scholarly journals Associations between unmet needs for daytime activities and company and scores on the Neuropsychiatric Inventory-Questionnaire in people with dementia: a longitudinal study

2021 ◽  
pp. 1-10
Author(s):  
Mona Michelet ◽  
Geir Selbaek ◽  
Bjørn Heine Strand ◽  
Anne Lund ◽  
Knut Engedal ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Unmet Needs ◽  
Neuropsychiatric Inventory ◽  
People With Dementia

scholarly journals A Longitudinal Study of Functional Unmet Need Among People with Dementia

2021 ◽  
pp. 1-12
Author(s):  
Sanna Read ◽  
Bo Hu ◽  
Raphael Wittenberg ◽  
Nicola Brimblecombe ◽  
Louise Robinson ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Unmet Needs ◽  
Functional Limitations ◽  
Care Home ◽  
Functional Decline ◽  
Unmet Need ◽  
Community Dwelling ◽  
Latent Growth Curves ◽  
People With Dementia ◽  
Over Time

Background: Understanding the changes of unmet need in dementia may enable effective targeting of help and allow people to stay in their homes longer. Objective: We investigated changes in unmet need and functioning over a 4-year period and the role of socio-demographic factors in these changes among people with dementia. Methods: 234 community-dwelling people with dementia at baseline were studied in three consecutive waves (four years) of the English Longitudinal Study of Ageing (ELSA). Unmet needs (self/informant-reported limitations for which no help was received) and functional limitations (self/informant-reported difficulties in activities/instrumental activities of daily living and mobility) were modelled with latent growth curves. Sex, age, partnership, and socioeconomic status at baseline were used as predictors. Admission to a care home was an additional outcome. Results: Unmet needs increased over time, especially among those who initially had more functional limitations. Unmet needs contributed to faster decline in functional capability, except among those with many limitations initially. The major driver of increased unmet needs was not having a partner (direct effect). Age, sex, and wealth contributed indirectly via the initial level of functional limitations and/or unmet need. Those with several functional limitations but few unmet needs were most likely to move to a care home. Conclusion: Unmet need increases over time in those with dementia with mitigating effects of having a partner and initial levels of functioning. Meeting needs at early stages of dementia, especially for those living alone and when functional limitations are low may help slow functional decline.

scholarly journals 411 - Implementing the STrAtegies for RelaTives (START) intervention in Portugal – preliminary findings

2020 ◽  
Vol 32 (S1) ◽  
pp. 127-127
Author(s):  
Fatima Urzal ◽  
Ana Quintão ◽  
Catarina Santos ◽  
Nuno Moura ◽  
Ana Banazol ◽  
...  
Keyword(s):  
Pilot Study ◽  
Coping Strategies ◽  
Family Caregivers ◽  
Clinical Training ◽  
Unmet Needs ◽  
Depression Scale ◽  
Subjective Impression ◽  
Implementation Challenges ◽  
People With Dementia ◽  
The Uk

IntroductionAs in other countries, Portuguese family caregivers have unmet needs regarding information and distress. START (STrAtegies for RelaTives) is a manual-based coping intervention for families of people with dementia, including coping strategies and stress-management components, by Livingston and colleagues (https://www.ucl.ac.uk/psychiatry/research/mental-health-older-people/projects/start). In the UK, START has been clinically effective, immediately and continuing even after 6-years, without increasing costs. Clinical training and supervision ensures treatment fidelity. In Portugal, these kind of interventions are less available and, when provided, are mostly supportive and fail to address coping strategies. Paradoxically, recruitment may also prove challenging.ObjectivesWe describe the development of the Portuguese translation of START, incorporating guidance from the UK team, and a pilot study of delivery to family caregivers of people with dementia. We will also discuss the challenges of recruiting participants and delivering the intervention.MethodWe translated the START intervention and recruited family caregivers from neurology and psychiatry outpatients, in a central hospital in Lisbon. Our baseline assessment included the Hospital Anxiety and Depression Scale and the Zarit Burden Interview. The pilot is still ongoing at time of submitting, so we focus on recruitment, baseline assessments and process issues.ResultsDuring a three-month period, we recruited six caregivers. Five were primary caregivers (spouses or adult children) who had been caring for their relatives for 2 up to 10 years. Two caregivers met the international cutoff for clinically relevant affective disorder . The most frequent motivators for taking part were learning to communicate with their relatives and increasing knowledge to build community resources. Overall, the subjective impression of the therapist in charge is that the intervention seems acceptable and promising.Discussion/ConclusionsThis pilot study will eventually lead to an improved version of the Portuguese version of the START manual. So far, the intervention seems appropriate for selected caregivers in Portugal. However, response to striking unmet needs, particularly basic home support, may need to precede interventions like START. We look forward to concluding the intervention study and analyzing the implementation challenges, as a basis to inform a wider-scale trial.

scholarly journals Living at the farm, innovative nursing home care for people with dementia – study protocol of an observational longitudinal study

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
B. de Boer ◽  
J.P.H. Hamers ◽  
H.C. Beerens ◽  
S.M.G. Zwakhalen ◽  
F.E.S. Tan ◽  
...  
Keyword(s):  
Nursing Home ◽  
Longitudinal Study ◽  
Home Care ◽  
Study Protocol ◽  
Nursing Home Care ◽  
People With Dementia

scholarly journals Family carers' distress and abusive behaviour: longitudinal study

2010 ◽  
Vol 196 (6) ◽  
pp. 480-485 ◽  
Author(s):  
Claudia Cooper ◽  
Martin Blanchard ◽  
Amber Selwood ◽  
Zuzana Walker ◽  
Gill Livingston
Keyword(s):  
Longitudinal Study ◽  
Elder Abuse ◽  
Anxiety And Depression ◽  
Psychological Interventions ◽  
Family Carers ◽  
People With Dementia ◽  
Specialist Services ◽  
The Family ◽  
Abusive Behaviour ◽  
Conflict Tactics

BackgroundA third of family carers of people with dementia report abusive behaviour towards the person for whom they are caring. This is the first longitudinal study to investigate such behaviour.AimsTo test our hypotheses that carers' reports of abusive behaviour would increase over time, and that change in abuse scores would be predicted by change in anxiety and depression scores.MethodIn total, 131 (71.6%) of the family/friend dementia carers consecutively recruited from new referrals to Essex and London community mental health teams who were interviewed at baseline, completed the revised Modified Conflict Tactics Scale to measure abuse 1 year later.ResultsSixty-three (48.1%) of the carers reported any abusive behaviour at baseline compared with 81 (61.8%) a year later (χ2 = 6.9, P = 0.009). An increase in abuse scores was predicted by an increase in anxiety and depressive symptoms (respectively ß = 0.32, t = 3.9, P<0.001 and ß = 0.24, t = 2.9, P = 0.005), and by less domiciliary care at baseline (ß = –0.18, t =–2.2, P = 0.031).ConclusionsMost abusive behaviour reported by carers at baseline persisted or worsened in the following year, despite contact with specialist services. We suggest that trials of psychological interventions shown to reduce anxiety and depression in the carers of people with dementia are needed to determine whether they also reduce elder abuse, and can be delivered cost-effectively within the National Health Service (NHS).

scholarly journals TRATAMIENTO DE LA FRAGILIDAD Y APATÍA A TRAVÉS DE ACTIVIDADES PSICOMOTRICES EN LA ENFERMEDAD DE ALZHEIMER

2016 ◽  
Vol 1 (2) ◽  
pp. 103
Author(s):  
Claudia Guillen-Betancort ◽  
Guillermo Da Silva-Domingo ◽  
Josefa González Santos ◽  
Raquel De la Fuente-Anuncibay ◽  
Álvaro Da Silva González ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Occupational Therapy ◽  
Elderly People ◽  
Disease Type ◽  
Initial Assessment ◽  
Spearman Correlation ◽  
Vital Functions ◽  
People With Dementia ◽  
Relationship Of ◽  
Therapy Treatment

Abstract.Objective: To implement an Occupational Therapy treatment in elderly people with dementia and frailtyMethod: A longitudinal study of a sample of 23 users, 14 women and 9 men aged between 71 and 92 is performed, the average age 84.66 years, users of a residence, presenting frailty and dementia. Carried out an initial assessment and final tests with Short Physical Performance Battery (SPPB) and Dementia Apathy Interview and Rating (DAIR), participants attend occupational therapy sessions.Statistical analysis: it was performed nonparametric Wilcoxon, Spearman correlation and Mann Whitney U test.Results: We observed that the levels of fragility do not improve, there is no relationship of age with frailty, the level of apathy does not decrease with the intervention, there is no difference in the score of apathy or fragility by sex.Conclusions: the results indicate a maintenance of vital functions on both scales, which can be considered beneficial when dealing with degenerative processes.Keywords: fragility, apathy, dementia of Alzheimer’s disease type, psychomotor activities.Resumen.Objetivo: Implementar un tratamiento de Terapia Ocupacional en personas mayores con demencia y fragilidadMétodo: Se realiza un estudio longitudinal sobre una muestra de 23 usuarios, 14 mujeres y 9 hombres con edades comprendidas entre 71 y 92, siendo la edad media 84.66 años, usuarios de una residencia, que presentan fragilidad y demencia. Se lleva a cabo una evaluación inicial y otra final con las pruebas Batería Corta del Desempeño Físico (SPPB) y Dementia Apathy Interview and Rating (DAIR), los participantes asisten a sesiones de Terapia Ocupacional.Análisis estadístico: se llevan a cabo pruebas no paramétricas de Wilcoxon, Correlación de Spearman y U de Mann Whitney.Resultados: se observa que los niveles de fragilidad no mejoran, que no hay relación de la edad con la fragilidad, el nivel de apatía no disminuye con la intervención, no existen diferencias en la puntuación de apatía ni fragilidad según el sexo.Conclusiones. los resultados indican un mantenimiento de las funciones vitales en ambas escalas, lo que se puede considerar beneficioso al tratarse de procesos degenerativos.Palabras clave: fragilidad, apatía, demencia tipo Alzhéimer, actividades psicomotrices.

scholarly journals Pain Assessment in People With Dementia: Remaining Controversies

2018 ◽  
Vol 10 (5) ◽  
pp. 62 ◽  
Author(s):  
Mohammad Rababa
Keyword(s):  
Pain Assessment ◽  
Gold Standard ◽  
Unmet Needs ◽  
Behavioral Changes ◽  
Self Report ◽  
Advanced Dementia ◽  
Affective Experience ◽  
Pain Experience ◽  
People With Dementia ◽  
Background Pain

BACKGROUND: Pain in people with dementia is under recognized, underestimated, and under-treated due to the complexity of pain assessment in this population.SUMMARY: Self-report tools are the gold standard of pain assessment. However, people with dementia are not always able to clearly and meaningfully self-report their pain. Self-report tools capture the affective experience of pain, which is impaired in people with dementia. Observational pain tools are more useful to assess pain especially in people with advanced dementia who are unable to self-report. Observational pain tools capture the physical component of pain experience, which is unchanged in people with dementia. However, nurses often misunderstand the behavioral changes associated with pain in people with dementia. Also, there is a huge inconsistency in presentation of these behavioral changes associated with pain among people with dementia as behaviors can be due to multiple different unmet needs, pain being one.

scholarly journals Profiles of Met and Unmet Needs in People with Dementia According to Caregivers’ Perspective: Results from a European Multicenter Study

2020 ◽  
Vol 21 (11) ◽  
pp. 1609-1616.e1 ◽  
Author(s):  
Niels Janssen ◽  
Ron L. Handels ◽  
Sebastian Köhler ◽  
Manuel Gonçalves-Pereira ◽  
Maria J. Marques ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Unmet Needs ◽  
People With Dementia ◽  
European Multicenter Study

scholarly journals Necessidades de Cuidados e Recurso aos Serviços na Demência: Avaliação Inicial da Coorte Portuguesa no Estudo Actifcare

2019 ◽  
Vol 32 (5) ◽  
pp. 355 ◽  
Author(s):  
Manuel Gonçalves-Pereira ◽  
Maria J. Marques ◽  
Conceição Balsinha ◽  
Alexandra Fernandes ◽  
Ana Sá Machado ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Unmet Needs ◽  
Community Support ◽  
Community Dwelling ◽  
Formal Care ◽  
Needs For Care ◽  
People With Dementia ◽  
Moderate Dementia ◽  
Formal Services ◽  
Timely Access

Introduction: People with dementia and their relatives should have timely access to formal care in the community. The EU-Actifcare project analysed access to and use of formal services, as related to unmet needs for care. We describe the cohort study implementation and baseline results in Portugal, with a focus on needs for care and service use assessments.Material and Methods: Our convenience sample consisted of 66 dyads of community-dwelling people with mild to moderate dementia and no significant use of formal services, and their informal carers. Measures included the Camberwell Assessment of Need for the Elderly and Resources Utilization in Dementia.Results: People with dementia had unmet needs (mean 1.1; SD 1.7), mainly regarding company (23%), psychological distress (20%), and daily activities (14%). Family caregivers spent 150 minutes/day (median) providing support, and 44% had psychological distress unmet needs. Problems with access to or use of formal services, when present, were frequently due to attitudes or lack of knowledge of any or both members of the dyad.Discussion: The recruitment process was challenging, since the inclusion criteria were restrictive. Not claiming generalizability, we recruited a typical sample of Portuguese people with mild to moderate dementia and no significant formal community support. Levels and type of unmet needs found in some participants would call for formal support, were it not for problems regarding access or use.Conclusion: There are difficulties regarding timely access and effective use of formal care in dementia, along with relevant unmet needs.

Dementia, Sexuality, and the Law: The Case for Advance Decisions on Intimacy

2020 ◽  
Author(s):  
Oluwatoyin Sorinmade ◽  
Alex Ruck Keene ◽  
Carmelle Peisah
Keyword(s):  
Sexual Activity ◽  
Unmet Needs ◽  
England And Wales ◽  
Capacity To Consent ◽  
Level Of Functioning ◽  
People With Dementia ◽  
The World ◽  
The Law ◽  
Advance Decisions ◽  
The Right

Abstract Some individuals develop dementia and the invariable consequence of dementia is a decline in cognition and level of functioning. Despite the effects of this illness, people with dementia still seek intimacy and companionship as part of their expression of basic human instincts and have the right to equal enjoyment of relationships and privacy for such. At the same time, they have the right to be safeguarded against abuse. The law in England and Wales, in common with the majority, if not all, jurisdictions around the world is clear on the requirement for contemporaneous consent to sexual activity, thereby creating unmet needs for people with dementia who no longer have the capacity to consent to intimacy/sexuality. This creates an impetus to find ways to empower individuals with dementia to enjoy intimacy in a safe and lawful way and enable them to live well despite dementia. This article proposes an instrument known as the Advance Decision on Intimacy, in pursuit of the concept of precedent autonomy, to empower individuals to make decisions about how they would wish to express their sexuality at a material time in future when they would have lost the capacity to consent to such acts. While the article is framed by reference to English law, the principles are of wider relevance.

A grounded theory longitudinal study of carers’ experiences of caring for people with dementia

Dementia ◽  
2011 ◽  
Vol 11 (2) ◽  
pp. 181-197 ◽  
Author(s):  
Mei-Chun Lin ◽  
Maureen Macmillan ◽  
Norrie Brown
Keyword(s):  
Grounded Theory ◽  
Longitudinal Study ◽  
People With Dementia
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