International Journal of Geriatric Psychiatry, 36(6), 2021, pp.943-949.
Publisher:
Wiley
The effects of coronavirus disease 2019 (COVID‐19) have been well documented across the world with an appreciation that older people and in particular those with dementia have been disproportionately and negatively affected by the pandemic. This is both in terms of their health outcomes (mortality and morbidity), care decisions made by health systems and the longer‐term effects...
(Edited publisher abstract)
The effects of coronavirus disease 2019 (COVID‐19) have been well documented across the world with an appreciation that older people and in particular those with dementia have been disproportionately and negatively affected by the pandemic. This is both in terms of their health outcomes (mortality and morbidity), care decisions made by health systems and the longer‐term effects such as neurological damage. The International Dementia Alliance is a group of dementia specialists from six European countries and this paper is a summary of our experience of the effects of COVID‐19 on our populations. Experience from England, France, Germany, the Netherlands, Spain and Switzerland highlight the differential response from health and social care systems and the measures taken to maximise support for older people and those with dementia. The common themes include recognition of the atypical presentation of COVID‐19 in older people (and those with dementia) need to pay particular attention to the care of people with dementia in care homes; the recognition of the toll that isolation can bring on older people and the complexity of the response by health and social services to minimise the negative impact of the pandemic. Potential new ways of working identified during the pandemic could serve as a positive legacy from the crisis.
(Edited publisher abstract)
Subject terms:
dementia, Covid-19, health care, social care;
Content type:
research
Location(s):
Europe, England, France, Spain, Germany, Netherlands, Switzerland
Aging and Mental Health, 25(7), 2021, pp.1314-1319.
Publisher:
Taylor and Francis
Objectives: From the perspective of the nursing home (NH) practitioners, to gain understanding of (1) whether challenging behavior in NH residents changed during the COVID-19 measures, (2) whether the practitioners’ involvement in the treatment of challenging behavior changed, (3) what can be learned from the experience of NH staff. Methods: A mixed methods study with a survey in 323 NH practitioners (psychologists, elderly care physicians, nurse practitioners) in the Netherlands, and in-depth interviews in 16 NH practitioners. Nonparametric analyses were used to compare estimated proportions of residents with increased and with decreased challenging behavior. Content analyses were conducted for open-ended questions and in-depth interviews. Results: Participants reported changes in challenging behavior with slightly higher proportions for increased (Q1/Mdn/Q3: 12.5%, 21.7%, 30.8%) than for decreased (8.7%, 14.8%, 27.8%, Z = –2.35, p = .019) challenging behavior. Half of the participants reported that their work load increased and work satisfaction worsened during the measures. Different strategies were described to respond to the effects of COVID-19 measures, such as video calls, providing special areas for residents to meet their loved ones, adjusting activities, and reducing the exposure to negative news. Conclusions: Because COVID-19 measures resulted in both increased and decreased challenging behavior in NH residents, it is important to monitor for their potential long lasting effects. Increased work load and worsened work satisfaction of the NH staff, together with the changes in type of challenging behavior, indicate that the harmful effects of the anti-pandemic measures should be taken seriously.
(Edited publisher abstract)
Objectives: From the perspective of the nursing home (NH) practitioners, to gain understanding of (1) whether challenging behavior in NH residents changed during the COVID-19 measures, (2) whether the practitioners’ involvement in the treatment of challenging behavior changed, (3) what can be learned from the experience of NH staff. Methods: A mixed methods study with a survey in 323 NH practitioners (psychologists, elderly care physicians, nurse practitioners) in the Netherlands, and in-depth interviews in 16 NH practitioners. Nonparametric analyses were used to compare estimated proportions of residents with increased and with decreased challenging behavior. Content analyses were conducted for open-ended questions and in-depth interviews. Results: Participants reported changes in challenging behavior with slightly higher proportions for increased (Q1/Mdn/Q3: 12.5%, 21.7%, 30.8%) than for decreased (8.7%, 14.8%, 27.8%, Z = –2.35, p = .019) challenging behavior. Half of the participants reported that their work load increased and work satisfaction worsened during the measures. Different strategies were described to respond to the effects of COVID-19 measures, such as video calls, providing special areas for residents to meet their loved ones, adjusting activities, and reducing the exposure to negative news. Conclusions: Because COVID-19 measures resulted in both increased and decreased challenging behavior in NH residents, it is important to monitor for their potential long lasting effects. Increased work load and worsened work satisfaction of the NH staff, together with the changes in type of challenging behavior, indicate that the harmful effects of the anti-pandemic measures should be taken seriously.
(Edited publisher abstract)
International Journal of Geriatric Psychiatry, early cite 18 January 2021,
Publisher:
Wiley
The effects of Covid‐19 have been well documented across the world with an appreciation that older people and in particular those with dementia have been disproportionately and negatively affected by the pandemic. This is both in terms of their health outcomes (mortality and morbidity), care decisions made by health systems and the longer‐term effects such as neurological damage...
(Edited publisher abstract)
The effects of Covid‐19 have been well documented across the world with an appreciation that older people and in particular those with dementia have been disproportionately and negatively affected by the pandemic. This is both in terms of their health outcomes (mortality and morbidity), care decisions made by health systems and the longer‐term effects such as neurological damage. The International Dementia Alliance (IDEAL) is a group of dementia specialists from six European countries and this paper is a summary of our experience of the effects of COVID‐19 on our populations. Experience from England, France, Germany, the Netherlands, Spain and Switzerland highlight the differential response from health and social care systems and the measures taken to maximise support for older people and those with dementia. The common themes include recognition of the atypical presentation of COVID‐19 in older people (and those with dementia) the need to pay particular attention to the care of people with dementia in care homes; the recognition of the toll that isolation can bring on older people and the complexity of the response by health and social services to minimise the negative impact of the pandemic. Potential new ways of working identified during the pandemic could serve as a positive legacy from the crisis.
(Edited publisher abstract)
Subject terms:
Covid-19, dementia, older people, care homes;
Content type:
research
Location(s):
England, France, Germany, Netherlands, Spain, Switzerland
The findings of a study conducted by Alzheimer Europe and Bangor University, to better understand the experiences of informal carers of receiving a diagnosis of dementia across five European countries: France, Germany, Poland, Spain and the UK (Scotland). The questionnaire included 57 questions addressing; demographics of the carer and person with dementia; the symptoms that were experienced...
(Edited publisher abstract)
The findings of a study conducted by Alzheimer Europe and Bangor University, to better understand the experiences of informal carers of receiving a diagnosis of dementia across five European countries: France, Germany, Poland, Spain and the UK (Scotland). The questionnaire included 57 questions addressing; demographics of the carer and person with dementia; the symptoms that were experienced and prompted help-seeking; the pathway through the diagnostic process; the experience of the diagnostic process; support and information offered at the time of diagnosis; emotions experienced immediately after the diagnosis and subsequently; and the carers’ experience of their community as 'dementia friendly'. A total of 1,409 carers participated in the study, with just over 200 from Scotland. Carers across Europe reported that diagnosis took an average of 2.1 years from the time of problems being first noticed. Delays to diagnosis included the first professional they saw did not consider anything was wrong and the person with dementia not wanting to seek help. Post-diagnostic support was found to be still a major issue across Europe, with the need for information on coping and living well with dementia and on available services particularly high at 51.1 per cent and 46 per cent respectively.
(Edited publisher abstract)
Hogewey is an award winning development with an innovative approach to residential and nursing care for people with advanced dementia. Each of their 23 homes accommodates six or seven residents, providing care for 152 residents in total. The approach to care is based on two principles: to relieve anxiety by providing an environment that is safe and familiar and to keep everyone active
(Edited publisher abstract)
Hogewey is an award winning development with an innovative approach to residential and nursing care for people with advanced dementia. Each of their 23 homes accommodates six or seven residents, providing care for 152 residents in total. The approach to care is based on two principles: to relieve anxiety by providing an environment that is safe and familiar and to keep everyone active. This article describes the service.
(Edited publisher abstract)
Subject terms:
dementia, residential care, care homes, person-centred care;
MINKMAN Mirella M. N., LIGTHART Suzanne A., HUIJSMAN Robbert
Journal article citation:
Health and Social Care in the Community, 17(5), September 2009, pp.485-494.
Publisher:
Wiley
The purpose of this study was to describe and analyse a new approach in extensive case management programmes concerned with long-term dementia care in The Netherlands. The focus is on the characteristics, and success and failure factors of these programmes. A multiple case study was conducted in eight regional dementia care provider networks in The Netherlands. Based on a literature study...
The purpose of this study was to describe and analyse a new approach in extensive case management programmes concerned with long-term dementia care in The Netherlands. The focus is on the characteristics, and success and failure factors of these programmes. A multiple case study was conducted in eight regional dementia care provider networks in The Netherlands. Based on a literature study, a questionnaire was developed for the responsible managers and case managers of the eight case management programmes. During 16 semistructured face-to-face interviews with both respondent groups, a deeper insight into the dementia care programmes was provided. Project documentation for all the cases was studied. The eight programmes were developed independently to improve the quality and continuity of long-term dementia care. The programmes show overlap in terms of their vision, tasks of case managers, case management process and the participating partners in the local dementia care networks. Differences concern the targeted dementia patient groups as well as the background of the case managers and their position in the local dementia care provider network. Factors for success concern the expert knowledge of case managers, investment in a strong provider network and coherent conditions for effective inter-organizational cooperation to deliver integrated care. When explored, caregiver and patient satisfaction was high. Further research into the effects on client outcomes, service use and costs is recommended in order to further analyse the impact of this approach in long-term care. To facilitate implementation, with a focus on joint responsibilities of the involved care providers, policy recommendations are to develop incentives for collaborative financial contracts between insurers and providers.
van den WIJNGAART M. A. G., VERNOOIJ-DASSEN M. J. F. J., FELLING A. J. A.
Journal article citation:
Aging and Mental Health, 11(6), November 2007, pp.626-636.
Publisher:
Taylor and Francis
The aim of this study was to explore the main and mediating influences of stressors, a caregiver's appraisal, coping, personal conditions and social resources on the burden of dementia caregivers. The study sample consisted of 95 spousal caregivers of non-institutionalized persons with dementia. A path-analytic approach was used to test the conceptual model. The most important factors that were...
The aim of this study was to explore the main and mediating influences of stressors, a caregiver's appraisal, coping, personal conditions and social resources on the burden of dementia caregivers. The study sample consisted of 95 spousal caregivers of non-institutionalized persons with dementia. A path-analytic approach was used to test the conceptual model. The most important factors that were related to burden were the social and behavioural problems of the person with dementia; perceiving the caregiver role as a threat; perceived instrumental support; and the caregiver's functional health status and self-efficacy. The results showed no support for the mediating role of appraisal and coping on the relationship between the demands of the caregiving situation and burden. Although insufficient support for the empirical tenability of the hypothesised model was found, this study revealed some new findings of practical interest. The relationships found suggest that it might be possible to reduce the caregiving burden by improving the social functioning of the person with dementia, the caregiver's perceptions and the caregiver's capacity to function in daily life.
International Journal of Geriatric Psychiatry, 22(7), July 2007, pp.632-638.
Publisher:
Wiley
To estimate the prevalence of neuropsychiatric symptoms in general - and aggression and agitation in particular - of dementia patients in Dutch nursing homes. Cross-sectional study in a large sample of 1322 demented patients living in 59 dementia special care units (SCUs) in The Netherlands. Symptoms were observed by licensed vocational nurses during regular care-giving in a 2-week observational...
To estimate the prevalence of neuropsychiatric symptoms in general - and aggression and agitation in particular - of dementia patients in Dutch nursing homes. Cross-sectional study in a large sample of 1322 demented patients living in 59 dementia special care units (SCUs) in The Netherlands. Symptoms were observed by licensed vocational nurses during regular care-giving in a 2-week observational period prior to assessment. Neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory- Nursing home version (NPI-NH; frequency X severity score 4) and the Cohen-Mansfield Agitation Inventory (CMAI; symptoms occurring at least once a week). More than 80% of these patients suffered from at least one clinically significant symptom, as defined with the NPI-NH frequency X severity score 4. Measured with the NPH-NH agitation/aggression, apathy and irritability were the most frequently observed behaviours, with prevalences of 30-35%. Using the CMAI, 85% of the patients showed at least one symptom of agitation, of which general restlessness was observed most frequently (44%). Other frequently observed symptoms with prevalence rates of 30% were cursing or verbal aggression, constant request for attention, negativism, repetitious sentences, mannerisms, pacing, and complaining. Physically aggressive symptoms such as hitting, kicking, biting occurred less often (less than 13%). Prevalence rates of neuropsychiatric symptoms in Dutch nursing home patients with dementia residing in SCUs are high, especially agitation and apathy. Insight into the prevalence rates of individual symptoms in patients with dementia has important practical consequences for the accurate planning of staff allotment and stresses the need for patient oriented care.
International Journal of Geriatric Psychiatry, 21(11), November 2006, pp.1031-1035.
Publisher:
Wiley
Dementia with Lewy bodies (DLB) and Creutzfeldt-Jakob disease (CJD) share clinical features like cognitive decline, motor disturbances en psychiatric symptoms. Overlapping symptoms may cause physicians to mistake DLB for CJD. Clinical data of 12 patients with autopsy-confirmed DLB who had been clinically suspected to suffer from CJD were analysed to investigate possible clinical features which
Dementia with Lewy bodies (DLB) and Creutzfeldt-Jakob disease (CJD) share clinical features like cognitive decline, motor disturbances en psychiatric symptoms. Overlapping symptoms may cause physicians to mistake DLB for CJD. Clinical data of 12 patients with autopsy-confirmed DLB who had been clinically suspected to suffer from CJD were analysed to investigate possible clinical features which led to misdiagnosis. There was an association in time between administering neuroleptics and rapid clinical deterioration in 8 out of 9 patients. It is suggested that the neuroleptic sensitivity in LBD fuelled the misdiagnosis of CJD in the presented series. Diagnostic confusion between CJD and DLB may have important clinical consequences and may lead to treatment restrictions.
International Journal of Geriatric Psychiatry, 21(9), September 2006, pp.831-837.
Publisher:
Wiley
Apathy is a common symptom in dementia and is often associated with reduced emotional reactivity. This study examined whether reduced emotional reactivity can be demonstrated in dementia patients using a picture viewing task. The viewing time of three different types of visual stimuli was measured in 24 elderly participants, half of which suffered from dementia. The participants had to make...
Apathy is a common symptom in dementia and is often associated with reduced emotional reactivity. This study examined whether reduced emotional reactivity can be demonstrated in dementia patients using a picture viewing task. The viewing time of three different types of visual stimuli was measured in 24 elderly participants, half of which suffered from dementia. The participants had to make a target response to an emotionally neutral target stimulus that was intermixed with a frequently occurring non-target or background stimulus and infrequently presented emotional stimuli. All participants could control the presentation time of each stimulus, but one half of the participants were explicitly instructed to perform the task quickly. The main measure was a ratio score in which the viewing time for emotional stimuli was expressed relative to the viewing time for the neutral non-target stimulus. Using this measure, the instigation of a time-pressure condition proved to significantly reduce the viewing time for emotional stimuli in the healthy subjects. Irrespective of time-pressure condition, the dementia patients showed a similar short viewing time for emotional stimuli as did the healthy subjects in the time-pressure condition. However, both dementia patients and healthy controls displayed longer viewing times for unpleasant than for pleasant stimuli. These results suggest the ability of the present task to reveal the simultaneous occurrence of an overall reduced interest for novel stimuli and an intact differential emotional reactivity to stimuli with a negative versus positive valence in the dementia patients.