Montessori-Based Activities Among Persons with Late-Stage Dementia: Evaluation of Mental and Behavioral Health Outcomes

Dementia ◽  
2017 ◽  
Vol 18 (4) ◽  
pp. 1373-1392 ◽  
Author(s):  
Scott E Wilks ◽  
P August Boyd ◽  
Samantha M Bates ◽  
Daphne S Cain ◽  
Jennifer R Geiger
Keyword(s):  
Quality Of Life ◽  
Activities Of Daily Living ◽  
Behavioral Health ◽  
Problem Behaviors ◽  
Late Stage ◽  
Social Engagement ◽  
Daily Living ◽  
Well Being ◽  
Psychological Well Being

Objectives Literature regarding Montessori-based activities with older adults with dementia is fairly common with early stages of dementia. Conversely, research on said activities with individuals experiencing late-stage dementia is limited because of logistical difficulties in sampling and data collection. Given the need to understand risks and benefits of treatments for individuals with late-stage dementia, specifically regarding their mental and behavioral health, this study sought to evaluate the effects of a Montessori-based activity program implemented in a long-term care facility. Method Utilizing an interrupted time series design, trained staff completed observation-based measures for 43 residents with late-stage dementia at three intervals over six months. Empirical measures assessed mental health (anxiety, psychological well-being, quality of life) and behavioral health (problem behaviors, social engagement, capacity for activities of daily living). Results Group differences were observed via repeated measures ANOVA and paired-samples t-tests. The aggregate, longitudinal results—from baseline to final data interval—for the psychological and behavioral health measures were as follows: problem behaviors diminished though not significantly; social engagement decreased significantly; capacities for activities of daily living decreased significantly; quality of life increased slightly but not significantly; anxiety decreased slightly but not significantly; and psychological well-being significantly decreased. Conclusion Improvements observed for quality of life and problem behaviors may yield promise for Montessori-based activities and related health care practices. The rapid physiological and cognitive deterioration from late-stage dementia should be considered when interpreting these results.

Quality of life in poor prognosis patients with locally advanced non-small cell lung cancer (LA-NSCLC) undergoing a phase II study of concurrent cetuximab and definitive thoracic radiotherapy followed by docetaxel and cetuximab.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e17559-e17559
Author(s):  
Lora Thompson ◽  
Martine Extermann ◽  
Thomas J. Dilling ◽  
Jongphil Kim ◽  
Binglin Yue ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Locally Advanced ◽  
Well Being ◽  
Thoracic Radiotherapy ◽  
Significant Difference ◽  
Specific Symptoms

e17559 Background: A single institution prospective clinical trial was conducted to examine the safety and efficacy of concurrent cetuximab and definitive thoracic radiotherapy followed by docetaxel plus cetuximab. Quality of life (QOL) was assessed as a secondary endpoint. Survival and toxicity data are presented separately. Methods: Eligible pts with unresectable stage IIA or IIIB LA-NSCLC, who also had ECOG PS 2 OR weight loss ≥5% in 3 months OR age >70, completed QOL measures at baseline, after concurrent cetuximab/radiotherapy (recovery), and after docetaxol/cetuximab (consolidation). Scores were calculated for Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Fatigue Symptom Inventory (FSI) worst fatigue, FSI fatigue interference, and Functional Assessment of Cancer Therapy – Lung Trial Outcome Index (FACT-L TOI). FACT-L TOI assessed physical (e.g., nausea) and functional (e.g., difficulty sleeping) well-being as well as lung cancer specific symptoms (e.g., shortness of breath, cough). Descriptive and t-test results are presented. Results: Pts (N = 27) were primarily male (67%) and non-Hispanic Caucasian (96%) with mean age of 73 years. High attrition between recovery (N = 22) and consolidation (N = 10) occurred. Compared to baseline, pts reported higher levels of worst fatigue (p < .03) and fatigue interference (p = .01) at recovery. There was a decline in IADLs (p = .01) but no significant difference in ADLs or FACT-L TOI. Further examination of FACT subscales revealed declines in physical (p < .0001) and functional (p = .02) well-being but improvement in lung cancer specific symptoms (p < .0001). A similar pattern is found for comparisons between baseline and consolidation (ps < .05). There were no significant differences between recovery and consolidation. Conclusions: Although pts experienced declines in QOL across most domains after concurrent cetuximab and radiotherapy, there was improvement in lung cancer specific symptoms. Pts were also able to maintain their ability to perform ADLs. High attrition after recovery is a notable limitation.

Quality of Life for People With Dementia Living in Residential and Nursing Home Care: The Impact of Performance on Activities of Daily Living, Behavioral and Psychological Symptoms, Language Skills, and Psychotropic Drugs

2001 ◽  
Vol 13 (1) ◽  
pp. 93-106 ◽  
Author(s):  
Clive Ballard ◽  
John O'Brien ◽  
Ian James ◽  
Pat Mynt ◽  
Marisa Lana ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Activities Of Daily Living ◽  
Psychotropic Drugs ◽  
Daily Living ◽  
Psychological Symptoms ◽  
Well Being ◽  
Nursing Home Care ◽  
People With Dementia ◽  
The Impact

Many people with dementia reside in care facilities. Little is known about how key parameters impact upon their quality of life (QOL). All 209 people with dementia in six facilities received a standardized assessment (Neuropsychiatric Inventory [NPI], Barthel Scale, psychotropic drugs). One hundred twelve residents were assessed using Dementia Care Mapping, an observational method for QOL indices. Lower performance on activities of daily living (reduced well-being [WB] r = +0.39, p < .0001; social withdrawal [SW] r = +0.42, p < .0001; engagement in activities [EA] r = +0.31, p = .001) and taking psychotropics (WB 2.5 vs. 3.2, t = .2.3, p = .02; SW 11.4% vs. 2.7%, t = 3.0, p = .004; EA 56.5% vs. 71.9%; t = 3.5, p = .001) were associated with reduced QOL, but symptoms from the NPI were not. More focused prescribing of psychotropics and better staff training are essential.

Areas of Discharge Agreement and Disagreement Between Older Adult Patients and Nurses

2003 ◽  
Vol 4 (4) ◽  
pp. 185-190 ◽  
Author(s):  
Dawn Joosten ◽  
Marilyn Potts
Keyword(s):  
Quality Of Life ◽  
Activities Of Daily Living ◽  
Older Adult ◽  
Daily Living ◽  
Management Practice ◽  
Well Being ◽  
Adult Patients ◽  
Positive Effects ◽  
Quality Of Life Index

The objectives of this study were to identify areas of agreement and disagreement between nursing staff and older adult patients about discharge needs, and to explore relationships between hospitalized older adults’ perceived postdischarge Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) dependency, social networks, and quality of life. Differences between patients and nurses for the ADL scale showed that patients perceived themselves as being more independent with respect to ADLs upon discharge than did their nurses. Agreement between patients and nurses for the Quality of Life Index indicated high agreement about patients’ general well-being upon discharge. Positive relationships between overall IADL and both overall Social Network and Friend subscale scores were indicative of the positive effects of social support on patients’ perceptions of IADL independence. Implications for case management practice were suggested.

Hand Surgery and Quality of Life

1999 ◽  
Vol 24 (3) ◽  
pp. 263-266 ◽  
Author(s):  
R. J. I. COLVILLE ◽  
K. S. NICHOLSON ◽  
H. J. C. R. BELCHER
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Hand Function ◽  
Hand Surgery ◽  
Well Being ◽  
Metacarpophalangeal Joints ◽  
Hand Pain

The outcome in patients having surgery to the hand was assessed subjectively using a questionnaire that covered activities of daily living (ADL), hand pain and psychological well-being. The questionnaires were completed on average 6.9 months preoperatively and 20.6 months postoperatively by 15 patients with osteoarthritis undergoing trapeziectomy and 25 patients with rheumatoid arthritis undergoing Swanson arthroplasties of the metacarpophalangeal joints. Surgery resulted in significant improvements in reported ADL and hand pain, in both groups. Improvement in perception of hand function and health was only seen in the osteoarthritic group. There was no improvement in arthritis activity, mood or quality of life in either group. These results confirm that surgery for arthritis of the hand relieves pain and improves ADL. However, it has a greater effect in patients with localized osteoarthritis than in those with rheumatoid arthritis.

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