Auswahl der wissenschaftlichen Literatur zum Thema „Alzheimer Café“

Background: The Alzheimer Café is a psychosocial intervention shown to have benefits for family carers of people with dementia. Family carers experience a period of change across all aspects of their lives following the dementia diagnosis, and require new skills and tools to navigate these new landscapes. The objective of this research was to investigate family carers’ perspectives of the Alzheimer Café in Ireland, and explore how attendance may translate into broader benefits in their lives. This paper also provides an overview of Alzheimer Café models, which exist internationally. Methods: Semi-structured interviews were conducted with nine family carers of people with dementia who were currently attending or had attended an Alzheimer Café in the preceding six months. The research was conducted in three Alzheimer Cafés in Ireland. Data analysis was conducted using Braun and Clarke’s six step thematic analysis framework. Results: Community, atmosphere, activity and information were described as core features of the Alzheimer Café in Ireland. The Alzheimer Café was described as a community with a good atmosphere encompassing emotional support, friendship, equality and inclusion. Family carer also highlighted Alzheimer Cafés could potentially facilitate wider community awareness and engagement. The Alzheimer Café was shown to provide an activity which facilitated relationship building within care dyads as well as with other attendees. Several information streams were identified, including guest speaker input, attendees’ shared experiences, and specific advice from healthcare professionals. Conclusion: The Alzheimer Café offers strong personal support to family carers of people with dementia. Our findings suggest that Alzheimer Cafés can build family carers’ capacity to manage new social, environmental and cultural challenges associated with dementia. While it is important the Alzheimer Café is enjoyable, has useful information and is supportive, it is equally important that these features generate sustained improvements for family carers external to the Alzheimer Café.

Background: The Alzheimer Café is a psychosocial intervention shown to have benefits for family carers of people with dementia. Family carers of people with dementia experience a period of change across all aspects of their lives following a diagnosis of dementia, requiring the development of new skills and tools to navigate these new landscapes. The objective of this research is to investigate family carers’ perspectives of the Alzheimer Café in Ireland, and to explore how attendance may translate into broader benefits in their lives. This paper will also provide an overview of Alzheimer Café models, which exist internationally. Methods: This is a qualitative study using semi-structured interviews with nine family carers of people with dementia who were currently attending or have previously attended an Alzheimer Café in the preceding six months. The research was conducted in three Alzheimer Café sites in Ireland. Data analysis was conducted using Braun and Clarke’s six step framework for thematic analysis. Results: Community, atmosphere, activity and information were described as core features of the Alzheimer Café in Ireland for family carers. The Alzheimer Café was shown to provide a social outlet which facilitated relationship building within care dyads as well as with other attendees. Several information avenues were identified including broad overviews from guest speakers, attendees’ shared experiences, and specific advice from healthcare professionals. Conclusion: The Alzheimer Café offers strong personal support to family carers of people with dementia. It can also help to build family carers’ capacity to manage new social, environmental and cultural challenges associated with dementia. While it is important the Alzheimer Café is enjoyable, has useful information and is supportive, it is equally important that these features generate sustained improvements for family carers external to the Alzheimer Café.

ABSTRACTBackground: This paper describes the evaluation of the Memory Lane Café service in Victoria, Australia. The Alzheimer's Australia Vic Memory Lane Café model aims to provide a social and educational service to people living with dementia and their carers, family members or friends. Dementia is a serious health issue in Australia, with prevalence estimated at 6.5% of people over 65 years of age. Living with dementia has significant social and psychological ramifications, often negatively affecting quality of life. Social support groups can improve quality of life for people living with dementia.Methods: The evaluation included focus groups and surveys of people with dementia and their carers, staff consultation, service provider interviews, and researcher observation. The Melbourne Health Mental Health Human Research Ethics Committee approved the project. Participants included people with dementia (aged 60 to 93 years, previously enrolled in the Alzheimer's Australia Vic's six-week Living With Memory Loss Program), their carers, friends and/or family members, staff working in the Cafés, and service providers with links to the Cafés.Results: This evaluation found that Memory Lane Cafés promote social inclusion, prevent isolation, and improve the social and emotional well-being of attendees. However, Cafés did not meet the needs of all potential attendees.Conclusions: The evaluation recommended that existing Café services be continued and possibilities for extending the Cafés be explored. Based on evaluation outcomes, the Department of Health Victoria is funding four additional pilot programs in café style support services.

Purpose Dementia cafés (also known as Alzheimer’s or memory cafés) have been running in the UK since 2000. The purpose of this paper is to report on the recommendations from recent research that interviewed family carers on their experiences of using the cafés. Design/methodology/approach The research was carried out in cafés in and around London, and focussed on informal, unpaid carers’ experiences of using them. In total, 11 carers from five different dementia cafés were interviewed, using semi-structured questionnaires. The results were thematically analysed. Findings The findings showed that carers had an overwhelming appreciation of the cafés and what they offered, but several of the findings led to the recommendations about the recruitment and training of café co-ordinators; how cafés present themselves and their services and how they can offer dedicated support to informal carers. Originality/value These recommendations will be of use to café organisers and commissioners, especially considering the dearth of information currently available in this area.

Introdução: A prevalência da Doença de Alzheimer (DA) e da Doença de Parkinson (DP), tende a aumentar com o envelhecimento populacional. Até o momento, os esquemas terapêuticos para essas doenças não consegue alcançar a cura e geralmente não são atualizados, o que evidencia a necessidade de outras opções para a melhora da qualidade de vida desses pacientes. Dado que essas síndromes demenciais tem etiologia multifatorial, a dieta, por meio do café, tem mostrado evidências significativas na degeneração neuronal, que é um dos principais aspectos alterados no desenvolvimento dessas patologias. Metodologia: Trata-se de uma revisão integrativa, que buscou responder quais os possíveis efeitos da cafeína como fator protetor no desenvolvimento e na progressão da revisional e da DP, nas bases de dados: Biblioteca Virtual de Saúde (BVS), National Library of Medicine (PubMed MEDLINE) e Scientific Electronic Library Online (Scielo). Resultados e Discussão: A cafeína age no sistema nervoso central (SNC) pela mimetização aos receptores de adenosina, mais concentrada nos receptores A1R e A2aR. Como antagonista competitivo, a cafeína, eventualmente, poderia reduz os processos de formação das placas b-amiloides na DA e reduzir a neuroinflamação e neurodegeneração na DP, além de outros possíveis mecanismos. Conclusão: A delimitação de um consenso sobre a relação dose/efeito decorrente do uso da cafeína é de difícil estabelecimento e ainda não se observa um consenso, entretanto, é possível observar que um consumo entre 200mg a 511mg por dia poderia trazer efeitos benéficos tanto na DP, como na DA, superando os possíveis efeitos colaterais.

La tesi presenta i risultati di una articolata indagine sul teatro sociale tesa a delinearne la genealogia e le caratteristiche di metodo, alla luce dell’esperienza di laboratorio teatrali, spettacoli e feste realizzata presso gli Alzheimer Café di Milano. Ne sono emersi alcuni aspetti rilevanti. Il teatro sociale si radica nei movimenti di ricerca italiani degli anni ‘60 e ’70 e la nascita Nuovo Teatro. Ha assunto progressivamente una sua identità, impiegando quanto maturato in quegli anni per scopi di ordine sociale. Viene ritenuto sia un’etichetta che denomina diversi metodi e processi di intervento teatrale nel sociale, sia un metodo con propri criteri e obiettivi. Di fatto assomma nella sua pratica i diversi livelli performativi della rappresentazione, della relazione e dell’azione sociale, con la precisa intenzionalità di produrre, attraverso la pratica performativa teatrale, un cambiamento evolutivo nell'esperienza di vita della persona, del gruppo che partecipa al laboratorio e dell’intero sistema sociale che lo ospita, sia esso un’organizzazione oppure una comunità locale. I nodi critici rilevati sono l’inadeguatezza dei sistemi di valutazione, il non riconoscimento di uno specifico profilo professionale e di iter formativi condivisi e legittimati.
The dissertation presents the results of an articulated investigation on the TS for to describe its genealogy and its method, with reference to the experience of theatrical ateliers and labs, shows and feasts realized at the Alzheimer Cafè of Milan. Some relevant aspects came to light. The TS takes root in the Italian artistic movements during the Sixties and the Seventies and in the birth of the New Theatre. It progressively took on its own identity, employing the acquired for social aims. It is considered both a label to denominate all kinds of social theatrical methods, and a specific method with its criterions and purposes. Actually the TS integrates in its practice the different performative levels of representation, relationship and social action with the willfulness to produce, throughout the theatrical performative activities, a developing change in the individual’s life, in the group who participates at the atelier and in the social system involved, whether an organization or a local community. The unsolved issues are the inadequate evaluation systems, the nonrecognition of a specific professional role and of a shared and legitimate iter of training.

La tesi presenta i risultati di una articolata indagine sul teatro sociale tesa a delinearne la genealogia e le caratteristiche di metodo, alla luce dell’esperienza di laboratorio teatrali, spettacoli e feste realizzata presso gli Alzheimer Café di Milano. Ne sono emersi alcuni aspetti rilevanti. Il teatro sociale si radica nei movimenti di ricerca italiani degli anni ‘60 e ’70 e la nascita Nuovo Teatro. Ha assunto progressivamente una sua identità, impiegando quanto maturato in quegli anni per scopi di ordine sociale. Viene ritenuto sia un’etichetta che denomina diversi metodi e processi di intervento teatrale nel sociale, sia un metodo con propri criteri e obiettivi. Di fatto assomma nella sua pratica i diversi livelli performativi della rappresentazione, della relazione e dell’azione sociale, con la precisa intenzionalità di produrre, attraverso la pratica performativa teatrale, un cambiamento evolutivo nell'esperienza di vita della persona, del gruppo che partecipa al laboratorio e dell’intero sistema sociale che lo ospita, sia esso un’organizzazione oppure una comunità locale. I nodi critici rilevati sono l’inadeguatezza dei sistemi di valutazione, il non riconoscimento di uno specifico profilo professionale e di iter formativi condivisi e legittimati.
The dissertation presents the results of an articulated investigation on the TS for to describe its genealogy and its method, with reference to the experience of theatrical ateliers and labs, shows and feasts realized at the Alzheimer Cafè of Milan. Some relevant aspects came to light. The TS takes root in the Italian artistic movements during the Sixties and the Seventies and in the birth of the New Theatre. It progressively took on its own identity, employing the acquired for social aims. It is considered both a label to denominate all kinds of social theatrical methods, and a specific method with its criterions and purposes. Actually the TS integrates in its practice the different performative levels of representation, relationship and social action with the willfulness to produce, throughout the theatrical performative activities, a developing change in the individual’s life, in the group who participates at the atelier and in the social system involved, whether an organization or a local community. The unsolved issues are the inadequate evaluation systems, the nonrecognition of a specific professional role and of a shared and legitimate iter of training.

There is limited research into the impact of non-specific factors on the outcome of Cognitive Behaviour Therapy (CBT). This current study aimed to investigate the relationship between client and therapist attachment styles and client interpersonal problems to the therapeutic relationship and symptom reduction over eight sessions of CBT. Seventeen therapist-client dyads were asked to complete measures of interpersonal problems, attachment style and report on the therapeutic relationship. Results showed that in this small sample there was a relationship between core alliance, as rated by clients, to reduction in symptoms of depression over the course of eight sessions of CBT (TB=0.423, p<0.05) but not anxiety. Client level of confidence in relationships was negatively correlated with the reduction in anxiety symptoms over time (TB =-.320; p<0.05). The level of difference in scores on a measure of ‘confidence in relationships’ between therapists and clients was found to be positively correlated to the level of reduction in anxiety scores over eight sessions (TB = .0428; p<0.05) and negatively correlated to the therapist rated core alliance (TB=-.428, p<0.05). These results indicate that the role of attachment styles in CBT warrants further investigation and both clinical and theoretical implications of these findings are discussed. Key words: Cognitive Behaviour Therapy, therapeutic relationship, treatment outcomes, attachment, interpersonal problems Service Improvement Project Title: What is helpful about attending an Alzheimer’s café: does it do what it says on the tin? Abstract: Alzheimer’s Cafes were developed in 1997 in the Netherlands and have since been set up all over the world. They are a post-diagnostic support group for people with dementia and their families with an aim to reduce stigma around having dementia. As yet there have been very few evaluations of these cafes. This project aimed to find out what family carers of people with dementia found helpful about attending one of two Alzheimer’s cafes. Seven carers took part in a focus group and two were interviewed individually about what they found helpful about attending an Alzheimer’s Café and what they thought could be improved on in the future. Results showed that people found the opportunities to socialise with others ‘in the same boat’ the most helpful aspect as well as meeting professionals outside of the clinic. The results of this study will enable the development of a questionnaire that can be used to continue to evaluate the café and the feedback provided used to guide future service development. Key words: Alzheimer’s Café, social support, dementia, service evaluation Critical Literature Review Title: Risk and protective factors for psychological adjustment of children born with a cleft lip and/or palate and their families: A review of the literature Abstract: Research suggests that around 30-40% of children born with a cleft lip and /or palate will develop psychological difficulties. Services supporting these individuals need to be able to identify those that might be vulnerable as early as possible so that preventative support can be offered. This review summarises findings from research studies looking at within-group differences in samples of children with a cleft and their families. Risk factors found included being male, experiencing bullying or having additional difficulties. Protective factors included satisfaction with appearance and social support. The methodological strengths and weaknesses of these studies are discussed along with implications of the findings for theory and clinical practice.

La maladie d'Alzheimer (MA) est la cause la plus fréquente de démence dans les pays occidentaux industrialisés et les coûts reliés à cette maladie approchent les 5,5 milliards de dollars par année au Canada (DeKosty & Orgozogo, 2001; Diamond, 2006). De plus, la Société Alzheimer du Canada (2009) s'attend à ce que le nombre de personnes atteintes double en l'espace d'une génération. La MA se caractérise par des modifications neurophysiologiques de nature pathologique. Ces modifications provoquent un déclin cognitif d'évolution constante (Giffard, Desgranges, & Eustache, 2008). Ce déclin peut prendre diverses formes et affecter certaines sphères cognitives telles que les fonctions executives et instrumentales. Les atteintes cognitives peuvent être importantes et elles requièrent une prise en charge croissante au fil de l'évolution de la maladie, tant par le système de santé que par l'entourage des personnes atteintes (Derouesné, 2006). Les répercussions engendrées par le déclin cognitif peuvent être sévères en ce qui concerne l'autonomie de l'individu, plus précisément sur la réalisation d'activités de la vie quotidienne (AVQ) et de la vie domestique (AVD). La perturbation des AVQ et des AVD augmente le risque d'accident à domicile, de même que le fardeau des aidants, et est en lien avec l'institutionnalisation des patients atteints de MA (Mahurin, DeBettignies, & Pirozzolo, 1991). Afin de pallier à la pression issue d'une demande croissante de soins qui incombe souvent aux proches (aidants) de la personne atteinte, des travaux de recherche s'effectuent actuellement afin de développer des mécanismes de compensation des déficits cognitifs prenant la forme d'agents intelligents (de type prothétique) qui seraient en mesure de soutenir les patients atteints de MA dans la réalisation de leurs AVQ et AVD. Ces agents prothétiques et intelligents visent notamment à compenser temporairement les altérations cognitives engendrées par la MA, ce qui permet une prolongation du maintien à domicile. La charge et la demande mise sur les aidants pour les soins pourraient ainsi potentiellement être réduites, ce qui autoriserait un allongement de la période de vie à domicile (Bouchard, Bouzouane, & Giroux, 2007). Afin de parvenir à cet objectif, différentes techniques peuvent être utilisées, dont l'émission de messages-guides ayant comme visée d'accompagner l'individu dans la réalisation d'AVQ (alimentation, soins personnels, habillement, etc.). Mihailidis, Barbenel et Fernie (2004) ont démontré, dans une étude d'efficacité auprès de 10 patients atteints de démence modérée à sévère, que le nombre d'étapes pour la completion d'une tâche spécifique que les participants sont en mesure de réaliser sans l'aidant est accru de 25 % lors de l'utilisation d'une méthode de guidage verbale informatisée. Cependant, une autre étude d'efficacité réalisée auprès d'un participant atteint de MA sévère montre que, malgré le fait que l'utilisation d'un guidage verbal informatisé augmente le niveau d'autonomie, seulement un faible pourcentage des guidages s'est avéré efficace (Mihailidis, Boger, Canido, & Hoey, 2007). Ces résultats suggèrent que différents facteurs semblent agir sur l'efficacité du guidage informatisé, dont le médium par lequel le guidage est transmis. À ce jour, différentes équipes de recherche ont utilisé plusieurs types de guidages informatisés auprès d'échantillons de personnes atteintes de démence, mais peu d'entre elles se sont attardées à en étudier systématiquement les effets différentiels. Ces guidages informatisés peuvent prendre la forme de commandes vocales comprenant des niveaux variables de précision (Mihailidis et al., 2007) ou encore de stimulations visuelles (images, vidéos, lumières) ou sonores (Pigot, Mayers, & Giroux, 2003). Il est donc primordial d'effectuer des études concernant l'efficacité de diverses formes de guidages informatisés afin d'optimiser leurs effets et impacts auprès des patients. C'est pourquoi ce projet de recherche, réalisé sous forme d'observation de base du comportement prenant la forme de trois descriptions cliniques, se penche sur cette problématique de premier plan et a pour but de décrire l'efficacité de trois types de guidages informatisés auprès de participants atteints de MA en stade modéré. Les méthodes de guidage utilisées sont présentées sous forme visuelle (iconique), auditive avec contenu verbal, ainsi qu'une combinaison des deux. De plus, le volet neuropsychologique (atteintes des fonctions instrumentales et executives) sera exploré en tant que facteur pouvant moduler les réponses des patients et donc, l'efficacité du guidage informatisé.