Interprofessional Work Model for Dementia Care in Hospitals for Community-Based Care

In this manuscript the authors have studied interprofessional work model for dementia care in hospitals for community-based care. As present situations and problems of dementia patients in hospitals for community-based care, 8 core categories (19 categories) were extracted and as actual situations of interprofessional work for dementia care, 8 core categories (13 categories) were obtained. The authors examined a function of interprofessional work model and practice contents using these categories. The results revealed that better interprofessional work can be expected by six specialists of nurses rehabilitation specialists, MSW, pharmacists, dietitians and care workers developing dementia care based on “Family handling function” “ADL maintenance and improved function” “Staff member education and empowerment function”.

The Importance of Bringing the Family Together. Exploring the Experience and Meaning of Family Health Conversations in Dementia Care

Aim: The aim of this study was to investigate family members’ experience of engaging in the “Family Health Conversations” intervention. Methods: A qualitative study was conducted with 15 family members who engaged in the intervention. The study used semi-structured interviews and data were analysed using reflexive thematic analysis. Findings: Through analysis and interpretation of the data, three themes were identified: 1) Support for navigating in unknown waters;2) Bringing peace and relief to the family;3) Involving the relative with dementia in Family Health Conversations. Family Health Conversations showed were beneficial to the families of persons with dementia and of great importance to both individual family members and the family. Involving the person with dementia in the Family Health Conversations was not always beneficial for the family. Conclusion: Deciding when to involve the person with dementia in Family Health Conversations requires thorough knowledge of the family as well as the person with dementia, to avoid excluding them. The intervention supports retaining selfhood and autonomy for the person with dementia, even when the individual did not participate in the conversation.

“Care That Respects Individuality” Provided to Elderly People with Dementia as Perceived by Japanese Dementia Carers Qualified

The objective of this study was to clarify the contents of “care that respects individuality” provided to elderly people with dementia living in group homes as perceived by dementia carers qualified. We interviewed 21 dementia carers qualified working at group homes in Prefecture A about the practical contents of and their thoughts on “care that respects individuality”. The data obtained from the interviews were analyzed using the modified grounded theory approach (M-GTA). As a result, 14 concepts regarding the contents of “care that respects individuality” provided to elderly people with dementia living in group homes as perceived by dementia carers qualified were generated in the following 4 categories: “placing emphasis on the individual”, “respecting feelings”, “eliciting strengths”, and “close mutual relationship”.

Integrating Psychiatric Services into Comprehensive Dementia Care in the Community

Purpose: This study was conducted to clarify the utility of patient-held records as an integrated care approach for patients with dementia in the community. Method: We analyzed the family-held/patient-held records of patients with dementia in the community. The inclusion criteria in the study were as follows: 1) patient-held/family member-held records of patients with dementia in the community;2) patient-held records designed to share information across different professionals, direct-care staff members, and local government staff;and 3) the continuous participation of psychiatrists in the development and use of the patient-held records. Results: We identified eight sets of family-held/patient-held records in Japanese communities of various sizes, all of which were aimed at integrating information from various services, including information provided by medical and psychiatric professionals to the family and patient. Innovative tools have been available in the areas of the hopes and preferences of the patient, medication and monitoring, sharing information, and the use of information technology. Conclusion and Discussion: Family-held/patient-held records have potential as a tool to enhance the integrated care of people with dementia in the community.

Relatives’ experiences of everyday life when receiving day care services for persons with dementia living at home

Relatives often become involved in the care of people with dementia who are living at home. The caregivers’ burdens are extensively described in several studies, and one of the most common, unmet needs of the caregivers is the opportunity for daytime activities. The aim in this qualitative study is therefore to explore the everyday lives of eight relatives of people with dementia who are receiving day care services. A content analysis is used, and three major themes emerge and are discussed: 1) when life becomes chaotic;2) rebuilding a new, everyday life;and 3) the agonies of choice. The findings indicate that day care service offers respite care, and, at the same time, it gives both the relatives and those with dementia a meaningful day. These findings can also be described as relatives traveling a route from a situation characterized by chaos and suffering to a new life situation that has meaning through day care services. It is important to note that despite this new meaning in the relatives’ lives, the relatives continue to struggle with decisions about the futures of their loves ones in regard to the dilemma of placing them in an institution versus aging in place.

The Influence of Place on Everyday Life: Observations of Persons with Dementia in Regular Day Care and at the Green Care Farm

Day care services for persons with dementia are becoming an important aspect of community services. Place, therefore, becomes vital concerning how such establishments are organized regarding both the physical and social environment and the programs that are offered. The aim of this study was to describe the influence of place on everyday life in two different organized daycare services for persons with dementia. Based on observations and informal conversations with persons with dementia and staff members at a green care farm and a regular day care, we used an inductive manifest content analysis. The analysis reveals a main category: enabling and collaboration in daily life. The results are discussed in light of Goffman’s analysis of the structures of social encounters from the perspective of the dramatic performance. The main findings in this study involve how place contributes to enabling activities and collaboration between participants and staff, as it influences participants’ ability to achieve an active or passive role in everyday life at the day care services.

Effects of Hand Care Therapy on Reducing the Conversion Rate from MCI to Dementia and Role of COVID-19 as Non-Pharmacotherapy

Dementia needs to be addressed by various researchers to reduce the risk of morbidity and progression. And dementia was regarded as one of lifestyle-related diseases, and it is estimated that about 10% of MCI (Mild cognitive impairment) progresses to dementia in one year. In this study, we examined whether hand care therapy (HCT) as one of passive horticultural therapy was effective in preventing dementia/MCI. In result, the use of HCT was shown to be effective in preventing dementia and MCI illness and slowing progression. The elderly people tended to decrease iADL year by year, but the HCT group did not. In addition, the senile depressive tendency, which is said to be increasing year by year, tended to be reduced in the HCT-treated group. This is thought to be due to not only the healing effect of the massage by HCT treatment and the effect of transmitting the pleasant stimulus from the tactile sense to the frontal lobe, but also the true communication effect created by sitting gently and touching the hand. This HCT technique can improve the euphoria of the treated side and the treated side. Therefore, it can be expected that the autoimmunity of all people involved can be improved, and it can be judged to be promising as a preventive technique and non-pharmacotherapy for lifestyle-related diseases and various infectious diseases like COVID-19.

Rehabilitative Outcomes after Hip Fracture in a Special Care Unit for Persons with Dementia and Behavioral and Psychotic Symptoms

Aim: Hip fracture implies severe problems to older people;special concerns regard persons with dementia, due either to cognitive impairment, or to behavioral and psychic symptoms. This study illustrates rehabilitative outcomes of these patients discharged by a special care unit ruled by “GentleCare” principles. Method: 54 patients [89% females, aged 82.3 years (range 66 - 94)] followed a post-surgery rehabilitative program carried out by a physiotherapist and an occupational therapist, supported by a psychologist. The multidimensional assessment consisted of cognition evaluation (Mini Mental State Examination, Clinical Dementia Rating, Global Deterioration Scale), functional evaluation (Barthel Index, Tinetti Gait and Balance, Bedford Alzheimer Nursing Severity scale), behavioral evaluation (UCLA Neuropsychiatric Inventory) and comorbidity evaluation (Cumulative Illness Rating Scale). Results: All parameters improved, including the 5 most frequent behavioral and psychic symptoms that usually preclude admission in ordinary rehabilitation units. 24% of improvement in Barthel Index total score was explained by agitation and apathy at discharge, in a multiple linear regression model: better functional levels corresponded to smoother behavioral problems. Most patients improved;70.5% of them were discharged to home. Conclusion: A prosthetic approach enables valuable results in the rehabilitation of severely demented patients with hip fracture also in presence of behavioral symptoms.

Rural nurses’ perceptions of a volunteer program in an acute setting: Volunteers delivering person-centred care for patients with dementia and delirium

Community volunteers were recruited and trained to deliver person-centred care to patients with dementia or delirium in an acute hospital setting, in a small rural Australian hospital. The volunteer program was grounded in action research methodology, and modelled on a previous research project. As a form of evaluation, interviews were conducted with nursing staff eight weeks after implementation of the volunteer program to explore their opinions. Data were analysed through a collaborative process and findings revealed strong benefits from the perspectives of the nursing staff. These benefits included overall improved patient care and improved time management for nursing tasks.

“Being Free Like a Bird”―The Meaning of Being an Informal Caregiver for Persons with Dementia Who Are Receiving Day Care Services

Respite care in the form of day care is one of the several respite services that aims to provide temporary relief to informal caregivers from their responsibilities of caring for a person with dementia. The purpose of this study was to illuminate the meaning of being an informal caregiver for a person with dementia living at home and receiving day care services. Narrative interviews were conducted, and data were analyzed using the phenomenological hermeneutic method. Two main themes emerged: “Living with limitations in everyday life” and “Having a life besides being a caregiver”. The comprehensive understanding suggested living with a person with dementia, changes and influences the informal caregiver’s life through a set of new roles and a new way of living and thinking. The result is discussed in light of Goffman’s analysis of the structures of social encounters from the perspective of the dramatic performance.

Long-Term Active and Passive Horticultural Therapy Intervention for Elderly Patients with Moderate Dementia and AI Analysis of Medical Records and Care Documents

Background: Previous studies have shown that Hand Care Treatment, a form of passive horticultural therapy, is effective in preventing dementia and MCI and reducing the rate of progression. Due to the Covid-19 pandemic, various activity restrictions were implemented in Japan from March 2020, and the number of elderly people without care and rehabilitation will the number of elderly people without care and rehabilitation has been increasing. Purpose: Progression of cognitive, physical, and mental disability was examined for long-term horticultural therapy study subjects by level of care required. Methods: One subject who had been diagnosed with dementia and was residing in an elderly care facility and consented to a long-term study was selected. In addition to assessments using various evaluation forms, data recorded from time to time, including changes in care plans, were analyzed using text mining methods. Results: This subject tended to progress slowly from 1 to 2 care needs, but progressed from 3 to 5 care needs over a 2-year period. The results of the assessment chart test showed that cognitive impairment and IADL decreased with each increase in the level of care required, but DBD remained the same at the time of admission, even at 5 years of care required. A comparison of HCT and aroma intervention with and without aroma intervention during the nursing care level 1 showed that the improvement in physical, mental, and cognitive function was expected to be higher at the time of intervention. Text-mining inspections have revealed that during the period of nursing care level 1 - 5, active horticultural therapy techniques, and passive horticultural therapy techniques such as HCT and brain rejuvenation aromatherapy were found to betweenness centrality with each other. Conclusion: From the results of mean score of DBD, although the nursing care level has progressed from 1 to a maximum of 5, it can be concluded that the burden of care has not become heavier. There was no tendency for the progression of cognitive impairment in this subject to be faster than in the general AD population, despite the influences of Covid-19. The results indicated that caregiving techniques and active and passive horticultural therapy techniques in Japanese welfare facilities for the elderly are expected to be effective in preventing the progression of cognitive impairment.

Desired Lifestyle of Older Adults with Dementia Living at Home from Their Perspective and That of Their Families with Support from Care Providers

Objective: This study aimed to determine the lifestyle of older adults with dementia living at home, how their families perceive them, and how care providers support their desired lifestyle. Methods: Semi-structured interviews were conducted with 12 pairs of older adults with dementia, their families, and care providers followed by a qualitative descriptive study. Results: Older adults with dementia described their lifestyle as follows: “I continue to take pride in the way I have lived so far,” “I want to do what I can now even if I cannot do it well,” “I live peacefully with my family,” “I go out and interact with people,” and “I live this time today with care.” Families regarded the lifestyle of older adults with dementia as a desire “to continue living at home peacefully,” “to live on their own,” and that they “probably do not want anything.” Care providers’ support was based on “respect (for an older adult with dementia) as a person,” “drawing out and making use of what they can do with their current abilities through providing care,” “supporting families and confirming their sense of satisfaction with life,” and “predicting the future course and supporting decision-making.” Conclusions: To support the lifestyle of older adults with dementia, it is important to ensure that they continue to have dignity and are comfortable living with their families and in their communities without intimidation.

Caring for Individuals with Early-Onset Dementia and Their Family Caregivers: The Perspective of Health Care Professionals

The phenomenon of early-onset dementia remains an under-researched subject from the perspective of health care professionals. The aim of this qualitative study was to document the experiences and service needs of patients and their family caregivers for optimal clinical management of early-onset dementia from the perspective of health care professionals. A sample of 13 health care professionals from various disciplines, who worked with individuals who suffered from Alzheimer’s disease or related disorders and their family caregivers, took part in focus groups or semi-structured individual interviews, based on a life course perspective. Three recurrent themes emerged from the data collected from health care professionals and are related to: 1) identification with the difficult experiences of caregivers and powerlessness in view of the lack of services;2) gaps in the care and services offered, including the lack of clinical tools to ensure that patients under age 65 were diagnosed and received follow-up care, and 3) solutions for care and services that were tailored to the needs of the caregiver-patient dyads and health care professionals, the most important being that the residual abilities of younger patients be taken into account, that flexible forms of respite be offered to family caregivers and that training be provided to health care professionals. The results of this study provided some innovative guidelines for optimal clinical management of early-onset dementia in terms of the caregiver-patient dyad.

Caregivers'awareness regarding the care of dementia and the coping strategies among the caregivers of people with dementia:a cross-sectional study in Udupi District,Karnataka

Objectives:To assess the awareness and coping skills of the informal and formal caregivers of people living with dementia(PLWD).Dementia is a condition,which leads to memory loss and gradual deterioration of cognitive abilities in the affected person.The lack of awareness regarding the care of people with dementia and the caregivers'poor coping strategies can negatively impact caregivers'experiences.Methods:A cross-sectional survey was conducted among the 80 caregivers of PLWD from the psychiatric units of the selected hospitals of Udupi district,Karnataka,India.The baseline data were collected by a self-reported sociodemographic questionnaire.The“Dementia Knowledge Assessment Scale”was used to gauge participants'awareness of the care of people with dementia,while the“Brief COPE inventory,”a 28-item questionnaire,was used to gauge carers'coping mechanisms.Descriptive and inferential statistics were used for the data analysis using Jamovi(2.3.24),a graphical user interface for R programming,and Microsoft Excel.Results:Most of the caregivers(n=68,85%)had lesser awareness regarding the care of people with dementia.The mean coping strategies score was 60.9±7.71.There was a positive correlation between the awareness and the coping strategies scores among the caregivers(r=0.659,P<0.05).Conclusions:The caregivers of people with dementia often lack awareness about dementia and hence experience poor coping due to their high workload and stress.The frontline healthcare professionals and nurses need to provide appropriate interventions to the caregivers to improve their awareness about dementia and its care.

Effectiveness of Hand Care Therapy and Garden Walks That Are Conscious of the Stimulation of the Five Senses for Recovery of Cognitive and Mental and Physical Dysfunction Caused by COVID-19

The Japan Dementia Prevention Society conducted a questionnaire survey of dementia specialists conducted in August 2020. Regarding the worsening of symptoms in people with dementia, 8% answered that they “accept more” and 32% answered that they “recognize a minority”. In the previous research report (Open Journal of Therapy and Rehabilitation Vol.8 No.3), we examined whether hand care therapy (HCT) as one of the passive horticultural therapy was effective in preventing dementia/MCI. Start of the test in August 2018 (I: BL) to February 2020 (VII: 18M) was, the use of HCT was to be effective in preventing dementia and MCI illness and slowing progression. Due to the COVID19 pandemic, VIII (24M) was evaluated in August 2020, and IX (27M) also measured ANS during activity. At that time, they divided into the Group E who had refrained from welfare facilities for the elderly due to the influence of COVID19 and the Group F who HCT continued. In the evaluation of VIII (24M), it was found that the cognitive function of the Group E was significantly reduced compared to VII, and Group F did not show a significant decrease. ADL decreased and depressive symptoms increase by continuing a life with less going out due to the influence of COVID 19 regardless of the use of the facility. It became clear that both Group E and Group F show good changes in ANS balance in the IX. Therefore, by utilizing horticultural therapy that the power of nature and plants in addition to utilizing welfare facilities for the elderly, cognitive impairment in COVID 19. It was expected to lead to prevention and prevention of negative psychology and behavior such as depressive views and depressive tendencies. In the previous research report (Open Journal of Therapy and Rehabilitation Vol.8 No.3), we examined whether hand care therapy (HCT) as one of passive horticultural therapy was effective in preventing dementia/MCI. In the trend from the start of the test in August 2018 (I: BL) to February 2020 (VII: 18M) was, the use of HCT was shown to be effective in preventing dementia and MCI illness and slowing progression. Due to the COVID19 pandemic, various activity restrictions have been implemented in Japan since March 2020, and the number of elderly people who do not receive long-term care or rehabilitation has increased. Therefore, in August and November 2020, when the spread of COVID19 was reduced, cognitive function evaluation was carried out. At that time, they divided into the elderly group (Group E) who had refrained from welfare facilities for the elderly due to the influence of COVID19 and the elderly group (Group F) who HCT continued.

Relationships among Social Capital, Positive Aspect, and Caregiver Burden in Dementia Families: A Mediating Model

Objective: To investigate the current situation and influencing factors of care giving burden among family caregivers with dementia and to analyze the Positive Aspect of caregivers between Social Capital and Caregiver Burden. Methods: A total of 205 elderly dementia patients and family caregivers were select from 3 tertiary hospital by convenience sampling method in Zhengzhou. The general information questionnaire. The Social Capital Scale for Caregiver of People with Dementia, The Positive Aspect of Care giving scale and The Caregiver Burden Inventory were utilized for investigation. Results: In this study the scores of the Social Capital Scale of Caregivers with dementia were (48.76 ± 6.44), the scores of the Positive Aspect of Care giving scale were (37.41 ± 4.29), and the scores of the Caregiver Burden Inventory were (64.43 ± 10.89). The results of multiple linear regression analysis showed that patient’s age, patient’s disease duration, social capital, and positive feelings were the main influencing factors of caregiver’s burden of care (P Conclusion: The burden of family caregivers is at a medium-high level, and it is recommended that the medical, social levels fully mobilize the social support system of caregivers from the caregivers’ conditions, increase the level of the caregivers’ social capital, and pay attention to the positive feelings of the caregivers and regulate them in time social alleviate the burden of their care giving.

Functional Contentment Model: Optimizing Quality of Life for Nursing Home Residents with Dementia

The Functional Contentment Model (FCM) attains two objectives: 1) building a relationship focused plan of care for nursing home residents diagnosed with dementia;and 2) maximizing and maintaining older adults’ contentment, peace, and happiness while living in dementia care environments. There are three essential components within the FCM: 1) Person/Family Centered Care;2) Slow Medicine;and 3) Team Care Management. The principles of “Person/Family-Centered Care” are coupled with the philosophy of “Slow Medicine,” and neither can exist without the engagement of “Team Care Management.” In short, the FCM maximizes the older adult’s potential functioning in activities of daily living, cognition, gross and fine motor skills, communication, and physical well-being, while maintaining the highest possible level of contentment, peace, and happiness. This is accomplished through dynamically utilized professional modalities adapted to the changing needs of the older adult resident—pharmacologic, physical and occupational therapies, family education and involvement, dietary, spiritual, stimulating activities, as well as any individualized modality. The lead for operationalizing the Functional Contentment Model is the nursing home medical director, whose key role is assuring a team approach to care including the older adult resident, the family, and all staff (dietary, housekeeping maintenance as well as care and administrative staff). The FCM is a culture change model that has implications in practice and policy for each nursing home.

FORGET: Pilot of an Innovative and Simple History Based Screening Tool for Dementia Community Clinics and Acute Medical Hospitals

The aim of this study is to pilot FORGET as screening tool for dementia in community OP clinic and acute medical hospital assessments. Sample size included 30 each of memory clinic and acute medical hospital patients. Assessments included FORGET and MMSE. Psychometric test parameters were calculated for FORGET (Cut-off >1 in OP clinic and >3 in acute medical hospital). Of 30 referrals to memory clinic, 25 had dementia. A score >1 on FORGET had sensitivity 80%, specificity 80%, PPV 95.24%, NPV 44.44%, OR 16.00 (p = 0.02) for diagnosis of dementia. Of 30 acute hospital referrals, 20 had dementia. A score >3 on FORGET had sensitivity 95%, specificity 90%, PPV 95% and NPV 90%, OR 171 (p = 0.0005). FORGET at a score of >1 in community and >3 in acute medical hospital is a useful screening tool for dementia.

阿尔兹海默病护理领域研究热点及演进趋势分析

目的探索阿尔兹海默病(alzheimer's disease,AD)护理这一领域的研究现状及热点,为今后的研究提供参考和方向。方法通过运用数据分析软件CiteSpace 5.8.R3C对Web of Science核心数据库中2012—2022年期间关于阿尔兹海默病护理的高水平论文进行文献计量学分析,并进行可视化展示。结果Web of Science核心数据库纳入文献956篇,AD护理研究的需求度和关注度逐年上升,发文量最多的国家是美国(175篇),其次是法国(43篇)和中国(31篇);发文量最多的机构是明尼苏达大学和哈佛医学院(11篇),作者共现分析显示发文量最多的作者是法国科学院院士BRUNO VELLAS,关键词共现分析显示近十年研究热点主要集中在“护理院”“以人为本”和“生存质量”等领域,“长期护理”和“运动疗法”可能成为未来重点研究方向。结论未来研究应注重如何建立长期护理的社会保障机制、推行“以人为本”的人性化护理服务和制定适宜的运动训练项目。

New Spectacle on Dementia——Concern together brain healthy of humanity

Dementia is a syndrome due to brain disease and is characterized by a progressive,global deterioration in intellectual abilities,including memory, learning,orientation, language,comprehension, and judgment.