This document takes the wellbeing pathway for dementia and sets out the adjustments and amendments needed to respond to the COVID-19 pandemic. It covers six domains, which include: preventing well; diagnosing well; treating well; supporting well; living well; and dying well. The guide highlights key priorities and actions for each step in the pathway and provides links to further information...
(Edited publisher abstract)
This document takes the wellbeing pathway for dementia and sets out the adjustments and amendments needed to respond to the COVID-19 pandemic. It covers six domains, which include: preventing well; diagnosing well; treating well; supporting well; living well; and dying well. The guide highlights key priorities and actions for each step in the pathway and provides links to further information and guidance. The guide spans community, in-patient and other health and social care settings and signposts to useful resources from a variety of organisations. This resource is primarily for clinicians working with people with dementia, but can also be used by carers and people with dementia. A resource section for people with dementia and their carers is also included.
(Edited publisher abstract)
Subject terms:
care pathways, dementia, Covid-19, prevention, diagnosis, wellbeing, end of life care, dying, treatment;
The risk of living with dementia and, separately, cancer, increases exponentially with age. However, to date, there is a paucity of research investigating the experiences of people living with both these conditions. This study used semi-structured interviews to explore the decision-making and treatment options for people who live with both dementia and cancer. In total, ten people living...
(Edited publisher abstract)
The risk of living with dementia and, separately, cancer, increases exponentially with age. However, to date, there is a paucity of research investigating the experiences of people living with both these conditions. This study used semi-structured interviews to explore the decision-making and treatment options for people who live with both dementia and cancer. In total, ten people living with both dementia and cancer (aged 39–93 years) and nine family carers were interviewed. Braun and Clarke's approach to thematic analysis was used together with framework matrices to organise the data. In this article four sequential and descriptive themes are presented. ‘Reaching a diagnosis of cancer’ describes the vital role that family carers play in encouraging the person with dementia to seek an explanation for their presenting (undiagnosed cancer) symptoms to their general practitioner. ‘Adjusting to the cancer diagnosis when living with dementia’ outlines a variety of emotional and practical responses to receiving news of the diagnosis. ‘Weighing up the cancer treatment options’ highlights the different decisions and circumstances that family carers and people living with both dementia and cancer are faced with post-diagnosis. ‘Undergoing cancer treatment’ shares the finding that cancer treatment decision-making was not straightforward and that people living with both dementia and cancer would often forget about their cancer and what procedures they had been through.
(Edited publisher abstract)
Subject terms:
user views, decision making, dementia, cancer, carers, qualitative research, family members, carer views, treatment;
Dementia: the International Journal of Social Research and Practice, 18(2), 2019, pp.725-741.
Publisher:
Sage
The extent to which technology may be able to support people with dementia and their carers along the care pathway and in different care settings is of interest to policy makers and governments. In this paper the authors provide an overview of the role of technology in dementia care, treatment and support by mapping existing technologies – by function, target user and disease progression...
(Edited publisher abstract)
The extent to which technology may be able to support people with dementia and their carers along the care pathway and in different care settings is of interest to policy makers and governments. In this paper the authors provide an overview of the role of technology in dementia care, treatment and support by mapping existing technologies – by function, target user and disease progression. Technologies identified are classified into seven functions: memory support, treatment, safety and security, training, care delivery, social interaction and other. Different groups of potential users are distinguished: people with mild cognitive impairment and early stages of dementia, people with moderate to severe dementia and unpaid carers and health- and social care professionals. The authors also identified the care settings, in which the technologies are used (or for which the technologies are developed): at home in the community and in institutional care settings. The evidence has been drawn from a rapid review of the literature, expert interviews and web and social media searches. The largest number of technologies identified aim to enhance the safety and security of people with dementia living in the community. These devices are often passive monitors, such as smoke detectors. Other safety interventions, such as panic buttons, require active intervention. The second largest number of interventions aims to enhance people’s memory and includes global positioning systems devices and voice prompts. These technologies mostly target people in the early stages of dementia. A third group focusing on treatment and care delivery emerged from the literature. These interventions focus on technology-aided reminiscence or therapeutic aspects of care for people with dementia and their carers. While the review found a range of technologies available for people with dementia and carers there is very little evidence of widespread practical application. Instead, it appears that stakeholders frequently rely on everyday technologies re-purposed to meet their needs.
(Edited publisher abstract)
Subject terms:
dementia, carers, treatment, health care, social care, digital technology, literature reviews, telecare, assistive technology, information technology, care pathways, home care, residential care;
International Journal of Geriatric Psychiatry, 34(9), 2019, pp.1308-1315.
Publisher:
Wiley
Background: The prevalence of neuropsychiatric symptoms (NPS) diminishes the quality of life and increases the care burden in patients with dementia. Despite the clinical importance of dementia‐associated NPS, no protocols for treating NPS are already well established. Attention has turned to the effectiveness of nonpharmacological treatments for NPS since their potential safe alternative...
(Edited publisher abstract)
Background: The prevalence of neuropsychiatric symptoms (NPS) diminishes the quality of life and increases the care burden in patients with dementia. Despite the clinical importance of dementia‐associated NPS, no protocols for treating NPS are already well established. Attention has turned to the effectiveness of nonpharmacological treatments for NPS since their potential safe alternative to pharmacotherapy. Objective: This study is aimed to compare the effects in older individuals with dementia living in a residential care, of two intervention programs, the gesture‐verbal treatment (GVT), a treatment implemented by us on a previous method for word retrieval in individuals with aphasia, and the better‐known doll therapy (DT). The GVT would act on both receptive and expressive language skills, the DT on attachment and emotional connections. Methods: We evaluated NPS by the neuropsychiatric inventory in a total of 30 patients divided into 3 groups, the GVT, the DT, and control groups, using a pre‐post design. The treatment groups completed 12‐week nonpharmacological interventions in addition to standard rehabilitative therapies, while the control group participated only in standard rehabilitative therapies. Results: The DT group showed significant improvements in agitation, irritability, apathy, depression, and delusions relative to controls. The GVT group showed significant improvements in apathy and depression with respect to controls. The DT intervention ameliorated symptoms of agitation compared to the GVT intervention whereas the GVT intervention improved apathy compared to the DT intervention. Conclusion: Improved understanding of the potential therapeutic benefits of different treatments for neuropsychiatric symptoms is crucial for establishing nonpharmacological interventions in dementia.
(Edited publisher abstract)
Earlier literature on “welfare technologies” in general – and the use of GPS devices in dementia care in special – has been overwhelmingly focused on either individual (user-centric), technical or ethical challenges related to technology implementation. This paper argues for a relational analysis to supplement and adjust shortcomings in the existing research literature and introduces the concept...
(Edited publisher abstract)
Earlier literature on “welfare technologies” in general – and the use of GPS devices in dementia care in special – has been overwhelmingly focused on either individual (user-centric), technical or ethical challenges related to technology implementation. This paper argues for a relational analysis to supplement and adjust shortcomings in the existing research literature and introduces the concept of “techno-organizational networks” for the task. Through an analysis of a post-pilot period of a pilot-project with GPS-tracking of dementia patients, it is shown how a relational approach contributes to a better understanding of the dynamics and obstacles of developing technology-assisted health-care services. An original contribution of the article is also the argument for studying transitional, post-project or in-between project phases of technology implementation, which as a rule tend to be project driven, also in terms of research.
(Edited publisher abstract)
Subject terms:
dementia, assistive technology, treatment, telecare, telehealth, service development;
Purpose of the Study: Behavioural and psychological symptoms of dementia (BPSD) affect quality of life for people with dementia. Nonpharmacological interventions are the preferred first line of treatment, and it is theorized that BPSD are directly influenced by sensory imbalance and improved by sensory equilibrium. The purpose of this article is to investigate the evidence regarding the use...
(Edited publisher abstract)
Purpose of the Study: Behavioural and psychological symptoms of dementia (BPSD) affect quality of life for people with dementia. Nonpharmacological interventions are the preferred first line of treatment, and it is theorized that BPSD are directly influenced by sensory imbalance and improved by sensory equilibrium. The purpose of this article is to investigate the evidence regarding the use of multisensory environments (MSEs) as treatment for BPSD. Design and Methods: A systematic literature review was performed using the PICO framework within PsycINFO, Web of Science, ERIC, PubMED, and Cinahl databases, as well as additional hand-searched documents. Included articles were published during 1990 to 2015 and report empirical studies of MSE BPSD interventions that include furniture, fixtures, and equipment to provide visual, auditory, tactile, and olfactory stimulation. Desired elements include ergonomic vibroacoustic furniture, bubble tubes, colour-changing lights, and fiber optics. Results: Twelve articles met the inclusion criteria for review. Evidence supports the positive impact of sensory stimulation as a nonpharmacological behavioural treatment for dementia. Many studies investigated both behaviour and mood, and several investigated biomedical parameters including heart rate and cognition. Significant differences were not found in the between-group studies when MSE was compared with other one-to-one interventions. Results on long-term effects were mixed. Variations can be seen in terms of research methods, types of environmental interventions, duration, and specific characteristics of participants, thus confounding the reliability of findings. Implications Key findings and directions for future research are discussed including primary outcomes, study design, environmental intervention types, and relevant assessment tools.
(Edited publisher abstract)
British Journal of Psychiatry, 213(5), 2018, pp.668-669.
Publisher:
Cambridge University Press
The authors, practising clinicians who provide care to adults with Down syndrome, whilst appreciating the findings of a study by Eady and colleagues into the treatment of people with Down Syndrome who have dementia, report significant concerns about the potential use of the conclusions in practice. The authors believe that the Eady, et al study (referenced in this article) offers false hope
(Original abstract)
The authors, practising clinicians who provide care to adults with Down syndrome, whilst appreciating the findings of a study by Eady and colleagues into the treatment of people with Down Syndrome who have dementia, report significant concerns about the potential use of the conclusions in practice. The authors believe that the Eady, et al study (referenced in this article) offers false hope and may result in wasted resources.
(Original abstract)
British Journal of Psychiatry, 213(5), 2018, p.669.
Publisher:
Cambridge University Press
Response to Smith and Chicoine on the comments they made about the authors' research into diagnosis and treatmet of people with Down Syndrome who have dementia.
(Original abstract)
Response to Smith and Chicoine on the comments they made about the authors' research into diagnosis and treatmet of people with Down Syndrome who have dementia.
(Original abstract)
Dementia: the International Journal of Social Research and Practice, 17(8), 2018, pp.976-989.
Publisher:
Sage
Many people living with dementia experience sleep disturbances yet there are currently no known effective, safe and acceptable treatments. Working with those affected by dementia to co-produce interventions is increasingly promoted to ensure that approaches are fit for purpose and meet the specific needs of target groups. The authors' aim here is to outline and reflect upon the co-production...
(Edited publisher abstract)
Many people living with dementia experience sleep disturbances yet there are currently no known effective, safe and acceptable treatments. Working with those affected by dementia to co-produce interventions is increasingly promoted to ensure that approaches are fit for purpose and meet the specific needs of target groups. The authors' aim here is to outline and reflect upon the co-production of Dementia RElAted Manual for Sleep; STrAtegies for RelaTives (DREAMS:START), an intervention to improve sleep for people living with dementia. Their co-production team brought together experts in the development and testing of manualised interventions in dementia care and cognitive behavioural interventions for sleep disorders, with Alzheimer’s Society research network volunteers (ASRNVs) whose lives had been affected by dementia. Here we present the process of intervention development. The authors worked with (ASRNVs) at each stage of the process bringing together ‘experts by training’ and ‘experts by experience’. (ASRNVs)shared their experiences of sleep disturbances in dementia and how they had managed these difficulties, as well as suggestions for how to overcome barriers to putting the intervention into practice; making (DREAMS:START) more accessible and usable for those in need. In this paper the authors discuss both the benefits and challenges to this process and what can be learnt for future work. Collaborating with ‘experts by experience’ caring for a relative with sleep difficulties helped the authors to develop a complex intervention in an accessible and engaging way which they have tested and found to be feasible and acceptable in a randomised controlled trial.
(Edited publisher abstract)
Subject terms:
dementia, co-production, patients, service users, user participation, sleep problems, intervention, treatment, participatory research;
Aging and Mental Health, 22(9), 2018, pp.1097-1106.
Publisher:
Taylor and Francis
Objectives: The aim of the present study was to meta-analyze the effect of music therapy (MT) on cognitive functions in patients with dementia. Method: A systematic literature search was performed in Medline, PsycINFO, Embase, CINAHL and RILM up to 8 September 2016. The authors included all randomized controlled trials that compared MT with standard care, or other non-musical types...
(Edited publisher abstract)
Objectives: The aim of the present study was to meta-analyze the effect of music therapy (MT) on cognitive functions in patients with dementia. Method: A systematic literature search was performed in Medline, PsycINFO, Embase, CINAHL and RILM up to 8 September 2016. The authors included all randomized controlled trials that compared MT with standard care, or other non-musical types of intervention, evaluating cognitive outcomes in patients with dementia. Outcomes included global cognition, complex attention, executive function, learning and memory, language, and perceptual-motor skills. Results: From 1089 potentially relevant records, 110 studies were assessed for eligibility, and 7 met the inclusion criteria, of which 6 contained appropriate data for meta-analysis (330 participants, mean age range 78.8–86.3). Overall, random-effects meta-analyses suggested no significant effects of MT on all outcomes. Subgroup analysis found evidence of a beneficial effect of active MT on global cognition (SMD = 0.29, 95% CI 0.02 to 0.57, p = 0.04). Conclusion: Despite the limited evidence of the present review, it is important to continue supporting MT as a complementary treatment for older adults with dementia. RCTs with larger sample sizes are needed to better elucidate the impact of MT on cognitive functions.
(Edited publisher abstract)
Subject terms:
music therapy, arts, cognitive impairment, intervention, systematic reviews, literature reviews, outcomes, treatment, complementary therapies, older people;