Month: May 2017

Montessori-based activities among persons with late-stage dementia: Evaluation of mental and behavioral health outcomes (Dementia, 2017 Apr. Epub)

Literature regarding Montessori-based activities with older adults with dementia is fairly common with early stages of dementia. Conversely, research on said activities with individuals experiencing late-stage dementia is limited because of logistical difficulties in sampling and data collection. Given the need to understand risks and benefits of treatments for individuals with late-stage dementia, specifically regarding their mental and behavioral health, this study sought to evaluate the effects of a Montessori-based activity program implemented in a long-term care facility.
Improvements observed for quality of life and problem behaviors may yield promise for Montessori-based activities and related health care practices. The rapid physiological and cognitive deterioration from late-stage dementia should be considered when interpreting these results.

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An innovative approach to hydration for a patient with dementia. (Nurs Older People, 2017, 29(4) p. 26-29)

Nursing older people in acute settings involves the provision of complex care, including the maintenance of good hydration. Dehydration is a serious condition that may contribute to the development of pressure ulcers, urinary tract infections, acute kidney injury and venous thromboembolism. If oral hydration methods are not successful, the alternatives are intravenous (IV) or subcutaneous fluid hydration therapy. These are invasive methods and may not be tolerated by all patients.

This article uses a case study to explore an innovative approach to oral hydration. The intervention was developed for Roy, a patient with advanced Alzheimer’s disease, who had a reduced fluid intake and who became agitated when staff or family members attempted to assist him with nutrition and hydration. It involved consultation with Roy’s family and the introduction of a flavoured drink to encourage the patient to drink. His weekly fluid intake doubled as a result and the intervention avoided the use of alternative invasive rehydration therapy. Although this was a local initiative developed for one patient, it is an example of how a person – entred, collaborative approach can have a positive effect for patients.

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Family caregivers experiences of formal care when caring for persons with dementia through the process of the disease. (Scand J Caring Sci, 2016, 30(3) p. 526-34)

Family caregivers’ experiences of formal care when caring for persons with dementia through the process of the disease is sparsely investigated. Family caregiving requires collaboration with formal care to get support adjusted to the individual’s needs, specific to the stages of dementia. Caregivers experience a transition process with three main turning points: the dementia diagnosis; when they realise increased need for formal care to continue caring at home; and when the person with dementia is moved into a nursing home. The interviewed caregivers experience formal care reactive to their needs and this often promoted unhealthy transitions. Formal care needs to be proactive and deliver available care and support early on in the dementia trajectory. Interventions should focus on facilitating a healthy transition for family caregivers through the trajectory of the dementia disease to ensure their well-being.

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Comparison of the adaptive implementation and evaluation of the Meeting Centers Support Program for people with dementia and their family carers in Europe; study protocol of the MEETINGDEM project. (BMC Geriatr, 2017, 17(1) p. 79)

The MEETINGDEM study aims to implement and evaluate an innovative, inclusive, approach to supporting community dwelling people with mild to moderate dementia and their family carers, called the Meeting Centers Support Program (MCSP), in three countries in the European Union (EU): Italy, Poland and United Kingdom. Demonstrated benefits of this person-centered approach, developed in The Netherlands, include high user satisfaction, reduced behavioral and mood problems, delayed admission to residential care, lower levels of caregiving-related stress, higher carer competence, and improved collaboration between care and welfare organizations.
An overall evaluation will draw together findings from the three countries to develop recommendations for successful implementation of MCSP across the EU. If the Meeting Centers approach can be widely implemented, this could lead to major improvements in dementia care across Europe and beyond.

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The occurrence and persistence of thoughts of suicide, self-harm and death in family caregivers of people with dementia: a longitudinal data analysis over 2 years. (Int J Geriatr Psychiatry, 2017 Apr. Epub)

Family caregivers of people with dementia often report high levels of stress and depression, but little is known about those who contemplate suicide or self-harm. This study explores thoughts of suicide, self-harm and death in dementia caregivers and investigates the characteristics that distinguish them from those without such thoughts.
Caregivers with suicidal thoughts had more severe depressive and anxious symptoms, had a lower sense of competence and mastery, felt less happy and experienced more health problems, less family support and more feelings of loneliness than caregivers who had not.

Suicidal thoughts are present in dementia caregivers and can persist across the care trajectory. Various psychological and social characteristics significantly distinguish caregivers with suicidal thoughts from those without. More research is needed to enable the identification of high-risk caregivers and provide an evidence base for the development of preventive strategies and interventions.

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