scholarly journals Predictors of the one-year-change in depressiveness in informal caregivers of community-dwelling people with dementia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lara Kürten ◽  
Nikolas Dietzel ◽  
Peter L. Kolominsky-Rabas ◽  
Elmar Graessel
Keyword(s):  
Social Inclusion ◽  
Informal Caregivers ◽  
Multiple Regression Model ◽  
Community Dwelling ◽  
Subjective Burden ◽  
The People ◽  
People With Dementia ◽  
One Year ◽  
The One ◽  
Person With Dementia

Abstract Background The care of people with dementia is usually carried out by their family members, which can cause objective und subjective burden and raise their risk of depressiveness. Thus, the aim of this study is to identify predictors of the change in depressiveness of informal caregivers over 1 year in order to be able to derive hypotheses for interventions that promise success. Methods The Bavarian Dementia Survey (BayDem) is a multi-center, longitudinal study conducted at three different sites in Bavaria, Germany. Participants were people with dementia and their informal caregivers. Data was collected at baseline and after 12 months by standardized face-to-face interviews in cooperation with local players. The informal caregivers’ depressiveness was assessed with the WHO-5. Data was also collected on the people with dementia’s cognition (MMSE), behavioral symptoms (NPI) and comorbidities (Charlson Comorbidity Index) as well as caregivers’ social inclusion (LSNS), time spent on care and care contribution (RUD). For statistical analysis, a multiple regression model was used. Results The data of 166 people with dementia and their informal caregivers was analyzed. Of the latter, 46% were categorized as “likely depressed”. The change in depressiveness over a year was significantly predicted by baseline depressiveness as well as an increase in the time informal caregivers spent supervising the person with dementia. Conclusions Informal caregivers of people with dementia are at high risk of depression. The time spent supervising the person with dementia has a significant impact on increasing depressiveness. This highlights the importance of support services to provide the informal caregiver with relief and possibly reduce depressiveness.

scholarly journals Incidence of and Risk Factors for Missing Events Due to Wandering in Community-dwelling Older People with Dementia and Mild Cognitive Impairment

2021 ◽  
Author(s):  
seungwon Jeong ◽  
Takao Suzuki ◽  
Kiyoko Miura ◽  
Takashi Sakurai
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Recurrence Rate ◽  
Community Dwelling ◽  
Disease Assessment ◽  
People With Dementia ◽  
One Year ◽  
The One

Abstract BackgroundThe burden of missing incidents is not only on the person with dementia, but also on their family, neighbors, and community. The extent to which dementia-related wandering and missing incidents occur in the community has not been evaluated thoroughly in the published literature. Therefore, we evaluated the incidence of and risk factors for missing events due to wandering.MethodsWe conducted a non-randomized prospective one-year follow-up cohort study based on symptom registration with missing events due to wandering as the endpoint. In the first consultation, 374 patients with dementia or mild cognitive impairment (MCI) and their caregivers who visited the National Center for Geriatrics and Gerontology in Japan were included. The incidence and recurrence rate of missing events were calculated. Participants were divided into (those with) dementia and (those with) MCI. Patients' basic and medical information was documented at baseline and after one year of follow-up. Furthermore, analysis of variance and logistic regression analysis were performed to clarify the risk factors associated with the missing event.ResultsAmong the 236 patients with dementia enrolled, 65 (27·5%) had a previous missing event at baseline, and 28 had a missing event during the one-year follow-up period (recurrence rate of 43·1%). Of the 171 who did not have a previous missing event at baseline, 23 had a missing event during the one-year follow-up period (incidence rate of 13·5%). The scores of Mini-Mental State Examination (MMSE), Dementia Behavior Disturbance Scale (DBD), and Alzheimer's Disease Assessment Scale (ADAS) were statistically significant as the risk factors for the incidence of wandering leading to a missing event (p<0·05).ConclusionsPrevention of missing event due to wandering requires focused attention on changes in the MMSE, DBD, ADAS scores, and the development of a social environment to support family caregivers.

‘This is my story, how I remember it’: In-depth analysis of Dignity Therapy documents from a study of Dignity Therapy for people with early stage dementia

Dementia ◽  
2015 ◽  
Vol 16 (5) ◽  
pp. 543-555 ◽  
Author(s):  
Bridget Johnston ◽  
Sally Lawton ◽  
Jan Pringle
Keyword(s):  
Early Stage ◽  
Framework Analysis ◽  
Self Identity ◽  
Dignity Therapy ◽  
The People ◽  
People With Dementia ◽  
Care And Support ◽  
Depth Analysis ◽  
Self Forgiveness ◽  
Person With Dementia

Dementia is a progressive condition that impacts on individuals, families and care professionals. Maintaining quality of life through engagement with the person with dementia is an important part of their care. Dignity Therapy is an interactive, psychotherapeutic intervention that uses a trained dignity therapist to guide the person with dementia through an interview that then creates a written legacy called a generativity document. This can provide knowledge to inform care, as the condition progresses. Generativity documents were analysed using framework analysis. Main themes from the analysis were origin of values, essence and affirmation of self, forgiveness and resolution and existentialism/ meaning of life. These themes provide evidence of the type, scope and contribution that information generated from Dignity Therapy can make to the care and support of people with dementia. They provide information about the values, self-identity and the people and events that have been important to them and influenced their lives.

The effects of a multi-component dyadic intervention on the psychological distress of family caregivers providing care to people with dementia: a randomized controlled trial

2015 ◽  
Vol 27 (12) ◽  
pp. 2031-2044 ◽  
Author(s):  
Anna-Eva Prick ◽  
Jacomine de Lange ◽  
Jos Twisk ◽  
Anne Margriet Pot
Keyword(s):  
Randomized Controlled Trial ◽  
Physical Exercise ◽  
Family Caregivers ◽  
Controlled Trial ◽  
Skills Training ◽  
Community Dwelling ◽  
Randomized Controlled ◽  
People With Dementia ◽  
The Us ◽  
Person With Dementia

ABSTRACTBackground:Earlier research showed that multi-component dyadic interventions – including a combination of intervention strategies and addressing both the person with dementia and caregiver – have a beneficial impact on the mental and physical health of people with dementia and their family caregivers. A randomized controlled trial (RCT) of a multi-component dyadic intervention, which is a translated and adapted version of an intervention that has been shown to be effective in the US by Teri et al. (2003), was performed. The effects on caregivers’ mood (primary outcome), burden, general health, and salivary cortisol levels (secondary outcomes) were studied.Methods:Community-dwelling people with dementia and their family caregivers (N = 111 dyads) were randomly assigned. The experimental group received eight home visits during three months, combining physical exercise and support (psycho-education, communication skills training, and planning of pleasant activities). Both the physical exercise and support component were directed at both the person with dementia and the caregiver. The comparison group received monthly information bulletins and phone calls. There were three measurements at baseline (prior to the intervention), at three months, and at six months into the intervention. Data were analyzed with Generalized Estimating Equations (GEE) based on an intention-to-treat analysis of all available data.Results:All analyses showed no benefits of the intervention over time on any of the outcomes.Conclusion:The negative results might be explained by the translation and adaptation of the intervention that has been shown to be effective in the US: the intervention was shortened and did not include cognitive reframing. However, only the health effects on people with dementia and not on caregivers were studied in the US. Several other factors might also have played a role, which are important for future studies to take into account. These are: the usual health care in the country or region of implementation; the wishes and needs of participants for specific intervention components; the room for improvement regarding these components; the inclusion of positive outcome measures, such as pleasure, and the quality of the relationship.

Keeping the person with dementia and the informal caregiver together: a systematic review of psychosocial interventions

2016 ◽  
Vol 29 (4) ◽  
pp. 583-593 ◽  
Author(s):  
Annemarie Rausch ◽  
Monique A. A. Caljouw ◽  
Eva S. van der Ploeg
Keyword(s):  
Social Factors ◽  
Informal Caregiver ◽  
Informal Caregivers ◽  
Psychosocial Interventions ◽  
Skills Training ◽  
Narrative Synthesis ◽  
People With Dementia ◽  
Person With Dementia ◽  
Support Relationships ◽  
The Relationship

ABSTRACTBackground:Social support, relationships, and closeness are emphasized as important by both people with dementia and their informal caregivers. Psychosocial interventions might be helpful to reinforce the relationship between a person with dementia and his or her informal caregiver. Therefore, this review explores what types of psychosocial interventions have been provided for people with dementia and their informal caregivers together, and the effectiveness of these interventions.Methods:PubMed, PsychInfo, Cinahl, and references of key papers were searched for studies describing a psychosocial intervention for people with dementia and their informal caregivers together. Psychosocial interventions were defined as focusing primarily on psychological or social factors.Results:A total of seven publications describing six studies were identified as eligible for inclusion in this review. Interventions ranged in focus from skills training to viewing/making art. The methodology of the studies varied, especially regarding the outcome measures used. The results of individual studies were mixed. A narrative synthesis of the included studies is given.Conclusion:Although caregiving dyads emphasize the importance of their relationship, this is mostly not taken into consideration in the design and effect evaluations of the interventions. Improved research is needed on this subject, which focuses on people with dementia living in the community and those living in nursing homes.

The course of neuropsychiatric symptoms in patients with dementia in primary care

2018 ◽  
Vol 36 (4) ◽  
pp. 437-444 ◽  
Author(s):  
Petra Borsje ◽  
Peter L B J Lucassen ◽  
Hans Bor ◽  
Roland B Wetzels ◽  
Anne Margriet Pot ◽  
...  
Keyword(s):  
Primary Care ◽  
Neuropsychiatric Symptoms ◽  
Informal Caregivers ◽  
The People ◽  
People With Dementia ◽  
The Mean ◽  
Professional Care ◽  
State Examination ◽  
Cumulative Prevalence

Abstract Background During the course of dementia, most people develop some type of neuropsychiatric symptoms (NPS), which result in lower quality of life, high caregiver burden, psychotropic drug use and a major risk of institutionalization. Studies on NPS in people with dementia have been mainly conducted in clinical centres or psychiatric services. Objectives To investigate the course of NPS in people with dementia in primary care. Methods Analysis of (cumulative) prevalence and incidence, persistence and resolution based on data collected during an assessment at home of a prospective naturalistic cohort study in primary care in a sample of 117 people with dementia and their informal caregivers. Subsyndromes of NPS were assessed with the Neuropsychiatric Inventory (NPI) and Cohen-Mansfield Agitation Inventory. Multivariate analyses were used to detect determinants for the course of NPS. Results The mean age of the people with dementia was 78.6 years, and 52% were female. Mean Mini-Mental State Examination total score was 19.5, mean NPI total score 15.7. The most prevalent clinically relevant subsyndromes of the NPI were hyperactivity and mood/apathy, and the most prevalent individual NPS were aberrant motor behaviour (28%), agitation/aggression (24%) and apathy/indifference (22%). Of the people with dementia, 72.3% had one or more symptoms of the mood/apathy and 75.3% of the hyperactivity subsyndrome. Conclusions GPs should be aware of NPS in people with dementia and should actively identify them when they visit these patients or when informal caregivers consult them. Timely diagnosing facilitates adequate professional care.

scholarly journals Factors of Resilience in Informal Caregivers of People with Dementia from Integrative International Data Analysis

2016 ◽  
Vol 42 (3-4) ◽  
pp. 198-214 ◽  
Author(s):  
Karlijn J. Joling ◽  
Gill Windle ◽  
Rose-Marie Dröes ◽  
Franka Meiland ◽  
Hein P.J. van Hout ◽  
...  
Keyword(s):  
Informal Caregivers ◽  
Well Being ◽  
Negative Consequences ◽  
Data Set ◽  
Male Caregiver ◽  
People With Dementia ◽  
Different Types ◽  
High Care ◽  
International Data ◽  
Person With Dementia

Background/Aims: Although caring for a person with dementia can be stressful, some caregivers appear to experience few negative consequences to their well-being. This study aimed to examine what proportion of caregivers demonstrates resilience under different challenging circumstances and to identify factors related to their resilience. Methods: Baseline data from 4 studies from the Netherlands and UK among informal caregivers of people with dementia were harmonized and integrated. Caregiver resilience was defined as high levels of psychological well-being despite different types of high caregiving demands. Multivariate regression analyses identified factors significantly related to caregiver resilience. Results: The integrated data set included 15 harmonized variables with data from 1,048 caregivers facing a high care demand. The prevalence of resilience varied between 35 and 43%, depending on the demand for high care. Being a male caregiver, caring for a female, living apart from your relative, and low caregiver burden were positively related to caregiver resilience. Conclusion: Caregivers have the capacity to demonstrate resilience despite significant challenges. This study demonstrates how harmonization of data from multiple existing studies can be used to increase power and explore the consistency of findings. This contributes to a better understanding of which factors are likely to facilitate caregiver resilience and offers insights for developing services.

scholarly journals What do we require from surveillance technology? A review of the needs of people with dementia and informal caregivers

2019 ◽  
Vol 6 ◽  
pp. 205566831986951 ◽  
Author(s):  
Yvette Vermeer ◽  
Paul Higgs ◽  
Georgina Charlesworth
Keyword(s):  
Web Of Science ◽  
Informal Caregivers ◽  
Database Searching ◽  
Electronic Database ◽  
Surveillance Technology ◽  
People With Dementia ◽  
Scoping Literature Review ◽  
Global Concern ◽  
Effective Use ◽  
Person With Dementia

Introduction Dementia has become a major global concern and surveillance technology might provide support for informal caregivers and people with dementia. However, the needs of caregivers and people with dementia for surveillance technology have not been reviewed. Method A scoping literature review was used to identify the needs of caregivers and/or people with dementia towards surveillance technology. Electronic database searching was undertaken on LexisNexis, PubMed, Scopus, EMBASE, MEDLINE, Cumulative Index to Nursing, Allied Health Literature, PsycINFO, Web of Science, Assistive Technology database, and Google Scholar. Eligible studies were synthesized by theme. Results Twenty-eight eligible studies were identified, with the majority reporting the needs of caregivers rather than people with dementia. The predominant themes for caregivers were location accuracy, and increasing the safety of the person with dementia. People with dementia wanted simple useful technology that fits within their capacity and existing routines. Conclusions The needs of people with dementia must be considered when designing surveillance products. Studies have mostly focused on caregivers and discount ST product requirements. Further work is required to establish effective use of surveillance technology in dementia care. Therefore, further research should cross analyze these results by examining both the needs of caregivers, and people with dementia.

scholarly journals Memory and communication support strategies in dementia: Effect of a training program for informal caregivers

2012 ◽  
Vol 24 (12) ◽  
pp. 1927-1942 ◽  
Author(s):  
Jacki Liddle ◽  
Erin R. Smith-Conway ◽  
Rosemary Baker ◽  
Anthony J. Angwin ◽  
Cindy Gallois ◽  
...  
Keyword(s):  
Training Program ◽  
Controlled Trial ◽  
Informal Caregivers ◽  
Training Group ◽  
Well Being ◽  
Care Recipient ◽  
Control Group ◽  
People With Dementia ◽  
Person With Dementia ◽  
The Impact

ABSTRACTBackground: People with dementia have a range of needs that are met by informal caregivers. A DVD-based training program was developed using research-based strategies for memory and communication in dementia. The effectiveness of the training on the caregiver experience and the well-being of the person with dementia was evaluated.Methods: A pre-test/post-test controlled trial was undertaken with caregiver–care-recipient dyads living in the community. Measures of the carers’ knowledge of memory and communication strategies, burden, positive perceptions of caregiving, and perceptions of problem behaviors were taken pre- and three months post-intervention. The depression and well-being of the person with dementia were also evaluated. Satisfaction with the training and feedback were measured.Results: Twenty-nine dyads (13 training group, 16 control group) participated. Bonferroni's correction was made to adjust for multiple comparisons, setting α at 0.00385. A significant improvement was found in caregivers’ knowledge for the training group compared to the control group (p = 0.0011). The training group caregivers reported a reduction in the frequency of care recipient disruptive behaviors (p = 0.028) and increased perceptions of positive aspects of caregiving (p = 0.039), both at a level approaching significance. The training group care recipients had increased frequency of verbally communicated depressive behaviors at a level approaching significance (p = 0.0126). The frequency of observed depressive behaviors was not significantly different between groups.Conclusions: This approach to training for caregivers of people with dementia appears promising for its impact on knowledge and the caregiving experience. Further research could monitor the impact of the training on broader measures of depression and well-being, with a larger sample.

scholarly journals ONCOLOGICAL CARE FOR THE PATIENTS WITH HEPATOCELLULAR CARCINOMA IN SVERDLOVSK REGION

2020 ◽  
Vol 66 (4) ◽  
pp. 364-369
Author(s):  
Vladislav Petkau ◽  
V. Breder ◽  
E. Bessonova ◽  
A. Tarkhanov
Keyword(s):  
Current Issue ◽  
Annual Number ◽  
Post Mortem ◽  
Virus Hepatitis ◽  
Standardized Incidence Ratio ◽  
The People ◽  
Number Of Patients ◽  
One Year ◽  
The One ◽  
Regular Alcohol Consumption

HCC epidemiologic data in Sverdlovsk region are presented in current issue. 1293 of new cases of HCC were diagnosed since 2015 till 2019. The incidence rate of HCC in 2019 was 6,53 cases per 100000 people and standardized incidence ratio was 3,48 per 100000 people. The maximum of new cases was among the people older than 70 years. HCC developed in cirrhotic liver in 70,2% of cases. The main risk factors were virus hepatitis (49,6%), regular alcohol consumption (23%) and obesity (9,9%). The post-mortem diagnosis exceeds 40% of cases. The one-year mortality was 72-73%. The number of patients with HCC sent to the regional oncology dispensary increased in the last 5 years in 5 times. There were 124 of such patients in 2019. The majority has HCC at BCLC D stage (56,5%). Only 16,7% of patients received specialized treatment. The introduction of multidisciplinary team led to a doubling of annual number of treated patients with HCC.

scholarly journals An insider’s view of Alzheimer: cinematic portrayals of the struggle for personhood

2013 ◽  
Vol 7 (2) ◽  
pp. 73-96 ◽  
Author(s):  
Amir Cohen-Shalev ◽  
Esther-Lee Marcus
Keyword(s):  
Film Industry ◽  
Advanced Stage ◽  
The Third ◽  
The Past ◽  
Human Aspects ◽  
Principal Character ◽  
People With Dementia ◽  
Meaningful Existence ◽  
The One ◽  
Person With Dementia

This article looks at three recent films in which a person with dementia is the principal character. These films have been chosen according to the following criteria: representing different stages of dementia (early, moderate and advanced); films where the demented is the protagonist; and films challenging the biomedical view of dementia. Two of the characters are diagnosed with Alzheimer’s disease: the protagonist of Cortex (2008) is at a moderate stage, the one in Pandora’s Box (2008) is diagnosed when already in advanced stage and the third, the protagonist of Old Cats (2010), while not officially diagnosed, is in early onset of dementia. While the number of dementia films has significantly increased during the past decade, only a few access the subjective world and acknowledge the personhood of people with dementia. Made outside the mainstream film industry, making elaborate use of cinematic image and metaphor, these films, each in its own particular cinematic idiom, succeed in conveying the psychological, social and spiritual realities of dementia as they are experienced from within the protagonist’s psyche. While not denying the often bleak and painful aspects of dementia, these recent productions go against the grain, inspiring a complex, richly nuanced picture of dementia that centres around the protagonist’s stubbornly courageous struggle to forge a meaningful existence even in the direst of circumstances. These films, we believe, offer a richer and profound understating of the human aspects embedded in the phenomena of dementia.

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