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Cognitive behavioural therapy with older people: interventions for those with and without dementia
- Author:
- JAMES Ian Andrew
- Publisher:
- Jessica Kingsley
- Publication year:
- 2010
- Pagination:
- 256p., bibliog.
- Place of publication:
- London
The use of Cognitive Behavioural Therapy (CBT) with older people both with and without cognitive difficulties is discussed. The book is divided into three main parts. The first orientates the reader, examines potential adaptations and discusses CBT from a practical and conceptual perspective. The second section reviews older people’s therapy in terms of assessment, formulation and interventions. The final part offers practical advice, using case examples in both dementia and depression. The text is aimed at trainees and experienced therapists alike and is expected to be of value to anybody using CBT in their work with older people, regardless of their clients' levels of cognitive ability.
Early-life characteristics, psychiatric history, and cognition trajectories in later life
- Author:
- BROWN Maria Teresa
- Journal article citation:
- Gerontologist, 50(5), October 2010, pp.646-656.
- Publisher:
- Oxford University Press
The relationship between a history of psychiatric problems and cognitive function in later life is not very well documented. This study explores the relationship between psychiatric problems and cognitive function or decline in later life, and also attempts to identify populations more likely to be affected. The study applied a longitudinal analysis of six waves of the Health and Retirement Study data. Growth curve models were used to analyse the relationships between childhood health and disadvantage, psychiatric history, and cognitive function, controlling for demographics, health behaviour, and health status. The results indicated that a history of psychiatric problems is associated with lower cognitive function and steeper declines in cognitive function with age. The influence of childhood health is mediated by later-life health status and behaviours. A combined history of childhood disadvantage and psychiatric problems more strongly affects cognitive function, but cognitive declines remain consistent with those associated with psychiatric history. These effects are partially mediated by later-life demographic, socioeconomic, or health characteristics. The findings demonstrate that cumulative disadvantage and a history of psychiatric problems shape later-life cognition and cognitive decline.
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.
Dementia
- Authors:
- AMES David, BURNS Alistair, O'BRIEN John
- Publisher:
- Hodder Arnold
- Publication year:
- 2010
- Pagination:
- 828p.
- Place of publication:
- London
- Edition:
- 4th ed.
The new edition of this definitive work on dementia and related disorders has been fully updated and revised to reflect recent advances in this fast-moving field. The editors have brought together a team of the world's leading international experts and key opinion leaders on all aspects of the condition, from history, epidemiology and social aspects to the latest neurobiological research and advanced therapeutic strategies, to provide a broad perspective on this multifaceted problem. The new edition includes: the latest neurobiological research made relevant to everyday practice; a thorough review of all treatment strategies from drug and stem cell therapies through to psychosocial interventions; and a comprehensive review of carer support strategies, community care, long term care facilities, and behavioural management techniques. The book is expected to be of value to a wide audience including; specialists in old age psychiatry, neurology and care of the elderly, and all clinicians working with patients affected by dementia, including psychologists, occupational therapists, social workers and specialist nursing staff. (Winner of the BMA 2011 book awards: psychiatry category.)
Using Appreciative Inquiry to promote choice for older people and their carers
- Authors:
- SEEBOHM Patience, et al
- Journal article citation:
- Mental Health and Social Inclusion, 14(4), November 2010, pp.13-21.
- Publisher:
- Emerald
This article describes how an ‘Appreciative Inquiry’ approach was used in south London to enhance the levels of choice that older adults with dementia or mental health problems and their carers have in relation to the care and support they receive. During this project, a wide range of participants across the borough of Lewisham took part in conversations about making the choices that matter most to them. This article tells the story of this project, its background, the Appreciative Inquiry approach, and what was learnt. The Appreciate Inquiry approach comprises 4 stages: discovery; dream; design; and delivery. In the discovery stage, over 60 people with different roles and backgrounds shared stories in appreciative interviews. The Design Group read all these stories and drew out their common and different themes. On 9 July 2010, 120 people including managers, practitioners, carers, and service users met to share more discovery stories and to convey their visions of the best possible future for older people and their carers, building on what works. Later, the Design Group drew up on action plan for taking the work forward. Through looking at successful stories about making real choice in Lewisham, the project provided information about the conditions that support choice, including the importance of good relationships, building trust, making time, giving and receiving encouragement, and support.
Mental capacity assessments: working in practice?: initial findings from the Mental Health Foundation's assessment of mental capacity audit tool (AMCAT)
- Author:
- MENTAL HEALTH FOUNDATION
- Publisher:
- Mental Health Foundation
- Publication year:
- 2010
- Pagination:
- 2p.
- Place of publication:
- London
The Mental Health Foundation has developed online resources to help staff working in health and social care, including those in the private and voluntary sectors, as well as unpaid carers, to improve the way they assess mental capacity. The Assessment of Mental Capacity Audit Tool (AMCAT) provides a free, confidential and simple way for staff working in health and social care settings to audit and evaluate mental capacity assessment of individuals that they have been involved with. The tool also provides an instantaneous, automated report that indicates to the person who has completed the tool how well the assessment accorded with the Mental Capacity Act and its Code of Practice. This report provides initial findings from an assessment of the tool. It shows the reasons for carrying out the assessment, noting that the main reasons were that the person had dementia (38%), a mental illness (27%), or a learning disability (18%). Although 33% of respondents said that they carried out the assessment because the person was having a problem making a decision, 38% said they carried out the assessment because of the person's disability, history, diagnosis, illness, age, appearance, or behaviour. The report also outlines how assessments were carried out.
Associations between stroke risk and cognition in normal aging and Alzheimer's disease with and without depression
- Authors:
- BANGEN Katherine J., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(2), February 2010, pp.175-182.
- Publisher:
- Wiley
The development of age-related cognitive decline, vascular cognitive impairment, and, more recently, Alzheimer's disease (AD), have all recently been attributed to stroke risk factors. Also, depression and the apolipoprotein 4 allele have been reported to influence the association between stroke risk and cognition. However, few studies have described the relations among stroke risk, cognition, and apolipoprotein genotype in AD, and the few findings have been ambiguous. This study of 30 cognitively normal older adults, 30 AD patients with depression, and 30 AD patients without depression were given a comprehensive neuropsychological battery designed to measure several domains including memory, attention, language, visuospatial skills, executive functions, and speed of information processing. The Framingham Stroke Risk Profile, a scale that was developed to predict 10-year probability of stroke, was used to quantify stroke risk burden. Results indicate that AD patients with depression demonstrate greater stroke risk burden relative to the cognitively normal group and, across all participants, increased stroke risk was associated with poorer performance on memory and processing speed measures. Also, stroke risk accurately predicted AD diagnosis. However, there were no differences in stroke risk or cognitive performance between the AD participants with depression and those without depression. Given that many markers of stroke risk are modifiable or treatable, the authors suggest their findings have implications for assessment, prevention, and treatment of cognitive decline.
Efficacy of integrated interventions combining psychiatric care and nursing home care for nursing home residents: a review of the literature
- Authors:
- COLLET Janine, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(1), January 2010, pp.3-13.
- Publisher:
- Wiley
Nursing home residents needing both psychiatric and nursing home care for either somatic illness or dementia combined with psychiatric disorders or severe behavioural problems are referred to as Double Care Demanding (DCD) patients. This study examined which integrated interventions combining both psychiatric care and nursing home care in DCD nursing home residents are described in the research literature, and which effects of these integrated models are reported in the literature. Following a critical review of studies and a systematic literature search performed in a number of international databases, eight intervention trials were identified as relevant for the purposes of the review. Seven studies, 3 of which were randomised controlled trials, showed beneficial effects of a comprehensive, integrated multidisciplinary approach combining medical, psychiatric and nursing interventions on severe behavioural problems in DCD nursing home patients. The authors conclude that important elements of a successful treatment strategy for DCD nursing home patients include a thorough assessment of psychiatric, medical and environmental causes as well as programmes for teaching behavioural management skills to nurses, and that this review underlines the need for more rigorously designed studies.
VA nursing home residents with substance use disorders: mental health comorbidities, functioning, and problem behaviors
- Authors:
- LEMKE Sonne, SCHAEFER
- Journal article citation:
- Aging and Mental Health, 14(5), July 2010, pp.593-602.
- Publisher:
- Taylor and Francis
This paper aimed to identify whether residents with substance use disorders (SUDs) in Veterans Administration nursing homes (VANHs) are distinctive in terms of their medical and mental health comorbidities, functioning, and problem behaviours. The study identified 27,002 residents over age 55 admitted to VANHs, and SUD and non-SUD residents were compared. Findings indicated that when compared with other residents, those with SUDs, which account for 18% of admissions over 55, were more likely to be younger, male, African-American, unmarried, have low income and a tobacco use disorder. Controlling for demographic factors and smoking, SUD residents were more likely to have mental health comorbidities including dementia, serious mental illness, depressive disorders, and post-traumatic stress disorder. SUD residents were: less likely to have cancer, diabetes, or neurological disorders; more independent in activities of daily living; more likely to engage in verbal disruption but not in other problem behaviours such as aggression. In conclusion, VANH residents with SUDs have distinctive patterns of comorbidities and functioning. Residents with SUDs present challenges but may have good potential for positive discharge outcomes, if their substance use problems and limited income can be addressed.