scholarly journals Neuropsychiatric symptoms in dementia

2016 ◽  
Author(s):  
Valeria Manera ◽  
Julie Brousse ◽  
Pierre Foulon ◽  
Audrey Deudon ◽  
Elsa Leone ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Healthcare Professionals ◽  
Neuropsychiatric Symptoms ◽  
Treatment Success ◽  
Critical Factor ◽  
Home Healthcare ◽  
Current Evidence ◽  
People With Dementia

Neuropsychiatric symptoms (NPS) are very common in people with dementia-related disorders, and are responsible for a large share of the suffering of patients and caregivers. Current evidence suggests that non-pharmacological treatments are promising solutions to NPS. However, a critical factor in the treatment success is represented by the involvement of professional and family caregivers. Here we briefly present “No panic in the nursing home”, an educational “serious game” designed for healthcare professionals working in nursing homes. Based on an educational program previously designed by our group, “No Panic in the Nursing Home”  teaches professional caregivers how to deal with NPS of dementia. The player takes the role of a nursing home nurse, and is confronted with practical situations in which he/she needs to decide how to behave. Results collected in three nursing homes suggest that the game is considered as very interesting by nursing home healthcare professionals, even by persons with no previous experience with videogames.

The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review

Dementia ◽  
2021 ◽  
pp. 147130122110126
Author(s):  
Alexandra E Harper ◽  
Lauren Terhorst ◽  
Marybeth Moscirella ◽  
Rose L Turner ◽  
Catherine V Piersol ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Scoping Review ◽  
Informal Caregivers ◽  
Nursing Home Care ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Background Person-centered care has been shown to increase desired outcomes for people with dementia, yet informal caregivers’ dissatisfaction with care is often reported. For those living in a nursing home, informal caregivers are uniquely situated to provide key insights into the individual’s care. However, little is known of the informal caregivers’ perspective, which hinders efforts to improve their satisfaction with person-centered nursing home care. Thus, we examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia. Methods In collaboration with stakeholders, a scoping review of Medline (Ovid), EMBASE.com , CINAHL (EBSCO), the Cochrane Library (Wiley), and PsycINFO (Ovid) databases from January 2000 to July 2020 was conducted. Data were extracted reflecting the experiences, priorities, and preferences of caregivers of people with dementia residing in nursing homes. Results We identified 114 articles that revealed nine themes: (1) communication, (2) transition to nursing home, (3) quality of care, (4) quality of life, (5) informal caregiver role, (6) knowledge of dementia, (7) end-of-life preferences, (8) medication use to manage neuropsychiatric behaviors, and (9) finances. Conclusion Informal caregivers described aspects of care that led to both positive and negative experiences with and perceptions of nursing home care. The shortcomings in communication were discussed most frequently, indicating a high priority area. While researchers define the identified themes individually, informal caregivers perceive them to be interwoven as they relate to person-centered care delivery. Although we did not assess the quality of included articles, by identifying themes relevant to caregivers’ perspectives of nursing home care, our findings may help to inform efforts to optimize caregivers’ satisfaction with nursing home care for residents with dementia.

scholarly journals Facilitators and barriers to implement nurse-led interventions in long-term dementia care: a qualitative interview study with Swiss nursing experts and managers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julian Hirt ◽  
Melanie Karrer ◽  
Laura Adlbrecht ◽  
Susi Saxer ◽  
Adelheid Zeller
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Public Perception ◽  
Dementia Care ◽  
Term Care ◽  
Face To Face ◽  
People With Dementia ◽  
Qualitative Interview Study ◽  
Facilitators And Barriers

Abstract Background To support the implementation of nurse-led interventions in long-term dementia care, in-depth knowledge of specific supporting factors and barriers is required. Conditions and structures of caring for people with dementia differ widely, depending on the country and the care context. Our study aimed to describe the experiences and opinions of nursing experts and managers with regard to facilitators and barriers to the implementation of nurse-led interventions in long-term dementia care. Methods We conducted a qualitative descriptive study using individual interviews based on qualitative vignettes as a useful stimulus to generate narrations allowing to study peoples’ perceptions and beliefs. The study took place in nursing homes in the German-speaking part of Switzerland and in the Principality of Liechtenstein using purposive sampling. We intended to conduct the interviews face-to-face in a quiet room according to the participant’s choice. However, due to the lockdown of nursing homes during the COVID-19 pandemic in spring 2020, we performed interviews face-to-face and by video. We analysed data thematically following Braun and Clarke to achieve a detailed, nuanced description. To verify our interpretation and to ensure congruence with participants’ perspectives, we conducted member checks. The Standards for Reporting Qualitative Research (SRQR) served to structure our manuscript. Results Six dyads of nursing home managers and nursing experts from six nursing homes took part in our study (n = 12). Our thematic analysis yielded seven themes reflecting facilitators and barriers to implementing nurse-led interventions in long-term dementia care: «A common attitude and cohesion within the organization», «Commitment on several levels», «A needs-oriented implementation», «The effect and the public perception of the intervention», «A structured and guided implementation process», «Supporting knowledge and competencies», as well as «Resources for implementing the intervention». Conclusions To support the implementation of nurse-led interventions in long-term dementia care, active commitment-building seems essential. It is necessary that the value of the intervention is perceptible.Commitment-building is the precondition to reach the persons involved, such as nursing home managers, nursing staff, residents and relatives. Furthermore, nurses should precisely inform about the intervention. It is necessary that the value of the intervention is perceptible. In addition, nurses should adjust the interventions to the situational needs of people with dementia, thus. Therefore, it is important to support dementia-specific competencies in long-term care. Findings indicate that the barrier is determined by the intervention and its implementation – and not by the behaviour of the person with dementia.

scholarly journals The Physical Environment of Nursing Homes for People with Dementia: Traditional Nursing Homes, Small-Scale Living Facilities, and Green Care Farms

Healthcare ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 137 ◽  
Author(s):  
Bram de Boer ◽  
Hanneke Beerens ◽  
Melanie Katterbach ◽  
Martina Viduka ◽  
Bernadette Willemse ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Physical Environment ◽  
Well Being ◽  
Nursing Home Care ◽  
Small Scale ◽  
People With Dementia ◽  
Different Types ◽  
Centered Care ◽  
Green Care Farms

It is well recognized that the physical environment is important for the well-being of people with dementia. This influences developments within the nursing home care sector where there is an increasing interest in supporting person-centered care by using the physical environment. Innovations in nursing home design often focus on small-scale and homelike care environments. This study investigated: (1) the physical environment of different types of nursing homes, comparing traditional nursing homes with small-scale living facilities and green care farms; and (2) how the physical environment was being used in practice in terms of the location, engagement and social interaction of residents. Two observational studies were carried out. Results indicate that the physical environment of small-scale living facilities for people with dementia has the potential to be beneficial for resident’s daily life. However, having a potentially beneficial physical environment did not automatically lead to an optimal use of this environment, as some areas of a nursing home (e.g., outdoor areas) were not utilized. This study emphasizes the importance of nursing staff that provides residents with meaningful activities and stimulates residents to be active and use the physical environment to its full extent.

scholarly journals Palliative Care Symptoms, Outcomes, and Interventions for Chronic Advanced Patients in Spanish Nursing Homes with and without Dementia

2020 ◽  
Vol 17 (5) ◽  
pp. 1465
Author(s):  
Daniel Puente-Fernández ◽  
Concepción Petra Campos-Calderón ◽  
Ana Alejandra Esteban -Burgos ◽  
César Hueso-Montoro ◽  
Concepción Beatriz Roldán-López ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Homes ◽  
Diagnostic Tests ◽  
Diagnostic Tools ◽  
Worth Living ◽  
Pharmacological Treatments ◽  
People With Dementia ◽  
Edmonton Symptom Assessment Scale ◽  
Therapeutic Procedures

The aim of this study was to compare the symptomatology, palliative care outcomes, therapeutic procedures, diagnostic tests, and pharmacological treatments for people with dementia (PWD) and without dementia (PW/OD) admitted to Spanish nursing homes. Design: This was a cross-sectional study which is part of a long-term prospective follow-up of elderly people performed in nursing homes to measure end-of-life care processes. Participants: 107 nursing home patients with advanced or terminal chronic diseases were selected according to the criteria of the Palliative Care Spanish Society. Setting: Two trained nurses from each nursing home were responsible for participant selection and data collection. They must have treated the residents and had a minimum seniority of 6 months in the nursing home. Measurements: Sociodemographic data; Edmonton Symptom Assessment Scale; Palliative Care Outcome Scale; and prevalence of diagnostic tests, pharmacological treatments, and therapeutic procedures were evaluated. Results: Pain, fatigue, and nausea were found to be significantly higher in the nondementia group and insomnia, poor appetite, and drowsiness were significantly higher in the dementia group. Patient anxiety, support, feeling that life was worth living, self-worth, and practical matters management were higher in the nondementia group. Regarding drugs, use of corticoids was higher in the nondementia group, while use of anxiolytics was higher in the dementia group. Diagnostic procedures such as urine analysis and X-ray were higher in the dementia group. Conclusions: Differences in symptom perception, diagnostic tests, and pharmacological procedures were found between patients with and without dementia. Specific diagnostic tools need to be developed for patients with dementia.

scholarly journals The Prevalence of and Documented Indications for Antipsychotic Prescribing in Irish Nursing Homes

Pharmacy ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 160
Author(s):  
Jayne E. Kelleher ◽  
Peter Weedle ◽  
Maria D. Donovan
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Antipsychotic Medication ◽  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Medication Use ◽  
Nursing Home Residents ◽  
Cross Sectional ◽  
Home Setting ◽  
Antipsychotic Prescribing

Background: Antipsychotic medications are often used ‘off-licence’ to treat neuropsychiatric symptoms and disorders of aging and to manage behavioural and psychological symptoms of dementia despite the warnings of adverse effects. Objective: To establish the prevalence of and documented indication for antipsychotic medication use in the Irish nursing home setting. Setting: This study was conducted in six nursing homes located in Co. Cork, Ireland. Method: A retrospective, cross-sectional study was employed. All patients who met the inclusion criteria (≥65 years, residing in a nursing home on a long-term basis) were eligible for inclusion. There were 120 nursing home residents recruited to the study. Main Outcome Measure: The prevalence of antipsychotic medication use in nursing home residents (with and without dementia). Results: The overall prevalence of antipsychotic prescribing was found to be 48% and patients with dementia were significantly more likely to be prescribed an antipsychotic compared to those without dementia (67% vs. 25%) (χ2 (1, N = 120) = 21.541, p < 0.001). In the cohort of patients with dementia, there was a trend approaching significance (p = 0.052) of decreasing antipsychotic use with increasing age (age 65–74 = 90%; age 75–84 = 71%; age 85 and over = 58%). An indication was documented for 84% of the antipsychotic prescriptions in this cohort. Conclusion: The findings of this study highlight that high rates of antipsychotic medication use remains an issue in Irish nursing homes. Further work should explore factors in influencing prescribing of these medications in such settings.

scholarly journals Gluten in pharmaceutical products: a scoping review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Irene Lizano-Díez ◽  
Eduardo L. Mariño ◽  
Pilar Modamio
Keyword(s):  
Scoping Review ◽  
Healthcare Professionals ◽  
Pharmaceutical Products ◽  
Current Evidence ◽  
Gluten Free ◽  
Scoping Reviews ◽  
The Us ◽  
Wide Variability ◽  
Definition Of

Abstract Background Celiac disease (CD) is one of the most common gluten-related disorders. Although the only effective treatment is a strict gluten-free diet, doubts remain as to whether healthcare professionals take this restriction into consideration when prescribing and dispensing medicines to susceptible patients. This scoping review aimed to find out the current evidence for initiatives that either describe the gluten content of medicines or intend to raise awareness about the risk of prescribing and dispensing gluten-containing medicines in patients with CD and other gluten-related disorders. Methods A scoping review was conducted using three search strategies in PubMed/MEDLINE, TripDatabase and Web of Science in April 2021, following the PRISMA extension for scoping reviews (PRISMA-ScR). References from included articles were also examined. Two researchers screened the articles and results were classified according to their main characteristics and outcomes, which were grouped according to the PCC (Population, Concept and Context) framework. The initiatives described were classified into three targeted processes related to gluten-containing medicines: prescription, dispensation and both prescription and dispensation. Results We identified a total of 3146 records. After the elimination of duplicates, 3062 articles remained and ultimately 13 full texts were included in the narrative synthesis. Most studies were conducted in the US, followed by Canada and Australia, which each published one article. Most strategies were focused on increasing health professional’s knowledge of gluten-containing/gluten-free medications (n = 8), which were basically based on database development from manufacturer data. A wide variability between countries on provided information and labelling of gluten-containing medicines was found. Conclusion Initiatives regarding the presence of gluten in medicines, including, among others, support for prescribers, the definition of the role of pharmacists, and patients’ adherence problems due to incomplete labelling of the medicines, have been continuously developed and adapted to the different needs of patients. However, information is still scarce, and some aspects have not yet been considered, such as effectiveness for the practical use of solutions to support healthcare professionals.

scholarly journals 423 - Characteristics of specialized units for people with dementia and very severe challenging behavior in the Netherlands: a mixed method study

2021 ◽  
Vol 33 (S1) ◽  
pp. 45-45
Author(s):  
Gerrie Van Voorden ◽  
Mijke Lips ◽  
Sytse Zuidema ◽  
Richard Christiaan Oude Voshaar ◽  
Martin Smalbrugge ◽  
...  
Keyword(s):  
Nursing Home ◽  
The Netherlands ◽  
Nursing Staff ◽  
Challenging Behavior ◽  
Elderly Care ◽  
Patient Characteristics ◽  
Nursing Home Care ◽  
Treatment Characteristics ◽  
People With Dementia

Introduction:Little is known about the raising number of specialized units for patients with dementia and very severe challenging behavior in the Netherlands. This study describes organizational and treatment characteristics of a sample of these units.Methods:The organizational and treatment characteristics were studied with digital questionnaires completed by the unit managers, interviews with the main physician(s) and observation of the physical environment. The questionnaire consisted of questions about general patient characteristics, unit characteristics and staff characteristics. Furthermore, an interview was held with the main/treating physician often together with another physician or psychologist. The interview guide consisted of questions about admission criteria, the role of staff involved and the treatment process.Results:Thirteen units participated. Five units were part of a mental health (MH) institution, seven units were part of a nursing home (NH) organization and one unit was a cooperation of MH and NH. Unit sizes ranged from 10 to 28 places. Ten of thirteen units started in 2010 or later. The age of patients admitted was estimated at 75 years. The percentage of involuntary admitted patients was 53% at MH-units and 18% at NH-units. Unit managers mentioned that due to a difference in reimbursement between MH and NH units had difficulty providing the specialized care. Another problem managers faced was recruiting nursing staff. Units strived for expertise in general staffing from both MH and NH. The education level of the nursing staff was comparable between MH and NH. At every unit a physician with background in elderly care medicine or geriatrics and a psychiatrist was involved. Interviewees stressed the role of the nursing staff in the treatment. They were key in providing the care and treatment that, since the main goal of interventions is treatment of and coping with challenging behavior.Conclusion:The main finding of this study is that units caring for patients with dementia and challenging behavior, despite barriers in regulations and staffing shortage, search for combining expertise from nursing home care and psychiatry in their treatment.

scholarly journals A Digital Platform for Facilitating Personalized Dementia Care in Nursing Homes: A Formative Evaluation Study (Preprint)

2020 ◽  
Author(s):  
GUBING WANG ◽  
Armagan Albayrak ◽  
Gerd Kortuem ◽  
Tischa J. M. van der Cammen
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
User Acceptance ◽  
Assistive Technologies ◽  
Perceived Usefulness ◽  
Technical Feasibility ◽  
Digital Platform ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

BACKGROUND Person-centered care is key to the wellbeing of people with dementia. A large quantity of personal data can be collected with the development of the Internet of Things, which has the potential to facilitate person-centered care for people with dementia. Yet, there are limited assistive technologies developed for this purpose, and the user acceptance for assistive technologies is low in nursing homes. Through a data-enabled design approach, a digital platform was developed for helping the care team to personalize the management of behavioral and psychological symptoms for people with dementia in nursing homes. OBJECTIVE This study aims to evaluate the digital platform from three aspects, in a real-life context with potential users. First, its technical feasibility in collecting sufficient data for pattern analysis; second, the types of insights and actions generated from the potential users by using it, if any; third, its perceived usefulness and its future improvements that potential users would like to see. METHODS The digital platform was deployed in a nursing home for seven weeks, and the data collected were first analyzed by the researchers for a technical feasibility check. The data were then visualized and presented to the potential users via the digital platform. The potential users were asked to analyze the visualizations and were interviewed on 1) the insights and actions generated, if any; 2) the usefulness of the digital platform and 3) what could be improved. RESULTS The data collected in the digital platform demonstrate its technical potential to reveal behavior patterns for PwD. The insights generated by the potential users were categorized into “client level”, “ward level” and “team level”. The actions taken by the potential users were classified into “investigation” and “implementation”. The user acceptance varied across potential users, and three aspects of improvements for the digital platform were identified. CONCLUSIONS This study provides the first evidence for the technical feasibility of the digital platform; besides, it offers future researchers some recommendations on how to integrate assistive technologies in the nursing home context from exploring the types of insights and actions identified, the varied perceived usefulness, and the areas of improvement for the digital platform.

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