scholarly journals A Novel Intervention for Management of Behavioral and Psychological Symptoms of Dementia in Nursing Home Communal Areas: Results of a Small-Scale Pilot Trial

2021 ◽  
pp. 1-7
Author(s):  
Gloria Gutman ◽  
Avantika Vashisht ◽  
Taranjot Kaur ◽  
Mojgan Karbakhsh ◽  
Ryan Churchill ◽  
...  
Keyword(s):  
Nursing Home ◽  
Psychological Symptoms ◽  
Positive Impact ◽  
Care Home ◽  
Pilot Trial ◽  
Small Scale ◽  
Aggressive Behaviors ◽  
Communal Areas ◽  
The Impact ◽  
Behavioral And Psychological Symptoms

Background: Behavioral and psychological symptoms of dementia (BPSD) exhibited by persons with dementia (PwD) in nursing home communal areas are generally managed by segregation and/or pharmacological interventions. Objective: This study trialed MindfulGarden (MG), a novel digital calming device, in a Canadian nursing home. Methods: Participants were 15 PwD (mean age = 87.67; 5m,10f; mean MMSE = 11.64±7.85). Each was observed by a research assistant (RA) for an average of 8–10 hours on two separate days. The RA followed them during time spent in communal areas of the nursing home including their unit’s dining space, lounges, and corridors and spaces shared with other units (e.g., gym and gift shop) and documented any BPSD exhibited. Day-1 provided baseline data; on Day-2, residents were exposed to MG if nursing staff considered their BPSD were sufficiently intense or sustained to warrant intervention. Staff rated the impact as positive, neutral, or negative. Results: On Day-1, 9 participants exhibited both aggressive and non-aggressive behaviors, 4 non-aggressive behaviors only, and 2 no BPSD. On Day-2, 7 exhibiting aggressive behaviors were exposed to MG. Staff reported MG as having distracting/calming effects and gave positive impact ratings to 6/13 exposures; there were no negative ratings. The most common aggressive BPSD on days of observation were pushing/shoving and screaming. Conclusion: MG may have value as a “psychiatric crash cart” in de-escalating agitation and aggression in care home settings.

TOP CITED PAPERS IN INTERNATIONAL PSYCHOGERIATRICS: 6a. QUALITY OF LIFE FOR PEOPLE WITH DEMENTIA LIVING IN RESIDENTIAL AND NURSING HOME CARE: THE IMPACT OF PERFORMANCE ON ACTIVITIES OF DAILY LIVING, BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS, LANGUAGE SKILLS, AND PSYCHOTROPIC DRUGS

2009 ◽  
Vol 21 (6) ◽  
pp. 1026-1030 ◽  
Author(s):  
C. Ballard ◽  
M. Margallo-Lana ◽  
J. T. O'Brien ◽  
I. James ◽  
R. Howard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychological Symptoms ◽  
Social Withdrawal ◽  
Care Home ◽  
Well Being ◽  
Nursing Home Care ◽  
People With Dementia ◽  
The Impact ◽  
Behavioral And Psychological Symptoms

The majority of people with dementia develop behavioral and psychological symptoms of dementia (BPSD) at some point during their illness (Jeste et al., 2008). These symptoms, which are especially common among care home residents, are frequently distressing for the patients who experience them (Gilley et al., 2006; Jeste et al., 2008) and problematic for their professional and/or family caregivers. The starting point for our paper “Quality of life for people with dementia living in residential and nursing home care: the impact of performance on activities of daily living, behavioral and psychological symptoms, language skills, and psychotropic drugs” (Ballard et al., 2001) was to try and understand the impact of BPSD, function and language skills on quality of life in care home residents with dementia. Although there were frequent statements in previous work referring to the capacity of psychiatric and behavioral symptoms to reduce quality of life, we had been unable to identify any empirical evidence to support this clinical impression in a thorough literature review. The parallel validation of Dementia Care Mapping (DCM), predominantly a practice development tool, as an observational measure of well-being/quality of life (Kitwood and Bredin, 1997; Fossey et al., 2002) provided an excellent opportunity to examine this issue in a care home setting. The study focused on 209 people with dementia living in residential and nursing home care in north-east England in the U.K., who received a detailed assessment of BPSD, function and cognition. A DCM evaluation was completed for 112 of these individuals, providing a detailed observational measure of well-being, activities and social withdrawal as indices of quality of life over a six-hour daytime period. To our surprise, there was actually no association between well-being, social withdrawal or activities and BPSD. In contrast, there was a significant association between antipsychotic medication and reduced well-being, social withdrawal and activities respectively, even after controlling for the severity of behavioral disturbance. Using an arbitrary definition of “ill-being”, defined as a well-being score of less than zero, 5% of people not taking antipsychotics, 10% of people taking atypical antipsychotics and 22% of people taking typical antipsychotics were defined as having ill-being. Lower levels of functional ability were also associated with significantly lower well-being, less activities and more social withdrawal. At first this latter finding appears to be contrary to one of the central principles of DCM – namely, that the assessment should be independent of dementia severity. Although high levels of well-being and engagement are possible for people with severe dementia, this probably requires higher staff numbers and a workforce with more specialized skills in order to achieve this.

scholarly journals The impact of lockdown during SARS-CoV-2 outbreak on behavioral and psychological symptoms of dementia

2021 ◽  
Vol 42 (3) ◽  
pp. 825-833
Author(s):  
Arianna Manini ◽  
Michela Brambilla ◽  
Laura Maggiore ◽  
Simone Pomati ◽  
Leonardo Pantoni
Keyword(s):  
Logistic Regression ◽  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Community Dwelling ◽  
Caregiver Distress ◽  
Neuropsychiatric Inventory ◽  
Logistic Regression Models ◽  
The Impact ◽  
Behavioral And Psychological Symptoms

Abstract Background During Covid-19 pandemic, the Italian government adopted restrictive limitations and declared a national lockdown on March 9, which lasted until May 4 and produced dramatic consequences on people’s lives. The aim of our study was to assess the impact of prolonged lockdown on behavioral and psychological symptoms of dementia (BPSD). Methods Between April 30 and June 8, 2020, we interviewed with a telephone-based questionnaire the caregivers of the community-dwelling patients with dementia who had their follow-up visit scheduled from March 9 to May 15 and canceled due to lockdown. Among the information collected, patients’ BPSDs were assessed by the Neuropsychiatric Inventory (NPI). Non-parametric tests to compare differences between NPI scores over time and logistic regression models to explore the impact of different factors on BPSD worsening were performed. Results A total of 109 visits were canceled and 94/109 caregivers completed the interview. Apathy, irritability, agitation and aggression, and depression were the most common neuropsychiatric symptoms experienced by patients both at baseline and during Covid-19 pandemic. Changes in total NPI and caregiver distress scores between baseline and during lockdown, although statistically significant, were overall modest. The logistic regression model failed to determine predictors of BPSD worsening during lockdown. Conclusion This is one of the first studies to investigate the presence of BPSD during SARS-CoV-2 outbreak and related nationwide lockdown, showing only slight, likely not clinically relevant, differences in BPSD burden, concerning mostly agitation and aggression, anxiety, apathy and indifference, and irritability.

FAKTOR PENANGULANGAN TERJADINYA WASTE PADA PROYEK KONSTRUKSI DI SURABAYA

EXTRAPOLASI ◽  
2020 ◽  
Vol 17 (2) ◽  
pp. 1-10
Author(s):  
Michella Beatrix ◽  
Nurul Rochmah ◽  
Gede Sarya ◽  
Pebru Dwijayanto
Keyword(s):  
Waste Management ◽  
Construction Projects ◽  
Positive Impact ◽  
Scale Construction ◽  
Small Scale ◽  
Construction Costs ◽  
Warehouse Storage ◽  
The Right ◽  
The Impact ◽  
Material Requirements

AbstractLarge and small scale construction projects have waste that cannot be predicted in advance, even the amount cannot be predicted directly, whether it is in large or small amounts. The existence of waste can have a significant impact that can affect construction costs. Waste can have both negative and positive impacts. Good waste management will have a positive impact on the company in terms of cost, even time, and quality, but if the waste that occurs cannot be handled or managed properly it will harm the company in terms of cost, time, and even in terms of quality. In this case, the party that always gets the impact of the waste is the contractor.This study focuses on mitigating the occurrence of waste that is how to minimize it. Thisstudy uses the distribution of questionnaires to the contractor in Surabaya. The results of this study are 5 item indicators on how to minimize the highest ranking. The 5 items are Updating material requirements, Mixing, transporting, and placing concrete at the right time, Increasing the competence and expertise of labor, Provision of good and adequate material/warehouse storage facilities, and accurate material measurement.  Abstrak Proyek konstruksi dalam skala besar maupun kecil, memiliki waste yang tidak dapat diprediksi sebelumnya, bahkan jumlahnya pun tidak dapat diprediksi secara langsung, apakah itu dalam jumlah besar ataupun jumlah yang kecil. Adanya waste dapat memberikan dampak yang signifikan yang dapat mempengaruhi biaya konstruksi. Pada dasarnya waste dapat memberikan dampak negatif maupun positif. Pengelolaan waste yang baik akan memberikan dampak positif bagi perusahaan dalam segi biaya, bahkan waktu dan mutu, namun apabila waste yang terjadi tidak dapat diatasi atau dikelola dengan baik maka akan memberikan dampak negatif bagi perusahaan dalam segi biaya, waktu bahkan dalam hal mutu. Dalam hal ini pihak yang selalu mendapatkan dampak dari adanya waste adalah pihak kontraktorPenelitian ini memfokuskan pada faktor penanggulangan terjadinya waste yaitu cara meminimalisirnya. Penelitian ini menggunakan penyebaran kuisioner kepada pihak kontraktor di Surabaya. Hasil dari penelitian ini adalah 5 item indicator cara meminimalisir yang memiliki ranking tertinggi. 5 item tersebut adalah Updating kebutuhan material, Mencampur, mengangkut dan menempatkan beton pada waktu yang tepat, Meningkatkan kompetensi dan keahlian tenaga kerja, Penyediaan fasilitas penyimpanan material/gudang yang baik dan memadai, dan Pengukuran bahan yang akurat.

scholarly journals THE ART OF CARING: EXPLORING HOW DEMENTIA CARE PARTNERS MANAGE CARE CHALLENGES AND FIND RESILIENCE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S594-S594
Author(s):  
Amanda N Leggett ◽  
Laura N Gitlin
Keyword(s):  
Psychological Symptoms ◽  
Management Styles ◽  
Manage Care ◽  
Intervention Science ◽  
Age Related ◽  
Care Partners ◽  
Manage Health Care ◽  
Positive Aspects Of Care ◽  
The Impact ◽  
Behavioral And Psychological Symptoms

Abstract Approximately 15 million Americans serve as family caregivers for a person with Alzheimer’s disease or another form of age-related dementia and this care can take a physical and emotional toll. Understudied is the process of how families actually provide care in response to care challenges, and how to find respite and resilience amidst care challenges. This symposium considers how caregivers handle daily challenges related to dementia including activities of daily living, behavioral and psychological symptoms of dementia, general health and medical comorbidities. In addition to characterizing care partner’s distinct styles of management (Leggett et al.) and knowledge and capacity to manage health care (Sadak et al.), the papers also provide perspective on positive aspects of care management such as the impact of respite on positive mood (Wylie et al.), the moderating role of relationship quality on responses to behavioral and psychological symptoms of dementia (Chunga et al.) and finally how caregivers’ problem-related, self-growth, and help-related behaviors compose their resilience to care challenges (Zhou et al.). To conclude, our discussant Dr. Laura Gitlin will offer insight on cross-cutting implications across studies and offer perspective on how research, intervention science, and clinical practice may better account for caregiver management styles to promote growth and resilience in caregivers and their care partners with dementia.

Behavioral and Psychological Symptoms of Dementia: Physical Nonaggressive Agitation

2000 ◽  
Vol 12 (S1) ◽  
pp. 125-127 ◽  
Author(s):  
Martin Haupt
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Psychological Symptoms ◽  
Institutional Care ◽  
Nursing Home Admission ◽  
Behavioral And Psychological Symptoms

Agitated behaviors occur frequently in patients with dementia. These behaviors affect the quality of life of the dementia sufferers and their caregivers. For example, these behaviors can greatly complicate everyday management in familiar surroundings and in institutional care, and they predict premature nursing home admission.

Comparison of behavioral and psychological symptoms of dementia and psychotropic drug treatments among old people in geriatric care in 2000 and 2007

2011 ◽  
Vol 23 (10) ◽  
pp. 1616-1622 ◽  
Author(s):  
Hugo Lövheim ◽  
Yngve Gustafson ◽  
Stig Karlsson ◽  
Per-Olof Sandman
Keyword(s):  
Cognitive Impairment ◽  
Drug Use ◽  
Psychotropic Drug ◽  
Psychological Symptoms ◽  
Antidepressant Drug ◽  
Geriatric Care ◽  
Psychotic Symptoms ◽  
Aggressive Behaviors ◽  
People With Dementia ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground: Behavioral and psychological symptoms, such as verbal or physical aggression, aberrant motor behaviors, psychotic symptoms, anxiety, depressive symptoms and apathy are common among people with dementia. The aim of the present study was to compare the one-week prevalence of behavioral and psychological symptoms and psychotropic drug treatment among people with cognitive impairment living in institutional care, in two large, comparable samples from 2000 and 2007.Methods: A comparison was made between two cross-sectional samples, collected in 2000 and 2007, comprising 4054 participants with cognitive impairment living in geriatric care units in the county of Västerbotten, Sweden. The Multi-Dimensional Dementia Assessment Scale (MDDAS) was used to assess cognitive impairment and behavioral and psychological symptoms. The use of psychotropic drugs was recorded.Results: Between 2000 and 2007, 15 out of 39 behavioral or psychological symptoms had become less common and no symptoms had become more common, after controlling for demographic changes. Four out of six behaviors within the cluster of aggressive behaviors had declined in prevalence. Patients prescribed anti-dementia drugs increased from 5.1% to 18.0% and antidepressant drug use increased from 43.2% to 49.1%, while anxiolytic, hypnotic, sedative and antipsychotic drug use remained largely unchanged.Conclusion: The prevalence of many behavioral symptoms had declined from 2000 to 2007, and among these changes, the decline in aggressive behaviors probably has the greatest clinical impact.

Behavioral and Psychological Symptoms in Dementia in Nursing Home Residents: The Economic Implications

2000 ◽  
Vol 12 (S1) ◽  
pp. 51-57 ◽  
Author(s):  
Judith A. O'Brien ◽  
Lori A. Shomphe ◽  
J. Jaime Caro
Keyword(s):  
Nursing Home ◽  
Caregiver Burden ◽  
Behavioral Problems ◽  
Sleep Disturbances ◽  
Psychological Symptoms ◽  
Violent Behavior ◽  
Nursing Home Residents ◽  
Level Of Care ◽  
Economic Implications ◽  
Behavioral And Psychological Symptoms

A variety of behavioral and psychological symptoms are inherent to dementia, such as delusional thinking, hallucinations, agitation, violent behavior, verbal outbursts, wandering, sleep disturbances, and sexually inappropriate behavior (Jackson et al., 1989; Reisberg et al., 1987; Teri et al., 1992; Yeager et al., 1995). Although opinions in the literature differ concerning behavioral problems and how they relate to caregiver burden and institutionalization (Martinson et al., 1995; Mega et al., 1996; Reisberg et al., 1987), this analysis focuses on their role in increasing the level of care once the patient is placed in permanent residential care.

scholarly journals The Impact of Center-Based Childcare Attendance on Early Child Development: Evidence From the French Elfe Cohort

Demography ◽  
2021 ◽  
Author(s):  
Lawrence M. Berger ◽  
Lidia Panico ◽  
Anne Solaz
Keyword(s):  
Child Development ◽  
Motor Skills ◽  
Negative Impact ◽  
Positive Impact ◽  
Language Skills ◽  
The United States ◽  
Small Scale ◽  
High Quality ◽  
Disadvantaged Children ◽  
The Impact

Abstract Proponents of early childhood education and care programs cite evidence that high-quality center-based childcare has positive impacts on child development, particularly for disadvantaged children. However, much of this evidence stems from randomized evaluations of small-scale intensive programs based in the United States and other Anglo/English-speaking countries. Evidence is more mixed with respect to widespread or universal center-based childcare provision. In addition, most evidence is based on childcare experiences of 3- to 5-year-old children; less is known about the impact of center-based care in earlier childhood. The French context is particularly suited to such interrogation because the majority of French children who attend center-based care do so in high-quality, state-funded, state-regulated centers, known as crèches, and before age 3. We use data from a large, nationally representative French birth cohort, the Étude Longitudinale Français depuis l'Enfance (Elfe), and an instrumental variables strategy that leverages exogenous variation in both birth quarter and local crèche supply to estimate whether crèche attendance at age 1 has an impact on language, motor skills, and child behavior at age 2. Results indicate that crèche attendance has a positive impact on language skills, no impact on motor skills, and a negative impact on behavior. Moreover, the positive impact on language skills is particularly concentrated among disadvantaged children. This implies that facilitating increased crèche access among disadvantaged families may hold potential for decreasing early socioeconomic disparities in language development and, given the importance of early development for later-life outcomes, thereby have an impact on long-term population inequalities.

scholarly journals Bridging the condensation-collision size gap: a direct numerical simulation of continuous droplet growth in turbulent cloud

2018 ◽  
Author(s):  
Sisi Chen ◽  
Man-Kong Yau ◽  
Peter Bartello ◽  
Lulin Xue
Keyword(s):  
Positive Impact ◽  
Cloud Droplet ◽  
Droplet Size Distribution ◽  
Droplet Growth ◽  
Small Scale ◽  
Combined Processes ◽  
The Individual ◽  
Condensational Growth ◽  
The Impact ◽  
Rain Formation

Abstract. In most previous DNS studies on droplet growth in turbulence, condensational growth and collisional growth were treated separately. Studies in recent decades have postulated that small-scale turbulence may accelerate droplet collisions when droplets are still small when condensational growth is effective. This implies that both processes should be considered simultaneously to unveil the full history of droplet growth and rain formation. This paper introduces the first DNS approach to explicitly study the continuous droplet growth by condensation and collisions inside an adiabatic ascending cloud parcel. Results from the condensation-only, collision-only, and condensation-collision experiments are compared to examine the contribution to the broadening of droplet size distribution by the individual process and by the combined processes. Simulations of different turbulent intensities are conducted to investigate the impact of turbulence on each process and on the condensation-induced collisions. The results show that the condensational process promotes the collisions in a turbulent environment and reduces the collisions when in still air, indicating a positive impact of condensation on turbulent collisions. This work suggests the necessity to include both processes simultaneously when studying droplet-turbulence interaction to quantify the turbulence effect on the evolution of cloud droplet spectrum and rain formation.

Sign in / Sign up

Export Citation Format

Share Document