scholarly journals Functional Analytic Multisensory Environmental Therapy for People with Dementia

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Jason A. Staal

This paper introduces Functional Analytic Multisensory Environmental Therapy (FAMSET) for use with elders with dementia while using a multisensory environment/snoezelen room. The model introduces behavioral theory and practice to the multisensory environment treatment, addressing assessment, and, within session techniques, integrating behavioral interventions with emotion-oriented care. A modular approach is emphasized to delineate different treatment phases for multisensory environment therapy. The aim of the treatment is to provide a safe and effective framework for reducing the behavioral disturbance of the disease process, increasing elder well-being, and to promote transfer of positive effects to other environments outside of the multisensory treatment room.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Carola M. E. Döpp ◽  
Hermijntje Drenth ◽  
Paul-Jeroen Verkade ◽  
Anneke F. Francke ◽  
Iris van der Heide

Abstract Background Dementia is a progressive disease that affects people’s everyday functioning, including the ability to express values, needs and wishes, which can be considered key elements of self-direction. For the purpose of this review, self-direction refers to the organization and/or coordination of your own life, including professional and other care, with the objective of having what you perceive to be a good life. The aim of this systematic review was to assess and describe interventions that aim to improve self-direction of people with dementia. Methods A systematic search was conducted in PubMed, Embase, CINAHL, PsycInfo and the Cochrane Library. Empirical studies up to April 2020 were included that used qualitative and/or quantitative methods and reported on interventions for people with dementia aimed at improving self-direction. Stepwise study selection and the assessment of methodological quality were conducted independently by two authors. Data on study and intervention characteristics, outcomes related to self-direction and well-being of people with dementia and factors influencing the feasibility were extracted systematically and described narratively. Results Ten studies were identified describing a total of nine interventions. Interventions varied in terms of goals, content, target population and duration. Overall, interventions consisted of multiple components focusing on identifying “Who am I?” (beliefs, strengths, values, goals), identifying “What is important to me?” (meaningful activities and goal setting) and/or communicating about preferences with professionals and/or caregivers. The review provides indications that people with dementia may benefit from the interventions included. Overall, positive effects were found in studies on outcomes related to self-direction and wellbeing. However, outcomes measured using quantitative methods showed inconsistent effects between the studies. Conclusions Although the methodological quality of all the studies included was ‘good’ or at least ‘fair’, the evidence base of interventions aiming to improve self-direction is still limited due to the low number of studies, the low number of participants and the frequent use of and their authors’ own non-standardized measures. Nevertheless, the review points towards positive effects on self-direction and well-being. Identifying individual beliefs, strengths, values, goals and meaningful activities can be essential components of these interventions, as well as communication about the desired care and support.


Author(s):  
Lesa Lorusso ◽  
Sheila Bosch ◽  
Nam-Kyu Park ◽  
Ronald Shorr ◽  
Maureen Conroy ◽  
...  

Objectives: This evidence-based design clinical trial assessed the feasibility of a multisensory environment (MSE) using aromatherapy, color-changing lights, and music as a behavioral intervention to calm Veterans with dementia during assisted bathing to improve the patient experience. Background: The number of Veterans with dementia is growing rapidly, along with the associated debilitating behavior challenges. The severity of these distressed behaviors that predominantly occur at bath time often necessitates costly, dangerous sedatives. Feasibility studies of nonpharmacological behavioral interventions during bathing for people with dementia are urgently needed, and research supports MSE as a viable solution. Method: Using an A–B, multiple baselines across participants design, this study tracked operational behaviors of four Veterans with dementia during bathing without and with an MSE intervention. Sessions were provided and recorded by a dedicated team of five nurses, so the study team could analyze the Veterans’ operational behaviors to understand the impact of individualized MSE during both baseline and intervention phases. Results: The results support the feasibility of MSE as a helpful, nonpharmacological behavioral intervention for Veterans with dementia during bathing. All participants experienced an overall increase in duration of positive operational behaviors and an overall decrease in duration of negative operational behaviors. Conclusions: Healthcare environments are integral components in dementia care and the use of MSE within the bathing setting appears to improve not only operational behaviors but the overall bathing experience.


2013 ◽  
Vol 25 (12) ◽  
pp. 2033-2046 ◽  
Author(s):  
Jacki Liddle ◽  
Sally Bennett ◽  
Shelley Allen ◽  
David C. Lie ◽  
Bradene Standen ◽  
...  

ABSTRACTBackground:The impact of dementia on safe driving is well recognized and is generally accepted that all people with dementia are likely to need to cease driving at some stage in the disease process. Both driving and driving cessation can have poor outcomes for people with dementia and their caregivers in terms of health, safety, community access, and well-being. Although approaches to facilitate better outcomes from driving cessation are being developed, the processes of driving cessation for people with dementia are still not fully understood.Methods:Within a descriptive phenomenological framework, semi-structured interviews were undertaken with key stakeholders, including retired drivers with dementia, family members, and health professionals.Results:Findings from four retired drivers with dementia, 11 caregivers, and 15 health professionals characterized driving cessation for people with dementia as a process with three stages and associated challenges and needs. The early stage involved worried waiting, balancing safety with impending losses, and the challenge of knowing when to stop. The crisis stage involved risky driving or difficult transportation, acute adjustment to cessation and life without driving, and relationship conflict. The post-cessation stage was described as a long journey with ongoing battles and adjustments as well as decreased life space, and was affected by the disease progression and the exhaustion of caregiver.Conclusions:The concept of stages of driving cessation for people with dementia could be used to develop new approaches or adapt existing approaches to driving cessation. Interventions would need to be individualized, optimally timed, and address grief, explore realistic alternative community access, and simultaneously maintain key relationships and provide caregiver support.


2020 ◽  
Vol 32 (S1) ◽  
pp. 131-131
Author(s):  
Claudia van der Velden ◽  
Marleen Prins ◽  
Henriëtte van der Roest

Introduction Healthcare professionals working with people with dementia (PwD) have increasingly been moving away from task-oriented models of healthcare towards a more person-centered care (PCC) model. Several studies have showed positive results of PCC on the quality of life of PwD. Also, it shows positive effects on self -esteem and work satisfaction of healthcare professionals. An effective way to educate professionals in PCC and improve their knowledge and person-centered attitude is by using online learning tools.We developed an e-learning in co-creation with end users focusing on well-being and (changing) behavior of PwD. The interactive e-learning supports healthcare professionals in developing a person-centered attitude, by using practical videos and exercises.Methods In the current pilot study, the e-learning is evaluated. To date, 33 healthcare professionals working in Dutch care homes from different care organizations participated in the study and completed the e-learning. In addition, they filled in online questionnaires before and after completing the e-learning. The questionnaires include the Approach to Dementia Questionnaire, Dementia Knowledge, Person Centered Care, Sense of Competence in Dementia Care Questionnaire. Post-measurement also included questions about satisfaction with the e-learning and user-friendliness.Results The final participants are currently completing their post-measurement questionnaires and final results are expected in September 2019. Preliminary data-analysis shows promising results. Positive effects on knowledge about dementia, person-centered attitude and sense of competence are expected. Also, user-friendliness, especially the flexibility of the e-learning (being able to follow the e-learning at home or at work and being able to stop and continue at any time) and the practice-oriented videos are positively evaluated.Conclusion Preliminary results of this pilot study suggest that the e-learning might contribute to developing a more person-centered attitude in healthcare professionals and indicate that participants have positive experiences with the e-learning module.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S891-S891
Author(s):  
Claudia van der Velden

Abstract Healthcare professionals working with people with dementia (PwD) have increasingly been moving towards a person-centered care (PCC) attitude. 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 professionals. An effective way to educate professionals in PCC is by using online-learning-tools. We developed an e-learning - in co-creation with end-users - focusing on well-being and challenging behavior of PwD. The interactive e-learning supports healthcare professionals in developing a PCC-attitude, using practical videos and exercises. In the current pilot-study, the e-learning is evaluated. To date, 32 professionals working in Dutch care homes from different care organizations participated in the study and completed the e-learning. In addition, they filled in online questionnaires before and after completing the e-learning. The questionnaires include the Approach to Dementia Questionnaire, Dementia Knowledge, Person Centered Care, Sense of Competence in Dementia Care Questionnaire. Post-measurement also included questions about satisfaction with the e-learning and user-friendliness. The final participants are currently completing their post-measurement questionnaires and final results are expected in October 2019. Preliminary data-analysis shows promising results. Although no significant effects were found, two-thirds of the participants indicated they had more knowledge about dementia, could better deal with challenging behavior and understood better how their own behavior and actions influence the behavior of PwD. The user-friendliness was also positively evaluated. Preliminary results suggest that the e-learning helps professionals in their approach to PwD and indicate that participants have positive experiences with the e-learning.


Author(s):  
J. Russ ◽  
C. Weyh ◽  
C. Pilat

AbstractDementia is a syndrome characterized by a progressive deterioration of cognitive and physical functions. The aim of this systematic review was to investigate the effects of high-intensity exercise training (HIT) programs on cognitive and mental health, physical performance, activities of daily living (ADLs) and quality of life (QoL) in people with dementia. A systematic literature search for randomized controlled trials was performed until July 2019. We calculated mean difference (MD) or standardized MD (SMD) and the 95% confidence interval (CI), and assessed heterogeneity using I2 statistic. Nine studies from three large-scale research projects which were based on the high-intensity functional exercise (HIFE) program incorporating strength, balance and mobility exercises of the lower limbs, including 456 participants (85.5 ± 7.0 years), were considered. There was an overall good study quality (mean PEDro score = 7.6 ± 0.7). Compared to seated control activities, strength and balance HIT resulted in statistically significant but small positive effects on balance performance (MD = 2.31, 95% CI = 0.44–4.17, p = 0.02; I2 = 73%) and on the abilities to independently perform ADLs (SMD = 0.28, 95% CI = 0.12–0.44, p = 0.0006; I2 = 0%). No differences were found in cognitive function, depressive symptoms and QoL. The qualitative analyses yielded sporadic beneficial results (mobility, psychological well-being and apathetic behaviour) in favour of HIT. There is only limited evidence for an intensity-related dose–response relationship. Further well-designed studies are needed to identify the best exercise type for different types and stages of dementia.


Dementia ◽  
2016 ◽  
Vol 18 (1) ◽  
pp. 8-35 ◽  
Author(s):  
Jan R Oyebode ◽  
Sahdia Parveen

An influential review in 2010 concluded that non-pharmacological multi-component interventions have positive effects on cognitive functioning, activities of daily living, behaviour and mood of people with dementia. Our aim here is to provide an up-to-date overview of research into psychosocial interventions and their impact on psychosocial outcomes. We focused on randomised controlled trials, controlled studies and reviews published between October 2008 and August 2015, since the earlier review. The search of PsychInfo, Medline and the Cochrane database of systematic reviews yielded 61 relevant articles, organised into four themes echoing key phases of the care pathway: Living at home with dementia (five reviews, eight studies), carer interventions (three reviews, four studies), interventions in residential care (16 reviews, 12 studies) and end-of-life care (three reviews, two studies), along with an additional group spanning community and institutional settings (six reviews, two studies). Community findings suggested that appointment of dementia specialists and attention to case management can produce positive outcomes; physical therapies, cognitive training and modified cognitive behaviour therapy also had a range of benefits. There was more limited evidence of positive benefits for people with dementia through interventions with family carers. Thirty-two articles focused on the management of ‘behavioural symptoms’ through a range of interventions all of which had some evidence of benefit. Also a range of multi-component and specific interventions had benefits for cognitive, emotional and behavioural well-being of people with dementia in residential settings, as well as for quality of life. Overall, interventions tended to be short term with impact only measured in the short term. We recommend further research on interventions to promote living well in the community post-diagnosis and to address end-of-life care. Development of psychosocial interventions would benefit from moving beyond the focus on control of behaviours to focus on wider aspects of life for people with dementia.


2020 ◽  
Vol 32 (S1) ◽  
pp. 113-113
Author(s):  
Mareike C. Sittler ◽  
Nils F. Töpfer ◽  
Franziska Meichsner ◽  
Christina Theurer ◽  
Gabriele Wilz

Background:Even if cognitive-behavioral therapy (CBT) for caregiving relatives of people with dementia (PwD) has been found to be effective across various outcome measures, investigations into the long-term effects of these interventions remain scarce. Therefore, the purpose of the present study was the evaluation of a CBT intervention for caregiving relatives of PwD three years after intervention onset.Method:273 caregivers were randomly assigned to receive the intervention (IG) or usual care (CG). IG participants received over 6 month twelve 50-min sessions of individual CBT by trained psychotherapists. Symptoms of depression (CES-D), physical health symptoms (GBB-24), challenging behavior (BEHAVE-AD), quality of life (WHOQOL-BREF), utilization of psychosocial resources (RES), burden of care, coping with the care situation, and emotional well-being (visual analogue scales) were assessed three years after baseline. Data were analyzed using generalized ANCOVA.Results:164 participants (IG: n = 83, CG: n = 81; 60% of the baseline sample) participated in the three-year follow-up. Based on changes in the caregiving situation at three-year follow-up, we divided the sample into three subgroups: “still caring at home” (n = 52), “nursing home placement of the care recipient” (n = 29), “bereaved caregivers” (n = 83). Positive effects were found in the subgroup of caregivers “still caring at home” (on burden of care, coping with challenging behavior, social relationships QoL-domain) and “bereaved caregivers” (on overall QoL and physical health QoL-domain) compared to the CG. However, IG participants who decided for “nursing home placement of the care recipient” had poorer outcomes on a few measures (overall QoL, psychological health, emotional well-being, utilization of resources related to well-being).Discussion:It is impressive that CBT for caregiving relatives yielded positive effects in caregivers still caring at home and bereaved caregivers investigating long-term effects three years after baseline. Many challenges arise over the course of the different caregiving trajectories with changes in the caregiving situation being probably particularly influential. We will provide some ideas on how effects could be further sustained and discuss the need for further investigating the impact of changes in the caregiving situation.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 632-632
Author(s):  
Jean Gajardo ◽  
Jose Aravena ◽  
Ignacia Navarrete ◽  
Andrea Slachevsky ◽  
Laura Gitlin

Abstract Chile is currently implementing policies addressing dementia care with efforts to translate evidence-based programs towards culturally sensitive models of care. This study describes the cultural adaptation of the Tailored Activity Program (TAP). A complementary mixed-method design was performed following the 4-phase Dynamic Adaptation Process (DAP) model by Aarons et al, 2012. Ten dyads (family caregivers and people with dementia) completed a regular 8-session home-based TAP intervention during 2017-2018. Qualitative data was collected through interviews and observation with caregivers, and weekly follow-up and a focus group with provider occupational therapists. Quantitative data in pilot testing was obtained through assessments at baseline and after intervention. The TAP was well accepted by family caregivers, and sociocultural adaptations on content, context, target level, and training were identified. Significant reduction of frequency and severity of neuropsychiatric symptoms in individuals with dementia was found, and caregivers reported reduction of depressive symptoms, improved perceived well-being & self-confidence. Part of a symposium sponsored by the Behavioral Interventions for Older Adults Interest Group.


GeroPsych ◽  
2019 ◽  
Vol 32 (3) ◽  
pp. 125-134
Author(s):  
Mechthild Niemann-Mirmehdi ◽  
Andreas Häusler ◽  
Paul Gellert ◽  
Johanna Nordheim

Abstract. To date, few studies have focused on perceived overprotection from the perspective of people with dementia (PwD). In the present examination, the association of perceived overprotection in PwD is examined as an autonomy-restricting factor and thus negative for their mental well-being. Cross-sectional data from the prospective DYADEM study of 82 patient/partner dyads (mean age = 74.26) were used to investigate the association between overprotection, perceived stress, depression, and quality of life (QoL). The analyses show that an overprotective contact style with PwD has a significant positive association with stress and depression, and has a negative association with QoL. The results emphasize the importance of avoiding an overprotective care style and supporting patient autonomy.


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