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Use of dementia care mapping in the care for older people with intellectual disabilities: a mixed‐method study
- Authors:
- SCHAAP Feija D., et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 34(1), 2021, pp.149-163.
- Publisher:
- Wiley
Background: The ageing of people with intellectual disabilities, with associated morbidity like dementia, calls for new types of care. Person‐centred methods may support care staff in providing this, an example being Dementia Care Mapping (DCM). DCM has been shown to be feasible in ID‐care. We examined the experiences of ID‐professionals in using DCM. Methods: We performed a mixed‐methods study, using quantitative data from care staff (N = 136) and qualitative data (focus‐groups, individual interviews) from care staff, group home managers and DCM‐in‐intellectual disabilities mappers (N = 53). Results: DCM provided new insights into the behaviours of clients, enabled professional reflection and gave new knowledge and skills regarding dementia and person‐centred care. Appreciation of DCM further increased after the second cycle of application. Conclusion: DCM is perceived as valuable in ID‐care. Further assessment is needed of its effectiveness in ID‐care with respect to quality of care, staff‐client interactions and job performance. (Edited publisher abstract)
The effectiveness of dyadic interventions for people with dementia and their caregivers
- Authors:
- MOON Heehyul, ADAMS Kathryn Betts
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 12(6), 2013, pp.821-839.
- Publisher:
- Sage
To review the effects of dyadic interventions on caregivers and care recipients in the early stages of dementia searches were carried out on four databases (AgeLine, Medline, EBSCO, and PyscINFO) and relevant literature from 2000 onwards reviewed. The twelve studies identified used a variety of intervention approaches including support group, counseling, cognitive stimulation, skill training, and notebook-keeping. This review suggests that intervention programs for early-stage dementia caregiving dyads were feasible and well accepted by participants. The reviewed studies provided rich evidence of the significance of mutual understanding and communication to partners’ well-being and relationship quality within the caregiving process. The findings suggest that these intervention approaches improved cognitive function of the care recipients, social relations, and the relationship between the primary caregivers and the care recipients, although evidence of long-term effectiveness is lacking. (Edited publisher abstract)
Poetry in dementia care: overcoming the challenges
- Authors:
- GREGORY Helen, et al
- Journal article citation:
- Journal of Dementia Care, 20(2), March 2012, pp.20-23.
- Publisher:
- Hawker
The poem ‘opposite’ was written during Try to remember, an intervention for people with dementia. The authors have previously described the project, from its commissioning and design to the implementation and evaluation, and highlighted some of the benefits brought to people with dementia. In this second article, the authors present some of the challenges they encountered, and in doing so, present a ‘less polished’ view of the arts-based intervention. The article has sections from all four project team members (the GP, project coordinator, the poet and the researcher), each presenting their individual views on the challenges they faced. The article attempts to highlight some of the complexities, contradictions, struggles and setbacks which characterise dementia care.
Using spaced retrieval and Montessori-based activities in improving eating ability for residents with dementia
- Authors:
- LIN Li-Chan, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(10), October 2010, pp.953-959.
- Publisher:
- Wiley
This study aimed to construct a training protocol for spaced retrieval (SR). It also investigated the effectiveness of SR and Montessori-based activities in decreasing eating difficulty in older residents with dementia. Eighty-five residents with dementia were chosen from three special care units for residents with dementia in long-term care facilities in Taiwan. The institutions were randomised into three groups: spaced retrieval; Montessori-based activities; and a control group. The invention consisted of three 30 to 40 min sessions per week, for 8 weeks. Results revealed that after the intervention, the Edinburgh Feeding Evaluation in Dementia scores and assisted feeding scores for the SR and Montessori-based activity groups were significantly lower than that of the control group. However, the frequencies of physical assistance and verbal assistance for the Montessori-based activity group were significantly higher than that of the control group, suggesting residents who received Montessori-based activity needed more physical and verbal assistance during mealtimes. In conclusion, this study confirmed the efficacy of SR and Montessori-based activities for eating difficulty and eating ability.
Effects of caregiver-provided individual cognitive interventions on cognition, social functioning and quality of life in older adults with major neurocognitive disorders: a systematic review
- Authors:
- Silva Rosa, et al
- Journal article citation:
- JBI Evidence Synthesis, 18(4), 2020, pp.743-806.
- Publisher:
- Wolters Kulwer
Objective: The objective of this review was to investigate the effectiveness of caregiver-provided individual cognitive interventions for improving cognition, social functioning and quality of life in older adults with major neurocognitive disorders. Introduction: A large number of people with major neurocognitive disorders live in their homes, requiring ongoing community care. Different individual cognitive intervention programs have been explored as a potential approach for implementation by caregivers on a one-to-one basis. These programs have the advantage of being implemented in a home setting and in the real-life context of the older adult, in a society that is increasingly aging and where aging in place is being fostered. Inclusion criteria: This review considered experimental studies that included older adults aged 60 years and over with major neurocognitive disorders who were receiving individual cognitive interventions (e.g. cognitive stimulation, cognitive training or cognitive rehabilitation) provided by their caregivers. The comparator was usual care, wait-list control or alternative therapeutic intervention. The primary outcomes of interest included cognition, social functioning and quality of life. Additionally, behavior, mood and activities of daily living were considered. Methods: A comprehensive search strategy was used to identify relevant published and unpublished studies from January 1995 to March 2018, written in English, Spanish and Portuguese. Studies meeting the inclusion criteria were retrieved and their methodological quality was assessed by two independent reviewers using the JBI critical appraisal checklists for randomized controlled trials and quasi-experimental studies. Quantitative data were extracted using the standardized data extraction tool from the JBI System for the Unified Management, Assessment and Review of Information. Due to the clinical and methodological heterogeneity in the included studies, statistical pooling was not possible. Therefore, findings are presented in a narrative format. Results: Eight randomized controlled trials and two quasi-experimental studies were included, with a total sample of 844 dyads (older adults and caregivers). The number of dyads included in the studies ranged from 16 to 356. Beneficial effects of the caregiver-provided individual cognitive interventions were observed in various cognitive domains, including memory, attention, verbal fluency and problem-solving. Two studies additionally reported the positive impact of the intervention of interest on general cognitive functioning. None of the reviewed studies revealed significant changes in quality of life. Social functioning was not analyzed in any of the included studies. Beneficial effects were also reported in relation to behavior and activities of daily living, despite the low level of evidence. Conclusions: This review responds to a gap in current international literature on the synthesis of evidence on the use of caregiver-provided individual cognitive interventions. The intervention of interest is associated with improvement in cognitive performance, revealing some benefits for the stabilization of neuropsychiatric symptoms and an increase in autonomy in activities of daily living. Further research on the impact of sociodemographic and clinical factors on the intervention effects is needed, as these factors seem to interfere with successful intervention implementation. To reinforce current evidence, the methodological quality of future studies should be improved. (Edited publisher abstract)
Towards defining restlessness in individuals with dementia
- Authors:
- REGIER Natalie G., GITLIN Laura N.
- Journal article citation:
- Aging and Mental Health, 21(5), 2017, pp.543-552.
- Publisher:
- Taylor and Francis
Objectives: Most individuals with dementia develop significant behavioural problems. Restlessness is a behavioural symptom frequently endorsed by caregivers as distressing, yet is variably defined and measured. Lack of conceptual and operational clarity hinders an understanding of this common behavioural type, its prevalence, and development of effective interventions. The authors advance a systematic definition and understanding of restlessness from which to enhance reporting and intervention development. Method: The literature for existing definitions and measures of restlessness, is reviewed and common elements across existing definitions are identified. Fit with relevant theoretical frameworks are assessed, and the relationship between restlessness and other behavioural symptoms in a data set of 272 community-dwelling persons with dementia are explored. Results: Twenty-five scales assessing restlessness were identified. Shared components included motor/neurological, psychiatric, and needs-based features. Exploratory analyses suggest that restlessness may co-occur primarily with argumentation, anxiety, waking the caregiver, delusions/hallucinations, and wandering. The authors propose that restlessness consists of three key attributes: diffuse motor activity or motion subject to limited control, non-productive or disorganised behavior, and subjective distress. Restlessness should be differentiated from and not confused with wandering or elopement, pharmacological side effects, a (non-dementia) mental or movement disorder, or behaviours occurring in the context of a delirium or at end-of-life. Conclusion: Restlessness appears to denote a distinct set of behaviours that have overlapping but non-equivalent features with other behavioural symptoms. The authors propose that it reflects a complex behaviour involving three key characteristics. Understanding its specific manifestations and which components are present can enhance tailoring interventions to specific contexts of this multicomponent behavioural type. (Edited publisher abstract)
Effects of multisensory and motor stimulation on the behavior of people with dementia
- Authors:
- SPOSITO Giovana, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 16(3), 2017, pp.344-359.
- Publisher:
- Sage
A quasi-experimental study using a pre–posttest design was conducted in four aged care facilities to assess the effects of a person-centred care (PCC) multisensory stimulation (MSS) and motor stimulation (MS) programme, implemented by direct care workers, on the behaviours of residents with dementia. Data were collected at baseline and after the intervention through video recordings of morning care routines. Forty-five residents with moderate and severe dementia participated in the study. A total of 266 morning care routines were recorded. The frequency and duration of a list of behaviours were analysed. The frequency of engagement in task decreased significantly (p = .002) however, its duration increased (p = .039). The duration of gaze directed at direct care workers improved significantly (p = .014) and the frequency of closed eyes decreased (p = .046). There was a significant decrease in the frequency of the expression of sadness. These results support the implementation of PCC–MSS and MS programmes as they may stimulate residents' behaviours. (Edited publisher abstract)
Meeting through music
- Author:
- DOWSON Becky
- Journal article citation:
- Journal of Dementia Care, 20(2), March 2012, pp.26-28.
- Publisher:
- Hawker
The Guideposts Trust’s Music Therapy service, in Oxfordshire, England, has been supporting people with dementia by helping them maintain their sense of identity and express themselves through music. This article, based on client feedback, describes the positive difference the service has made to many people. The service, staffed by three part-time music therapists, services 15 people in individual weekly sessions, and a further 35 who attend in group sessions. The therapy allows for non-verbal communication, and facilitates social interaction at a time when attendees are at risk from social isolation. Clients enjoyed playing together as a group, listening to others, singing, and playing instruments. The therapy simultaneously fulfilled a range of different needs.
Therapeutic interventions in dementia 1: cognitive symptoms and function
- Authors:
- TAYLOR Clare, et al
- Journal article citation:
- Nursing Times, 13.1.09, 2009, pp.16-17.
- Publisher:
- Nursing Times
This is the first of a two part article on therapeutic interventions in dementia which outlines how to maintain function and independence for patients with dementia. It also examines specific interventions - both psychological and pharmacological - for cognitive symptoms. The article draws on recently developed national guidance from NICE and the Social Care Institute for Excellence (SCIE).
Cognitive plasticity in people at risk for dementia: Optimising the testing-the-limits-approach
- Authors:
- SCHREIBER M., SNEIDER R.
- Journal article citation:
- Aging and Mental Health, 11(1), January 2007, pp.75-81.
- Publisher:
- Taylor and Francis
A topic of great interest in gerontology research is the prediction of cognitive deterioration which marks the transition from mild cognitive impairment (MCI) to dementia. In this area, the term cognitive plasticity can be of great interest. We examined the utility of the Adaptive Figure Series Learning Test (ADAFI) to evoke cognitive plasticity and to show whether reduced plasticity can be found in people with MCI. In a pre-test–intervention–post-test design, intervention with the ADAFI was compared to an unspecific brain jogging task in MCI participants and healthy controls. A total of 42 subjects were included. Independent of mental health status only using the ADAFI led to pronounced improvements in post-test performances, but MCI participants profited less from the intervention with the ADAFI than healthy controls, that is, showed lower cognitive plasticity. Thus, the overlap in performance distributions between healthy participants and MCI individuals at pre-test was reduced at the time of post-test once the ADAFI had been given as intervention. The findings of the present article indicate that plasticity oriented information can be gained when the ADAFI is given as an intervention in a pre-test–training–post-test-design. The cognitive plasticity approach seems potentially useful for purposes of early identification of dementia.