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Environmental correlates of neuropsychiatric symptoms in nursing home patients with dementia
- Authors:
- ZUIDEMA Sytse U., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(1), January 2010, pp.14-22.
- Publisher:
- Wiley
The aim of this study was to estimate the influence of the physical and psychosocial environment on the prevalence of neuropsychiatric symptoms in nursing home patients with dementia. The study assessed 1,289 patients in 56 Dementia Special Care Units in the Netherlands. The environmental correlates measured were the presence of a walking circuit, number of patients per unit or per living room, staff/patient ratio, and hours spent on direct patient care. Key points identified were: neuropsychiatric symptoms in nursing homes varies among dementia special care units, nursing home patients with dementia show less apathy at units with more staff, patients in large units do not show more symptoms than in smaller units, and the variation of symptom prevalence rates among units is evidence for the environmental contribution of neuropsychiatric symptoms in dementia. The authors conclude that future research should focus on the complex interactions between patients with dementia and the physical and social environment, and that a better understanding of such interactions could be used for future staff training to reduce neuropsychiatric symptoms in nursing homes and for designing appropriate housing that will meet the needs of patients with dementia.
Effect of the Meeting Centres Support Program on informal carers of people with dementia: Results from a multi-centre study
- Authors:
- DROES R-M, et al
- Journal article citation:
- Aging and Mental Health, 10(2), March 2006, pp.112-124.
- Publisher:
- Taylor and Francis
Because of the complex nature of the problems that carers of persons with dementia encounter, several comprehensive support programs for carers were developed in the past decade. One such program is the Meeting Centres Support Program (MCSP) that integrates different types of support for persons with dementia and their carers, which have proved to be effective in practice and/or research. Within the framework of a study into the national implementation of the MCSP, it was investigated whether the positive effects found in carers that participated in the first Amsterdam Meeting Centres, were also achieved in other regions of The Netherlands. A pre-test–post-test control group design with matched groups was applied. In total, 94 carers in the MCSP in eight meeting centres and 34 carers of dementia patients who frequented regular psychogeriatric day care (PDC) in three nursing homes were included in the study. During the study period 23 carers of the MCSP group and 21 carers of the PDC group dropped out. At baseline and after seven months indicators of burden (psychological and psychosomatic symptoms, feelings of burden and time between start of support and institutionalization of the persons with dementia) were measured, as well as potential determinants of burden (sense of competence, coping strategies, experienced support, loneliness and the emotional impact of behaviour problems). Though on a group level no effect was found, either in psychological and psychosomatic symptoms or in the determinants of burden, a subgroup of carers who felt lonely (n?=?22) at baseline benefited significantly more from the MCSP than from PDC in terms of psychological and psychosomatic symptoms. A majority of MCSP carers (82.1%) experienced less burden and more professional support. After seven months significantly fewer persons with dementia in the MCSP (4%) were institutionalized as compared to the patients in PDC (29%). Patients in the MCSP participated for a longer period of time before institutionalization. Although the effect on sense of competence of carers that was found in the Amsterdam study was not found in this multi-centre study, the effect on burden and delayed institutionalization of the person with dementia were confirmed. The integrated MCSP also proved more effective than PDC in decreasing psychological and psychosomatic symptoms in lonely carers. Further dissemination of the MCSP is therefore recommended.
A virtual reality intervention to improve the understanding and empathy for people with dementia in informal caregivers: results of a pilot study
- Authors:
- WIJMA Eva M., et al
- Journal article citation:
- Aging and Mental Health, 22(9), 2018, pp.1115-1123.
- Publisher:
- Taylor and Francis
Objective: Informal caregivers often experience psychological distress due to the changing functioning of the person with dementia they care for. Improved understanding of the person with dementia reduces psychological distress. To enhance understanding and empathy in caregivers, an innovative technology virtual reality intervention Through the D'mentia Lens (TDL) was developed to experience dementia, consisting of a virtual reality simulation movie and e-course. A pilot study of TDL was conducted. Methods: A pre-test–post-test design was used. Informal caregivers filled out questionnaires assessing person-centeredness, empathy, perceived pressure from informal care, perceived competence and quality of the relationship. At post-test, additional questions about TDL's feasibility were asked. Results: Thirty-five caregivers completed the pre-test and post-test. Most participants were satisfied with TDL and stated that TDL gave more insight in the perception of the person with dementia. The simulation movie was graded 8.03 out of 10 and the e-course 7.66. Participants significantly improved in empathy, confidence in caring for the person with dementia, and positive interactions with the person with dementia. Conclusion: TDL is feasible for informal caregivers and seems to lead to understanding of and insight in the experience of people with dementia. Therefore, TDL could support informal caregivers in their caregiving role. (Publisher abstract)