Virtual reality can improve quality of life for people with dementia

Virtual reality (VR) technology could vastly improve the quality of life for people with dementia by helping to recall past memories, reduce aggression and improve interactions with caregivers, new research has discovered | University of Kent | via ScienceDaily

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Many people with dementia (PWD) residing in long-term care may face barriers in accessing experiences beyond their physical premises; this may be due to location, mobility constraints, legal mental health act restrictions, or offence-related restrictions.

In recent years, there have been research interests towards designing non-pharmacological interventions aiming to improve the Quality of Life (QoL) for PWD within long-term care.

The authors of this study explored the use of Virtual Reality (VR) as a tool to provide 360°-video based experiences for individuals with moderate to severe dementia residing in a locked psychiatric hospital.

The paper discusses the appeal of using VR for PWD, and the observed impact of such interaction. It also presents the design opportunities, pitfalls, and recommendations for future deployment in healthcare services. This paper demonstrates the potential of VR as a virtual alternative to experiences that may be difficult to reach for PWD residing within locked setting.

Full article: Tabbaa, L. et al. |  Bring the Outside In: Providing Accessible Experiences Through VR for People with Dementia in Locked Psychiatric Hospitals | Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, 2019 | DOI: 10.1145/3290605.3300466

See also: VR can improve quality of life for people with dementia | ScienceDaily

Reducing anxiety, agitation, and aggression in older people with dementia

Wendy Moyle et al. | Can lifelike baby dolls reduce symptoms of anxiety, agitation, or aggression for people with dementia in long-term care? Findings from a pilot randomised controlled trial | Aging & Mental Health | Published online: 24 November 2018

Abstract
Objectives: To compare a lifelike baby doll intervention for reducing anxiety, agitation, and aggression in older people with dementia in long-term care (LTC), with usual facility care; and explore the perceptions of care staff about doll therapy.

Method: Pilot, mixed-methods, parallel, randomised controlled trial, with follow-up semi-structured interviews. Thirty-five residents from five LTC facilities in Queensland, Australia were randomised to the lifelike baby doll intervention (three, 30-minute, individual, non-facilitated sessions per week) or usual care. Outcomes were changes in levels of anxiety, agitation, and aggression after the 3-week intervention, and short-term effects at week 1. Following intention-to-treat principles, repeated measure MANOVA was undertaken. Qualitative interviews involved five staff.

Results: The doll intervention did not significantly reduce residents’ anxiety, agitation, or aggression when compared to usual care at weeks 3 (primary outcome) and 1 (secondary outcome). However, there was a significant group-by-time interaction for the outcome of pleasure – the doll group showed a greater increase in displays of pleasure at week 3 compared to baseline than usual care. Staff perceived benefits for residents included emotional comfort, a calming effect, and providing a purposeful activity. Perceived limitations were that doll therapy may only be suitable for some individuals, some of the time, and the potential for residents to care for the doll at the expense of their health.

Conclusions: Doll therapy can provide some residents with enjoyment and purposeful engagement. Further research should focus on understanding the individual characteristics and circumstances in which residents most benefit.

Full abstract available here

Management of behavioral and psychological symptoms in people with Alzheimer’s disease

Kales, H. et al. | Management of behavioral and psychological symptoms in people with Alzheimer’s disease: an international Delphi consensus | Published online: August 2018

Objectives:
Behavioral and psychological symptoms of dementia (BPSD) are nearly universal in dementia, a condition occurring in more than 40 million people worldwide. BPSD present a considerable treatment challenge for prescribers and healthcare professionals. Our purpose was to prioritize existing and emerging treatments for BPSD in Alzheimer’s disease (AD) overall, as well as specifically for agitation and psychosis.

Design:
International Delphi consensus process. Two rounds of feedback were conducted, followed by an in-person meeting to ratify the outcome of the electronic process.

Settings:
2015 International Psychogeriatric Association meeting.

Participants:
Expert panel comprised of 11 international members with clinical and research expertise in BPSD management.

Results:
Consensus outcomes showed a clear preference for an escalating approach to the management of BPSD in AD commencing with the identification of underlying causes. For BPSD overall and for agitation, caregiver training, environmental adaptations, person-centered care, and tailored activities were identified as first-line approaches prior to any pharmacologic approaches. If pharmacologic strategies were needed, citalopram and analgesia were prioritized ahead of antipsychotics. In contrast, for psychosis, pharmacologic options, and in particular, risperidone, were prioritized following the assessment of underlying causes. Two tailored non-drug approaches (DICE and music therapy) were agreed upon as the most promising non-pharmacologic treatment approaches for BPSD overall and agitation, with dextromethorphan/quinidine as a promising potential pharmacologic candidate for agitation. Regarding future treatments for psychosis, the greatest priority was placed on pimavanserin.

Conclusions:
This international consensus panel provided clear suggestions for potential refinement of current treatment criteria and prioritization of emerging therapies.

Lighting intervention improves sleep and mood for Alzheimer’s patients

A tailored lighting intervention in nursing homes can positively impact sleep, mood and behavior for patients with Alzheimer’s disease, according to preliminary findings from a new study | American Academy of Sleep Medicine | via ScienceDaily

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People with Alzheimer’s disease and related dementias may experience sleep problems, wandering, and associated daytime irritability. This study tested whether a tailored daytime lighting intervention could improve sleep and behavior in Alzheimer’s patients living in long-term care facilities.

The study involved 43 subjects diagnosed with Alzheimer’s disease and related dementias who were exposed to an active and inactive tailored lighting intervention for successive 4-week periods. Compared to baseline and to the inactive lighting condition, the lighting intervention significantly decreased sleep disturbances, depression and agitation. While all measures improved, the most significant improvement was seen in sleep quality.

Full story at ScienceDaily

Further detail: American Academy of Sleep Medicine

 

Discussing the MARQUE Study – Managing Agitation in Dementia

University College London  | MARQUE

Scientists at University College London (UCL) are involved in MARQUE (Managaing Agitation and Raising Quality of life), a five year long study taking place all over England. MARQUE aims to increase knowledge about dementia, agitation and personhood. Agitation is extremely common in people with dementia and causes distress to themselves, family carers and paid carers. Agitation is currently tackled on an individual level, not an organisation level (via UCL).

The research responds to the government’s ‘Challenge on Dementia’ and aims to

  • Build on theories of personhood in dementia to understand agitation, resilience and compassion to improve public debate and discourse.
  • Make agitation as much as a part of dementia care as risk assessment.
  • To improve and maintain quality of life in people with dementia whether at home, in a care home or in hospital.

More information about MARQUE can be found from UCL here 

A podcast has been released by Dementia Researcher, in it researchers Francesca La Frenais, and Dr Penny Rapaport from the Division of Psychiatry at UCL talk about the MARQUE Study, and how their work is helping us to understand what causes agitation. The scientists also explain how the interventions tested in this study are improving quality of life for those living with dementia, and helping carers.

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Image source: dementiaresearcher.nihr.ac.uk

You can listen to the podcast at Dementia Reseracher

Alternatively, you can listen via SoundCloud 

Dementia Researcher |  April 2018 | Discussing the MARQUE Study – Managing Agitation in Dementia