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Sources of well-being for older adults with and without dementia in residential care: relations to presence of meaning and life satisfaction
- Authors:
- DEWITTE Laura, et al
- Journal article citation:
- Aging and Mental Health, 25(1), 2021, pp.170-178.
- Publisher:
- Taylor and Francis
Objectives: To explore what sources of well-being are rated meaningful by older adults in residential care and how they are related to two important well-being outcomes. Method: Two cross-sectional questionnaire studies were conducted in a sample of care residents without cognitive disability (n = 329) and with Alzheimer’s disease (n = 104). Structural equation modelling was used to test a hypothesized and exploratory model of different sources as predictors of presence of meaning in life (POM) and satisfaction with life (SWL). Results: Family and Health were rated most meaningful by residents with and without dementia. In both studies, the hypothesized model showed adequate fit with the data. For cognitively intact residents, Personal Growth, Spirituality/Religion, and Interpersonal Relationships predicted POM, while Family and Leisure predicted SWL. Exploratory testing identified Leisure as a possible additional predictor of POM. For residents with Alzheimer’s disease, Personal Growth and Society/Community predicted POM, while Family predicted SWL. Conclusion: For older adults in residential care, many sources of well-being remain highly meaningful and some are directly related to the experience of meaning and life satisfaction. Both for residents with and without dementia, continued or increased investment in moments that foster personal growth and family relationships might be especially valuable. (Edited publisher abstract)
The relationship between apathy and participation in therapeutic activities in nursing home residents with dementia: evidence for an association and directions for further research
- Authors:
- ELLIS Julie M., DOYLE Colleen J., SELVARAJAH Suganya
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 15(4), 2016, p.494–509.
- Publisher:
- Sage
Apathy is one of the most frequent and early symptoms of dementia. Because apathy is characterised by lack of initiative and motivation, it leads to considerable burden being placed on carers to ensure that the person living with dementia has a reasonable quality of life. The aim of this study was to investigate the relationship between apathy and participation in therapeutic activities for older people with dementia living in nursing homes. Ninety residents were recruited into the study, and apathy was measured by nursing home staff using the Apathy Evaluation Scale Clinician version. Staff also compiled data on each resident’s involvement in therapeutic activities. Among this sample, the mean age was 84.8 years, and mean length of stay in the nursing home was 1.8 years. The mean apathy score was 50.4, indicating that on average the residents had a moderate level of apathy. Overall, residents participated in six activities per week and those residents who were involved in the most activities had the lowest levels of apathy. This paper provides evidence that residents involved in therapeutic activities have lower levels of apathy. Further research should be conducted on the direction of causality, whether apathy levels can be changed through participation in therapeutic activities, the relationship between dementia severity and modifiability of apathy, and the intensity of therapeutic activities required to maintain functioning. (Publisher abstract)
Associations of special care units and outcomes of residents with dementia: 2004 national nursing home survey
- Authors:
- LUO Huabin, et al
- Journal article citation:
- Gerontologist, 50(4), August 2010, pp.509-518.
- Publisher:
- Oxford University Press
This study examined the rates of specialised care for residents with Alzheimer's disease or dementia in special care units (SCUs) and other nursing home (NH) units and explored the associations of SCU residence with process of care and resident outcomes. The indicators of process of care included physical restraints, continence management, feeding tubes, and influenza and pneumococcal vaccinations. Resident outcomes included pressure ulcers, hospitalisation, emergency room visits, weight loss, and falls. Findings revealed that SCU residents were more likely to have received specialised dementia care and specialised behavioural problem management. They were less likely to have bed rails, use catheters, and yet more likely to have toilet plans/bladder training for incontinence control than those in regular units and those in NHs without an SCU. Also, SCU residents were less likely to have: pressure ulcers; hospitalisation; experienced weight loss. However, they were more likely to have falls than those in regular units and those in NHs without an SCU. The results showed that SCU residents had, in general, better process of care than those in regular units and in NHs without an SCU.
Sharing meals with institutionalized people with dementia: a natural experiment
- Authors:
- CHARRAS Kevin, FREMONTIER Michele
- Journal article citation:
- Journal of Gerontological Social Work, 53(5), July 2010, pp.436-448.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
A natural experiment was conducted in two French special care units located in nursing homes to study the impact of changed mealtime experiences for people with Alzheimer type dementia. One special care unit implemented shared meal times between residents and caregivers, and the other served as a comparison group. The weight of participants was measured at baseline and six months afterwards, and staff reports and observations were analysed. Participants in the study who had the benefit of shared meals gained weight in comparison to participants who did not, and observations indicated that in terms of autonomy residents were seen as more independent in feeding themselves and regulating their food intake, that quality of interactions was enhanced and that shared meals seem to have improved staff perception of work conditions. The article describes the intervention and discusses the findings and their implications.
Exercise training for depressed older adults with Alzheimer's disease
- Authors:
- WILLIAMS C. L., TAPPEN R. M.
- Journal article citation:
- Aging and Mental Health, 12(1), January 2008, pp.72-80.
- Publisher:
- Taylor and Francis
The purpose of this study was to compare the effects of 16 weeks of a comprehensive exercise routine to supervised walking and social conversation on depression in nursing home residents with Alzheimer's disease (AD). The American study was a three-group, repeated-measures design with random assignment to treatment group. Forty-five nursing home residents with moderate to severe AD were randomly assigned to a 16-week programme of comprehensive exercise, supervised walking or social conversation. Raters were blinded to treatment group assignment. Major outcome variables were depression measured by the Cornell Scale for Depression in Dementia, mood measured by the Dementia Mood Assessment Scale and the Alzheimer's Mood Scale, and affect measured by the Observed Affect Scale. Depression was reduced in all three groups with some evidence of superior benefit from exercise. Depression is a common problem with serious and costly consequences for nursing home residents with AD. Exercise as a behavioural approach to treatment of depression in nursing home residents with severe AD evidenced a clear benefit to participants in this study. More research is needed to clarify the relative benefits of different types of exercise in conjunction with or without pharmacological intervention.
Special acute care unit for older adults with Alzheimer's disease
- Authors:
- SOTO Maria E., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(2), February 2008, pp.215-219.
- Publisher:
- Wiley
The article describes the cognitive, functional, and nutritional features of patients admitted to a Special Acute Care Unit (SACU) for elderly patients with Alzheimer's disease (AD). One-year observational study of patients with AD and other related disorders hospitalized in the SACU, Department of Geriatrics, Toulouse university Hospital during 2005. A comprehensive neurocognitive and non-cognitive geriatric assessment was performed. Data on full clinical evaluation, nutritional status, activities of daily living (ADL), gait and balance disturbance, behavioural and psychological symptoms (BPSD), and sociodemographics were recorded. Four-hundred and ninety-two patients were assessed. Their mean age was 81.1 ± 7.7, the mean length of stay was 10.7 ± 6.3 days, 62% were female, 63.9% were admitted from their own home and 30.4% from a nursing home. Eighty percent of patients had probable Alzheimer's disease or mixed dementia, less than 20% had other causes of dementia. Results of their comprehensive assessment showed a mean mini-mental state examination of 14.5 ± 7.4; a mean total ADL score of 3.7 ± 1.7. Seventy-seven percent had gait or balance disturbances; 90% of patients presented an unsatisfactory nutritional status. The most common reason for admission was BPSD. AD complications are responsible for many acute admissions. Elderly patients suffering from dementia represent a population with unique clinical characteristics. Further randomised clinical trials are needed to evaluate the effectiveness of Special Acute Care Units for patients with AD and other related disorders.
Positive affect among nursing home residents with Alzheimer's dementia: the effect of recreational activity
- Authors:
- SCHREINER A. S., YAMANOTO E., SHOTANI H.
- Journal article citation:
- Aging and Mental Health, 9(2), March 2005, pp.129-134.
- Publisher:
- Taylor and Francis
The experience of positive emotions is an integral component of quality of life. Research suggests that cognitive deficits in persons with dementia may impede their ability to generate pleasurable moments and hence decrease their positive affect. Therefore, structured recreation activities may have the potential to significantly improve resident affect. However, differences in affect between ordinary time and recreation time are not well known. The present study used previously published structured-observation instruments to measure affect and behaviour among 35 dementia residents at two nursing homes in Japan during ordinary time and during recreation time. A total of 3,854 one-minute observations were coded. Dementia residents expressed happiness over seven times more often during recreation time than during ordinary time. Over 60% of ordinary time was solitary, with 65.72% of all observed affect being ‘Null Affect'. A total of 43.75% of residents expressed happiness only during recreation time. In addition 48.9% of all behaviour during ‘Ordinary Time' was coded as ‘Null Behaviour', which indicated that the resident was sitting and doing nothing. Findings indicate that recreation time is significantly higher in positive affect than ordinary time and that virtually all residents benefited from recreation.
The therapeutic design of environments for people with dementia: a review of the empirical research
- Authors:
- DAY Kristen, CARREON Daisy, STUMP Cheryl
- Journal article citation:
- Gerontologist, 40(4), August 2000, pp.397-416.
- Publisher:
- Oxford University Press
Design of the physical environment is increasingly recognised as an important aid in caring for people with dementia. This article reviews the empirical research on design and dementia, including research concerning facility planning, research on environment attributes, and research on specific rooms and activity spaces. The analysis reveals major themes in research and characterises strengths and shortcomings in methodology, theoretical conceptualisation, and applicability of findings.
Potential cost savings in residential care for Alzheimer's Disease patients
- Authors:
- LEON Joel, MOYER Delores
- Journal article citation:
- Gerontologist, 39(4), August 1999, pp.440-449.
- Publisher:
- Oxford University Press
This American study uses data from a 1996 cross-sectional study examining the costs of care for Alzheimer's Disease patients to estimate the potential cost savings that could result from a new model of care. This model involves substituting assisted living for nursing home care for Alzheimer's Disease residents with health care profiles that appear to be manageable within assisted living facilities that specialise in dementia care. Results indicate that 13 percent of nursing home costs could be saved, making such a service substitution an attractive alternative in the provision of residential care for certain categories of Alzheimer Disease patients.
A wanderer's lounge program for nursing home residents with Alzheimer's Disease
- Authors:
- McGROWDER-LIN Rachel, BHATT Ashok
- Journal article citation:
- Gerontologist, 28(5), October 1988, pp.607-609.
- Publisher:
- Oxford University Press
Describes work with a group of confused elderly people at risk of wandering.