International Journal of Geriatric Psychiatry, 31(11), 2016, pp.1172-1187.
Publisher:
Wiley
Objective: Caring for people with dementia can be emotionally challenging and is often linked to low job satisfaction and burnout in care staff. Staff training within care settings is potentially valuable in improving well-being and quality of care. This review aimed to (i) establish the impact of training on staff outcomes; (ii) compare the impact of different training approaches; (iii) explore
(Edited publisher abstract)
Objective: Caring for people with dementia can be emotionally challenging and is often linked to low job satisfaction and burnout in care staff. Staff training within care settings is potentially valuable in improving well-being and quality of care. This review aimed to (i) establish the impact of training on staff outcomes; (ii) compare the impact of different training approaches; (iii) explore the influence of training intensity; and (iv) explore potential barriers to success.
Method: A database search of staff training interventions revealed 207 papers, 188 of which were excluded based on prespecified criteria. Nineteen studies were included and appraised using a quality rating tool.
Results: Overall, the studies were found to be of variable quality; however, 16 studies found a significant change following training in at least one staff domain, with knowledge improving most frequently. Approaches focusing on managing challenging behaviours appeared to be the most effective.
Conclusion: Training staff can be an effective method of improving well-being, and programmes helping staff to manage challenging behaviour appear to be the most beneficial. There is no clear relationship between training intensity and outcome. Most studies point to the importance of addressing organisational factors as a barrier to change.
(Edited publisher abstract)
Subject terms:
dementia, training, staff, systematic reviews, care workers, challenging behaviour, outcomes;
Aging and Mental Health, 20(10), 2016, pp.1055-1062.
Publisher:
Taylor and Francis
Objective: The relationship between people with dementia and their carers is complex and has a significant impact on the dementia experience. The aim of this current study was to determine (1) which factors are associated with the quality of the patient–carer relationship and (2) whether these differ between the two perspectives.
Method: Participants (people with dementia and their carers) were...
(Publisher abstract)
Objective: The relationship between people with dementia and their carers is complex and has a significant impact on the dementia experience. The aim of this current study was to determine (1) which factors are associated with the quality of the patient–carer relationship and (2) whether these differ between the two perspectives.
Method: Participants (people with dementia and their carers) were taken from a randomised controlled trial of cognitive behaviour therapy for anxiety in dementia. The quality of the relationship from both perspectives, anxiety and depression in both parties; and the quality of life, neuropsychiatric symptoms and cognitive functioning in people with dementia was examined at three time points (baseline, 15 weeks and 6 months).
Results: There were 127 observations from 50 dyads (100 individuals) across the three time points. Factors significantly related to quality of relationship from the person with dementia's perspective were their own aggression, agitation, irritability, depression, anxiety and quality of life. Factors significantly associated with quality of relationship from the carer's perspective were their own anxiety and depression, and the depression, irritability, behavioural disturbances and quality of life of the person with dementia. People with dementia generally rated the quality of relationship higher, irrespective of level of dementia, depression or anxiety.
Conclusion: This study is novel in that it provides a valuable insight into the impact of mental health on relationship quality for both members of the dyad. The findings emphasise the importance of providing interventions which target mood for both parties, and behavioural problems for people with dementia.
(Publisher abstract)
Subject terms:
anxiety, dementia, older people, mental health problems, informal care, carers, relationships, cognitive behavioural therapy, depression, quality of life, behaviour problems;
British Journal of Psychiatry, 206(6), 2015, pp.509-516.
Publisher:
Cambridge University Press
Background: Anxiety is common and problematic in dementia, yet there is a lack of effective treatments.
Aims: To develop a cognitive–behavioural therapy (CBT) manual for anxiety in dementia and determine its feasibility through a randomised controlled trial.
Method: A ten-session CBT manual was developed. Participants with dementia and anxiety (and their carers) were randomly allocated to CBT...
(Publisher abstract)
Background: Anxiety is common and problematic in dementia, yet there is a lack of effective treatments.
Aims: To develop a cognitive–behavioural therapy (CBT) manual for anxiety in dementia and determine its feasibility through a randomised controlled trial.
Method: A ten-session CBT manual was developed. Participants with dementia and anxiety (and their carers) were randomly allocated to CBT plus treatment as usual (TAU) (n = 25) or TAU (n = 25). Outcome and cost measures were administered at baseline, 15 weeks and 6 months.
Results: At 15 weeks, there was an adjusted difference in anxiety (using the Rating Anxiety in Dementia scale) of (–3.10, 95% CI –6.55 to 0.34) for CBT compared with TAU, which just fell short of statistical significance. There were significant improvements in depression at 15 weeks after adjustment (–5.37, 95% CI –9.50 to –1.25). Improvements remained significant at 6 months. CBT was cost neutral.
Conclusions: CBT was feasible (in terms of recruitment, acceptability and attrition) and effective. A fully powered RCT is now required.
(Publisher abstract)
Subject terms:
anxiety, dementia, treatment, cognitive behavioural therapy, therapies, mental health problems;
Aging and Mental Health, 19(11), 2015, pp.955-967.
Publisher:
Taylor and Francis
Objectives: Whilst a range of psychosocial interventions are used for people with dementia, there lacks evidence for the processes which underpin them. Systematic reviews focus on quantitative studies and there is a lack of qualitative reviews in the area. This review explores what existing qualitative studies reveal about the implementation, effects and processes of psychosocial interventions...
(Edited publisher abstract)
Objectives: Whilst a range of psychosocial interventions are used for people with dementia, there lacks evidence for the processes which underpin them. Systematic reviews focus on quantitative studies and there is a lack of qualitative reviews in the area. This review explores what existing qualitative studies reveal about the implementation, effects and processes of psychosocial interventions for dementia.
Method: A systematic literature search was conducted using Psychinfo and Embase. The grey literature was also searched, using Google Scholar. A total of 363 studies were identified. Sixteen studies were found to meet the inclusion criteria and assessed for quality using pre-specified criteria. Thematic analysis was used to synthesise the findings.
Results: Types of psychosocial interventions selected included music therapy, group psychotherapy and counselling, reminiscence therapy and life story work, multi-sensory environments, horticultural therapy, support groups, and psychoeducation. Despite the diversity of the interventions there were common themes in relation to (1) contextual and individual factors affecting the implementation and delivery of the intervention, individual factors including attitudes and beliefs of staff, carers and people living with dementia (2) perceived impact or outcomes of the interventions and (3) the processes active in achieving these effects. Study quality was adequate but variable.
Conclusion: Common processes may underlie different psychosocial interventions for dementia. The synthesis of qualitative findings can offer insight into what makes interventions ‘work’ and factors which may facilitate or impede their use.
(Edited publisher abstract)
Aging and Mental Health, 15(8), November 2011, pp.945-949.
Publisher:
Taylor and Francis
Cognitive Stimulation Therapy (CST), a brief group intervention, is known to lead to significant improvements in cognitive function and quality of life for people with dementia. This study explored whether improvements found in clinical trials were also noted by people with dementia, their carers and group facilitators in everyday life. Participants included 38 people attending CST groups
Cognitive Stimulation Therapy (CST), a brief group intervention, is known to lead to significant improvements in cognitive function and quality of life for people with dementia. This study explored whether improvements found in clinical trials were also noted by people with dementia, their carers and group facilitators in everyday life. Participants included 38 people attending CST groups, their carers and the group facilitators, in the greater London area. Qualitative interviews and focus groups were transcribed and analysed using framework analysis. Findings revealed two main themes: positive experiences of being in the group; and changes experienced in everyday life. The overall experience of attending CST was seen as being positive and most participants reported some cognitive benefits. The authors concluded that the findings added to previous research findings, as well as informing about the personal experience of CST.
Aging and Mental Health, 14(6), August 2010, pp.740-751.
Publisher:
Taylor and Francis
Young onset dementia is the term for dementia in people under 65. This study aimed to discover the experiences of the children of younger people with dementia, and whether they can be compared to other young carers. Twelve participants (aged under 18 years, living with or had lived with parents with dementia, and aware of the diagnosis) were recruited through UK dementia charities...
Young onset dementia is the term for dementia in people under 65. This study aimed to discover the experiences of the children of younger people with dementia, and whether they can be compared to other young carers. Twelve participants (aged under 18 years, living with or had lived with parents with dementia, and aware of the diagnosis) were recruited through UK dementia charities and an advertisement. A grounded theory methodology was used, and data was gathered through questionnaires and semi structured interviews. Four high level themes were identified: discovering dementia, developing a new relationship with the diagnosed parents, learning to live with it and adapting to increased responsibility, and going through it together and relationships both within and outside the family. Few participants showed depressive symptoms, but more than half showed high levels of burden and most showed moderate levels of resilience. The process the children went through to adapt to the change in their parent is conceptualised as a 3 stage model: grief for the parent before dementia, emotional detachment from the parent, and increased maturity. The authors discuss the implications of the study for service development in the light of the National Dementia Strategy and proposals for whole family approaches for young carers.
International Journal of Geriatric Psychiatry, 25(12), December 2010, pp.1253-1258.
Publisher:
Wiley
The aim of this paper was to investigate the effects of Cognitive Stimulation Therapy (CST) on specific areas of cognition for people with dementia. The study used data from a recent randomised controlled trial involving a 14 session group treatment programme using CST with 201 participants from day centres and residential homes in the Greater London area, and analysed subsections
The aim of this paper was to investigate the effects of Cognitive Stimulation Therapy (CST) on specific areas of cognition for people with dementia. The study used data from a recent randomised controlled trial involving a 14 session group treatment programme using CST with 201 participants from day centres and residential homes in the Greater London area, and analysed subsections of the Alzheimer's disease assessment scale-Cognition (ADAS-Cog) from those results. The key finding from the study was that the cognitive skill which showed most improvement following CST was language. The authors conclude that CST appears to have particular effects in promoting language function, which is likely to lead to generalised benefits.
Recent trials on Cognitive Stimulation Therapy (CST) identified the need to evaluate its more long-term benefits for people with dementia. This study evaluates the effectiveness of a weekly maintenance CST programme for people with dementia in residential care. This manual is for people who want to make a difference to the quality of life of the people with dementia they are working...
Recent trials on Cognitive Stimulation Therapy (CST) identified the need to evaluate its more long-term benefits for people with dementia. This study evaluates the effectiveness of a weekly maintenance CST programme for people with dementia in residential care. This manual is for people who want to make a difference to the quality of life of the people with dementia they are working with. It describes a specific programme of group activity and stimulation, grounded firmly in the values of person-centred care and suitable for use with many people with dementia. The cognitive benefits of CST can be maintained by weekly sessions for around 6 months. Quality of life (QoL) is now seen as a key outcome in many aspects of dementia care. This further analysis of results examines whether the changes in these two domains occurred independently, perhaps for different reasons, or whether the effect of treatment on QoL was mediated by the changes in cognition.
Subject terms:
long term care, older people, quality of life, behaviour therapy, dementia, evaluation, evidence-based practice;
Journal of Dementia Care, 14(2), March 2006, pp.33-36.
Publisher:
Hawker
The authors describe the findings of their Cochrane systematic review on aromatherapy for people with dementia, and draw out the important messages for practitioners.
The authors describe the findings of their Cochrane systematic review on aromatherapy for people with dementia, and draw out the important messages for practitioners.
British Journal of Psychiatry, 18(9), September 2003, pp.248-254.
Publisher:
Cambridge University Press
A recent Cochrane review of reality orientation therapy identified the need for large, well-designed, multi-centre trials. This article tests the hypothesis that cognitive stimulation therapy (CST) for older people with dementia would benefit cognition and quality of life. A single-blind, multi-centre, randomised controlled trial recruited 201 older people with dementia. The main outcome measures...
A recent Cochrane review of reality orientation therapy identified the need for large, well-designed, multi-centre trials. This article tests the hypothesis that cognitive stimulation therapy (CST) for older people with dementia would benefit cognition and quality of life. A single-blind, multi-centre, randomised controlled trial recruited 201 older people with dementia. The main outcome measures were change in cognitive function and quality of life. An intention-to-treat analysis used analysis of covariance to control for potential variabilityin baseline measures. One hundred and fifteen people were randomised within centres to the intervention group and 86 to the control group. At follow-up the intervention group had significantly improved relative to the control group on the Mini-Mental State Examination (P=0.044), the Alzheimer’s Disease Assessment Scale – Cognition (ADAS–Cog) (P=0.014) and Quality of Life – Alzheimer’s Disease scales (P=0.028). Using criteria of 4 points or more improvement on the ADAS–Cog the number needed to treat was 6 for the intervention group. The results compare favourably with trials of drugs for dementia. CST groups may have worthwhile benefits for many people with dementia.