scholarly journals BESI: Behavioral and Environmental Sensing and Intervention for Dementia Caregiver Empowerment—Phases 1 and 2

2020 ◽  
Vol 35 ◽  
pp. 153331752090668 ◽  
Author(s):  
Azziza Bankole ◽  
Martha S. Anderson ◽  
Nutta Homdee ◽  
Ridwan Alam ◽  
Ashley Lofton ◽  
...  
Keyword(s):  
Phase 1 ◽  
Care Facility ◽  
Community Dwelling ◽  
Ethnographic Study ◽  
Environmental Sensing ◽  
Dementia Caregiver ◽  
Home Based ◽  
Person With Dementia ◽  
Design And Methods ◽  
The Relationship

Background and Objectives: Caregiver burden associated with dementia-related agitation is one of the commonest reasons a community-dwelling person with dementia (PWD) transitions to a care facility. Behavioral and Environmental Sensing and Intervention for Dementia Caregiver Empowerment (BESI) is a system of body-worn and in-home sensors developed to provide continuous, noninvasive agitation assessment and environmental context monitoring to detect early signs of agitation and its environmental triggers. Research Design and Methods: This mixed methods, remote ethnographic study is explored in a 3-phase, multiyear plan. In Phase 1, we developed and refined the BESI system and completed usability studies. Validation of the system and the development of dyad-specific models of the relationship between agitation and the environment occurred in Phase 2. Results: Phases 1 and 2 results facilitated targeted changes in BESI, thus improving its overall usability for the final phase of the study, when real-time notifications and interventions will be implemented. Conclusion: Our results show a valid relationship between the presence of dementia related agitation and environmental factors and that persons with dementia and their caregivers prefer a home-based monitoring system like BESI.

scholarly journals Who Cares for Whom and Is That important? A Typology of Dementia Care Dyads and Health-Related Support Measures

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 757-758
Author(s):  
Karin Wolf-Ostermann ◽  
Henrik Wiegelmann ◽  
Liane Schirra-Weirich ◽  
Lisa-Marie Verhaert ◽  
Werner Brannath ◽  
...  
Keyword(s):  
Latent Class ◽  
Decisive Role ◽  
Dementia Care ◽  
Community Dwelling ◽  
Living Situation ◽  
Disease Characteristics ◽  
Home Based ◽  
Care And Support ◽  
Health Related ◽  
Person With Dementia

Abstract In Germany, about 70% of all care-dependent persons are community dwelling. In dementia care arrangements you will commonly find a primary informal caregiver (IC) taking on the decisive role in providing care and support for the person with dementia (PwD). This study aimed to develop a typology of dyads based on typical characteristics of the PwD, the IC and their relationship and to gain a better understanding of home-based dementia care arrangements. A latent class analysis was used to detect different dyad types based on personal, social, care and disease characteristics of 551 dyads of CGs and PwD living at home. A 6-class model was identified. The classes could be differentiated based on IC-PwD key characteristics (gender, age, relationship, living situation, occupation). There are significant differences with regard to observed outcomes. The verification of different types of dyads strengthens the need to develop tailored dyad-centred interventions in dementia care

scholarly journals Content of Home-Based Dementia Care: Adverse Consequences of Unmet Toileting Needs

2020 ◽  
pp. 073346482095299
Author(s):  
Jennifer M. Reckrey ◽  
Evan Bollens-Lund ◽  
Katherine A. Ornstein
Keyword(s):  
High Intensity ◽  
Community Dwelling ◽  
Medicare Beneficiaries ◽  
Multivariable Model ◽  
Care Needs ◽  
Content Of Care ◽  
Home Based ◽  
Key Variables ◽  
The Relationship ◽  
Reduced Risk

Despite high-intensity caregiving support, those with dementia may experience adverse consequences because the care they receive does not match their care needs. This study evaluates the relationship between content of care (i.e., specific assistance with toileting) and adverse consequences (i.e., toileting accidents because no one was there to help) in a population of community-dwelling Medicare beneficiaries with dementia and impairment in toileting enrolled in the National Health and Aging Trends Study (NHATS). Only two thirds of individuals received specific assistance with toileting, which was associated with a reduced risk of adverse consequences related to toileting in a multivariable model adjusted for key variables including high-intensity caregiving (odds ratio [OR] = 0.36, 95% confidence interval [CI] = [0.23, 0.58]). To ensure care meets the needs of those with dementia living in the community, it is important to consider not only the quantity but also the content of care received.

scholarly journals A-025 Subjective Cognitive Decline and Likelihood of Participation Across Home-Based Cognitive Assessment Modalities

2020 ◽  
Vol 35 (6) ◽  
pp. 815-815
Author(s):  
Splonskowski M ◽  
Smith S ◽  
Jacova C
Keyword(s):  
Cognitive Decline ◽  
Cognitive Assessment ◽  
Help Seeking ◽  
Symptom Burden ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Amazon Mechanical Turk ◽  
Subjective Cognitive Decline ◽  
Home Based ◽  
The Relationship

Abstract Objective Individuals with subjective cognitive decline (SCD) are approximately twice as likely to develop dementia and less likely to seek cognitive assessment. Home-based cognitive assessment (HBCA) could reduce many practical and emotional barriers associated with in-person cognitive testing. We aimed to explore the relationship between SCD and likelihood of HBCA participation across various modalities. Method A nation-wide sample of 483 community-dwelling adults age 50 years and older (M = 63.61 ± 5.47) were recruited via Amazon Mechanical Turk, an online crowdsourcing website, to complete a survey. SCD was measured using the SCD-MyCog Questionnaire. A score of 7/24 endorsed symptoms classified respondents into SCD and non-SCD. Likelihood of participation in HBCA was measured using 4 likert-scale items (e.g., “How likely would you be to participate in HBCA via computer?”). Total likelihood was calculated by summing items. Results Regression revealed SCD symptom burden predicted likelihood of participation in HBCA [F(1, 481) = 12.42, B = .097, [.043–.150], p < .001, r^2 = .025]. Likelihood was higher in SCD (15.25 ± 3.3) than non-SCD (14.23 ± 3.5). When looking at specific HBCA modalities, SCD were more likely than non-SCD to participate in computer and videoconferencing modalities (1.36 ± 0.6 vs1.68 ± 0.87, p < .001; 2.26 ± 1.11 vs 2.58 ± 1.16, p < .001). There was no relationship with iPad or smartphone modalities. Conclusion SCD endorsement was associated with increased likelihood of engagement in HBCA. It is possible that HBCA can help overcome barriers to help-seeking in this group. SCD may prefer videoconferencing and computer modalities.

scholarly journals COVID-19-Related Worries, Social Disruptions, and Depressive Symptoms Among Community-Dwelling Older Adults With Disabilities: What Makes the Difference?

2021 ◽  
Author(s):  
Shiau-Fang Chao ◽  
Meng-Hsuan Yu
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Community Dwelling ◽  
Older Individuals ◽  
Adults With Disabilities ◽  
Home Based ◽  
The Difference ◽  
Community Dwelling Older Adults ◽  
The Relationship ◽  
Over Time

Abstract Objectives This study explores how home- and community-based services use, coronavirus disease 2019 (COVID-19)-related worries, and social disruptions are related to the depressive symptoms of community-dwelling older adults with disabilities, and whether the associations differ by month of interview. Methods Data on a sample of 593 older individuals in Taiwan were collected between April and July 2020. Multiple regression analyses were performed to test the hypothesized relationships. Results As the number of confirmed cases of COVID-19 in Taiwan continuously declined from April 2020, participants who were interviewed in May, June, and July experienced significantly fewer COVID-19-related worries and social disruptions than those interviewed in April. The month interviewed, representing the pandemic development phase of COVID-19, moderated the relationships between home-based service (HBS) use and COVID-19 worries. The month interviewed also moderated the association between COVID-19-related social disruptions and depressive symptoms. Discussion Differences in the level of COVID-19-related worries between HBS users and nonusers were greatest in April, followed by May, and least in June and July, suggesting that the disparities between HBS users and nonusers attenuated over time. Perceived high COVID-19-related social disruptions were weakly and negatively correlated with depressive symptoms in April, but the relationship became moderately positive in May and strongly positive in June and July. These results supported the claim that the associations between COVID-19-related social disruptions and depressive symptoms can vary over time. Professionals who serve disabled older individuals in communities should be aware of their unstated needs and adopt strategies that are appropriate for the current stage of the COVID-19 pandemic to respond better to their needs and emotional state.

The relationship between aviators' home-based stress to work stress and self-perceived performance.

2000 ◽  
Author(s):  
Edna R. Fiedler ◽  
Pam Della Rocco ◽  
David J. Schroeder ◽  
Kiet T. Nguyen
Keyword(s):  
Work Stress ◽  
Perceived Performance ◽  
Home Based ◽  
The Relationship

Inequality in the Promised Land

2020 ◽  
Vol 9 (1) ◽  
pp. 177-180
Author(s):  
Muhammad Sharif Uddin
Keyword(s):  
United States ◽  
Minority Students ◽  
Doctoral Dissertation ◽  
Ethnographic Study ◽  
Suburban Area ◽  
Midwestern United States ◽  
Minority Community ◽  
Promised Land ◽  
Land Race ◽  
The Relationship

Inequality in the promised land: Race, resources, and suburban schooling is a well-written book by L’ Heureux Lewis-McCoy. The book is based on Lewis-McCoy’s doctoral dissertation, that included an ethnographic study in a suburban area named Rolling Acres in the Midwestern United States. Lewis-McCoy studied the relationship between families and those families’ relationships with schools. Through this study, the author explored how invisible inequality and racism in an affluent suburban area became the barrier for racial and economically minority students to grow up academically. Lewis-McCoy also discovered the hope of the minority community for raising their children for a better future.

Care Work on the Front Lines

2020 ◽  
Vol 119 (820) ◽  
pp. 326-328
Author(s):  
Mary F. E. Ebeling
Keyword(s):  
Nurse Practitioners ◽  
Outpatient Care ◽  
Care Facility ◽  
Safety Net ◽  
Ethnographic Study ◽  
Care Work ◽  
Medical Professionals ◽  
Essential Work ◽  
Social Safety Net ◽  
The Us

An ethnographic study of the work of nurse practitioners at an outpatient care facility shows how these medical professionals must endlessly multitask to fill gaps in the US social safety net. In the context of the COVID-19 pandemic, a new focus on the essential work of nurses and the lack of resources with which they often contend is especially timely.

A Decade of Disparities in Diabetes Technology Use and HbA1c in Pediatric Type 1 Diabetes: A Trans-Atlantic Comparison

2020 ◽  
Author(s):  
Ananta Addala ◽  
Marie Auzanneau ◽  
Kellee Miller ◽  
Werner Maier ◽  
Nicole Foster ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Technology Use ◽  
Hemoglobin A1c ◽  
Diabetes Technology ◽  
Design And Methods ◽  
Relationship Of ◽  
The Relationship ◽  
Pediatric Type 1 Diabetes

<b>Objective:</b> As diabetes technology use in youth increases worldwide, inequalities in access may exacerbate disparities in hemoglobin A1c (HbA1c). We hypothesized an increasing gap in diabetes technology use by socioeconomic status (SES) would be associated with increased HbA1c disparities. <p> </p> <p><b>Research Design and Methods: </b>Participants aged <18 years with diabetes duration ≥1 year in the Type 1 Diabetes Exchange (T1DX, US, n=16,457) and Diabetes Prospective Follow-up (DPV, Germany, n=39,836) registries were categorized into lowest (Q1) to highest (Q5) SES quintiles. Multiple regression analyses compared the relationship of SES quintiles with diabetes technology use and HbA1c from 2010-2012 and 2016-2018. </p> <p> </p> <p><b>Results: </b>HbA1c was higher in participants with lower SES (in 2010-2012 & 2016-2018, respectively: 8.0% & 7.8% in Q1 and 7.6% & 7.5% in Q5 for DPV; and 9.0% & 9.3% in Q1 and 7.8% & 8.0% in Q5 for T1DX). For DPV, the association between SES and HbA1c did not change between the two time periods, whereas for T1DX, disparities in HbA1c by SES increased significantly (p<0.001). After adjusting for technology use, results for DPV did not change whereas the increase in T1DX was no longer significant.</p> <p> </p> <p><b>Conclusions: </b>Although causal conclusions cannot be drawn, diabetes technology use is lowest and HbA1c is highest in those of the lowest SES quintile in the T1DX and this difference for HbA1c broadened in the last decade. Associations of SES with technology use and HbA1c were weaker in the DPV registry. </p>

Evaluation of the Efficacy of ST2 and NT-proBNP in the Diagnosis and Prediction of Short- Term Prognosis in Heart Failure with Reduced Ejection Fraction

2017 ◽  
Vol 9 (04) ◽  
Author(s):  
Shivananda B Nayak ◽  
Dharindra Sawh ◽  
Brandon Scott ◽  
Vestra Sears ◽  
Kareshma Seebalack ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiac Biomarkers ◽  
Double Blind Study ◽  
Short Term ◽  
Double Blind ◽  
Reduced Ejection Fraction ◽  
The Mean ◽  
Design And Methods ◽  
The Relationship

Purpose: i) To determine the relationship between the cardiac biomarkers ST2 and NT-proBNP with ejection fraction (EF) in heart failure (HF) patients. ii) Assess whether a superiority existed between the aforementioned cardiac markers in diagnosing the HF with reduced EF. iii) Determine the efficacy of both biomarkers in predicting a 30-day cardiovascular event and rehospitalization in patients with HF with reduced EF iv) To assess the influence of age, gender, BMI, anaemia and renal failure on the ST2 and NT-proBNP levels. Design and Methods: A prospective double-blind study was conducted to obtain data from a sample of 64 cardiology patients. A blood sample was collected to test for ST2 and NT-proBNP. An echocardiogram (to obtain EF value), electrocardiogram and questionnaire were also obtained. Results: Of the 64 patients enrolled, 59.4% of the population had an EF less than 40%. At the end of the 30- day period, 7 patients were warded, 37 were not warded, one died and 17 were non respondent. Both biomarkers were efficacious at diagnosing HF with a reduced EF. However, neither of them were efficacious in predicting 30-day rehospitalization. The mean NT-proBNP values being: not rehospitalized (2114.7486) and 30 day rehospitalization (1008.42860) and the mean ST2 values being: not rehospitalized (336.1975), and 30-day rehospitalization. (281.9657). Conclusion: Neither ST2 or NT-proBNP was efficacious in predicting the short- term prognosis in HF with reduced EF. Both however were successful at confirming the diagnosis of HF in HF patients with reduced EF.

Increasing Life-Space Mobility in Community-Dwelling Older Persons With Cognitive Impairment Following Rehabilitation: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Phoebe Ullrich ◽  
Christian Werner ◽  
Martin Bongartz ◽  
Tobias Eckert ◽  
Bastian Abel ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Older Persons ◽  
Controlled Trial ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Life Space ◽  
Home Based ◽  
Independent Life

Abstract Background Community-dwelling older persons with cognitive impairment (CI) following discharge from geriatric rehabilitation are at high risk of losing life-space mobility (LSM). Interventions to improve their LSM are, however, still lacking. The aim of this study was to evaluate the effects of a CI-specific, home-based physical training and activity promotion program on LSM. Methods Older persons with mild-to-moderate CI (Mini-Mental State Examination: 17–26 points) discharged home from rehabilitation were included in this double-blinded, randomized, placebo-controlled trial with a 12-week intervention period and 12-week follow-up period. The intervention group received a CI-specific, home-based strength, balance, and walking training supported by tailored motivational strategies. The control group received a placebo activity. LSM was evaluated by the Life-Space Assessment in Persons with Cognitive Impairment, including a composite score for LSM and 3 subscores for maximal, equipment-assisted, and independent life space. Mixed-model repeated-measures analyses were used. Results One hundred eighteen participants (82.3 ± 6.0 years) with CI (Mini-Mental State Examination: 23.3 ± 2.4) were randomized. After the intervention, the home-based training program resulted in a significant benefit in the Life-Space Assessment in Persons with Cognitive Impairment composite scores (b = 8.15; 95% confidence interval: 2.89–13.41; p = .003) and independent life-space subscores (b = 0.39; 95% confidence interval: 0.00–0.78; p = .048) in the intervention group (n = 63) compared to control group (n = 55). Other subscores and follow-up results were not significantly different. Conclusions The home-based training program improved LSM and independent life space significantly in this vulnerable population. Effects were not sustained over the follow-up. The program may represent a model for improved transition from rehabilitation to the community to prevent high risk of LSM restriction.

Sign in / Sign up

Export Citation Format

Share Document