MFT Academy Library

Exercise may lead to improvements on functional ability, physical function, and neuropsychiatric symptoms (particularly depression) in people with dementia (PWD). However, high-quality randomised controlled trial (RCT), controlling for the socialisation aspect of group-based exercise interventions, and designed to delay the declines on the functional ability of PWD in the nursing home (NH) setting is almost inexistent. This article describes the protocol of the LEDEN study, an exercise RCT for PWD living in NHs.
LEDEN is a cluster-randomised controlled pilot trial composed of two research arms: exercise training (experimental group) and social/recreational activity (control group). Both interventions will be provided twice a week, for 60min, during the 6-month intervention. The total duration of the study is 12months, being six months of intervention plus six months of observational follow-up. Eight French NHs volunteered to participate in LEDEN; they have been randomised to either exercise intervention or social/recreational intervention in a 1:1 ratio.
The primary objective is to investigate the effects of exercise, compared to a social/recreational intervention, on the ability of PWD living in NHs to perform activities of daily living (ADL). Secondary objectives are related with the cost-effectiveness of the interventions, and the effects of the interventions on patients’ physical function, neuropsychiatric symptoms, pain, nutritional status, and the incidence of falls and fractures.
LEDEN will provide the preliminary evidence needed to inform the development of larger and more complex interventions using exercise or non-exercise social interventions.

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The aim of this study is to develop and try out an approach for personalized nature activities for people with dementia. Methods: A qualitative descriptive study using focus group interviews with people with dementia was conducted. Based on the results of the focus groups and the relevant literature, the approach was developed. In a qualitative descriptive pilot study with a one-group design, we tried out the approach regarding acceptability and experience of the intervention among people with dementia, and satisfaction with the approach among healthcare professionals. Additionally, we investigated the organizational feasibility. Results: From the focus groups, eight key aspects of experiencing nature were identified as being important for quality of life (e.g. relaxation, freedom), as well as six categories of preferred activities (e.g. active, passive, and social activities). Based on these themes and categories, an approach was developed to design nature activities according to the personal wishes, needs, and experiences of people with dementia. During the intervention, participants in the pilot study showed high levels of positive behaviors and low levels of negative behaviors. As regards, organizational feasibility, eight themes for successful implementation of nature activities were identified. Conclusions: This exploratory study contributes to the knowledge regarding the development and implementation of person-centered nature activities for people with dementia. The implementation of the activities could be improved by training professionals in person-centered care. The effect of the person-centered nature activities approach should be investigated.

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Engagement in meaningful activities is associated with positive outcomes for persons with dementia, yet studies demonstrating quantitative evidence for which activities can be considered meaningful are lacking. We investigated MemPics™, a program designed to promote meaningful activity for individuals with dementia through engagement and cognitive stimulation. It was compared with other recreation activities offered in U.S. long-term care facilities to determine whether MemPics™ was rated as having more meaningful activity from both the perspectives of participants and recreation staff.
Long-term care residents with mild to moderate dementia that met eligibility criteria were randomly assigned to an activity group (treatment, control). Participants completed 2 sessions of either the experimental or control group activity with facility recreation staff. Both participants and staff rated each activity in terms of meaningfulness following each session.
Of the enrolled participants study analyses were based on the 94 participants who completed the activity sessions. Compared to the control group activities, MemPics™ had significantly higher participant and staff ratings of meaningfulness. Scores between the 2 rater types were significantly different, with staff reporting higher meaningful activity than participants. Further support for MemPics™ was found in exit survey responses from participating staff.
We discuss the merits and shortcoming of this study, the utility of MemPics™ for providing meaningful engagement in long-term care residents with mild to moderate dementia, and ideas for future research.

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A nurse-led intervention, Daily Engagement of Meaningful Activities (DEMA), was evaluated for feasibility and effect sizes in a two-group randomized pilot study with 36 patient–caregiver dyads (17 DEMA and 19 attention control). Effect sizes were estimated on 10 outcomes: dyad functional ability awareness congruence; patients’ meaningful activity performance and satisfaction, confidence, depressive symptoms, communication satisfaction, physical function, and life satisfaction; and caregivers’ depressive symptoms and life changes. High feasibility of DEMA was supported by the following indicators: consent (97.7%), session completion (91.7%), and Time 3 measure completion (97.2%). Compared to the attention control group, the DEMA group had higher dyad congruence in functional ability awareness and life satisfaction 3 months post-intervention and improved physical function at 2 weeks post-intervention.

Feasibility and effect sizes of the revised daily engagement of meaningful activities intervention for individuals with mild cognitive impairment and their caregivers (Follow this link if you have an Athens password). Alternatively contact the UHSM Academy Library for a copy of the article or call 0161 291 5778)

Spiritual care is an essential aspect of caring for people with dementia. It can improve their quality of life and give them the strength to cope with living with their condition. However, spirituality is a poorly understood concept and healthcare practitioners often lack confidence in assessing and meeting spiritual needs. Therefore, the spiritual needs of people with dementia are often overlooked, which can result in spiritual distress. This article provides an overview of spirituality and spiritual needs. It discusses the potential causes of spiritual distress in people with dementia and provides examples of spiritual care strategies.

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