVAL TO OTHER SCHEDULES OF PRACTICE FOR PEOPLE WITH DEMENTIA

2005 ◽  
Vol 31 (2) ◽  
pp. 101-118 ◽  
Author(s):  
Angela K. Hochhalter ◽  
J. Bruce Overmier ◽  
Sarah M. Gasper ◽  
Bruce L. Bakke ◽  
Richard J. Holub
Keyword(s):  
Spaced Retrieval ◽  
People With Dementia

scholarly journals Walking Aids Moderate Exercise Effects on Gait Speed in People With Dementia: A Randomized Controlled Trial

2017 ◽  
Vol 18 (3) ◽  
pp. 227-233 ◽  
Author(s):  
Annika Toots ◽  
Håkan Littbrand ◽  
Henrik Holmberg ◽  
Peter Nordström ◽  
Lillemor Lundin-Olsson ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Gait Speed ◽  
Controlled Trial ◽  
Moderate Exercise ◽  
Randomized Controlled ◽  
People With Dementia ◽  
Walking Aids

Preserved Musical Instrument Playing in Dementia

2019 ◽  
pp. 138-168 ◽  
Author(s):  
Amee Baird ◽  
William Forde Thompson
Keyword(s):  
Cognitive Impairment ◽  
Frontotemporal Dementia ◽  
Case Studies ◽  
Musical Instrument ◽  
Alzheimer’S Dementia ◽  
The Self ◽  
Autobiographical Memories ◽  
Unique Form ◽  
People With Dementia ◽  
Severe Stage

The ability to play a musical instrument can remain in people with dementia, despite their cognitive impairment in other non-music domains. Case studies of people with Alzheimer’s Dementia (AD) or Behavioural variant Frontotemporal dementia (Bv-FTD) have reported preserved musical instrument playing even in the severe stage and, in some cases, the ability to learn a musical instrument after the onset of dementia. We propose that playing a musical instrument allows a unique form of access to two crucial domains, memory and the self. It enables the expression of preserved forms of memory, namely procedural, semantic, and episodic, including autobiographical memories. In doing so, it can provide access to one’s past and continuing self and can be considered a form of self-preservation and expression in musicians with dementia. Four new cases of preserved musical instrument playing in people with AD and Bv-FTD are described to illustrate our proposal.

scholarly journals The association between cognition and gait in a representative sample of very old people – the influence of dementia and walking aid use

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jerry Öhlin ◽  
Anders Ahlgren ◽  
Robert Folkesson ◽  
Yngve Gustafson ◽  
Håkan Littbrand ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Multiple Imputation ◽  
Gait Speed ◽  
Interaction Analysis ◽  
Old People ◽  
Very Old ◽  
Global Cognitive Function ◽  
People With Dementia ◽  
Walking Aids ◽  
Walking Aid

Abstract Background Cognition has been related with gait speed in older adults; however, studies involving the oldest age group, where many have mobility disability and cognitive impairment, are few. The aim was to investigate the association between global cognitive function and gait speed in a representative sample of very old people, and whether the association was affected by dementia, and walking aid use. Method This cross-sectional study included 1317 participants, mean age 89.4 years, and 68% women, from the Umeå85+/Gerontological Regional Database. Self-paced gait speed was measured over 2.4 m, with or without walking aids, and global cognitive function with the Mini-Mental State Examination (MMSE). The association between cognition and gait speed was analyzed using multiple linear regression and stratified according to dementia. The influence of missing gait speed values was explored using multiple imputation. An interaction analysis was performed to investigate the influence of walking aid use. Results In comprehensively adjusted analyses, MMSE associated with gait speed (unstandardized β (β) 0.011 m/s, 95% Confidence Interval [CI] = 0.009, 0.013, p < 0.001) in the total sample. No association was found in people with dementia (β 0.003 m/s, 95%CI = 0.000, 0.006, p = 0.058), until missing gait speed values were compensated for by multiple imputation (β 0.007 m/s, 95% [CI] = 0.002, 0.011, p = 0.002). In interaction analysis the use of walking aids attenuated the association between cognition and gait speed (β − 0.019 m/s, 95%CI = − 0.024, − 0.013, p < 0.001). Conclusion Global cognitive function appears to associate with gait speed in very old people. However, in people with dementia selection bias was indicated since unless missing gait speed values were accounted for no association was observed. Walking aid use attenuated cognitive load, which may not apply to walking in daily activities, and requires further investigation.

scholarly journals The Person, Interactions and Environment Programme to improve care of people with dementia in hospital: a multisite study

2018 ◽  
Vol 6 (23) ◽  
pp. 1-154 ◽  
Author(s):  
Mary Godfrey ◽  
John Young ◽  
Rosemary Shannon ◽  
Ann Skingley ◽  
Rosemary Woolley ◽  
...  
Keyword(s):  
Older People ◽  
Case Studies ◽  
Contextual Factors ◽  
Care Quality ◽  
Acute Hospital ◽  
Service Improvement ◽  
Patient Profile ◽  
Aggregate Information ◽  
People With Dementia ◽  
Hospital Wards

Background Improving the care of people with dementia on acute hospital wards is a policy priority. Person-centred care is a marker of care quality; delivering such care is a goal of service improvement. Objectives The Person, Interactions and Environment (PIE) Programme comprises an observation tool and a systematic approach to implement and embed a person-centred approach in routine care for hospitalised patients with dementia. The study aims were to evaluate PIE as a method to improve the care of older people with dementia on acute hospital wards, and develop insight into what person-centred care might look like in practice in this setting. Methods We performed a longitudinal comparative case study design in 10 purposively selected wards in five trusts in three English regions, alongside an embedded process evaluation. Data were collected from multiple sources: staff, patients, relatives, organisational aggregate information and documents. Mixed methods were employed: ethnographic observation; interviews and questionnaires; patient case studies (patient observation and conversations ‘in the moment’, interviews with relatives and case records); and patient and ward aggregate data. Data were synthesised to create individual case studies of PIE implementation and outcomes in context of ward structure, organisation, patient profile and process of care delivery. A cross-case comparison facilitated a descriptive and explanatory account of PIE implementation in context, the pattern of variation, what shaped it and the consequences flowing from it. Quantitative data were analysed using simple descriptive statistics. A qualitative data analysis employed grounded theory methods. Results The study furthered the understanding of the dimensions of care quality for older people with dementia on acute hospital wards and the environmental, organisational and cultural factors that shaped delivery. Only two wards fully implemented PIE, sustaining and embedding change over 18 months. The remaining wards either did not install PIE (‘non-implementers’) or were ‘partial implementers’. The interaction between micro-level contextual factors [aspects of leadership (drivers, facilitators, team, networks), fit with strategic initiatives and salience with valued goals] and meso- and macro-level organisational factors were the main barriers to PIE adoption. Evidence suggests that the programme, where implemented, directly affected improvements in ward practice, with a positive impact on the experiences of patients and caregivers, although the heterogeneity of need and severity of impairment meant that some of the more visible changes did not affect everyone equally. Limitations Although PIE has the potential to improve the care of people with dementia when implemented, findings are indicative only: data on clinical outcomes were not systematically collected, and PIE was not adopted on most study wards. Research implications Further research is required to identify more precisely the skill mix and resources necessary to provide person-focused care to hospitalised people with dementia, across the spectrum of need, including those with moderate and severe impairment. Implementing innovations to change practices in complex organisations requires a more in-depth understanding of the contextual factors that have an impact on the capacity of organisations to absorb and embed new practices. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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