494 DISCOMFORT IN PEOPLE WITH DEMENTIA ADMITTED TO AN ACUTE GENERAL MEDICAL HOSPITAL: A HOSPITAL CROSS SECTIONAL STUDY OF PREVALENCE

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii1-ii4
Author(s):  
R Low ◽  
E West ◽  
P L Sampson
Keyword(s):  
Cross Sectional Study ◽  
Acute Hospital ◽  
Neuropsychiatric Inventory ◽  
Ward Staff ◽  
Cross Sectional ◽  
People With Dementia ◽  
Acute Hospitals ◽  
Severity Of Dementia ◽  
Person With Dementia ◽  
Challenging Behaviours

Abstract Introduction The acute hospital is a challenging place for a person with dementia whose ability to communicate discomfort and need is impaired. Their discomfort may go unnoticed due to insufficient staffing and time resources in this acute environment. Concerns have been raised about the consequences of these overlooked discomfort (e.g. distress and agitation), and hence how we can correctly identify their sources and severity. This study aimed to describe the source of discomfort and challenging behaviours in people with dementia (PwD) in UK acute hospital. Method A cross-sectional observational study of 49 patients with dementia admitted to a NHS acute hospital. Their discomfort was detected and its sources were identified (Sources of Discomfort Scale) during an hour observation when they were at rest and moved by staff. Their challenging behaviours were also recorded (Neuropsychiatric Inventory) through interviewing with the ward staff, as well as documentation of severity of dementia and presence of delirium. Results The overall prevalence of discomfort was 98%, with excessively sleepy or tired being the commonest; 39 (80%) participants experienced three or more type of discomfort. The commonest sources of discomfort were physical (e.g. constipation) and environmental (e.g. physically restrained), affecting up to 43 (88%) and 42 (83%) participants respectively. There was also evidence of an association between delirium and sleepiness or tiredness’s discomfort, meaning that PwD with delirium were nearly triply as likely to feel uncomfortable because of sleepiness or tiredness. Challenging behaviours affected over 80% of our participants, with agitation or aggression being the commonest. On average, these behaviours were moderately severe. Conclusion Discomfort and challenging behaviours were very common in PwD admitted to acute hospitals. Patients and staff would benefit from more accurate and frequent detection of discomfort by focusing on non-pain-related discomfort and using observational scales.

scholarly journals Antipsychotics in people with dementia: frequency of use and rationale for prescribing in a UK mental health service

2012 ◽  
Vol 36 (5) ◽  
pp. 165-169 ◽  
Author(s):  
Monica Crugel ◽  
Gilly Paton ◽  
Pratima Singh ◽  
Regina Jeboda ◽  
Adrian Treloar
Keyword(s):  
Mental Health ◽  
Health Service ◽  
Psychotic Symptoms ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
People With Dementia ◽  
Frequency Of Use ◽  
Clinical Records ◽  
Severity Of Dementia ◽  
Challenging Behaviours

Aims and methodTo determine how often and why antipsychotic medicines are prescribed to people with dementia. A cross-sectional survey of all clinical records was conducted in one National Health Service mental health trust.ResultsOf 946 people with dementia in the trust, 186 (20%) were prescribed an antipsychotic. Prevalence increased with the severity of dementia. The most common indication for initiating treatment was agitation/distress (70%), followed by verbal aggression (45%), psychotic symptoms (44%) and physical aggression (33%). The mean number of indications per patient was 2.6. In 58% of cases, the antipsychotic had been prescribed for more than a year, and a third of patients had not been reviewed in the past 6 months.Clinical implicationsPeople with dementia who are prescribed antipsychotic drugs generally display a range of challenging behaviours, but most notably are distressed. Systems for ongoing clinical review need improvement.

scholarly journals Caregivers of people with dementia and mental health during COVID-19: findings from a cross-sectional study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Anna Messina ◽  
Martina Lattanzi ◽  
Emiliano Albanese ◽  
Maddalena Fiordelli
Keyword(s):  
Cross Sectional Study ◽  
Anxiety Symptoms ◽  
Care Recipient ◽  
Mental Wellbeing ◽  
Mild Stress ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
People With Dementia ◽  
Person With Dementia ◽  
The Impact

Abstract Background There is sparse evidence on the impact on vulnerable populations of the COVID-19 pandemic. The aim of our study was to explore burden and mental wellbeing (including depressive, anxiety, and stress symptoms) in caregivers of people with dementia during the first wave of the pandemic in Italy and southern Switzerland, two bordering regions severely hit by the COVID-19 pandemic. Methods We conducted an online cross-sectional survey with family carers of people with dementia between May and June 2020. We registered socio-demographic characteristics, and information about the relationship with the care recipient, dementia subtype, care inputs from others, and the need of care of the person with dementia. We measured caregiver burden with the Zarit Burden Interview (ZBI), psychological distress with the Depression, Anxiety and Stress Scale (DASS-21), and perceived isolation with the 3-item UCLA Loneliness Scale (UCLALS3). Results Caregivers (N =571) reported moderate to severe care-related burden (mean=54.30; SD=18.33), moderate anxiety symptoms (mean=10.04; SD=6.93), mild depressive symptoms (mean=11.79; SD=6.12) and mild stress (mean=12.95; SD=5.53), and 72.3% of participants reported to feel lonely. All scores were significantly more severe in Swiss compared to Italian caregivers (all p values<0.001). Conclusions We found that caregivers’ burden, anxiety symptoms, depression and perceived loneliness were marked during the first wave of the COVID-19 pandemic, in two severely hit bordering countries. Regional differences in the impact of the epidemic on caregivers could be due to contextual, societal, and cultural circumstances. As the pandemic endures, support to caregivers of people with dementia should be proportionate and tailored to needs and adapted to contextual factors.

Public attitudes towards people living with dementia: A cross-sectional study in urban Japan (innovative practice)

Dementia ◽  
2016 ◽  
Vol 19 (2) ◽  
pp. 438-446 ◽  
Author(s):  
Yoko Aihara ◽  
Hisako Kato ◽  
Tetsuko Sugiyama ◽  
Kuniko Ishi ◽  
Yasushi Goto
Keyword(s):  
Public Attitudes ◽  
Cross Sectional Study ◽  
Multiple Regression Model ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Knowledge And Attitudes ◽  
Positive Attitudes ◽  
People With Dementia ◽  
Key Factor ◽  
Person With Dementia

Stigma and social isolation are major challenges in building dementia friendly communities. Information is a key factor in improving knowledge and attitudes about dementia. This cross-sectional survey aimed to investigate public attitudes towards people with dementia in an urban community in Japan. Nearly 90% of the participants responded that they were able to have a good relationship with a person with dementia and help such a person if needed. However, around half of the participants would be ashamed of a family member with dementia. A multiple regression model showed that information from television and educational classes was associated with positive attitudes towards people with dementia among older adults. Information from educational classes and the Internet was likewise associated with positive attitudes among the volunteers. Increasing the availability and accessibility of information on dementia may contribute to improving public attitudes towards people with dementia.

Relationship Between Quality of Life of People with Dementia and Their Caregivers in Indonesia

2021 ◽  
pp. 1-10
Author(s):  
Martina Wiwie S. Nasrun ◽  
Profitasari Kusumaningrum ◽  
Petrin Redayani ◽  
Hasya Layalia Lahino ◽  
Fithriani Salma Mardhiyah ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Strong Correlation ◽  
Elderly Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
People With Dementia ◽  
Care Improvement ◽  
Severity Of Dementia ◽  
The Relationship

Background: Caregivers, as one of the most important roles in caring for a person with dementia, have a challenging task. Therefore, maintaining the quality of life (QoL) of caregivers is an integral part of dementia care. Objective: To explore the relationship between the QoL of people with dementia and their caregivers in Indonesia. Methods: This is a cross-sectional study using binary correlations to analyze the relationship between people with dementia and caregivers’ QoL. Conducted in Cipto Mangunkusumo Hospital in Jakarta, the subjects were 42 people diagnosed with dementia according to the PPDGJ-III (adapted from the ICD 10) and 42 primary caregivers with at least 6 hours duration of caregiving per day. The QoL of people with dementia was measured by EuroQol-5D and VAS EQ-5D, while severity of dementia was measured by MMSE. Caregivers underwent an interview using WHO Quality of Life Instrument (WHOQOL-BREF) and NPI. Results: Most caregivers were women, aged 40–70 years old. The study found caregivers’ QoL environmental domain strongly correlated with people with dementia’s QoL (r = 0.839). Severity of dementia had a strong correlation with caregivers’ QoL physical domain (r = 0.946). Age, duration of caregiving per day, period of care provided by caregivers, and caregiver’s distress had a strong correlation with caregiver QoL for specific domains. Conclusion: There was a strong correlation between people with dementia’s QoL and caregiver QoL, so in managing dementia, clinicians should consider caregivers’ wellbeing as an essential part significantly affecting the quality of elderly care improvement.

scholarly journals The Relationship between Clinic Visit Accompanied by Family and Dementia Severity in Taiwan

2021 ◽  
Vol 18 (4) ◽  
pp. 1792
Author(s):  
Chih-Yen Chang ◽  
Shou-Jen Lan ◽  
Chiao-Lee Chu ◽  
Ching-Sung Ho
Keyword(s):  
Educational Level ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Clinic Visit ◽  
Clinical Dementia Rating ◽  
Score Distribution ◽  
Chi Square ◽  
Cross Sectional ◽  
Central Taiwan ◽  
Severity Of Dementia

Introduction: This study analyzes the severity of dementia status with clinical dementia rating (CDR) score distribution among patients according to various family functional and sociodemographic issues. Methods: A cross-sectional study was performed in a regional hospital in Central Taiwan. The sample consisted of 318 patients who came to the clinic from May 2018 to April 2019, and who were diagnosed by the physicians with CDR scores ≧ 0.5. The Chi-Square test and binary logistic regression analyses were performed for inferential statistical analysis. Results: The mean age of the sample was 78.7 ± 8.51 years, and 61.6% of the samples’ CDR scores were equal or less than 1.0. Patients visiting the clinic were accompanied by spouses (21.7%), sons or daughters-in-law (40.6%), daughters (23.6%). Of the sample, 142 (44.3%) patients live with sons. Patients with a lower educational level had higher CDR scores. Compared to the patients who went to the clinic by themselves, the higher OR values of CDR scores ≧ 2 are found in patients who were accompanied by other relatives (OR = 18.871, 95% C.I. = 3.117–114.237, p = 0.001), or spouse (OR = 10.783, 95% C.I. = 1.996–58.245, p = 0.006). Conclusion: The family member who accompanied the patient to a clinic visit and the patient’s educational level are both significant issues relating to the severity of dementia.

scholarly journals Use of the first National Early Warning Score recorded within 24 hours of admission to estimate the risk of in-hospital mortality in unplanned COVID-19 patients: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043721
Author(s):  
Donald Richardson ◽  
Muhammad Faisal ◽  
Massimo Fiori ◽  
Kevin Beatson ◽  
Mohammed Mohammed
Keyword(s):  
Hospital Mortality ◽  
Early Warning ◽  
Absolute Risk ◽  
Cross Sectional Study ◽  
Early Warning Score ◽  
Cross Sectional ◽  
Risk Of Mortality ◽  
Baseline Mortality ◽  
Acute Hospitals ◽  
National Early Warning Score

ObjectivesAlthough the National Early Warning Score (NEWS) and its latest version NEWS2 are recommended for monitoring deterioration in patients admitted to hospital, little is known about their performance in COVID-19 patients. We aimed to compare the performance of the NEWS and NEWS2 in patients with COVID-19 versus those without during the first phase of the pandemic.DesignA retrospective cross-sectional study.SettingTwo acute hospitals (Scarborough and York) are combined into a single dataset and analysed collectively.ParticipantsAdult (≥18 years) non-elective admissions discharged between 11 March 2020 and 13 June 2020 with an index or on-admission NEWS2 electronically recorded within ±24 hours of admission to predict mortality at four time points (in-hospital, 24 hours, 48 hours and 72 hours) in COVID-19 versus non-COVID-19 admissions.ResultsOut of 6480 non-elective admissions, 620 (9.6%) had a diagnosis of COVID-19. They were older (73.3 vs 67.7 years), more often male (54.7% vs 50.1%), had higher index NEWS (4 vs 2.5) and NEWS2 (4.6 vs 2.8) scores and higher in-hospital mortality (32.1% vs 5.8%). The c-statistics for predicting in-hospital mortality in COVID-19 admissions was significantly lower using NEWS (0.64 vs 0.74) or NEWS2 (0.64 vs 0.74), however, these differences reduced at 72hours (NEWS: 0.75 vs 0.81; NEWS2: 0.71 vs 0.81), 48 hours (NEWS: 0.78 vs 0.81; NEWS2: 0.76 vs 0.82) and 24hours (NEWS: 0.84 vs 0.84; NEWS2: 0.86 vs 0.84). Increasing NEWS2 values reflected increased mortality, but for any given value the absolute risk was on average 24% higher (eg, NEWS2=5: 36% vs 9%).ConclusionsThe index or on-admission NEWS and NEWS2 offers lower discrimination for COVID-19 admissions versus non-COVID-19 admissions. The index NEWS2 was not proven to be better than the index NEWS. For each value of the index NEWS/NEWS2, COVID-19 admissions had a substantially higher risk of mortality than non-COVID-19 admissions which reflects the increased baseline mortality risk of COVID-19.

scholarly journals Neuropsychiatric symptoms and severity of dementia

2013 ◽  
Vol 7 (2) ◽  
pp. 171-175
Author(s):  
Gustavo Henrique de Oliveira Caldas ◽  
Sueli Luciano Pires ◽  
Milton Luiz Gorzoni
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Motor Behavior ◽  
Neuropsychiatric Symptoms ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Clinical Dementia Rating ◽  
Cross Sectional ◽  
Specific Stage ◽  
Severity Of Dementia

ABSTRACT Neuropsychiatric symptoms (NPS) cause distress, disabilitiy and reduced quality of life for both the patient and their families Objective: To evaluate the prevalence of NPS as a specific stage of dementia status. Methods: A cross-sectional study in patients attending an outpatient clinic for dementia was performed. We applied the Neuropsychiatric Inventory and Clinical Dementia Rating (CDR) scale. Statistical analysis was carried out with SPSS 17 software. Results: The 124 subjects (mean age of 80.4±7.0 years), 88 women (70.9%) had average duration of dementia of 7.1±3.2 years, most common dementias of Alzheimer's disease (35.5%) and mixed (31.5%) and most prevalent NPS of apathy (75%) and irritability (66.9%). Correlation between apathy and a CDR 1 had a PR (prevalence ratio) = 0.289 and p<0.001 while between apathy and CDR 4-5 (PR=8.333, p<0.005). A similar result was found between aberrant motor behavior (AMB) and CDR 1 (PR=0.352, p<0.003) and between AMB and CDR4-5 (PR=2.929, p<0.006). Conclusion: Alzheimer's disease and mixed dementia were predominant, while apathy and AMB were detected in association with the progressive stages of dementia.

How do people with dementia respond to different types of art? An explorative study into interactive museum programs

2018 ◽  
Vol 31 (06) ◽  
pp. 857-868 ◽  
Author(s):  
I. Hendriks ◽  
F. J. M. Meiland ◽  
K. Slotwinska ◽  
R. Kroeze ◽  
H. Weinstein ◽  
...  
Keyword(s):  
Cognitive Impairments ◽  
Target Group ◽  
Cross Sectional ◽  
Art Programs ◽  
People With Dementia ◽  
Study Results ◽  
Different Types ◽  
Museum Programs ◽  
Severity Of Dementia ◽  
Museum Tour

ABSTRACTObjectives:Various art programs are available for people with dementia. These have been shown to contribute to the patient’s quality of life. But are all types of art suitable for this purpose and for the target group? This study investigated whether responsiveness during museum programs depends on the type of art work shown and/or characteristics of the person with dementia, such as severity of dementia or specific cognitive impairments.Method:A cross-sectional observational study was conducted in which the responsiveness of people with dementia to different types of art was investigated as part of a study into the implementation of the Unforgettable program, an interactive guided museum tour program in Dutch museums for people with dementia.Results:The appreciative and active responsiveness and interaction with others during the program appeared related to the severity of dementia, to specific cognitive impairments, and to type of artworks. People with more severe dementia responded less to art than people with mild dementia. Artworks with more natural elements revealed less interaction with others. Artifacts (i.e., objects not originally meant as artworks) evoked more reactions than artworks.Conclusion:The study results are important to take into account when designing and offering art programs for people with dementia. Knowing which type of art works appeals most to (subgroups of) people with dementia will contribute to the optimization of art programs for this target group and to their active participation in such programs.

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