scholarly journals Deep Assessment: A Novel Framework for Improving the Care of People with Very Advanced Alzheimer’s Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Gordon Lyons ◽  
Michael Arthur-Kelly ◽  
Ami Eidels ◽  
Aimee Mavratzakis
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Best Practice ◽  
Cognitive Impairments ◽  
Self Report ◽  
Reflex Modulation ◽  
State Observation ◽  
Assessment Approach

Best practice in understanding and caring for people with advanced Alzheimer’s disease presents extraordinary challenges. Their severe and deteriorating cognitive impairments are such that carers find progressive difficulty in authentically ascertaining and responding to interests, preferences, and needs. Deep assessment, a novel multifaceted framework drawn from research into the experiences of others with severe cognitive impairments, has potential to empower carers and other support professionals to develop an enhanced understanding of people with advanced Alzheimer’s disease and so deliver better calibrated care in attempts to maximize quality of life. Deep assessment uses a combination of techniques, namely, Behaviour State Observation, Triangulated Proxy Reporting, and Startle Reflex Modulation Measurement, to deliver a comprehensive and deep assessment of the inner states (awareness, preferences, likes, and dislikes) of people who cannot reliably self-report. This paper explains deep assessment and its current applications. It then suggests how it can be applied to people with advanced Alzheimer’s disease to develop others’ understanding of their inner states and to help improve their quality of life. An illustrative hypothetical vignette is used to amplify this framework. We discuss the potential utility and efficacy of this technique for this population and we also propose other human conditions that may benefit from research using a deep assessment approach.

Preventing Alzheimer's Wandering

2019 ◽  
pp. 77-89
Author(s):  
Sara Paiva ◽  
Rui Peleja ◽  
Jorge Cunha ◽  
Carlos Abreu
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Quality Of Care ◽  
Cognitive Impairments ◽  
The Elderly ◽  
Strong Impact ◽  
Brain Disorder ◽  
Age Related

With increased life expectancy, the incidence of age-related cognitive impairments, faced by the elderly and older generations, is growing. Among the population with cognitive impairments, those that suffer from Alzheimer's disease are the most common. The Alzheimer's disease is a chronic degenerative brain disorder that is characterised by a failure of memory and, in some instances, by disorders in language, perception and planning. As a consequence of the progressive damages imposed by the illness, patients will increasingly seek and need assistance. This paper presents a tool to aid the development and managing of caregiving communities, comprising immediate family members, relatives, neighbours and healthcare professionals, to assist patients with Alzheimer's disease. Such communities could have a strong impact on the quality of care provided to the patients. At the same time, it is hoped that involving communities will significantly improve the quality of life of Alzheimer's patients and their families while reducing the costs related to the care provided.

Preventing Alzheimer’s Wandering

2013 ◽  
Vol 8 (4) ◽  
pp. 32-43 ◽  
Author(s):  
Sara Paiva ◽  
Rui Peleja ◽  
Jorge Cunha ◽  
Carlos Abreu
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Healthcare Professionals ◽  
Cognitive Impairments ◽  
The Elderly ◽  
Strong Impact ◽  
Brain Disorder ◽  
Age Related

With increased life expectancy, the incidence of age-related cognitive impairments, faced by the elderly and older generations, is growing. Among the population with cognitive impairments, those that suffer from Alzheimer’s disease are the most common. The Alzheimer’s disease is a chronic degenerative brain disorder that is characterised by a failure of memory and, in some instances, by disorders in language, perception and planning. As a consequence of the progressive damages imposed by the illness, patients will increasingly seek and need assistance. This paper presents a tool to aid the development and managing of caregiving communities, comprising immediate family members, relatives, neighbours and healthcare professionals, to assist patients with Alzheimer’s disease. Such communities could have a strong impact on the quality of care provided to the patients. At the same time, it is hoped that involving communities will significantly improve the quality of life of Alzheimer's patients and their families while reducing the costs related to the care provided.

Validity and Reliability of the German Quality of Life–Alzheimer’s Disease (QoL-AD) Self-Report Scale

2020 ◽  
Vol 77 (2) ◽  
pp. 581-590 ◽  
Author(s):  
Vanessa Stypa ◽  
Peter Haussermann ◽  
Tim Fleiner ◽  
Sandra Neumann
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Construct Validity ◽  
Internal Consistency ◽  
Short Form ◽  
Self Report ◽  
Retest Reliability ◽  
Test Retest Reliability

Background: The Quality of Life–Alzheimer’s Disease (QoL-AD) scale is a widely used measure of quality of life (QoL) in dementia. Although the instrument has been validated in several languages, the psychometric properties of the German self-report version have not yet been analyzed. Objective: This study examines the internal consistency, test-retest reliability, and construct validity of the German QoL-AD self-report scale. Methods: The sample included 30 patients suffering from mild to moderate Alzheimer’s disease or vascular dementia (19 females; mean age 77.3 years; mean Mini-Mental State Examination (MMSE) score 19.7 points). To determine test-retest reliability, the QoL-AD self-report scale was re-administered four to seven days apart. For construct validity analysis, the Dementia Quality of Life instrument (DQoL), Geriatric Depression Scale (GDS), MMSE, and an adapted short form of the Neuropsychiatric Inventory (NPI) were used. Results: The German QoL-AD self-report scale shows an internal consistency of α= 0.79 and a test-retest reliability of r = 0.75 (p < 0.01). Regarding construct validity, there was a significant positive correlation between the total scores of the QoL-AD and DQoL (r = 0.47, p < 0.05). The analysis revealed no significant correlations with the GDS or the adapted NPI. No association could be observed between the QoL-AD and the MMSE (r = 0.01), confirming divergent validity. Conclusion: The results indicate that the German QoL-AD self-report scale is a suitable instrument for assessing QoL in patients suffering from mild to moderate dementia, thus supporting its use in clinical practice and research.

Validación de la escala Quality of Life in Alzheimer’s Disease (QOL-AD) en pacientes mexicanos con demencia tipo Alzheimer, vascular y mixta

2010 ◽  
Vol 51 (02) ◽  
pp. 72 ◽  
Author(s):  
Oscar Rosas Carrasco ◽  
Laura del Pilar Torres Arreola ◽  
María de Guadalupe Guerra Silla ◽  
Sara Torres Castro ◽  
Luis Miguel Gutiérrez Robledo
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease

Assessing Alzheimer's disease patients' quality of life: Discrepancies between patient and caregiver perspectives

2015 ◽  
Vol 12 (4) ◽  
pp. 427-437 ◽  
Author(s):  
Sandrine Andrieu ◽  
Nicola Coley ◽  
Yves Rolland ◽  
Christelle Cantet ◽  
Catherine Arnaud ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease

CLINICAL AND COST-EFFECTIVENESS OF DONEPEZIL, RIVASTIGMINE, AND GALANTAMINE FOR ALZHEIMER'S DISEASE

2002 ◽  
Vol 18 (3) ◽  
pp. 497-507 ◽  
Author(s):  
Andrew Clegg ◽  
Jackie Bryant ◽  
Tricia Nicholson ◽  
Linda McIntyre ◽  
Sofie De Broe ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cost Effectiveness ◽  
Global Health ◽  
Cochrane Library ◽  
The Impact ◽  
Health Cognition ◽  
Economic Studies

Objectives: Systematic review of the clinical and cost-effectiveness of donepezil, rivastigmine, and galantamine for people suffering from Alzheimer's disease.Methods: Sixteen electronic databases (including MEDLINE, the Cochrane Library, and Embase) and bibliographies of related papers were searched for published/unpublished English language studies, and experts and pharmaceutical companies were consulted for additional information. Randomized controlled trials (RCTs) and economic studies were selected. Clinical effectiveness was assessed on measurement scales assessing progression of Alzheimer's disease on the person's global health, cognition, functional ability, behavior and mood, and quality of life. Cost-effectiveness was presented as incremental cost per year spent in a nonsevere state (by Mini Mental Health State Examination) or quality-adjusted life-year.Results: Twelve of 15 RCTs included were judged to be of good quality. Although donepezil had beneficial effects in Alzheimer's patients on global health and cognition, rivastigmine on global health, and galantamine on global health, cognition, and functional scales, these improvements were small and may not be clinically significant. Measures of quality of life and behavior and mood were rarely assessed. Adverse effects were usually mild and transient. Cost-effectiveness base case estimates ranged from £2,415 savings to £49,476 additional cost (1997 prices) per unit of effect for donepezil and a small savings for rivastigmine. Estimates were not considered robust or generalizable.Conclusions: Donepezil, rivastigmine, and galantamine appear to have some clinical effect for people with Alzheimer's disease, although the extent to which these translate into real differences in everyday life remains unclear. Due to the nature of current economic studies, cost-effectiveness remains uncertain and the impact on different care sectors has been inadequately investigated. Further research is needed to establish the actual benefits of acetylcholinesterase inhibitors (AChEls) for people with Alzheimer's disease and their caregivers, the relationship of these changes to clinical management, and careful prospective evaluation of resource and budgetary consequences.

scholarly journals Quality of life of elderly with alzheimer’s disease: a comparative study between the patient’s and the caregiver’s report

2010 ◽  
Vol 18 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Keika Inouye ◽  
Elisete Silva Pedrazzani ◽  
Sofia Cristina Iost Pavarini ◽  
Cristina Yoshie Toyoda
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Life Assessment ◽  
Quality Of Life Assessment ◽  
Patient Reports ◽  
The Family ◽  
Final Score ◽  
High Level

This paper aimed to compare the reports of patients and caregivers about how they perceive quality of life (QoL) in general and each of its dimensions in elderly with Alzheimer’s Disease (AD). The participants were elderly diagnosed with AD (n=53) attended by the Exceptional Medication Program in a city in the interior of Sao Paulo; and their respective family caregivers. The QoL measures were obtained through the Quality of Life Assessment Scale on Alzheimer’s Disease. The results showed statistically significant differences in the “memory” (p<0.05) and “you in general” (p<0.005) dimensions. Regarding the final score, the average in the patient’s version was 29.32 points (sd=6.27), against 28.33 points (sd=5.58) in the family version, p>0.100. Although the relative and patient reports were not identical, the results pointed to a high level of consistency among information.

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