Setting personal goals for dementia care

Research finds that goal setting may help people with dementia work with healthcare professionals and caregivers to identify and achieve realistic goals that are most important to them. | Journal of the American Geriatrics Society | News Medical

New research published in the Journal of the American Geriatrics Society has concluded that “goal attainment scaling” (GAS) can be used in clinical care to help people with dementia and their caregivers set and achieve personalised health goals.

old-690842_1920The researchers developed a process for using GAS to set goals and to measure whether participants reached those goals. In a first phase of the study, they tested goal setting with 32 people who had dementia and their caregivers.

In the next phase, the dementia care managers helped an additional 101 people with dementia and their caregivers set care goals. The research team used a scale to measure how well the participants achieved their goals 6 and 12 months after setting them.

Most often, the goals focused on improving quality of life for the person with dementia, followed by caregiver support goals. Some commonly chosen goals for the person with dementia included:

  • Maintaining physical safety
  • Continuing to live at home
  • Receiving medical care related to dementia
  • Avoiding hospitalization
  • Maintaining mental stimulation
  • Remaining physically active

Commonly chosen caregiver goals included:

  • Maintaining the caregiver’s own health
  • Managing stress
  • Minimizing family conflict related to dementia caregiving

Full story: Personalized goal setting to improve dementia care | News Medical

Full reference: Lee A. Jennings et al. | Personalized Goal Attainment in Dementia Care: Measuring What Persons with Dementia and Their Caregivers Want | Journal of the American Geriatrics Society | 2018

 

Dementia patients could remain at home longer thanks to ground breaking technology

Innovative new technology could enable people with dementia to receive round the clock observation and live independently in their own homes, a new study reports. | University of Surrey | via ScienceDaily

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Researchers from the University of Surrey in partnership with Surrey and Borders Partnership NHS Foundation Trust have developed state of the art Artificial  technologies, powered by machine learning algorithms, to monitor the wellbeing of people with dementia.

The study known as Technology Integrated Health Management (TIHM) for dementia, uses the ‘Internet of Things,’ a network of internet enabled devices (sensors, monitors and trackers) installed in homes, which can detect an immediate crisis as well as changes in people’s health and daily routines. Any change could indicate a potential health issue and if identified early could prevent a person from becoming seriously unwell and requiring emergency hospital admission.

The well-being of people with dementia can also be monitored using this innovative technology which can detect agitation and irritability.

Full story at ScienceDaily

Journal reference:  Shirin Enshaeifar, S. et al. | Health management and pattern analysis of daily living activities of people with dementia using in-home sensors and machine learning techniques | PLOS ONE |  2018; 13 (5):

 

 

Rehabilitation in dementia care

Rehabilitation in dementia care | Age and Ageing

Abstract:

Multidisciplinary rehabilitation is increasingly accepted as valuable in the management of chronic disease. Whereas traditional rehabilitation models focussed on recovery, maintaining independence and delaying functional decline are now considered worthwhile aims even where full recovery is not feasible.

Despite this, rehabilitation is notably absent from dementia care literature and practice. People with dementia report frustration with the lack of availability of structured post-diagnosis pathways like those offered for other conditions.

Alternative terms such as ‘re-ablement’ are used to refer to rehabilitation-like services, but lack an evidence-base to guide care.

This commentary will discuss possible reasons for the resistance to accept multidisciplinary rehabilitation as part of dementia care, and identifies the value of doing so for people with dementia, their families, and for health professionals.

Full reference: Cations, M et al. |  Rehabilitation in dementia care | Age and Ageing Volume 47, Issue 2, no.1 | March 2018 |  Pages 171–174

A roadmap to advance dementia research in prevention, diagnosis, intervention, and care by 2025

Pickett JBird CBallard C, et al. | A roadmap to advance dementia research in prevention, diagnosis, intervention, and care by 2025 | International Journal of Geriatric Psychiatry  201817

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  • A broad-based taskforce of researchers, clinicians, UK funders of dementia research, people with dementia, and carer representatives was convened to generate consensus on research ambitions in prevention, diagnosis, intervention, and care for people with dementia.
  • Five goals and 30 recommendations that align with current national dementia strategies and plans were produced. A 10-point action plan was developed to support the delivery of these goals.

Abstract

Objective

National and global dementia plans have focused on the research ambition to develop a cure or disease-modifying therapy by 2025, with the initial focus on investment in drug discovery approaches. We set out to develop complementary research ambitions in the areas of prevention, diagnosis, intervention, and care and strategies for achieving them.

Methods

Alzheimer’s Society facilitated a taskforce of leading UK clinicians and researchers in dementia, UK funders of dementia research, people with dementia, and carer representatives to develop, using iterative consensus methodology, goals and recommendations to advance dementia research.

Results

The taskforce developed 5 goals and 30 recommendations. The goals focused on preventing future cases of dementia through risk reduction, maximising the benefit of a dementia diagnosis, improving quality of life, enabling the dementia workforce to improve practice, and optimising the quality and inclusivity of health and social care systems. Recommendations addressed gaps in knowledge and limitations in research methodology or infrastructure that would facilitate research in prioritised areas. A 10-point action plan provides strategies for delivering the proposed research agenda.

Conclusions

By creating complementary goals for research that mirror the need to find effective treatments, we provide a framework that enables a focus for new investment and initiatives. This will support a broader and more holistic approach to research on dementia, addressing prevention, surveillance of population changes in risk and expression of dementia, the diagnostic process, diagnosis itself, interventions, social support, and care for people with dementia and their families.

Full document: A roadmap to advance dementia research in prevention, diagnosis, intervention, and care by 2025

Home support services in later stage dementia

Kampanellou, E at al. | Carer preferences for home support services in later stage dementia  | Aging and Mental Health | Published online: 01 Nov 2017

Objectives: To examine the relative importance of different home support attributes from the perspective of carers of people with later-stage dementia.

Method: Preferences from 100 carers, recruited through carers’ organisations, were assessed with a Discrete Choice Experiment (DCE) survey, administered online and by paper questionnaire. Attributes were informed by an evidence synthesis and lay consultations. A conditional logit model was used to estimate preference weights for the attributes within a home support ‘package’.

Results: The most preferred attributes were ‘respite care, available regularly to fit your needs’ (coefficient 1.29, p = < 0.001) and ‘home care provided regularly for as long as needed’ (coefficient 0.93, p = < 0.001). Cost had a significant effect with lower cost packages preferred. Findings were similar regardless of the method of administration, with respite care considered to be the most important attribute for all carers. Carers reported that completing the DCE had been a positive experience; however, feedback was mixed overall.

Conclusions: These carer preferences concur with emerging evidence on home support interventions for dementia. Respite care, home care and training on managing difficulties provided at home are important components. Carers’ preferences revealed the daily challenges of caring for individuals with later stage dementia and the need for tailored and specialised home support.

 

Enabling People with Dementia to Remain at Home: A Housing Perspective

Published to coincide with World Alzheimer’s Month this report has been produced on behalf of the Dementia and Housing Working Group, and supported by partners Homeless Link, Foundations and the Life Story Network

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Image source: Housing LIN

The report and the accompanying Executive Summary set out the key role housing providers, and in particular social housing providers, can play in supporting people living with dementia to stay independent in the home of their choice for as long as possible. Its findingse are divided into ones directly relevant to those working in the housing sector and those that provide a platform for wider application; for example, to become more dementia-friendly.

Practical problems preventing people with dementia from living at home

Although the majority of people with dementia wish to age in place, they are particularly susceptible to nursing home admission | Geriatric Nursing

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Nurses can play an important role in detecting practical problems people with dementia and their informal caregivers are facing and in advising them on various ways to manage these problems at home.

Six focus group interviews (n = 43) with formal and informal caregivers and experts in the field of assistive technology were conducted to gain insight into the most important practical problems preventing people with dementia from living at home. Problems within three domains were consistently described as most important: informal caregiver/social network-related problems (e.g. high load of care responsibility), safety-related problems (e.g. fall risk, wandering), and decreased self-reliance (e.g. problems regarding self-care, lack of day structure).

To facilitate aging in place and/or to delay institutionalization, nurses in community-based dementia care should focus on assessing problems within those three domains and offer potential solutions.

Full reference: Thoma-Lürken, T. et al. (2017) Facilitating aging in place: A qualitative study of practical problems preventing people with dementia from living at home. Geriatric Nursing. Published online: 14 June 2017