Experiences of attending day care services designed for people with dementia

Margit Gausdal Strandenæs et al. | Experiences of attending day care services designed for people with dementia – a qualitative study with individual interviews |  Aging and Mental Health | Published online 27th March 2017

Objectives: Day care is assumed to promote independence in home-dwelling people with dementia, increase well-being and enhance social stimulation. Few studies have directly engaged people with dementia to better understand the benefits and impacts of such services. The aim of this study was to explore attendees’ experiences with day care designed for people with dementia.

Method: This study had a qualitative descriptive design and included individual interviews with 17 users attending day care. The analysis was undertaken using content analyses.

Results: The participants reported that day care had a positive influence on their physical functioning, cognition, well-being, and situation at home because they were provided with social stimulation, meals, and activities. Day care contributed to the maintenance of a rhythm and structure in everyday life. Furthermore, the staff contributed to making the day care a safe place to be and enhanced a sense of belonging.

Conclusion: This study reveals the positive impact of day care on the daily lives of people with dementia because this service contributes to the enhancement of activities and social support, prevents isolation, and enhances practical and cognitive functioning as experienced by the users. The staff has a major impact on the experience of the participants in the day care.

An adapted mindfulness intervention for people with dementia in care homes

Clarke, A.C. et al. International Journal of Geriatric Psychiatry. Published online: 7 February 2017

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Objective: Depression and anxiety are common in dementia. There is a need to develop effective psychosocial interventions. This study sought to develop a group-based adapted mindfulness programme for people with mild to moderate dementia in care homes and to determine its feasibility and potential benefits.

Conclusions: The intervention was feasible in terms of recruitment, retention, attrition and acceptability and was associated with significant positive changes in quality of life. A fully powered randomised controlled trial is required.

Read the full abstract here

Factors associated with the quality of life of family carers of people with dementia

Farina, N. et al. Alzheimer’s & Dementia. Published online: 3 February 2017

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Introduction: Family carers of people with dementia are their most important support in practical, personal, and economic terms. Carers are vital to maintaining the quality of life (QOL) of people with dementia. This review aims to identify factors related to the QOL of family carers of people with dementia.

Discussion: The quality and level of evidence supporting each theme varied. We need further research on what factors predict carer QOL in dementia and how to measure it.

Read the full article here

Social health in dementia

Social health in dementia. Towards a positive dementia discourse | Marjolein de Vugt and Rose-Marie Dröes  | Aging & Mental Health  Vol. 21 , Iss. 1,2017

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Abstract:

A shift in focus from symptoms and disability towards the capacity and potential of the person with dementia is urgently needed to create a more balanced view of dementia and a more dementia-friendly society, which enables people and their families to adapt to the changes dementia brings in their lives.

The new concept of social health suggested by Huber and colleagues seems helpful to make such a shift. In this dedicated special issue, a consensus-based operationalization of the concept of social health in dementia is proposed and several aspects of social health and related dementia care are addressed within the framework of European collaborative projects of the INTERDEM network.

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

Determinants of quality of life in young onset dementia

Millenaar, J. et al. Aging & Mental Health. Published online: 27 September 2016

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Background: Promoting adaptation, improving well-being and maintaining an optimal quality of life (QOL) is an important aspect in dementia care. The purpose of this study was to identify determinants of QOL in young onset dementia, and to assess differences in QoL domains between people with Alzheimer’s disease (AD) and frontotemporal dementia (FTD).

Methods: In total 135 persons with AD and 58 persons with FTD were included from two prospective cohort studies. QOL was assessed with the proxy reported quality of life in Alzheimer’s disease questionnaire (QoL-AD). Possible determinants were explored using multiple linear regression and included sociodemographic variables, diagnosis, dementia severity, disease awareness, neuropsychiatric symptoms, met and unmet needs and hours of personal and instrumental care. Differences between QOL domains in people with AD and FTD were calculated using Mann-Whitney U tests.

Results: Lower QOL was associated with more depressive symptoms, lower disease awareness, and a higher amount of needs, both met and unmet. People with AD scored lower on the memory and higher on the friends’ subscale. No differences were found for the other items.

Conclusion: This study demonstrates a unique set of determinants of QOL in AD and FTD. Interventions directed towards these specific factors may improve QOL.

Read the abstract here

Does a dementia diagnosis have a silver lining? Study suggests it can.

ScienceDaily. Published online: 25 July 2016

heart-1213475_960_720Results from a study of patients with a diagnosis of mild cognitive impairment or early dementia indicates that their outlook isn’t as dark as expected.

A group of scientists from the University of Kentucky’s Sanders-Brown Center on Aging asked 48 men and women with early dementia or mild cognitive impairment (MCI) a series of questions about their quality of life and personal outlook post-diagnosis.

Called the Silver Lining Questionnaire (SLQ), the instrument measures the extent to which people believe their illness has had a positive benefit in areas such as: improved personal relationships, greater appreciation for life, positive influence on others, personal inner strength and changes in life philosophy. The SLQ has been administered previously to patients with cancer diagnoses, but hasn’t been given to MCI/dementia patients, according to Gregory Jicha, MD, PhD, a professor at the Sanders-Brown Center on Aging and the study’s lead author.

Positive responses were even higher on certain scores, such as:

  • appreciation and acceptance of life
  • less concern about failure
  • self-reflection, tolerance of others, and courage to face problems in life
  • strengthened relationships and new opportunities to meet people.

Read the full story here

Differences in quality of life in home-dwelling persons and nursing home residents with dementia

Olsen, C et al. Differences in quality of life in home-dwelling persons and nursing home residents with dementia – a cross-sectional study.  BMC Geriatrics published 11 July 2016

Background

Dementia often eventually leads to dependency on others and finally to residential care. However, in Norway about half of the dementia population lives at home, due to individual and political wishes. There is scarce and inconclusive knowledge of how living in a nursing home differs from living at home for persons with dementia (PWDs) with regard to their quality of life (QoL). The first aim of the study was therefore to compare QoL, cognitive and physical functions, social contacts, sleep patterns, physical activity levels, exposure to light, and medication of PWDs in nursing homes and home-dwelling PWDs, and whether living in nursing homes was associated with a lower QoL than living at home for PWDs. A second aim was to examine if possible differences between residencies in QoL were consistent over time.

Methods

The cross-sectional study was based on baseline data from two RCT studies of PWDs. A total of 15 nursing homes with adapted units for PWDs and 23 adapted day care centres for home-dwelling PWDs recruited 78 and 115 participants respectively. Trained nurses scored sociodemographic data, level of dementia (on the Clinical Dementia Rating scale), amount of medication, and QoL (QUALID). Sleep patterns, physical activity levels, and light exposure were measured by actigraphy. A multiple regression analysis was used to test the association between residency and QoL. The association between residency and change in QoL over time was investigated by linear regression analysis of a subsample with follow-up data.

Results

Home-dwelling PWDs showed significantly higher QoL than PWDs in nursing homes. This difference was maintained even after stratifying on the severity of dementia. Home-dwelling PWDs with moderate dementia showed significantly less use of walking aids, more social contact, higher levels of activity and exposure to daylight, and less use of psychotropic medications. The regression model explained 28 % of the variance in QoL in persons with moderate dementia. However, only residency contributed significantly in the model. Residency also significantly predicted negative change over time in QoL.

Conclusion

The study indicated that living at home as long as possible is not only desirable for economic or health political reasons but also is associated with higher QoL for persons with moderate dementia. More studies are needed to investigate how QoL could be increased for PWDs in nursing homes.

Full text available via BMC Geriatrics

Older peoples sensory experiences of the natural world

 Orr, N. et.al. How do older people describe their sensory experiences of the natural world? A systematic review of the qualitative evidence. BMC Geriatrics. Published: 1 June 2016

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Image source: Sandra – Flickr// CC BY-ND 2.0

Background

Despite the increased scholarly interest in the senses and sensory experiences, the topic of older people’s sensory engagement with nature is currently under researched. This paper reviews and synthesises qualitative research evidence about how older people, including those living with dementia, describe their sensory engagement with the natural world.

Methods

Ten databases were searched from 1990 to September 2014: MEDLINE (Ovid), MEDLINE-in-Process (Ovid), PsycINFO (Ovid), CINAHL (EBSCO), GreenFILE (EBSCO), ProQuest Sociology, ASSIA (ProQuest), International Bibliography of the Social Sciences (ProQuest); HMIC (Ovid); Social Policy and Practice (Ovid). Forward and backward citation chasing of included articles was conducted; 20 organizations were contacted to identify unpublished reports. Screening was undertaken independently by two reviewers.

Results

Twenty seven studies were included. Thematic analysis revealed that descriptions of sensory experiences are encompassed within six themes: descriptions from ‘the window’; sensory descriptions that emphasise vision; descriptions of ‘being in nature’; descriptions of ‘doing in nature’; barriers to sensory engagement; and meanings of being and doing in nature.

Conclusions

Older people derive considerable pleasure and enjoyment from viewing nature, being and doing in nature which, in turn has a positive impact on their wellbeing and quality of life. Future research could usefully explore how sensory engagement with nature could be used to stimulate reminiscences of places and people, and evoke past sensory experiences to enrich everyday life and maintain a sense of self.

click here to access the paper