scholarly journals An individualised, non-pharmacological treatment strategy associated with an improvement in neuropsychiatric symptoms in a man with dementia living at home

2019 ◽  
Vol 12 (5) ◽  
pp. e229048 ◽  
Author(s):  
Mark McLean Carter ◽  
Angelina Wei ◽  
Xinlei Li
Keyword(s):  
Neuropsychiatric Symptoms ◽  
Emergency Department Visits ◽  
Pharmacological Interventions ◽  
First Line ◽  
Term Care ◽  
People With Dementia ◽  
Care Facilities ◽  
At Home

More than 90% of people with dementia experience neuropsychiatric symptoms which are often distressing and can result in early institutionalisation, diminished quality of life, increased frequency of emergency department visits along with stress and ill-health in caregivers. Non-pharmacological interventions are recommended as first-line treatment for neuropsychiatric symptoms, instead of medications such as atypical antipsychotics which have significant side effects. Most systematic reviews of non-pharmacological interventions for neuropsychiatric symptoms of dementia focus on patients in long-term care facilities and there are a limited number of research studies assessing the use of non-pharmacological interventions for patient’s living at home. In this case report, we discuss an elderly man with dementia whose cognitive symptoms were accompanied by significant neuropsychiatric symptoms of suspicion, delusions, agitation and aggression. We describe how a programme of individualised, non-pharmacological interventions was associated with an improvement in neuropsychiatric symptoms within 3 months.

Multiple perspectives on quality of life for residents with dementia in long term care facilities: protocol for a comprehensive Australian study

2015 ◽  
Vol 27 (10) ◽  
pp. 1739-1747 ◽  
Author(s):  
Elizabeth Beattie ◽  
Maria O’Reilly ◽  
Wendy Moyle ◽  
Lynn Chenoweth ◽  
Deirdre Fetherstonhaugh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Long Term Care ◽  
Self Report ◽  
Care Staff ◽  
National Study ◽  
Term Care ◽  
People With Dementia ◽  
Care Facilities

ABSTRACTBackground:Dementia is a chronic illness without cure or effective treatment, which results in declining mental and physical function and assistance from others to manage activities of daily living. Many people with dementia live in long term care facilities, yet research into their quality of life (QoL) was rare until the last decade. Previous studies failed to incorporate important variables related to the facility and care provision or to look closely at the daily lives of residents. This paper presents a protocol for a comprehensive, multi-perspective assessment of QoL of residents with dementia living in long term care in Australia. A secondary aim is investigating the effectiveness of self-report instruments for measuring QoL.Methods:The study utilizes a descriptive, mixed methods design to examine how facility, care staff, and resident factors impact QoL. Over 500 residents with dementia from a stratified, random sample of 53 facilities are being recruited. A sub-sample of 12 residents is also taking part in qualitative interviews and observations.Conclusions:This national study will provide a broad understanding of factors underlying QoL for residents with dementia in long term care. The present study uses a similar methodology to the US-based Collaborative Studies of Long Term Care (CS-LTC) Dementia Care Study, applying it to the Australian setting.

scholarly journals The effects of placement on dementia care recipients’ and family caregivers’ quality of life: a literature review

2017 ◽  
Vol 18 (1) ◽  
pp. 44-57 ◽  
Author(s):  
Heehyul Moon ◽  
Peggye Dilworth-Anderson ◽  
Johannes Gräske
Keyword(s):  
Quality Of Life ◽  
Long Term Care ◽  
Research Literature ◽  
Term Care ◽  
Content Type ◽  
Care Recipients ◽  
People With Dementia ◽  
Care Facilities

Purpose The purpose of this paper is to review and synthesize the research literature on the quality of life (QoL) of both caregivers (CGs) and care recipients (CRs) with dementia after admission to long-term care facilities. Design/methodology/approach Four databases – AgeLine, Medline, EBSCO, and PyscINFO – were searched and the relevant literature from 2002 onwards was reviewed. Findings The review of 12 studies (five studies, including only family CGs; six studies including residents; one study including both family CGs and CRs) reveals a discrepancy regarding the effects of institutionalization on the CRs’ and CGs’ QoL. Among seven studies on CRs’ QoL change, some reviewed studies found a significant decline in CRs’ QoL after placement with others showing that CRs’ QoL was improved or stable. While some reports indicated that some family CGs benefited from placement, others showed that CGs merely maintained their QoL. However, family CGs in the reviewed studies were more likely to report improved QoL than were their CRs after institutionalization. Research limitations/implications The authors recommend that future studies should focus on understanding the individual’s adaptation to placement, dyadic changes in QoL (including mediators/moderators). They emphasize the need for a comprehensive longitudinal study with more than one wave and includes diverse groups including racial/ethnic minority CGs and CRs. Originality/value This study reviewed and synthesized the research literature on the QoL of both caregiver and the people with dementia they cared for after those they cared for were admitted to long-term care facilities. The conclusions drawn about influences on QoL provide guidance for identifying best practices and research.

scholarly journals 514 - Practice-based intervention to implement Person Centered care in long-term care facilities for people with Dementia

2021 ◽  
Vol 33 (S1) ◽  
pp. 64-65
Author(s):  
Claudia Van Der Velden ◽  
Henriëtte G. Van Der Roest
Keyword(s):  
Healthcare Professionals ◽  
Long Term Care ◽  
Term Care ◽  
Person Centered Care ◽  
People With Dementia ◽  
Care Facilities ◽  
Centered Care ◽  
E Learning

Healthcare professionals working with people with dementia (PwD) have increasingly been moving away from task-oriented models of healthcare towards person-centered care (PCC). Several studies have showed positive results of PCC on quality of life of PwD. Also, it shows positive effects on self-esteem and work satisfaction of healthcare professionals (HCP).We developed an successful practice-oriented intervention to implement PCC in long-term care facilities (LTCFs), based on the theory of Kitwood. The intervention consists of different components and learning methods: 1)Management of the facility is trained. They have an important role in motivating HCPs and safeguarding PCC-policy in the future.2)Dementia Care Mapping (DCM)-observations are carried out to gain understanding of the LTCF. DCM is an evidence-based observational method and aims to give a good understanding of the quality of life of PwD.3)The training of staff starts with a Kick-off-meeting. During a ‘Mirror theater’ with professional actors, an act representing a familiar care situation is performed. Staff participates in the act to become aware of PCC. The kick-off also serves as a warming-up on PCC knowledge.4)After this, staff complete an interactive e-learning on the basic theory of PCC. The e-learning contains practical videos and exercises.5)Finally, staff follow two consecutive, practical-oriented team-trainings. They will learn what PCC means for their daily practice and how to reflect on it. The most effective part is the reflection on examples of their own clients, and get more aware of their own behavior. In between trainings, HCP will carry out a practice exercise and provide feedback in session two.In an early stage of the intervention we discuss the possibilities and adjust the approach to the needs and situation (culture, level of knowledge etc.) of the LTCF. Involvement of all the staff in the intervention is essential, so everyone speaks the same ‘language’ and staff can rely on each other. Based on experience, these factors contributes to a sustainable way to implement PCC in LTCFs.

scholarly journals Non-pharmacological interventions for improving quality of life of long-term care residents with dementia: a scoping review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032661
Author(s):  
Abimbola A Akintola ◽  
Wilco P Achterberg ◽  
Monique A A Caljouw
Keyword(s):  
Quality Of Life ◽  
Scoping Review ◽  
Long Term Care ◽  
Pharmacological Interventions ◽  
Term Care ◽  
People With Dementia ◽  
Scoping Reviews ◽  
Review Protocol

IntroductionEvidence concerning the effectiveness of non-pharmacological interventions that are applied to people with dementia living in long-term care facilities is inconsistent. The purpose of this protocol is to describe the methodological considerations that will guide the completion of a scoping review that will inventorise and assess the effectiveness of the various non-pharmacological interventions that are documented in literature for improving quality of life of people with dementia living in long-term care.Methods and analysisThis scoping review will combine the methodology outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and Guidance for conducting systematic scoping reviews by Peterset al. PubMed; MEDLINE; CINAHL; Embase; Cochrane Database of Systematic Reviews; Cochrane Central Register of Controlled Trials; Emcare; Sociological Abstracts and PsycINFO databases will be searched. Grey literature databases will also be explored. A two-stage screening process consisting of a title and abstract scan and a full-text review will be used to determine the eligibility of studies. Studies, irrespective of design, will be included that quantitatively assess quality of life of long-term care residents who receive non-pharmacological interventions for dementia. A pair of reviewers will independently assess all articles for eligibility, and all eligible articles will be abstracted and charted using a standardised form. The extracted data will undergo a ‘narrative review’ or a descriptive analysis of the contextual or process-oriented data and quantitative analysis reflecting the objectives of this scoping review.Ethics and disseminationResearch ethics approval is not required for this scoping review. This review started off in October 2018, anticipated end date is June 2020. We plan to disseminate this research through publications, presentations at relevant national and international conferences and meetings with relevant stakeholders. This scoping review protocol has been registered at Open Science Framework (https://osf.io/tupbv).

scholarly journals Does paracetamol improve quality of life, discomfort, pain and neuropsychiatric symptoms in persons with advanced dementia living in long-term care facilities? A randomised double-blind placebo-controlled crossover (Q-PID) trial

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Paulien H. van Dam ◽  
Wilco P. Achterberg ◽  
Bettina S. Husebo ◽  
Monique A. A. Caljouw
Keyword(s):  
Long Term Care ◽  
Pain Treatment ◽  
Neuropsychiatric Symptoms ◽  
Study Medication ◽  
Advanced Dementia ◽  
Double Blind ◽  
Term Care ◽  
Care Facilities

Abstract Background The objectives of this study are to determine the effects of regularly scheduled administration of paracetamol (acetaminophen) on quality of life (QoL), discomfort, pain and neuropsychiatric symptoms of persons with dementia living in long-term care facilities (LTCFs). Methods A multicentre randomised double-blind placebo-controlled crossover trial for 13 weeks (January 2018 to June 2019) in 17 LTCFs across the west of the Netherlands. Inclusion criteria were age ≥ 65 years, (advanced) dementia and a moderate to low QoL, independent of the presence of pain (QUALIDEM ≤ 70). Exclusion criteria were the use of regular pain treatment, allergies to the study medication, severe liver disease, use of > 4 units of alcohol/day, weight < 50 kg and/or concomitant use of flucloxacillin. Participants received study medication (paracetamol/placebo) in two periods of 6 weeks each (1 week in between as a wash-out period). Randomisation decided in which order participants received paracetamol and placebo. Primary outcomes included QoL (QUALIDEM) and discomfort (DS-DAT), secondary outcomes included pain (MOBID-2) and neuropsychiatric symptoms (NPI-NH). Results Ninety-five LTCF residents (mean age 83.9 years [SD 7.6], 57.9% females) were included. Repeated linear mixed models showed no difference in mean differences of QUALIDEM (paracetamol +1.3 [95% CI -1.0–3.5], placebo +1.5 [95% CI -0.7–3.8]), DS-DAT (paracetamol -0.1 [95% CI -1.4–1.2], placebo 0.6 [95 CI -0.7–1.8]), MOBID-2 (paracetamol 0.0 [95% CI -0.5–0.5], placebo -0.2 [95% CI -0.7–0.3]) and NPI-NH (paracetamol +1.5 [95% CI -2.3–5.4], placebo -2.1 [95% CI -6.0–1.7]) in favour of either paracetamol or placebo. Conclusions Compared to placebo, paracetamol showed no positive effect on QoL, discomfort, pain and neuropsychiatric symptoms in persons with advanced dementia with low QoL. It is important to find out more specifically which individual persons with advanced dementia could benefit from pain treatment with paracetamol, and for clinicians to acknowledge that a good assessment, monitoring and multidomain approach is vital for improving QoL in this vulnerable group. Trial registration Netherlands Trial Register NTR6766. Trial registration date: 20 October 2017

The association between aspects of daily life and quality of life of people with dementia living in long-term care facilities: a momentary assessment study

2016 ◽  
Vol 28 (8) ◽  
pp. 1323-1331 ◽  
Author(s):  
Hanneke C. Beerens ◽  
Bram de Boer ◽  
Sandra M.G. Zwakhalen ◽  
Frans E.S. Tan ◽  
Dirk Ruwaard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Interaction ◽  
Long Term Care ◽  
Daily Life ◽  
Positive Mood ◽  
Term Care ◽  
People With Dementia ◽  
Care Facilities

ABSTRACTBackground:To improve the quality of life (QoL) of people with dementia (PwD) living in long-term care facilities, insight into the association between QoL and how people spend their daily lives is urgently needed. This study investigated which aspects of daily life are related to QoL in dementia.Methods:An observational study was conducted. Daily life was assessed with the tablet-based Maastricht Electronic Daily Life Observation-tool (MEDLO-tool). Aspects included activity, engagement in the activity, social interaction, physical effort, mood, and agitation. QoL was assessed by formal nursing caregivers using the Quality of Life-Alzheimer's Disease scale (QoL-AD). A total of 9,660 momentary assessments were conducted.Results:The mean age of the 115 participants was 84 years and most (75%) were women. Bivariate analyses showed that residents with a higher QoL carried out less passive/purposeless activities (25% vs. 38%), were more engaged in active, expressive, and social activities, (40% vs. 27%), had more social interaction (34% vs. 22%), and had better mood scores (scale 1–7, 5.0 vs. 4.8), compared with residents with a lower QoL (allp-values < 0.001). Multivariate analyses showed that having more social interaction and a positive mood are related to a higher QoL.Conclusions:The results underline the importance of social interaction and a positive mood for a higher QoL. Future research should investigate the importance of engagement in activities in more detail.

Nursing staff needs in providing palliative care for people with dementia at home or in long-term care facilities: A scoping review

2019 ◽  
Vol 96 ◽  
pp. 143-152 ◽  
Author(s):  
Sascha R. Bolt ◽  
Jenny T. van der Steen ◽  
Jos M.G.A. Schols ◽  
Sandra M.G. Zwakhalen ◽  
Sabine Pieters ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Staff ◽  
Scoping Review ◽  
Long Term Care ◽  
Term Care ◽  
People With Dementia ◽  
Care Facilities ◽  
At Home

scholarly journals Quality of life of people with dementia in nursing homes in Austria: A cross-sectional study

2017 ◽  
Vol 3 (1) ◽  
pp. 34
Author(s):  
Daniela Deufert ◽  
Karoline Schermann
Keyword(s):  
Quality Of Life ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Severe Dementia ◽  
Cross Sectional ◽  
Term Care ◽  
People With Dementia ◽  
Care Facilities

Background: The preservation and promotion of the quality of life (QoL) is a central objective in the provision of nursing care for people with dementia (PwD). Long-term care facilities face the major challenge to promote the QoL of the ever-growing group of PwD by providing adequate nursing care.Objective: The aim of the study was to outline the QoL of residents with dementia in Austrian nursing homes.Methods: A cross-sectional study was carried out. The data were collected through the Quality of Life in Dementia Questionnaire (QUALIDEM) and the Functional Assessment Staging Test (FAST).Results: 147 people with mild to moderately severe dementia and 80 people with severe dementia residing in 23 nursing homes were included in the study. In people with mild to severe dementia, the highest scores were observed in the QUALIDEM-subscales positive affect and feeling at home, indicating a high QoL in these areas. The lowest scores with respect to the QoL were found in the categories restless tense behavior and having something to do. People with a very severe dementia had the lowest scores inthe QUALIDEM-subscales social relations, restless tense behavior and having something to do, indicating a low QoL in these areas. The categories with the highest scores were positive self-image and feeling at home.Conclusion: The results of the study provide first data and clues for possible developments or necessary changes in the care of PwD in long-term care facilities in Tyrol/Austria.

Factors associated with quality of life of people with dementia in long-term care facilities: A systematic review

2013 ◽  
Vol 50 (9) ◽  
pp. 1259-1270 ◽  
Author(s):  
Hanneke C. Beerens ◽  
Sandra M.G. Zwakhalen ◽  
Hilde Verbeek ◽  
Dirk Ruwaard ◽  
Jan P.H. Hamers
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Long Term Care ◽  
Term Care ◽  
Factors Associated ◽  
People With Dementia ◽  
Care Facilities
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