Search results for ‘Subject term:"cognitive impairment"’ Sort:
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The prevalence and recognition of major depression among low-level aged care residents with and without cognitive impairment
- Authors:
- DAVISON T. E., et al
- Journal article citation:
- Aging and Mental Health, 11(1), January 2007, pp.82-88.
- Publisher:
- Taylor and Francis
Previous research has demonstrated a high level of depression in nursing homes. The current study was designed to determine the prevalence of depression, using a structured diagnostic interview, among older people with and without mild-moderate cognitive impairment residing in low-level care facilities. The results demonstrated that, consistent with previous research in nursing homes, 16.9% of older people were diagnosed with major depressive disorder. Less than half of these cases had been detected or treated. Individuals with moderate cognitive impairment were more likely to be depressed, but cognitive impairment did not appear to act as a strong impediment to the detection of depression by general practitioners. A low awareness of their use of antidepressant medications was demonstrated among older people prescribed this treatment, including those with normal cognitive function. Reasons for the poor recognition of depression among older people are discussed.
Dressing of cognitively impaired nursing home residents: description and analysis
- Authors:
- COHEN-MANSFIELD Jiska, et al
- Journal article citation:
- Gerontologist, 46(1), February 2006, pp.89-96.
- Publisher:
- Oxford University Press
Getting dressed is an activity that is of particular difficulty for many persons with dementia, given the need for hand-eye coordination, fine motor skills, and overall planning skills. Despite several studies concerning interventions to improve dressing behaviour, very little is known about the dressing process as it is currently performed. The purpose of this study is to characterize the dressing activity of daily living (ADL) of nursing home residents suffering from dementia and thereby identify ways to improve the dressing process. The authors analyzed videotapes of dressing of 20 special care unit residents to describe the dressing process and the interaction between residents and staff members. Staff members completely dressed the residents in the majority of cases. Interaction between the staff members and the residents was considered insufficient in most sessions. The study identified possible intervention techniques, assistive devices, organizational routines, and environmental changes that may improve the dressing process. The results have implications that nursing homes may consider in their policies, care activities, staff training, and environment to facilitate safety, comfort, and satisfaction during the dressing process.
"Interactive surfaces" technology as a potential tool to stimulate physical activity in psychogeriatric nursing home residents
- Authors:
- BRAUN Susy M., et al
- Journal article citation:
- Disability and Rehabilitation: Assistive Technology, 10(6), 2015, pp.486-492.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Purpose: This study aimed to determine whether and how psychogeriatric nursing home residents would respond to the interactive surfaces on the floor without receiving instructions and to determine how long residents would be physically active. Methods: The 'interactive surfaces' technology includes different graphic shapes that are projected through a beamer on a floor. The surfaces are 'activated' by a person’s movements in the area of the projection field, which is detected by an infrared camera. Every day for 1 h during an 11-day period one of seven different projections was shown. Spontaneous observed physical responses were counted, clustered and visualised in a tree diagram. Duration of physically responses was measured per session and during the total observation period of 11 h. Results: During 343 of 490 observations residents (n = 58) noticed the interactive surface and in 148 observations they engaged physically. In total, 4067 s (1 h, 7 min and 47 s) of physical activity were measured. Individual times that residents were active ranged from 3 to 415 s. Conclusions: Interactive surfaces technology may be a promising tool in psychogeriatric nursing home residents to stimulate physical activity. Further research is needed to assess its full potential. (Edited publisher abstract)
Alternate housing models for older people with disabilities: their clientele, structures and resources in relation to the quality of and satisfaction with care delivery
- Authors:
- DUBUC Nicole, et al
- Journal article citation:
- Ageing and Society, 34(9), 2014, pp.1575-1600.
- Publisher:
- Cambridge University Press
This paper reports on the study of a subsidy programme that was established in Quebec for alternate housing models (AHMs), which allows private and community organisations to offer housing services within the framework of a partnership with public health-care services. The research objectives were: (a) to compare how facility characteristics and services provided by AHMs and nursing homes (NHs) differ; (b) to examine the personal characteristics of residents living in AHMs; and (c) to compare residents with similar characteristics within AHMs and NHs in terms of unmet needs, quality of care, satisfaction with care and services, and psycho-social adaptation to the residence. A cross-sectional study was undertaken with individually matched groups to assess whether AHMs meet the needs of elders in a way similar to NHs. Overall, residents in both groups had moderate to severe levels of disability and about 60 per cent had mild to severe cognitive problems. While their general features were heterogeneous, the AHMs were more comfortable and homelike than the NHs. The quality of and satisfaction with care was appropriate in both settings, although AHMs performed better. Only one-quarter of residents in both settings, however, evidenced a good level of psycho-social adaptation to their residence. This partnership approach is a good strategy to provide a useful range of housing types in communities that can respond to the needs of elders with moderate to severe disabilities. (Publisher abstract)
The role of extra care housing in supporting people with dementia: early findings from the PSSRU evaluation of extra care housing
- Authors:
- DARTON Robin, CALLAGHAN Lisa
- Journal article citation:
- Journal of Care Services Management, 3(3), April 2009, pp.284-294.
- Publisher:
- Taylor and Francis
The Personal Social Services Research Unit (PSSRU) is undertaking an evaluation of 19 extra care schemes that were allocated funding in the first two rounds of the Extra Care Housing Fund. All but two of the schemes indicated that they were making provision for people suffering from dementia, ranging from five designed to make specific provision to four that would meet the needs of residents who developed dementia after they moved in. This paper draws on information collected from 15 schemes that had opened during 2006–07, and a recent comparable study of residents admitted to care homes providing personal care. Overall, the people who moved into extra care were much less physically and cognitively impaired than those who moved into care homes, even in schemes designed specifically to provide for residents with dementia, and exhibited less change in functioning during the first six months. However, levels of cognitive impairment in schemes were generally consistent with the approach of each scheme to providing care for people with dementia. The findings are consistent with previous reports suggesting that extra care schemes generally prefer residents to move in when they can become familiar with their new accommodation, before the development of more severe cognitive impairment.
Factors associated with depression in Norwegian nursing homes
- Authors:
- LAGE BARCA Maria, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(4), April 2009, pp.417-425.
- Publisher:
- Wiley
This study aimed to confirm or reject the hypothesis that depression in nursing homes is associated with worse medical health, cognitive and functional impairment. A sample of 902 randomly selected nursing-home patients was assessed using the Cornell Scale, the Clinical Dementia Rating Scale (CDR) the Self-Maintenance Scale and a general measurement of medical health. Additionally, information was collected from the patients' records. A multiple linear regression was performed with the Cornell Scale total score, and mood and non-mood subscale scores as the dependent variables. In the adjusted analysis, depression according to the Cornell total score was associated with worse medical health (strongest) and worse cognitive impairment, but not with worse functional impairment. The mood subscale score was associated with worse medical health, being unmarried and female gender, but not with worse cognitive impairment. The non-mood subscale score was correlated with cognitive impairment, worse medical health, younger age, digestive diseases and not having suffered from stroke. The hypothesis was partially confirmed. Worse general medical health was the strongest factor associated with depression, followed by degree of cognitive impairment. Cognitive impairment was not associated with the mood subscale score, but was the strongest correlate for the non-mood symptoms of the Cornell Scale.
Comparison of the diagnostic accuracy of the Cognitive Performance Scale (Minimum Data Set) and the Mini-Mental State Exam for the detection of cognitive impairment in nursing home residents
- Authors:
- PAGUAY Louis, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(4), April 2007, pp.286-293.
- Publisher:
- Wiley
This study aimed to compare the diagnostic accuracy of an outcome measurement scale of the Minimum Data Set of the Resident Assessment Instrument for nursing homes (MDS/RAI-NH), the Cognitive Performance Scale (CPS) and the Mini-Mental State Exam (MMSE) for the detection of cognitive impairment. The Cambridge Examination for Mental Disorders of the Elderly - Revised (CAMDEX-R) was used as the reference standard. This study was part of a larger prospective study (QUALIDEM) involving a diagnostic procedure and two-year follow-up on the quality of primary care for demented patients. CAMDEX-R and MDS/RAI-NH were administered to 198 residents, aged 65 or more, living in 42 low and high care institutions for older people in Belgium. Main outcome measures used were indicators of diagnostic accuracy: sensitivity, specificity, predictive values, likelihood ratios, odds ratio and area under receiver operating characteristics curve (AUC). The CAMDEX-based prevalence of cognitive impairment was 75%. The results found that CPS and MMSE demonstrated similar performance to detect cognitive impairment in nursing home residents.
Assisting cognitively impaired nursing home residents with bathing: effects of two bathing interventions on caregiving
- Authors:
- HOEFFER Beverly, et al
- Journal article citation:
- Gerontologist, 46(4), August 2006, pp.524-532.
- Publisher:
- Oxford University Press
When cognitively impaired nursing home residents exhibit agitated and aggressive behaviours during bathing, nursing home caregivers are in a unique position to improve residents' experience. This article addresses whether certified nursing assistants (CNAs) who received training in a person-centred approach with showering and with the towel bath showed improved caregiving behaviours (gentleness and verbal support) and experienced greater preparedness (confidence and ease) and less distress (hassles) when assisting residents with bathing. The research used a crossover design and randomized 15 nursing homes into two treatment groups and a control group of 5 facilities each. In one treatment group, CNAs received person-centred training, first with showering for 6 weeks (Time 1) and then with the towel bath for 6 weeks (Time 2). The treatment order was reversed in the other treatment group. Control group CNAs used usual showering procedures without person-centred training. Observational and self-report data was collected at baseline and at the end of Time 1 and Time 2 on five caregiving outcomes. Data was analysed from 37 CNAs assisting 69 residents by using 3 x 2 repeated measures analyses of variance to compare the three groups on change from baseline. Compared with the control group, treatment groups significantly improved in the use of gentleness and verbal support and in the perception of ease. It is concluded that a person-centred approach with showering and with the towel bath improved not only how care is given to residents who become agitated and aggressive during bathing but also how CNAs perceive their experience when bathing these residents.
Obtaining self-report data from cognitively impaired elders: methodological issues and clinical implications for nursing home pain assessment
- Authors:
- FISHER Susan E., et al
- Journal article citation:
- Gerontologist, 46(1), February 2006, pp.81-88.
- Publisher:
- Oxford University Press
The authors developed and evaluated an explicit procedure for obtaining self-report pain data from nursing home residents across a broad range of cognitive status, and we evaluated the consistency, stability, and concurrent validity of resident responses. Using a modification of the Geriatric Pain Measure (GPM-M2), 61 residents from two nursing homes were interviewed once a week for 4 consecutive weeks. The authors collected additional data by means of chart review, cognitive status assessments, and surveys of certified nursing assistants. The authors used descriptive and correlational analyses to address our primary aims. Eighty-nine percent of residents completed all four scheduled interviews. Cognitive status was not significantly correlated with number of nonresponses and prompts for yes–no questions, but it was significantly correlated with nonresponses and prompts for Likert-scale questions. Completion time for the 17-item pain measure was not predicted by cognitive status. Residents' scores on the GPM-M2 were significantly correlated with number of chronic pain-associated diagnoses, and internal consistency was excellent. Residents' GPM-M2 scores were stable over time for all comparisons. Using explicit protocols and reporting procedural data allows researchers and clinicians to better understand and apply results of self-report studies with cognitively impaired elders. Results suggest that many nursing home residents can provide consistent and reliable self-report pain data, given appropriate time and assistance.
Cognitive status and analgesic provision in nursing home residents
- Authors:
- CLOSS S. Jose, BARR Bridget, BRIGGS Michelle
- Journal article citation:
- British Journal of General Practice, 54(509), December 2004, pp.919-921.
- Publisher:
- Royal College of General Practitioners
Although it is becoming acknowledged that pain management is generally poor for older people, little is known about pain management for nursing home residents in the UK, and the specific problems for those with cognitive impairments. This study explored analgesic prescription and administration according to nursing home residents' cognitive status using a survey of residents and medication documentation. The sample included 113 residents from 15 homes in large city in northern England. Cognitive status was assessed using the mini-mental state examination (MMSE). Pain was measured with a 4-point verbal rating scale and a 10-point horizontal numeric rating scale. Medications (name, dose, frequency) were noted, and provision within the previous 24 hours. There were no statistically significant differences in pain scores according to level of cognitive impairment. Prescription and administration of opioid and non-opioid analgesics were highest for residents with low cognitive impairment, decreasing as impairment increased. Those prescribed neither opioid nor non-opioid analgesics had significantly lower MMSE scores than those who were. A low MMSE score indicates high cognitive impairment. It is not clear why those with greater impairment received fewer analgesics. More research is needed into relationships between pain assessment, pain experience, cognitive impairment and analgesic provision. It is likely that improvements in carers' knowledge of pain assessment and the risks and benefits of commonly used analgesics could improve analgesic provision.