Month: October 2016

Factors influencing the person-carer relationship in people with anxiety and dementia. (Aging & mental health, 2016, 20(10) p. 1055-1062)

The relationship between people with dementia and their carers is complex and has a significant impact on the dementia experience. The aim of this current study was to determine (1) which factors are associated with the quality of the patient-carer relationship and (2) whether these differ between the two perspectives. . People with dementia generally rated the quality of relationship higher, irrespective of level of dementia, depression or anxiety. This study is novel in that it provides a valuable insight into the impact of mental health on relationship quality for both members of the dyad. The findings emphasise the importance of providing interventions which target mood for both parties, and behavioural problems for people with dementia.

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Cognitive Stimulation Therapy (CST) for dementia. (Journal of Alzheimer’s Disease, 2016, 53(S14))

CST is a brief, evidence-based intervention for people with mild to moderate dementia. Complex psychological techniques are embedded within simple, manualised group sessions which aim to stimulate and maximise cognitive skills. These include categorisation, word association and discussion of current affairs, all following guiding principles which encourage the making of new semantic connections to aid learning. More recently, an individualised, carer-led CST programme has been developed and evaluated. This talk will provide an overview of the CST research programme and key findings from three clinical trials. This includes standard CST, longer-term CST and individualised CST (iCST). In summary, changes following group CST may be comparable to those associated with anti-dementia drugs and it is cost-effective. Memory, executive functioning and language were significantly improved, and significant benefits in quality of life were maintained for six months. Individualised CST led to significant improvements in one’s relationship with their caregivers, although cognition did not improve – suggesting the importance of delivery within a group format. The CST research programme has led to changes in service provision in the UK. Government guidelines now recommend routine provision of Cognitive Stimulation, regardless of medication use and as the only non-pharmacological intervention for the cognitive symptoms of dementia. CST provision is now a key standard for memory service accreditation and used in over 66% of UK memory clinics. The World Alzheimer’s Report recommends routine provision of CST in early stage dementia, resulting in its use globally.

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Effect of animal-assisted activity on balance and quality of life in home-dwelling persons with dementia. (Geriatr Nurs. 2016 37(4) p.284-91)

Purpose of the study was to examine if animal-assisted activity with a dog (AAA) in home-dwelling persons with dementia (PWDs) attending day-care centers would have an effect on factors related to risk of fall accidents, with balance (Berg balance scale) and quality of life (Quality of Life in Late-stage Dementia) as main outcome. The intervention consisted of 30 min sessions with AAA led by a qualified dog handler twice a week for 12 weeks in groups of 3-7 participants. The significant positive effect on balance indicates that AAA might work as a multifactorial intervention in dementia care and have useful clinical implication by affecting risk of fall.

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Engagement in elderly persons with dementia attending animal-assisted group activity. (Dementia (London). Sep 2016)

In this study, we systematically registered behaviours related to engagement in a group animal-assisted activity (AAA) intervention for 21 PWDs in NHs and among 28 home-dwelling PWDs attending a day care centre. The participants interacted with a dog and its handler for 30 minutes, twice a week for 12 weeks. Video-recordings were carried out early (week 2) and late (week 10) during the intervention period and behaviours were categorized by the use of an ethogram. AAA seems to create engagement in PWDs, and might be a suitable and health promoting intervention for both NH residents and participants of a day care centre. Degree of dementia should be considered when planning individual or group based AAA.

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Perceptions of Home Health Nurses Regarding Suffering, Artificial Nutrition, and Hydration in Late-Stage Dementia. (Home Healthc Now. Oct 2016, 34(9) p. 478-84)

The purpose of this study was to explore perceptions of home healthcare nurses related to suffering, artificial nutrition and hydration in people with late-stage dementia, and if these perceptions influence care to people with dementia and their families. Seventeen home healthcare nurses participated in this study. Although many of the nurses reported that artificial nutrition and hydration was of comfort to the patient and family because of the potential for “starving,” they also felt it prolonged the patient’s suffering due to the invasive procedure, need for restraints, and possibility of fluid overload. Several nurses felt that artificial nutrition and hydration gave a sense of false hope to the family that the patient would live longer. The perceptions of these home healthcare nurses influence their care to people with dementia and their families related to artificial nutrition and hydration, possibly based on experience. Their perceptions could influence family decisions regarding treatment options.

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The eating behavior inventory (EBI): A new clinical tool for the early diagnosis of frontotemporal dementia. (J Neurochem, Aug 2016, 138(267))

Changes in eating behaviors and food preference are very frequent in patients with frontotemporal dementia. Despite a specific pattern, this behavioral change is not used as a diagnosis tool. In this study we proposed a new caregiver questionnaire named Eating Behavior Inventory (EBI). This questionnaire consisted in 30 questions investigating four domains of eating behavior (eating habits, food preference, table manners, and swallowing problems). The aim of this study was to show how this questionnaire could be used as a clinical tool allowing to distinguish frontotemporal dementia from Alzheimer’s disease. Concludes that the EBI, shown as a rapid and simple caregiver questionnaire, could be proposed as a new diagnosis tool distinguishing fv-FTD patients from AD patients.

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Experiences of healthcare professionals as caregivers of a dying family member: an exploratory study. (International Journal of Palliative Nursing, 2016.)

Many health-care professionals also take on a caregiver role at home, usually by caring for a dying relative. Very little is known about the perceptions, experiences and needs of this specific group of carers.

Healthcare professionals’ needs as caregivers are not assessed and addressed holistically, creating room for improvement. Participants felt emotionally pressured by their families to get answers and find solutions during caregiving. Despite it being a complex and painful process, participants still gave examples of rewards experienced during caregiving.

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