Exploring the health and well-being benefits of singing for people with dementia and their carers

Osman, S.E. et al. (2016) Dementia. 15(6) pp. 1326-1339

microphone-1674903_960_720Dementia has detrimental effects on cognitive, psychological and behavioural functioning, as well as significant impact on those who provide care. There is a need to find suitable psychosocial interventions to help manage the condition, enhance well-being, and to provide support for caregivers. This study explored the impact of Singing for the Brain™, an intervention based on group singing activities developed by The Alzheimer’s Society for people with dementia and their carers. This qualitative study used semi-structured interviews with people with dementia and their carers. Ten interviews involving 20 participants were analysed thematically. Social inclusiveness and improvements in relationships, memory and mood were found to be especially important to participants. As well as enjoying the sessions, participants found that attending Singing for the Brain™ helped in accepting and coping with dementia.

Read the article here

Dementia caregivers’ coping with pre-death grief: effects of a CBT-based intervention

Meichsner, F. & Wilz, G. Aging & Mental Health. Published online: 28 Oct 2016

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Image source: Jasmine Parker – Wellcome Images // CC BY-NC-ND 4.0

Objectives: Pre-death grief plays a significant role in dementia caregiving, and has adverse impacts on caregivers. It was the purpose of the present study to examine whether a cognitive-behavioral intervention including a grief intervention module could increase caregivers’ coping with pre-death grief and whether these effects could be maintained as of a six-month follow-up assessment.

Method: In a randomized-controlled trial examining the effectiveness of a cognitive-behavioral intervention, 273 caregivers were allocated to either an intervention or control group. Intervention group participants received 12 therapy sessions over six months; all participants completed a measure of pre-death grief. The analysis was conducted using latent change models. In the first model, study group was included as a predictor of change in pre-death grief; subsequent models also included care situation and sociodemographic variables.

Results: The burden due to pre-death grief was reduced for intervention but not control group participants at the time of the six-month follow-up assessment (Cohen’s d = −0.361). When controlling for changes in the care situation and sociodemographic variables, the treatment effect was also found in the assessment completed post intervention (Cohen’s d = −0.248).

Conclusion: Results indicate that a cognitive-behavioral intervention including grief-specific strategies can successfully foster caregivers’ coping with loss and reduce burden of pre-death grief.

Read the full article here

Improved decision support in the assessment and management of pain for people with dementia in hospital

Closs, S.J. et al. NIHR. Published online: October 2016

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It is difficult for people with dementia to communicate their pain to health-care professionals. Pain often has damaging effects on mental and physical health, and research has shown that pain is often poorly managed in people with dementia in hospital.

We aimed to develop a new system that would help staff to manage pain. To this end, we first identified any accurate and reliable pain assessment tools available for use with hospital patients who have dementia. We then explored how pain is currently recognised, assessed and managed in people with dementia in four hospitals in England and Scotland.

We found 28 pain assessment tools which had been reviewed, but none had been tested rigorously. Seven had potentially useful features, but no single tool could be recommended for wider use. The 11 hospital wards studied were all different, with their own complex pain assessment and management practices. Information from different staff and carers was produced at different times and in different formats, and was recorded in separate documents. This information was mentally pulled together into an ‘overall picture’ of pain by each staff member for each individual patient.

We suggest developing a combined education package and electronic health record, the Pain And Dementia Decision Support (PADDS) intervention, to help staff recognise, assess and manage pain. This should incorporate carer input, staff narratives, pain histories, intensity assessments, medication and other interventions provided, and present an overall picture of pain in an integrated and easily accessible visual format. This will require thorough development and testing.

Read the full report here

Public unaware of the factors that increase the risk of dementia

Just 2% of people in Britain can identify all the health and lifestyle factors that can increase risk of developing dementia. | Public Health England

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Image source: http://www.natcen.ac.uk/

More than a quarter (28%) of the British public is unable to correctly identify any potentially modifiable risk factor for developing dementia, according to new findings from the British Social Attitudes survey, which was commissioned by Public Health England (PHE).

 

The survey, carried out by the National Centre for Social Research (NatCen), asked the public if they could identify any of the following risk factors: heavy drinking, smoking, high blood pressure, depression and diabetes as well as the protective factor of taking regular exercise and found just 2% of the public is able to identify all of them.

Also, more than 1 in 4 people (27%) in Britain incorrectly believe that there is nothing anyone can do to reduce their risks of getting dementia. There is growing evidence that a third of dementia cases could be a result of factors potentially in our control, and actions like taking regular exercise and not smoking can reduce your risk of developing it. This means there is huge potential for prevention.

Full report: Attitudes to dementia: Findings from the 2015 British Social Attitudes survey

Assistive technologies at home for people with a memory disorder

Nauha, L. et al. Dementia. Published online: October 20 2016

The aim of this study was to assess in practice whether assistive technologies support and facilitate the work of a family caregiver or care staff, and whether these technologies support the independence of a person with a memory disorder.

A comprehensive set of supportive devices and alarm systems were experimentally tested in the care of five test subjects in an assisted living facility by eight nurses, and in the care of four test subjects in a home environment by three family caregivers and one care team. Questionnaires, diaries and logged data were used to evaluate the benefits of the devices. Simple aids and alarm systems that did not need much adjusting were considered most useful by caregivers and nurses, though multiple false alarms occurred during the test period. Technical connection problems, complex user interface, and inadequate sound quality were the primary factors reducing the utility of the tested devices.

Further experimental research is needed to evaluate the utility of assistive technologies in different stages of a memory disorder.

Read the full article here

Reminiscence groups for people with dementia and their family carers: REMCARE trial

Collier, E. The Mental Elf Blog. Published online: 24 October 2016

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Reminiscence groups are a popular activity for people with dementia. It is an interesting and pleasurable activity that encourages empathy, good relationships and social interaction between people with dementia and others.

The benefits of participating in reminiscence groups for people with dementia seems to have a reasonably good evidence base (Woods et al 2005; Huang et al 2015), but the trial reviewed here (Woods et al, 2016) aimed to investigate the effectiveness of running reminiscence groups including people with dementia and their family carer. It also examined the cost effectiveness of the intervention.

Read the full analysis here

Read the original research here

Outdoor access for people living with dementia

Elaine Argyle, Tom Dening & Peter Bartlett (2016): Space, the final
frontier: outdoor access for people living with dementia, Aging & Mental Health, DOI:
10.1080/13607863.2016.1222351

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Studies have consistently found that access to outdoor space has a positive impact on the mental and physical well-being of people with dementia. Benefits are often linked to an affinity with nature and outdoor settings.

Specific benefits of going outside expressed by people with dementia include interaction with others, aesthetic appreciation, exercise and a sense of freedom. For those living in care homes, where privacy tends to be lacking, additional benefits of outdoor access can also potentially include the experience of being alone and in a peaceful place.

This editorial suggests that access to the outdoors is central to the promotion of the human rights and social inclusion of people with dementia. It also explore the barriers and facilitators to the achievement of this access.

Read the full editorial here

Care-planning intervention for people living with early-stage dementia

Orsulic-Jeras, S.  et al. The SHARE program for dementia: Implementation of an early-stage dyadic care-planning intervention. Dementia. Published online before print October 13, 2016.

 

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This article describes the implementation of SHARE (Support, Health, Activities, Resources, and Education), a counseling-based care-planning intervention for persons living with early-stage dementia and their family caregivers (CGs).

The foundation of SHARE is built upon assessing and documenting the person living with dementia’s care values and preferences for future care. Using the SHARE approach, CGs are given an opportunity to achieve an understanding of their loved one’s desires before the onset of disease progression when the demand for making care decisions is high.

Through working together with a SHARE Counselor, the care dyad begins to identify other sources of support, such as family and friends and service providers, in order to build a more balanced and realistic plan of care for the future.

Data were collected from 40 early-stage dementia care dyads to determine the acceptability of having structured discussions about future care in the early stages of dementia.

Findings from this study demonstrate the importance of planning in the early stages when persons with dementia can voice their care values and preferences for future care. Finally, this paper illustrates the use of supportive strategies such as rapport building, establishing buy-in, and communication to initiate care-related discussions with care dyads in the early stages that will help lead to more effective decision making in the future.

Environmental risk factors for dementia: a systematic review

Killin, L et. al. Environmental risk factors for dementia: a systematic review. BMC Geriatrics. Published 12 October 2016

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Abstract

Background
Dementia risk reduction is a major and growing public health priority. While certain modifiable risk factors for dementia have been identified, there remains a substantial proportion of unexplained risk. There is evidence that environmental risk factors may explain some of this risk. Thus, we present the first comprehensive systematic review of environmental risk factors for dementia.

Methods
We searched the PubMed and Web of Science databases from their inception to January 2016, bibliographies of review articles, and articles related to publically available environmental data. Articles were included if they examined the association between an environmental risk factor and dementia. Studies with another outcome (for example, cognition), a physiological measure of the exposure, case studies, animal studies, and studies of nutrition were excluded. Data were extracted from individual studies which were, in turn, appraised for methodological quality. The strength and consistency of the overall evidence for each risk factor identified was assessed.

Results
We screened 4784 studies and included 60 in the review. Risk factors were considered in six categories: air quality, toxic heavy metals, other metals, other trace elements, occupational-related exposures, and miscellaneous environmental factors. Few studies took a life course approach. There is at least moderate evidence implicating the following risk factors: air pollution; aluminium; silicon; selenium; pesticides; vitamin D deficiency; and electric and magnetic fields.

Conclusions
Studies varied widely in size and quality and therefore we must be circumspect in our conclusions. Nevertheless, this extensive review suggests that future research could focus on a short list of environmental risk factors for dementia. Furthermore, further robust, longitudinal studies with repeated measures of environmental exposures are required to confirm these associations.

Read the full article here

Young onset dementia: Negotiating future workplace roles and identities

Roach, P. Young onset dementia: Negotiating future workplace roles and identities
Dementia 1471301216674420, first published  October 9 2016

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In this Dementia editorial, Pamela Roach writes of the need to educate employers in ways of working with younger people with dementia, of supporting such individuals to maintain the person in employment such as by modifying activities and negotiating new horizons of work productivity. Through such education, understanding and consideration of mutual goals and needs – the needs of an employer being balanced with the needs of a person with dementia – it is also possible to maintain purposeful activity for younger people with dementia.

Read the full editorial here