The passage of a painting: The learning process of students creating art for people with dementia

2020 ◽  
Vol 16 (2) ◽  
pp. 209-225 ◽  
Author(s):  
Alison Shields ◽  
Alison Phinney
Keyword(s):  
Transitional Care ◽  
Fine Arts ◽  
Care Facility ◽  
The Elderly ◽  
Living Environment ◽  
Group Discussions ◽  
Post Secondary ◽  
People With Dementia ◽  
The Impact

Making Art for Making Place, a joint education and research project, engaged post-secondary fine arts students in the creation of paintings for residents of a transitional care facility. The purpose of the project was to explore how improving the living environment through art could benefit the residents with dementia while considering the impact this had on the students themselves. This article draws from participant observations and follow-up interviews to examine the learning experiences of students who created paintings for the facility. Further, it explores the impact on their learning through interactions with nurses and expert researchers who joined the class to participate in group discussions and share their expertise working with people living with dementia. The research revealed that the project fostered positive community building; engaged students in discussions and reflections about how art affects people; prompted consideration of experiences of the elderly ‐ particularly those with dementia; and expanded understandings of the roles of art in the society.

scholarly journals A longitudinal study over 40 years to study the metabolic syndrome as a risk factor for cardiovascular diseases

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lars Lind ◽  
Johan Sundström ◽  
Johan Ärnlöv ◽  
Ulf Risérus ◽  
Erik Lampa
Keyword(s):  
Metabolic Syndrome ◽  
Risk Factor ◽  
Longitudinal Study ◽  
Clinical Intervention ◽  
The Elderly ◽  
Adult Men ◽  
The Metabolic Syndrome ◽  
The Impact ◽  
Over 40 Years

AbstractThe impact of most, but not all, cardiovascular risk factors decline by age. We investigated how the metabolic syndrome (MetS) was related to cardiovascular disease (CVD) during 40 years follow-up in the Uppsala Longitudinal Study of Adult Men (ULSAM, 2,123 men all aged 50 at baseline with reinvestigations at age 60, 70, 77 and 82). The strength of MetS as a risk factor of incident combined end-point of three outcomes (CVD) declined with ageing, as well as for myocardial infarction, ischemic stroke and heart failure when analysed separately. For CVD, the risk ratio declined from 2.77 (95% CI 1.90–4.05) at age 50 to 1.30 (95% CI 1.05–1.60) at age 82. In conclusion, the strength of MetS as a risk factor of incident CVD declined with age. Since MetS was significantly related to incident CVD also at old age, our findings suggest that the occurrence of MetS in the elderly should not be regarded as innocent. However, since our data were derived in an observational study, any impact of MetS in the elderly needs to be verified in a randomized clinical intervention trial.

scholarly journals Impact of Frailty on Medical and Long-Term Care Expenditures for the Elderly Age 75 or Over in Japan

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 176-176
Author(s):  
Hiroto Yoshida ◽  
Yuriko Kihara
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Elderly Age ◽  
Term Care ◽  
Intentional Weight Loss ◽  
Long Term Care Insurance ◽  
And Gender ◽  
The Impact

Abstract This study examined the impact of frailty on medical and long-term care expenditures in an older Japanese population. The subjects were those aged 75 years and over who responded to the survey (March 2018) in Bibai, Hokkaido, Japan (n=1,203) and have never received certification of long-term care insurance at the survey. We followed up 867 individuals (72.1%) until the end of December 2018 (10 month-period). We defined frailty as a state in performing 4 items and over of 15 items which were composed of un-intentional weight loss, history of falls, etc. Among 867 subjects, 233 subjects (26.9%) were judged to be frailty group, and 634 subjects (73.1%) non-frailty group. We compared period to the new certification of long-term care insurance (LTCI), accumulated medical and long-term care expenditures adjusted for age and gender between the two groups during the follow-up period. Cox proportional hazard models were used to examine the association between baseline frailty and the new certification of LTCI. The relative hazard ratio (HR) was higher in frailty group than non-frailty group (HR=3.51, 95% CI：1.30-9.45, P=.013). The adjusted mean accumulated medical and long-term care expenditures per capita during the follow-up were significantly (P=.002) larger for those in the frailty group (629,699 yen), while those in the non-frailty group were 450,995 yen. We confirmed strong economic impact of frailty in the elderly aged 75 or over in Japan.

OP39 Evaluation Of Discharge Planning And Transitional Care For The Elderly

2018 ◽  
Vol 34 (S1) ◽  
pp. 15-15
Author(s):  
Maggy Wassef ◽  
Marc-Olivier Trepanier ◽  
Sylvie Beauchamp
Keyword(s):  
Readmission Rate ◽  
Transitional Care ◽  
Discharge Planning ◽  
Grey Literature ◽  
The Elderly ◽  
Narrative Synthesis ◽  
Local Data ◽  
Post Discharge ◽  
Level Of Evidence

Introduction:According to our local data, elderly patients accounted for 14 percent of the population yet, represent 58 percent of hospitalization and, they are more likely to return after discharge. These patients are more likely to return to the hospital following discharge. In order to meet ministerial target for length of stay of patient on a stretcher, the UETMIS-SS was requested to evaluate interventions aiming to improve the fluidity of patient trajectories in the acute care services. The objective of this health technology assessment is to evaluate the effectiveness of discharge planning and transitional care interventions aiming at reducing the readmission rate of the elderly.Methods:An umbrella review was conducted following the PRISMA statement to summarize the scientific evidence. The search was conducted in five databases along with the grey literature search. Two reviewers independently performed the study selection, the quality assessment and the data extraction. To better illustrate the activities and the healthcare professionals (HCP) involved in the interventions, an analytical framework was developed. Results were summarized in a narrative synthesis. The contextual and experiential data were collected through interviews with HCP and directorates from different settings. The level of evidence was and a committee was then held to elaborate the recommendations.Results:In the nine systematic reviews included in the narrative synthesis, three models were identified: Post-discharge planning and follow-up by the same HCP was established to be effective in reducing the readmission rate. Discharge planning interventions with follow-up by non-specific HCP have been shown to be promising, while discharge planning without follow-up after the hospital discharge has shown to be ineffective in reducing the readmission rate.Conclusions:An individualized discharge plan, coordination of services and follow-up performed by the same HCP is established to be effective in reducing readmission rate.

Social connectivity and creative approaches to dementia care: the case of a poetry intervention

2018 ◽  
pp. 65-86
Author(s):  
Kate de Medeiros ◽  
Aagje Swinnen
Keyword(s):  
Social Bonds ◽  
Care Facility ◽  
Human Beings ◽  
Social Connectivity ◽  
People With Dementia ◽  
Time Space ◽  
Imaginative Play ◽  
Participatory Arts ◽  
The Impact

This chapter draws together four concepts — resilience and flourishing, creativity and play — to explore the impact of poetry interventions in the lives of people with dementia living in a care facility. Participatory arts programmes can provide opportunities for people to be reminded of their humanness and re-membered as valuable human beings. Opportunities to be creative and engage with others contribute to resilience or the ability to transcend many dementia-associated losses. Through imaginative play, regardless of cognitive ability, people can express and/or enact important aspects of meaning and selfhood/personhood that might otherwise go unacknowledged in the care environment. While arts interventions may not be able to reverse cognitive decline, the case study points to ways that the poetry intervention creates a time–space in which people can ‘flourish’, express affinity with others, and foster social bonds, and how, in turn, these contribute to meaningful moments in people's lives.

scholarly journals Evaluation of a Group-Based Resilience Intervention for Typhoon Haiyan Survivors

2016 ◽  
Vol 10 ◽  
Author(s):  
Ma Regina M. Hechanova ◽  
Lynn C. Waelde ◽  
Pia Anna P. Ramos
Keyword(s):  
Coping Skills ◽  
The Philippines ◽  
Focus Group Discussions ◽  
Post Intervention ◽  
Group Discussions ◽  
Culturally Adapted ◽  
Disaster Survivors ◽  
Resilience Intervention ◽  
The Impact

This study evaluated the impact of Katatagan, a culturally adapted, group-based, and mindfulness-informed resilience intervention developed for disaster survivors in the Philippines. The intervention aimed to teach six adaptive coping skills: harnessing strengths, managing physical reactions, managing thoughts and emotions, seeking solutions and support, identifying positive activities, and planning for the future. Pre- and post-intervention assessments were conducted with 163 Typhoon Haiyan survivors. Six-month follow-up assessments were obtained for 37 participants. Pre- and post-results showed improvements in participants’ self-efficacy on all six coping skills. The 6-month follow-up revealed significant improvements in four of the six coping skills. Focus group discussions conducted at follow-up revealed that mindfulness, self-care, strengths, and reframing were some of the topics that were most memorable to participants. Among these, participants identified mindfulness as a skill that they continued to use. Participants also shared that they felt stronger because of the intervention and have shared what they learned with others in their communities.

scholarly journals Clinical effectiveness of the START (STrAtegies for RelaTives) psychological intervention for family carers and the effects on the cost of care for people with dementia: 6-year follow-up of a randomised controlled trial

2019 ◽  
Vol 216 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Gill Livingston ◽  
Monica Manela ◽  
Aidan O'Keeffe ◽  
Penny Rapaport ◽  
Claudia Cooper ◽  
...  
Keyword(s):  
Health Research ◽  
Psychological Intervention ◽  
Care Home ◽  
Clinical Effectiveness ◽  
Cost Of Care ◽  
Research Centre ◽  
Family Carers ◽  
People With Dementia ◽  
The Impact

BackgroundThe START (STrAtegies for RelaTives) intervention reduced depressive and anxiety symptoms of family carers of relatives with dementia at home over 2 years and was cost-effective.AimsTo assess the clinical effectiveness over 6 years and the impact on costs and care home admission.MethodWe conducted a randomised, parallel group, superiority trial recruiting from 4 November 2009 to 8 June 2011 with 6-year follow-up (trial registration: ISCTRN 70017938). A total of 260 self-identified family carers of people with dementia were randomised 2:1 to START, an eight-session manual-based coping intervention delivered by supervised psychology graduates, or to treatment as usual (TAU). The primary outcome was affective symptoms (Hospital Anxiety and Depression Scale, total score (HADS-T)). Secondary outcomes included patient and carer service costs and care home admission.ResultsIn total, 222 (85.4%) of 173 carers randomised to START and 87 to TAU were included in the 6-year clinical efficacy analysis. Over 72 months, compared with TAU, the intervention group had improved scores on HADS-T (adjusted mean difference −2.00 points, 95% CI −3.38 to −0.63). Patient-related costs (START versus TAU, respectively: median £5759 v. £16 964 in the final year; P = 0.07) and carer-related costs (median £377 v. £274 in the final year) were not significantly different between groups nor were group differences in time until care home (intensity ratio START:TAU was 0.88, 95% CI 0.58–1.35).ConclusionsSTART is clinically effective and this effect lasts for 6 years without increasing costs. This is the first intervention with such a long-term clinical and possible economic benefit and has potential to make a difference to individual carers.Declarations of interestG.L., Z.W. and C.C. are supported by the UCLH National Institute for Health Research (NIHR) Biomedical Research Centre. G.L. and P.R. were in part supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North Thames at Bart's Health NHS Trust. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Z.W. reports during the conduct of the study; personal fees from GE Healthcare, grants from GE Healthcare, grants from Lundbeck, other from GE Healthcare, outside the submitted work.

The biopsychosocial (BPS) model of dementia as a tool for clinical practice. A pilot study

2016 ◽  
Vol 28 (7) ◽  
pp. 1079-1089 ◽  
Author(s):  
Catherine Revolta ◽  
Martin Orrell ◽  
Aimee Spector
Keyword(s):  
Quality Care ◽  
Preliminary Evidence ◽  
Sense Of Competence ◽  
Positive Attitudes ◽  
People With Dementia ◽  
Within Subjects ◽  
Treatment Plans ◽  
Practical Tool ◽  
The Impact

ABSTRACTBackground:Equipping staff with the skills to provide high quality care in dementia is essential. The Biopsychosocial (BPS) model of dementia (Spector and Orrell, 2010) is a practical tool designed to encourage staff to develop personalized interventions and treatment plans for people with dementia. This feasibility study aimed to examine the impact of training staff to use the BPS model on skills of formulation, attitude towards dementia and sense of role competence.Method:A within-subjects design was used. Thirty-seven staff working in dementia care across a community mental health team (CMHT), inpatient wards, and residential care homes were trained to use the BPS model. Outcomes were measured at baseline, post-training, and four week follow-up.Results:The ability of staff to understand, formulate, and develop interventions for people with dementia increased significantly following training. There were small, non-significant improvements in positive attitudes, and sense of competence following training. Staff also reported that training improved their understanding of biological and psychosocial factors in dementia.Conclusions:This study provides preliminary evidence that training staff to use the BPS model can lead to improvements in their ability to understand and develop interventions for people with dementia. Further research would be required to draw firm conclusions about its effectiveness.

Metastatic melanoma in the elderly: Case series of clinical outcome and immune characteristics

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20018-e20018
Author(s):  
U. P. Hegde ◽  
N. Chakraborty ◽  
A. Chhabra ◽  
S. Ray
Keyword(s):  
Immune System ◽  
Clinical Outcome ◽  
Elderly Patients ◽  
Metastatic Melanoma ◽  
Cutaneous Melanoma ◽  
Proliferative Activity ◽  
The Elderly ◽  
High Dose ◽  
The Impact

e20018 Background: Cutaneous melanoma incidence is rapidly rising in the elderly population. Imbalances of the immune system are described due to aging associated changes between CD4+, CD8+, T helper (Th) 1, Th 2 and T regulatory and T effector lymphocytes (lym). We describe clinical outcome in 10 elderly patients (pts) with cutaneous metastatic melanoma (CMM) and results of the immune studies done in a subgroup. Methods: Between October 2002 and October 2008, 10 elderly pts with treatment naïve CMM, 6 males and 4 female, median ages 76, range 57–84 years were treated at the University of Connecticut Health Center. Metastatic sites included soft tissue in 2 patients (pts), lung and/or liver with lymph node (LN) involvement (6 pts) and distant LN metastasis (2pts). Eight pts opted for treatment and received single or combination chemotherapy (5pts), high dose Interleukin 2 (2 pts), complete tumor resection followed by tumor derived heat shock protein vaccine (1 pt on clinical trial) and bio chemotherapy (1pt). One patient declined treatment (included in follow up). In vitro immune characteristics were studied in HLA-A2 positive subgroup (5pts) and included cytotoxic T lym (CTL) generation against self and non self peptides (Mart-1 27–35 and influenza MP derived peptide flu 58–66), proliferative activity of CD4+ lym in response to anti CD3 antibody under Th1 and Th2 conditions and regulatory T lym activity of CD4+CD25+ lym against CTL. Results: All patients tolerated treatments well resulting in 1 complete response, 4 partial responses, and 4 stable diseases. During 6 year follow up period, 6 patients died while 4 patients are living (one with disease). The median survival of all patients is 28.1 month (mo) while in those surviving (4pts) is 72 mo. Immune studies revealed preserved proliferative activity of CD4+ lym with stronger Th1 induction than Th2. The CTL responses to self and non self antigens were preserved while regulatory T lym showed weak activity against CTL. Conclusions: Some elderly patients with metastatic melanoma demonstrate improved outcomes and favorable immune characteristics. Further studies are needed to understand the impact of aging immune system on cutaneous melanoma. No significant financial relationships to disclose.

scholarly journals Relocation experiences of the elderly to a long-term care facility in Taiwan: a qualitative study

2019 ◽  
Author(s):  
Chia-Shan Wu ◽  
Jiin-Ru Rong
Keyword(s):  
Qualitative Study ◽  
Elderly People ◽  
Long Term Care ◽  
Care Facility ◽  
The Elderly ◽  
Living Environment ◽  
Theory Approach ◽  
Major Life ◽  
Term Care

Abstract Background Relocation to a long-term care (LTC) facility is a major life change for most elderly people. Following relocation, many elderly experience difficulties in adapting to changes in the living environment. Taiwan is increasingly becoming an "aging society” and the numbers of those who relocate from family residences to long-term residential care facilities have increased over years. However, in-depth evidence on the experiences of the elderly of their stay in LTC facilities in Taiwan is relatively sparse. This study aimed to explore the relocation experiences of the elderly to a LTC facility to inform policy and practice to address their needs effectively. Methods A qualitative study, using semi-structured in-depth interviews, was conducted to explore the experiences of 16 elderly people who have relocated to and lived in a LTC facility in Taiwan for up to a period of 12 months. All interviews were recorded, transcribed, and analyzed using grounded theory approach. Results Participants’ accounts reflected four interrelated key themes: wish to minimize the burden, but stay connected with the family; perceived barriers to adaptation; valuing tailored care; and acceptance and engagement. Each theme included interrelated subthemes that influenced one another and represented the different stages in the relocation journey. Most participants viewed relocation as a way of minimizing the burden of their care from family members, but desired to keep a close connection with family and friends. Participants recounted experiences of psychological resistance while making the decision to relocate. Fear of losing autonomy and the ability to perform self-care was a major reason for resistance to adapt. Provision of tailored care was accorded much value by the participants. The decision to accept the relocation and to adapt themselves to the new environment due to their needs for constant care was explicit in some accounts. Conclusions Relocation to LTC facility is a dynamic process in the first year of moving into the facility, and involves a range of emotions, feelings and experiences. Adaptation of the elderly into the LTC facility can be maximized if the relocation is well planned with provisions for individually tailored care and family involvement.

scholarly journals Relocation experiences of the elderly to a long-term care facility in Taiwan: a qualitative study

2020 ◽  
Author(s):  
Chia-Shan Wu ◽  
Jiin-Ru Rong
Keyword(s):  
Qualitative Study ◽  
Elderly People ◽  
Long Term Care ◽  
Care Facility ◽  
The Elderly ◽  
Living Environment ◽  
Theory Approach ◽  
Major Life ◽  
Term Care

Abstract Background Relocation to a long-term care (LTC) facility is a major life change for most elderly people. Following relocation, many elderly experience difficulties in adapting to changes in the living environment. Taiwan is increasingly becoming an "aging society” and the numbers of those who relocate from family residences to long-term residential care facilities have increased over years. However, in-depth evidence on the experiences of the elderly of their stay in LTC facilities in Taiwan is relatively sparse. This study aimed to explore the relocation experiences of the elderly to a LTC facility to inform policy and practice to address their needs effectively. Methods A qualitative study, using semi-structured in-depth interviews, was conducted to explore the experiences of 16 elderly people who have relocated to and lived in a LTC facility in Taiwan for up to a period of 12 months. All interviews were recorded, transcribed, and analyzed using grounded theory approach.Results Participants’ accounts reflected four interrelated key themes: wish to minimize the burden, but stay connected with the family; perceived barriers to adaptation; valuing tailored care; and acceptance and engagement. Each theme included interrelated subthemes that influenced one another and represented the different stages in the relocation journey. Most participants viewed relocation as a way of minimizing the burden of their care from family members, but desired to keep a close connection with family and friends. Participants recounted experiences of psychological resistance while making the decision to relocate. Fear of losing autonomy and the ability to perform self-care was a major reason for resistance to adapt. Provision of tailored care was accorded much value by the participants. The decision to accept the relocation and to adapt themselves to the new environment due to their needs for constant care was explicit in some accounts. Conclusions Relocation to LTC facility is a dynamic process in the first year of moving into the facility, and involves a range of emotions, feelings and experiences. Adaptation of the elderly into the LTC facility can be maximized if the relocation is well planned with provisions for individually tailored care and family involvement.

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