Month: January 2017

Effects of Short-Term Exercise Interventions on Behavioral and Psychological Symptoms in Patients with Dementia: A Systematic Review. (Journal of Alzheimer’s Disease. 2017, 55(4) p. 1583-1594)

Observational and interventional studies indicate a direct link between the patients’ physical activity and the extent of behavioral and psychological symptoms of dementia (BPSD). At present, there are no evidence-based recommendations for physical exercise in the acute dementia care settings. Hence, this systematic review investigates the effects of short-term exercise trials on BPSD. Out of the three trials investigating the effects of exercise interventions on depressive symptoms, one reported significant reduction and two reported no differences in pre-post analysis. Exercise represents a potentially worthwhile approach for the treatment of patients suffering from BPSD.

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What do we know from clinical trials on exercise and Alzheimer’s disease? (Journal of Sport and Health Science. 2016, Vol. 5, p. 397–399)

Multiple evidences suggested that exercise in general plays beneficial roles in improving brain function. Most common mechanisms of exercise-induced enhancement of brain function are including alteration of neurogenesis, neuron plasticity, neuronal signalling and receptors, as well as neuronal networks. This mini review includes most recent clinical studies and focuses on the effects of physical exercise, cognitive stimulation, and combination of both physical and cognitive training on protection and rescue cognitive decline in people with AD.

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Randomized Trial of the Family Intervention: Telephone Tracking-Caregiver for Dementia Caregivers: Use of Community and Healthcare Resources. (J Am Geriatr Soc, 2016, Dec, Epub)

This article aims to examine the effects of a telephone-delivered intervention, Family Intervention: Telephone Tracking-Caregiver (FITT-C), on community support and healthcare use by dementia caregivers. It concludes that an entirely telephone-delivered intervention was effective in increasing caregiver engagement in community resources and reducing caregiver use of hospital-based healthcare resources. Results highlight the potential effect of FITT-C on healthcare use.

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Patient and caregiver goals for dementia care. (Qual Life Res, 2016, Dec, Epub)

Most health outcome measures for chronic diseases do not incorporate specific health goals of patients and caregivers. To elicit patient-centered goals for dementia care, we conducted a qualitative study using focus groups of people with early-stage dementia and dementia caregivers.
Participants identified 41 goals for dementia care within five domains (medical care, physical quality of life, social and emotional quality of life, access to services and supports, and caregiver support). Caregiver goals included ensuring the safety of the person with dementia and managing caregiving stress. Participants with early-stage dementia identified engaging in meaningful activity (e.g., work, family functions) and not being a burden on family near the end of life as important goals. Participants articulated the need to readdress goals as the disease progressed and reported challenges in goal-setting when goals differed between the person with dementia and the caregiver (e.g., patient safety vs. living independently at home.

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Dementia Caregivers and Live Discharge from Hospice: What Happens When Hospice Leaves? (Journal of Gerontological Social Work, 2016, Dec, Epub)

Hospice offers holistic support for individuals living with terminal illness and their caregivers. However, some individuals who enroll onto hospice services do not decline in health as quickly as determined by current regulations, termed a ‘live discharge.’ Persons with dementia are among those who experience a live discharge due to the slow physical decline associated with the disease. When a live discharge occurs, it affects not only the patient but also the caregiver(s).
Results of this study have implications for social workers supporting an increasing aging population and their caregivers in various health care settings and highlight the need to view a live discharge as a discharge of the patient-caregiver unit, rather than the patient alone.

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Caregiver Stress and the Patient With Dementia.( Continuum, 2016, 22(2) p. 619-25)

Informal caregivers (often, but not exclusively, family members) are essential to the clinical care of a patient with dementia. Most caregivers are untrained and unpaid. As a result, caregivers often experience stress caused by the caregiving experience; they are the “invisible second patients” in dementia care. Clinicians can help caregivers by supporting them in their role and by referring them to additional resources for support.

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Integrating Nursing Peer Review and a Restorative Just Culture for a Healthy Work Environment. (Creating Healthy Work Environments 2017

The purpose of this project is to describe a process for pairing a restorative just culture into nursing peer review in order to heal, learn, collaborate, retain staff, and improve outcomes for patients. Implications for practice: Organizations are challenged to meet quality outcomes performance standards and are also challenged to nimbly change nursing practice to drive positive outcomes. Peer review integrated with a restorative just culture drives nursing leaders to intervene at the point of care to align individual practice and system designs with standards of care and a healthy work environment.

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Effectiveness and Safety of an Independently Run Nurse Practitioner Outpatient Cardioversion Program (2009 to 2014). (American Journal of Cardiology. 2016,118(12), p. 1842-1846)

Sustained growth in the arrhythmia population at Stanford Health Care led to an independent nurse practitioner-run outpatient direct current cardioversion (DCCV) program in 2012. DCCVs performed by a medical doctor, a nurse practitioner under supervision, or nurse practitioners from 2009 to 2014 were compared for safety and efficacy. In conclusion, the success rate of DCCV in all groups was extremely high, and there were no complications in any of the DCCV groups.

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Trends in Nursing Care Efficiency From 2007 to 2011 on Acute Nursing Units. (Nursing Economics. 2016, 34(6))

The purpose of this study was to estimate trends in the efficiency of nursing care. This study confirmed an in –
crease in nursing efficiency across time, due to decreased outputs as measured by PrU rates and fall
rates along with a decrease in care hours provided by LPNs, and despite the increase in the care
hours provided by RNs. This information could be invaluable so nurse managers and policymakers can have a valid picture for decision making.

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Clinical and Demographic Factors Associated with the Cognitive and Emotional Efficacy of Regular Musical Activities in Dementia. (J Alzheimers Dis. 2016, 49(3) p. 767-81)

Aim: To determine how clinical, demographic, and musical background factors influence the cognitive and emotional efficacy of caregiver-implemented musical activities in persons with dementia. (PWD) The results of this RCT show that both music interventions alleviated depression especially in PWDs with mild dementia and AD. The musical background of the PWD did not influence the efficacy of the music interventions. The findings suggest that clinical and demographic factors can influence the cognitive and emotional efficacy of caregiver-implemented musical activities and are, therefore, recommended to take into account when applying and developing the intervention to achieve the greatest benefit.

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