scholarly journals The Mood-5 (M5): A New Scale for Detecting COVID-19 Psychological Burden in Post-acute and Long-term Care Residents (Preprint)

2020 ◽  
Author(s):  
William E Mansbach ◽  
Ryan A Mace ◽  
Melissa A Tanner
Keyword(s):  
Convergent Validity ◽  
Long Term Care ◽  
Psychological Symptoms ◽  
Demographic Variables ◽  
Self Assessment ◽  
Term Care ◽  
Psychological Burden ◽  
Virtual Visits ◽  
Novel Coronavirus

BACKGROUND Older adults are at high risk for developing serious somatic and psychological symptoms from the 2019 novel coronavirus (COVID-19). Available instruments may not be sensitive to concerns about COVID-19 in post-acute and long-term care (PA/LTC) and have unknown utility for telehealth. OBJECTIVE We investigated the psychometric properties of the Mood-5 Scale (M5) as a rapid self-assessment of COVID-19 psychological burden in PA/LTC residents. METHODS Residents (N = 131, age ≥ 50) in 20 Maryland, USA PA/LTC settings were evaluated in-person or via telehealth (33%) during a four-week COVID-19 period (05/11/2020 – 06/05/2020). COVID psychological burden was rated by psychologists who independently reviewed clinical documentation. Psychometric analyses were performed on the M5 in relation to psychological tests, COVID-19 psychological burden, and diagnostic data collected during the evaluation. RESULTS The M5 demonstrated acceptable internal consistency (???? = .77). M5 scores were not confounded by demographic variables or telehealth administration (ps > 0.08). Convergent validity for the M5 was established via positive associations with anxiety (r = 0.56, p < 0.001) and depressive (r = 0.49, p < 0.001) symptoms. A M5 cutoff of 3 demonstrated strong sensitivity (.92) and adequate specificity (.75) for identifying COVID-19 psychological distress in PA/LTC residents (AUC = .89, PPV = .79, NPV = .91). CONCLUSIONS The M5 is a reliable and valid mood self-assessment that can identify residents with significant psychological burden associated with COVID-19. It can be completed in less than one minute and is appropriate for in-person and virtual visits.

scholarly journals The Columbia Behavior Scale for Dementia: Validity and Reliability in Long-Term Care Settings

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 185-185
Author(s):  
William Mansbach ◽  
Ryan Mace
Keyword(s):  
Nursing Staff ◽  
Behavior Management ◽  
Convergent Validity ◽  
Long Term Care ◽  
Psychological Symptoms ◽  
Validity And Reliability ◽  
Term Care ◽  
D 63 ◽  
Behavior Scale

Abstract Numerous neuropsychiatric inventories have been created for behavioral and psychological symptoms of dementia (BPSD). These inventories are seldom used in long-term care (LTC) settings due to questionable psychometrics, lengthy administration, and reliance on knowledgeable informants. The Columbia Behavior Scale for Dementia (CBS) is a rapidly administered BPSD rating tool that was developed for LTC residents. The 11-item CBS can be completed in less &lt;5 minutes independently, with nursing staff, or in conjunction with interdisciplinary care teams. LTC residents (N = 350) participated in a validation study in Maryland, USA (M age = 78.38, SD = 10.82). Internal consistency (⍺ = 0.75) and inter-rater reliability (r = 0.99) for the CBS were strong. CBS scores were not biased by informant type (p &gt; 0.05): GNAs/CNSs (40.69%), nurses (36.10%), other facility staff (23.21%). Diagnostic validity was confirmed by significantly higher CBS scores (p &lt; 0.001; large effect, d = .63) for LTC residents with dementia (n = 197, M = 4.63, SD = 4.58) versus those without dementia (n = 145, M = 2.17, SD = 2.87). Higher CBS scores were significantly associated with greater impairment on cognitive instruments (r range = -0.25, -.36) and increased mood dysfunction (r range = 0.20, 0.26), indicating convergent validity. Principal components analysis produced three CBS factors, psychosis, aggression, and non-aggressive motor disinhibition, which significantly identified LTC residents with greater odds for antipsychotic use. Results will be discussed in terms of right-sizing antipsychotic utilization, improving nonpharmacological behavior management, and enhancing the dementia literacy of nursing staff.

Combating Coronavirus Disease-2019 Outbreak in Long-Term Care Facilities for Frail Older Adults: Preventive Measures and Palliative Care Go Hand-in-Hand

2021 ◽  
pp. 082585972110393
Author(s):  
Hon Wai Benjamin Cheng
Keyword(s):  
Palliative Care ◽  
Long Term Care ◽  
Care Delivery ◽  
Nursing Home Residents ◽  
Respiratory Illness ◽  
Term Care ◽  
The People ◽  
Care Facilities ◽  
Novel Coronavirus

While the whole population is at risk from infection with the coronavirus, older people—often frail and subject to multimorbidity—are at the highest risk for the severe and fatal disease. Despite strict infection control and social distancing measures, frail adults in long-term care facilities may be at particular risk of transmission of respiratory illness. Treatment decisions are often complex attributed to the heterogeneity of this population with regards to different geriatric domains such as functional status, comorbidity, and poly-pharmacy. While measures must be taken to prevent the novel coronavirus from spreading through these facilities, it is also essential that residents with coronavirus disease 2019 (COVID-19) have access to the symptom management and support they want and deserve. What most nursing home residents want during the course of their illness is to be able to stay in their facilities, to be surrounded by the people they love most, and to feel relief from their physical and emotional pain. By addressing the limited access to hospice and palliative care delivery in nursing homes, we can prevent unnecessary suffering and pain from COVID-19 as well as lay the groundwork for improving care for all residents moving forward.

scholarly journals Psychometric Evaluation of the Korean Version of the Personhood in Dementia Questionnaire Using Rasch Analysis

2019 ◽  
Vol 16 (23) ◽  
pp. 4834 ◽  
Author(s):  
Da Eun Kim ◽  
Young Ko ◽  
Paulette V. Hunter ◽  
Ju Young Yoon
Keyword(s):  
Convergent Validity ◽  
Rasch Analysis ◽  
Long Term Care ◽  
Internal Consistency Reliability ◽  
World Health ◽  
Term Care ◽  
Korean Version ◽  
Item Fit ◽  
Group Validity

There is an increasing awareness of the need to promote behaviors consistent with the understanding that individuals with dementia deserve adequate respect. Person-centered attitudes on the part of a care facility’s staff can affect care practices and relationships with residents. This study examined the psychometric properties of the Korean version of the Personhood in Dementia Questionnaire (KPDQ), which measures staff’s person-centered attitudes toward individuals with dementia. The KPDQ was translated and adapted based on commonly used guidelines from the World Health Organization. For psychometric testing, the data obtained from a total of 269 participants in 13 long-term care facilities were analyzed. Factor analysis, item fit, convergent validity, and known-group validity were examined. Reliability and differential item functioning (DIF) based on Rasch analysis were also assessed. The KPDQ consists of 20 items with three subscales (“agency”, “respect for personhood” and “psychosocial engagement”). Item fit statistics indicated that each item fits well with the underlying construct. The KPDQ demonstrated satisfactory convergent validity, known-group validity and internal consistency reliability. There was no DIF by subgroup according to age or educational status. Results indicated that the KPDQ is a reliable and valid tool for measuring long-term care staff’s beliefs about personhood.

scholarly journals Social Engagement and Antipsychotic Use in Addressing the Behavioral and Psychological Symptoms of Dementia in Long-Term Care Facilities

2017 ◽  
Vol 49 (4) ◽  
pp. 144-152 ◽  
Author(s):  
Nasrin Saleh ◽  
Margaret Penning ◽  
Denise Cloutier ◽  
Anastasia Mallidou ◽  
Kim Nuernberger ◽  
...  
Keyword(s):  
Social Engagement ◽  
Long Term Care ◽  
Psychological Symptoms ◽  
Term Care ◽  
Care Facilities ◽  
Behavioral And Psychological Symptoms

Comparison of behavioral and psychological symptoms of Alzheimer's disease among institution residents and memory clinic outpatients

2009 ◽  
Vol 21 (6) ◽  
pp. 1134-1141 ◽  
Author(s):  
Ting-Wen Cheng ◽  
Ta-Fu Chen ◽  
Ping-Keung Yip ◽  
Mau-Sun Hua ◽  
Chi-Cheng Yang ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Long Term Care ◽  
Psychological Symptoms ◽  
Global Rating ◽  
Memory Clinic ◽  
Term Care ◽  
Care Facilities ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground: Behavioral and psychological symptoms of dementia (BPSD) cause caregiver distress and earlier institutionalization. We compared the prevalence and characteristics of BPSD between institution residents and memory clinic outpatients with Alzheimer's disease (AD) to test the hypothesis that there is more BPSD among institution residents than among their outpatient counterparts.Methods: We assessed BPSD by interviewing the patients’ principal caregivers, either family or professionals, using the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). Data from 138 patients with probable AD from the memory clinic and 173 residents with possible AD living in the long-term care facilities were collected. The diagnoses followed the NINCDS-ADRDA criteria.Results: BPSD profiles of the two groups were similar but not identical. The prevalence of at least one BPSD was high in both groups (community 81.9%, institution 74.9%). Activity disturbance was the most frequently reported BPSD in both groups (community 52.2%, institution 38.7%). Delusions, hallucinations, anxiety and aggressiveness were seen more frequently in memory clinic outpatients. The outpatients also had higher scores of BEHAVE-AD subscales in delusion/paranoid ideation, affective disturbance, and global rating of severity. With the increase of disease severity there were significantly more activity disturbance, psychosis, and aggressiveness in patients with AD.Conclusions: Caregiver factor and institution effect were two possible reasons for the higher prevalence and the greater severity of BPSD in community patients. BPSD caused more distress to family caregivers than the professional caregivers. High levels of psychotropic prescriptions for patients living in the long-term care facilities may also play a role.

scholarly journals Factors associated with eating performance in older adults with dementia in long-term care facilities: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dukyoo Jung ◽  
Jennie C. De Gagne ◽  
Hyesoon Lee ◽  
Minkyung Lee
Keyword(s):  
Older Adults ◽  
Grip Strength ◽  
Long Term Care ◽  
Psychological Symptoms ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
Physical Capability

Abstract Background The purpose of this study was to investigate factors influencing eating performance in older adults with dementia (OAWDs) in long-term care (LTC) facilities. Methods This cross-sectional study examined risk factors for compromised eating performance by comparing both independent and dependent older adults with dementia. The study participants were 117 OAWDs in LTC facilities in South Korea. Measurements included (a) general characteristics, (b) activities of daily living (ADL) including eating performance, (c) cognitive function, (d) physical capability, (e) grip strength, (f) Behavioral Psychological Symptoms of Dementia (BPSD), and (g) depression. Data were analyzed by the percentage, mean and standard deviation, Chi-square test, t-test, and logistic regression. Results The eating independent group had more comorbidities than the dependent group (t = 2.793, p < .006); had significantly higher cognition (t = 4.108, p < .001) and physical capability (t = 5.258, p < .001); and had stronger grip strength (t = 2.887, p = .005). Comorbidities and physical capability were determinants for independent eating performance (Odds Ratio [OR] = 1.969, p = .014; OR = 1.324, p < .001). Conclusions It is suggested that maintaining physical capability should be encouraged to support independent eating performance by OAWDs in LTC facilities. The results of this study could serve as a basis for developing function-focused care to maintain the residual eating performance of OAWDs in Korean LTC facilities. This is a subject area that has not been fully explored.

A long-term care center interdisciplinary education program for antipsychotic use in dementia: program update five years later

2011 ◽  
Vol 24 (4) ◽  
pp. 599-605 ◽  
Author(s):  
Stephen Vida ◽  
Johanne Monette ◽  
Machelle Wilchesky ◽  
Michèle Monette ◽  
Ruby Friedman ◽  
...  
Keyword(s):  
Behavioral Problems ◽  
Educational Program ◽  
Intervention Program ◽  
Long Term Care ◽  
Psychological Symptoms ◽  
Care Center ◽  
Dose Assessment ◽  
Current Evidence ◽  
Term Care

ABSTRACTBackground: While antipsychotic (AP) medications are frequently used in long-term care, current evidence suggests that the risks may offset the benefits, necessitating periodic reassessment of their use. The aims of this present study were: (1) to assess rates of AP use five years after our first intervention to determine the long-term impact; and (2) to implement an updated AP reduction educational intervention program at the same center five years later in order to determine whether AP use could be further reduced.Methods: Participants were residents with dementia receiving AP medication. The educational program component included separate lectures on pharmacologic and non-pharmacologic treatment of behavioral and psychological symptoms of dementia (BPSD). Completion of the Nursing Home Behavior Problems Scale (NHBPS), physician interviews concerning AP treatment plans for subjects with dementia, and AP administration and dose assessment occurred both at baseline and again between four to five months after the educational program.Results: Of 308 long-term residents with dementia, 53 (17.2%) were receiving regular APs, primarily for agitation, aggressivity, other behavioral problems and psychosis. Of these, six died and one was transferred, leaving 46 participants. At five months, ten (21.7%) residents were no longer receiving APs and seven (15.2%) were on a lower dose; thus, 17 (37.0%) were either discontinued or on a lower dose. There was no worsening of NHBPS scores.Conclusion: Despite the low prevalence (17.2%) of AP users at the beginning of the current study compared to that observed five years prior (30.5%), it is still possible to further decrease the proportion of users.

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