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Dementia programme effectiveness in long-term care
- Authors:
- ROSEWARNE Richard, BRUCE Ann, McKENNA Margaret
- Journal article citation:
- International Journal of Geriatric Psychiatry, 12(2), February 1997, pp.173-182.
- Publisher:
- Wiley
Examines the effectiveness of dementia programmes in Australian hostels for the elderly. Also describes the characteristics which placed hostel residents at risk for nursing home placement and to measure changes in dependencies and impairments over two years. Results of the study found that residents in hostel dementia programmes remained significantly longer than those in the comparison group before exit to a nursing home. Quality of life in dementia programmes was enhanced thorough higher levels of social contact with relatives and lower reported levels of depressive symptoms. Benefits of the dementia programmes were that specialist staff could focus on the social and emotional needs of residents. Staff also provided appropriate, targeted activities for residents with dementia and increased the capacity of hostels to care for residents with dementia for longer periods, before admission to a nursing home.
Prognosis is important in decisionmaking in Dutch nursing home patients with dementia and pneumonia
- Authors:
- van der STEEN Jenny, HELTON Margaret R., RIBBLE Miel W.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(9), September 2009, pp.933-936.
- Publisher:
- Wiley
This study explored how physicians treating nursing home residents with dementia and pneumonia in the Netherlands consider prognosis in their treatment decision. Survey study with data collected between July 2006 and March 2008. Physicians (n = 69) from 54 nursing homes in the Netherlands completed a questionnaire on symptoms, treatment, and prognosis for their next dementia patient newly diagnosed with pneumonia. They were also asked a general question regarding withholding antibiotic treatment and prognosis. Outcome was assessed at least two months afterwards. Two-week mortality risk if treated with antibiotics was calculated with a validated prognostic score. The patients not treated with antibiotics had high (92%) actual 2-week mortality while only 12% of patients treated with antibiotics died. Physicians believed that mortality risk was high in the untreated group and would have been only slightly lower if treated with antibiotics (mean estimated risk 73%), which was higher than predicted from the risk score (42%). In general, three-quarters of physicians considered withholding antibiotics appropriate for mortality risks between 75% and 90%. Prognosis is an important consideration when Dutch nursing home physicians make antibiotic treatment decisions for patients with dementia and pneumonia. This suggests they prefer not to treat with antibiotics when to do so is probably futile. Physicians in other countries may hold different views on futility, which should be addressed in larger, cross-national comparative studies.
Bright light treatment improves sleep in institutionalised elderly: an open trial
- Authors:
- FETVEIT Arne, SKJERVE Arvid, BJORRVATIN Bjorn
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(6), June 2003, pp.520-526.
- Publisher:
- Wiley
This study evaluates the effects of bright light therapy among demented nursing home patients with sleep disturbances. 11 nursing home patients with actigraphically measured sleep efficiency below 85% took part in an open, non-randomised study where the subjects served as their own control. After two weeks of baseline measurements and two weeks of pretreatment measurements, patients received bright light exposure 2 h/day within the period 08:00-11:00 for two weeks. Sleep-wake patterns during the 24-h day were evaluated by nursing staff ratings and wrist-worn motor activity devices (actigraphs). Sleep improved substantially with bright light exposure. Waking time within nocturnal sleep was reduced by nearly two h, and sleep efficiency improved from 73% to 86%. Corresponding improvements were found in nursing staff ratings. Effects were consistent across subjects. The findings add further evidence of the effectiveness of morning bright light exposure in the treatment of disturbed sleep among demented nursing home patients
One last pleasure?: alcohol use among elderly people in nursing homes
- Authors:
- WALDO Klein.C., JESS Carol
- Journal article citation:
- Health and Social Work, 27(3), August 2002, pp.193-203.
- Publisher:
- Oxford University Press
The study discussed in this article describes the alcohol-related policies, practices, and problems experienced by a sample of 111 intermediate care facilities and homes for elderly people in the United States. Despite the problems reported, screening for alcohol problems among residents, treatment of identified problems and training of staff were not found to be widespread. Ambiguity about the role of alcohol as a social beverage or as a psychoactive substance to be managed was identified.
The prevalence diagnosis and treatment of depression in dementia patients in chronic care facilities in the last six months of life
- Authors:
- EVERS Martin M., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 17(5), May 2002, pp.464-472.
- Publisher:
- Wiley
Reports on an American study to asses the prevalence, diagnosis and treatment of depression among dementia patients. Perimortal data concerning dementia severity, depressive symptoms and diagnoses, and medication use for 279 dementia patients and 24 normal controls brought to autopsy through an Alzheimer's Disease Resource Center. Results found major depression was highly prevalent in both dementia patients and normal controls, indicating that depression is an important issue for the elderly in the last six months of life irrespective of cognitive status. Under-diagnosis of depression by physicians was also found. Dementia was also found to be undertreated in both dementia patients and normal controls.
The impact of mental health problems on leg ulcer treatment
- Authors:
- KILROY-FINDLEY Anita, WHEATLEY Carolyn
- Journal article citation:
- Nursing Times, 21.2.02, 2002, pp.51-52.
- Publisher:
- Nursing Times
Reports on a case study which follows the progress of a patient with chronic bilateral leg ulcers and mental health problems. Discuss how her mental health problems affected her physical health and the treatment she received and the collaboration required from staff in five settings to ensure she received continuity of care.
The experience of caring for older people with dementia in a rural area: using services
- Authors:
- PEAK J.S., CHESTON R.L.I.
- Journal article citation:
- Aging and Mental Health, 6(1), February 2002, pp.77-81.
- Publisher:
- Taylor and Francis
Simulated Presence Therapy (SPT) is a relatively new intervention, which has been reported to reduce levels of anxiety and challenging behaviour amongst people with dementia. The intervention consists of playing a tape of their carer's voice to a person with dementia over a personal stereo. This study provides details of the effectiveness of SPT with four in-patients on an assessment ward. The four showed differing levels of response to the SPT tapes. It is suggested that the differing response of participants may be related to their differing attachment styles.
Therapy use and discharge outcomes for elderly nursing home residents
- Authors:
- ARLING Greg, WILLIAMS Arthur R., KOPP Donna
- Journal article citation:
- Gerontologist, 40(5), October 2000, pp.587-595.
- Publisher:
- Oxford University Press
This study examines therapy use and discharge outcomes over 90-day period for elderly, post-acute care nursing home admission in South Dakota, USA. Receipt of therapies was related significantly to age, Medicare coverage, hip fracture or stroke diagnosis, absence of cancer diagnosis, and resident or staff expectations for functional improvement. Therapy use was related positively to community discharge and negatively to mortality when controlling for covariates such as age, marital status, payment source, functional status, cognitive status, and major diagnoses. Also, community discharge was related positively to the facility's volume of therapy provision and percentage medicare-covered stays.
Aggressive behaviour and environmental characteristics in Australian nursing homes
- Authors:
- SHAH A., CHIU E., AMES D.
- Journal article citation:
- Aging and Mental Health, 4(1), February 2000, pp.43-47.
- Publisher:
- Taylor and Francis
Aggressive behaviour is commonly observed in nursing homes for the elderly. It causes distress to carers, and leads to hospitalisation, over-medication and physical restraint. Environmental factors can influence aggressive behaviour. A 6-month prospective study was undertaken examining the relationship between aggressive behaviour and environmental characteristics of nursing homes in Melbourne. There is no significant relationship between aggressive behaviour and environmental characteristics of the nursing homes. Methodological issues may explain this lack of association. Avenues of future research are discussed.
Specialized dementia programs in residential care settings
- Authors:
- DAVIS Kourtney Johnston, et al
- Journal article citation:
- Gerontologist, 40(1), February 2000, pp.32-42.
- Publisher:
- Oxford University Press
Two types of institutional settings house the majority of long-term care residents in the United States: nursing homes and residential care (RC) facilities. In both nursing homes and residential care facilities, a substantial proportion of long-TR health care residents have Alzheimer's disease and related dementia. As RC settings have grown as sources of care for older persons, they, too, have begun developing specialised dementia programmes (SDPs). Describes administrative, structural, and resident characteristics in both settings and present and discuss subtypes of RC-SDPs.