Nurse’s dementia therapy dog gets hospital patients talking and walking

Ford,M. | 2021| Nurse’s dementia therapy dog gets hospital patients talking and walking | Nursing Times |

This article in the Nursing Times shows the impact of Julie Young’s dementia therapy dog Teddy on patients, families and staff at Woodhorn Ward at St George’s Park Hospital in Northumberland three times a week as part of a holistic care approach on the dementia in-patient unit. Julie is an advanced nurse practitioner at Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust.

“Sometimes people see her as their own dog which gives a sense of ownership and achievement.”

Teddy had also helped to “de-escalate situations on the ward as she aids engagement and provides a calming distraction”, noted Ms Young.

“There’s something about Teddy that makes people relax,” she added.

Staff on the ward had also highlighted the positive impact Teddy made on their wellbeing during the Covid-19 pandemic amid stressful times at work.

As well as boosting mental and emotional wellbeing, Teddy had also helped to encourage physical activity among patients.

The full article is available in the Nursing Times

NIHR: Case study: Therapy to help people live well with dementia

NIHR | July 2021 | Case study: Goal-oriented cognitive rehabilitation for people with early-stage dementia

This NIHR case study highlights the work of its NIHR HTA Programme, which commissioned the “Goal-oriented cognitive rehabilitation in early-stage Alzheimer’s disease: multi-centre single-blind randomised controlled trial” (GREAT).

475 participants with clinically diagnosed early-stage Alzheimer, vascular or mixed dementia were randomly assigned to two groups across eight NHS sites in England and Wales. Half of the participants received ten sessions of CR over three months, followed by four top-up sessions over six months. The other half were the control group, they were able to set goals but received treatment as usual. 

The results after the first three months were promising. Patients who underwent CR therapy improved their functioning in relation to their targeted goals. While the control group also set goals, their functioning in those areas did not improve. 

When the patients were assessed six months later, patients who underwent CR continued to benefit from the therapy, indicating that the intervention had a lasting impact and could help them to function better and more independently at home. 

The study also assessed the costs of delivering CR to people and found that the approximate cost under trial conditions was £1736 per patient. The actual cost of delivering CR within a service is likely to be less as the therapists would eventually be trained and supervised internally, and fewer CR sessions may be required.

One of the participants in the trial-Brian- was diagnosed with Alzheimer’s disease in 2012, at the outset of the trial his goal was to improve his independence, and a year later Brian is still using the techniques he learnt to maintain some independnece

“The trial helped me find strategies that made a real improvement to my life, and I’m sure it could help others too. I do a lot of shopping on my own now, and that’s really important to me. It means I get out of the house and talk to different people.”

Brian, participant in the trial who was diagnosed with and experienced memory difficulties and a loss of confidence.

Full details from NIHR

Music app for patients with dementia

Lancashire Teaching Hospital Trusts has trialled the use of a music app in patients with dementia (n equal to 25). The app uses an algorithm that selects music based on listeners’ personal backgrounds and this patient group experienced reductions in heart rate by a fifth (22 per cent) as well as lowering agitation and distress in some cases. The algorithm uses the  patient’s age, gender, nationality, and ethnicity and based on sociological and psychological science, it then compiles in seconds the perfect 20-minute playlist of soothing music to calm them.

“There has been an up to 22% reduction in heart rates in these patients,” said Dr Jacqueline Twamley, academic research and innovation manager. “Some people it doesn’t affect the heart rate at all, but you can see the effect in their facial expressions and in them tapping along. One patient burst out crying. He said the song brought back happy memories and they were happy tears.”

“The results have been very impressive. We believe that dispensing music as medicine could revolutionise the treatment of dementia and other similar neurological conditions such as Alzheimer’s.” (Source: The Guardian & The Yorkshire Post).

Story featured in:

The Guardian Alzheimer’s patients and hospital staff prescribed music in NHS trial

Yorkshire Post Revolutionary new app ‘dispenses music as medicine’ to reduce anxiety and pain

Family carers’ narratives of the financial consequences of young onset dementia

Bayly, M., O’Connell, M. E., Kortzman, A., Peacock, S., Morgan, D. G. & Kirk, A. | 2021| Family carers’ narratives of the financial consequences of young onset dementia | Dementia | https://doi.org/10.1177/14713012211009341

This study takes a qualitative approach to explore how family carers of persons with young onset dementia understand their experiences (n equal to 8), with a focus on financial consequences and how they may be ameliorated by support

Abstract

Individuals with young onset dementia and their families face unique challenges, such as disruptions to their life cycle and relationships and a dearth of appropriate supports. Financial consequences have also been noted in the literature yet have not been explored in-depth. The purpose of this research was to qualitatively explore carers’ experiences of financial consequences resulting from the young onset dementia of a family member and how these consequences may be managed. Eight carers (7 women and 1 man) provided a written online narrative about their journey with young onset dementia and any financial consequences experienced, with open-ended prompts to elicit details not yet shared. Narratives were inductively coded and analyzed using a thematic narrative approach. Carers described a voluntary or involuntary end to employment for the person with young onset dementia around the time of diagnosis. This engendered ongoing and anticipated financial consequences, combined with the need for carers to balance employment with the provision of care (which often meant early retirement for spousal carers). Common themes were tension between the needs to provide care and earn income, altered financial prospects, costs of care, and lack of available and accessible supports to ameliorate financial consequences. Findings illustrate the reality of financial consequences across the trajectory of young onset dementia. These consequences may manifest differently for spousal and child carers and are not being adequately addressed by existing supports.

Full paper available from Dementia

The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review

Harper, A. E. et al | 20201 | The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review | Dementia | https://doi.org/10.1177/14713012211012606

This review examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia in the published literature in the period from 2000 to July 2020

Abstract

Background

Person-centered care has been shown to increase desired outcomes for people with dementia, yet informal caregivers’ dissatisfaction with care is often reported. For those living in a nursing home, informal caregivers are uniquely situated to provide key insights into the individual’s care. However, little is known of the informal caregivers’ perspective, which hinders efforts to improve their satisfaction with person-centered nursing home care. Thus, we examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia.

Methods

In collaboration with stakeholders, a scoping review of Medline (Ovid), EMBASE.com, CINAHL (EBSCO), the Cochrane Library (Wiley), and PsycINFO (Ovid) databases from January 2000 to July 2020 was conducted. Data were extracted reflecting the experiences, priorities, and preferences of caregivers of people with dementia residing in nursing homes.

Results

We identified 114 articles that revealed nine themes: (1) communication, (2) transition to nursing home, (3) quality of care, (4) quality of life, (5) informal caregiver role, (6) knowledge of dementia, (7) end-of-life preferences, (8) medication use to manage neuropsychiatric behaviors, and (9) finances.

Conclusion

Informal caregivers described aspects of care that led to both positive and negative experiences with and perceptions of nursing home care. The shortcomings in communication were discussed most frequently, indicating a high priority area. While researchers define the identified themes individually, informal caregivers perceive them to be interwoven as they relate to person-centered care delivery. Although we did not assess the quality of included articles, by identifying themes relevant to caregivers’ perspectives of nursing home care, our findings may help to inform efforts to optimize caregivers’ satisfaction with nursing home care for residents with dementia.

Abstract only The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review

Rotherham NHS staff can request this paper from their Library Service

Alzheimer’s Society: 5 ways our new early career researchers are helping defeat dementia

The Alzheimer’s Society | 26 April 2021 | 5 ways our new early career researchers are helping defeat dementia

The Alzheimer’s Society has announced, that thanks to its supporters generosity over the past year, they are now able to fund early career researchers whose work has hung in the balance due to the pandemic.

The Alzheimer’s Society are investing over £800,000 into exciting research projects led by PhD students and postdoctoral fellows. Not only will these projects advance dementia research but they will help secure the positions for our dementia researcher leaders of tomorrow. 

It outlines five research projects they are funding:

  1. How certain factors could increase the risk of developing dementia
  2. How brain cells die in diseases causing dementia
  3.  How we could treat dementia
  4. How we can improve the quality of life for those living with dementia
  5. How we can support with quality end-of-life care planning-

The full details about each of these projects plus links to the project homepage are available from The Alzheimer’s Society

5 ways our new early career researchers are helping defeat dementia

Telemedicine and Dementia Care: A Systematic Review of Barriers and Facilitators

Yi, J.S., Pittman, C., Price, C.L., Nieman, C.L. & Oh, .E.S.| 2021| Telemedicine and Dementia Care: A Systematic Review of Barriers and Facilitators| J Am Med Dir Assoc| Apr 19:S1525-8610(21)00311-X. doi: 10.1016/j.jamda.2021.03.015. Epub ahead of print. PMID: 33887231.

Abstract

Objectives: An increasing reliance on telemedicine for older adults with cognitive impairment requires a better understanding of the barriers and facilitators for this unique patient population.

Design: The study team queried PubMed, Embase, the Cochrane Library, PsycINFO, CINAHL, Scopus, and ClinicalTrials.gov on May 1, 2020, for studies in English published from January 2010 to May 2020.

Setting and participants: We conducted a systematic review of articles investigating the use of telemedicine among older adults with Alzheimer’s disease and related dementia (ADRD) or mild cognitive impairment (MCI) that focused on the patient and care partner perspectives.

Methods: Telemedicine encounter purpose, technological requirements, and findings regarding sensory needs were extracted. The Cochrane Collaboration’s Risk of Bias Tool was applied for quality assessment.

Results: The search yielded 3551 abstracts, from which 90 articles were reviewed and 17 were included. The purpose of telemedicine encounters included routine care, cognitive assessment, and telerehabilitation. All studies reported successful implementation of telemedicine, supported by patient and care partner satisfaction, similar results on cognitive assessment and diagnosis compared to in-person visits, and improvement in outcome measures following rehabilitation. Sixteen studies relied on staff and care partners to navigate technologies. Six studies reported participants reporting difficulty hearing the provider during the telemedicine visits. Five studies excluded participants with visual or hearing impairment because of the potential difficulty of using telemedicine technology. No studies reported technological adaptations to account for sensory impairment.

Conclusions and implications: Telemedicine is well received among patients and care partners, but successful delivery incorporates support staff and the care partners to navigate technologies. The exclusion of older adults with sensory impairment, especially given that it is highly prevalent, in developing telemedicine systems may further exacerbate access to care in this population. Adapting technologies for sensory needs is critical to the advancement of accessible dementia care through telemedicine.

Request the full text of this article from the Library

Dementia UK: Cultural and religious awareness within dementia care

Dementia UK | 15 April 2021 | Cultural and religious awareness within dementia care

There are an estimated 25,000 people in ethnic minority communities with dementia in the UK; there are varying experiences and care needs in each of these communities. While the number of white, British people with dementia is expected to double by 2051, the numbers of people from ethnic minorities is expected to increase seven-fold by the same time (Alzheimer’s society, 2019).

Asma Pandor is an Admiral Nurse at Gloucestershire Hospitals NHS Foundation Trust. Dementia UK develops, trains and supports her in this role. Asma has written this post on Dementia UK’s website, it underscores the importance in recognising cultural differences; and delivering culturally competent dementia care. Asma also reflects on her experiences as an Admiral Nurse of supporting families and also provide training sessions to help build awareness of different cultures and religions.

Cultural and religious awareness within dementia care

Feeling fearful and lonely are indicative experiences of emotional distress for people with dementia

Gruber R, Schwanda MFeeling fearful and lonely are indicative experiences of emotional distress for people with dementiaEvidence-Based Nursing 2021;24:50-51.

Mixed-methods research set out to explore the following research questions as part of a review:

How can emotional distress be characterised for individuals with dementia?

What descriptions of emotional distress exist?

What explanations for emotional distress exist?’

The review found that, besides forgetfulness, feeling fearful, lonely, worried, angry or sad are additional psychological conditions in caring for people with dementia, which should not be overlooked. Feelings of fearfulness were the most frequently experienced for people with dementia.

This Commentary is published in BMJ title Evidence-Based Nursing 

The primary paper on which this commentary is based on an earlier study Emotional distress with dementia: A systematic review using corpus‐based analysis and meta‐ethnography, which is available from the International Journal of Geriatric Psychiatry