Journal articles: 'Dementia facility'

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Winchip, Susan. "Dementia Health Care Facility Design." Journal of Interior Design 16, no. 2 (September 1990): 39–46. http://dx.doi.org/10.1111/j.1939-1668.1990.tb00053.x.

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Wang, Jinjiao, Thomas V. Caprio, Helena Temkin-Greener, Xueya Cai, Adam Simning, and Yue Li. "Relationship of Medicare–Medicaid Dual Eligibility and Dementia With Unplanned Facility Admissions Among Medicare Home Health Care Recipients." Journal of Aging and Health 32, no. 9 (January 15, 2020): 1178–87. http://dx.doi.org/10.1177/0898264319899211.

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Objective: The objective of this study was to examine the effects of dementia and Medicare–Medicaid dual eligibility on unplanned facility admission among older Medicare home health (HH) recipients. Method: This study involves a secondary analysis of data from the Outcome and Assessment Information Set (OASIS) and billing records (i.e., International Classification of Diseases, 10th Revision [ICD-10] codes) of 6,153 adults ≥ 65 years receiving HH from a nonprofit HH agency in CY 2017. Results: Among dual eligible patients with dementia, 39.3% had an unplanned facility admission of any type, including the hospital, nursing home, or rehabilitation facility. In the multivariable Cox proportional hazard model of time-to-facility admission, dual eligible patients with dementia were more than twice as likely as Medicare-only patients without dementia to have an unplanned facility admission (hazard ratio = 2.35; 95% confidence interval: 1.28, 4.33; p = .006). Discussion: Low income and dementia have interactive effects on facility admissions. Among Medicare HH recipients, dual eligible patients with dementia are the most vulnerable group for unplanned facility admission.

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Wang, Jinjiao, Thomas V. Caprio, Helena Temkin-Greener, Xueya Cai, jingjing Shang, and Yue Li. "RELATIONSHIP OF DEMENTIA AND MEDICAID ELIGIBILITY WITH FACILITY ADMISSIONS IN MEDICARE HOME HEALTH PATIENTS." Innovation in Aging 3, Supplement_1 (November 2019): S880. http://dx.doi.org/10.1093/geroni/igz038.3225.

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Abstract This study was a secondary analysis of the Outcome and Assessment Information Set (OASIS) and administrative billing records of 6,153 adults ≥ 65 years old who received home health (HH) from a not-for-profit HH agency in upstate New York between 01/01/2017 and 12/31/2017. We examined the relationships of dementia and Medicare-Medicaid dual eligibility with unplanned institutional admission (i.e. to hospital, nursing home, or inpatient rehabilitation facility) among these HH recipients. Dementia was identified by ICD-10 codes and OASIS items (M1700, M1710, M1740). We also used OASIS record to identify dual eligible status (M0150) and unplanned facility admission (M2410 [occurrence], M0906 [date], M2430 [reason]). Time-to-facility admission was defined as the number of days from HH start date to the facility admission date. The rate of having an unplanned facility admission was 14.2% among Medicare-only patients without dementia, 15.8% among dual eligible patients without dementia, 16.7% among Medicare-only patients with dementia, and 39.3% among dual eligible patients with dementia (p<0.001). In the multivariable Cox proportional hazard model of time-to-facility admission adjusting for patient covariates, dually eligible patients with dementia were more than twice as likely as Medicare-only patients without dementia to have an unplanned facility admission (Hazard Ratio=2.35, p=0.006). This is the first study that identified synergistic effects of having both dementia and Medicare-Medicaid dual eligibility on increasing the risk of healthcare facility admission in the Medicare HH population in the United States. Policies should ensure that appropriate and sufficient HH services be provided for dually eligible patients with dementia.

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Hendricksen, Meghan, Daniel Habtemariam, and Susan Mitchell. "FACILITY AND RESIDENT LEVEL DIFFERENCES: ANTIBIOTIC USE IN NURSING HOMES FOR RESIDENTS WITH ADVANCE DEMENTIA." Innovation in Aging 3, Supplement_1 (November 2019): S883. http://dx.doi.org/10.1093/geroni/igz038.3233.

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Abstract Previous studies have shown that there is a high frequency of antibiotic use in NH for advance dementia patients. However, research has shown limited clinical benefit from antimicrobial use for this population, and antimicrobial exposure increases colonization with drug-resistant bacteria in nursing homes. The aim of this study was to identify NH and resident level characteristics associated with antibiotic use for patients with advance dementia. Using data from an ongoing cluster RCT in 28 Boston NHs; Trial to Reduce Antimicrobial use in Nursing home residents with Alzheimer’s disease and other Dementias (TRAIN-AD), testing a program intervention to improve management of infections in advanced dementia. These data are taken from baseline measurements 2 months prior to intervention, and individual nursing home residents with advance dementia are units of analysis (n = 425). We ran multivariable logistic regression model with antibiotic use as the outcome, adjusting for clustering at NH level, with NH (#beds, profit status, staffing, #cognitively impaired, etc.) and individual patient characteristics (age, gender, race, etc.) as independent variables. Analyses found residents were more likely to receive antibiotics if they resided in nursing homes that employed less intense infectious disease practices prior to baseline (AOR = 2.34; 95% CI 1.08, 5.05), and full-time nurse practitioners or physician assistants (AOR= 3.68; 95%CI 1.49, 9.04). Female patients also had higher odds of receiving antibiotics (AOR=2.16; 95%CI1.10, 4.67). These findings provide potential insight into the importance of education regarding stringent infectious disease practices for practitioners, particularly for patients with advanced dementia.

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Annerstedt, Lena, Junko Sanada, and Lars Gustafson. "A Dynamic Long-Term Care System for the Demented Elderly." International Psychogeriatrics 8, no. 4 (December 1996): 561–74. http://dx.doi.org/10.1017/s1041610296002888.

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The dynamic processes and the way they interact in shaping a care system for demented patients are analyzed and discussed. The development of disability/dependency, interpreted in a simulation model based on Katz's index of ADL and Berger's scale “Rating the severity of senility,” gave insight into the interplay of four care levels: psychogenatric long-term care for patients with severe behavioral disturbances, nursing-home care for patients with highly reduced ADL capacity who are often moderately to severely demented, group-living care for the demented with less dominating ADL dependency, and residential care for the elderly frail with or without symptoms of dementia. For each facility in this chain of care, characteristics in patients' symptomatology and behavior could also be identified. Resources necessary in order to fulfill goals in caring differed between each facility.

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Saxton, Judith, Myrna Silverman, Edmund Ricci, Christopher Keane, and Beth Deeley. "Maintenance of Mobility in Residents of an Alzheimer Special Care Facility." International Psychogeriatrics 10, no. 2 (June 1998): 213–24. http://dx.doi.org/10.1017/s1041610298005328.

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The cognitive and functional decline of demented residents in a specialized Alzheimer's facility was compared to that of demented residents living in a traditional nursing home. All residents met DSM-III-R criteria for dementia. The evaluation consisted of a clinical interview with patients and collateral assessments of cognition, general health, problem behaviors, depression, and a broad range of activities of daily living (ADLs) including mobility. Residents were evaluated at baseline and 6-month intervals over 18 months. Similar rates of decline were found in cognition and overall ADLs in both groups. However, the most striking finding was preserved mobility in residents of the Alzheimer's facility. This finding suggests that specialized facilities do not halt or slow the overall progression of cognitive and functional decline seen in Alzheimer's disease; however, residents of such facilities may show slower decline in mobility.

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Nakanishi, Miharu, Syudo Yamasaki, and Atsushi Nishida. "In-hospital dementia-related deaths following implementation of the national dementia plan: observational study of national death certificates from 1996 to 2016." BMJ Open 8, no. 12 (December 2018): e023172. http://dx.doi.org/10.1136/bmjopen-2018-023172.

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ObjectiveTo examine changes in places of dementia-related death following implementation of the national dementia plan and other policy initiatives.DesignObservational study.SettingJapan between October 1996 and September 2016. Four major changes in health and social care systems were identified: (1) the public long-term care insurance programme (April 2000); (2) community centres as a first access point for older residents (April 2006); (3) medical care system for older people (April 2008) and (4) the national dementia plan (April 2013).Participants9 60 423 decedents aged 65 years or older whose primary cause of death was Alzheimer’s disease, vascular or other types of dementia or senility.Main outcome measuresPlace of death which was classified into ‘hospital’, ‘intermediate geriatric care facility’ (rehabilitation facility aimed at home discharge), ‘nursing home’ or ‘own home’.ResultsThe annual number of deaths at hospital was consistently increased over time from 1996 to 2016 (age-adjusted OR: 6.01; 95% CI 5.81 to 6.21 versus home deaths). Controlling for individual characteristics, regional supply of hospital and nursing home beds and other changes in health and social care systems, death from dementia following the national dementia plan was likely to occur in hospital (adjusted OR: 1.21; 95% CI 1.18 to 1.24), intermediate geriatric care facility (adjusted OR: 1.53; 95% CI 1.48 to 1.58) or nursing home (adjusted OR: 1.64; 95% CI 1.60 to 1.69) rather than at home.ConclusionsAs the number of deaths from dementia increased over the decades, in-hospital deaths increased regardless of the national dementia plan. Further strategies should be explored to improve the availability of palliative and end-of-life care at patients’ places of residence.

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TSUSHIMA, Takafumi, and Kenji TAKEMIYA. "RESEARCH ON FACILITY PLANNING OF MEDICAL CENTERS FOR DEMENTIA." AIJ Journal of Technology and Design 26, no. 62 (February 20, 2020): 233–38. http://dx.doi.org/10.3130/aijt.26.233.

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Bonner, Alice. "Dementia care in nursing homes: a golden opportunity." International Psychogeriatrics 26, no. 3 (January 30, 2014): 361–62. http://dx.doi.org/10.1017/s1041610213002597.

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The paper by Kleijer and colleagues (2014) in this issue of International Psychogeriatrics describes factors that may influence antipsychotic drug (APD) prescribing rates in nursing homes in several countries. The authors conclude that the large variability is only partly explained by differences in resident characteristics, and that it is associated with certain facility characteristics such as bed size and urban/rural location. They also identify the likelihood that differences in physician prescribing patterns or facility prescribing culture may influence APD prescribing rates, as has been found in previous studies (Briesacher et al., 2005; Chen et al., 2010).

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Paun, Olimpia, Ben R. Inventor, Louis Fogg, Hugh Vondracek, and Ilse Salinas. "FAMILY DEMENTIA CAREGIVER RECRUITMENT STRATEGIES IN LONG-TERM CARE FACILITIES." Innovation in Aging 3, Supplement_1 (November 2019): S933. http://dx.doi.org/10.1093/geroni/igz038.3395.

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Abstract Recruitment of dementia caregivers whose family members reside in long-term care facilities (LTCFs) poses unique challenges as it traditionally relies on the assistance of facility administrators. The purpose of this presentation is to examine and evaluate new recruitment strategies to determine their effectiveness in an ongoing Stage I randomized clinical trial testing the effects of a Chronic Grief Management Intervention, Video-streamed (CGMI-V) on caregivers’ mental health (grief, depression, anxiety) and facility-related outcomes (conflict with staff, satisfaction with care). A total of 144 caregivers will be randomly assigned to the CGMI-V or to the minimal treatment conditions. The initial recruitment plan was to build on already-established relationships with more than 35 LTCFs that helped recruit in a previous study. The usual approach was to offer written materials and onsite presentations about the study to facility staff and to dementia family caregivers of facility residents. Within the first six months, recruitment efforts yielded less than a dozen participants, thus we had to refine our approach. Revised recruitment strategies included the adoption of resources from the National Institute on Aging’s ADORE (Alzheimer’s and Dementia Outreach, Recruitment, and Engagement) and ROAR (Recruiting Older Adults into Research) platforms. This new approach included online study advertising on NIH and Alzheimer’s Association research study repositories and advertising on parent institution’s on-hold messaging system. Adoption of these new strategies is yielding an increase in participant screening and enrollment. Results are pending.

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DiGasbarro, Diana, Courtney Whitaker, and Benjamin Mast. "Positive Behaviors and Strengths of People With Dementia." Innovation in Aging 4, Supplement_1 (December 1, 2020): 276. http://dx.doi.org/10.1093/geroni/igaa057.883.

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Abstract Assessment of and care for people with dementia is shifting away from a purely medical disease model toward a more holistic, biopsychosocial approach. Within this movement is growing interest in balancing the negative, symptom-based view of people with dementia with better understanding of strengths and positive behaviors exhibited by people with dementia. The aim of this qualitative study was to gather perspectives of professional caregivers regarding positive behaviors and strengths observed in people with dementia. Data were obtained from three focus groups conducted at a memory care unit within a large long-term care facility. Focus group participants (N=14) worked in nursing and the activities department. Inductive methods were used to code and analyze focus group transcripts and recordings. Five major themes were identified: enduring abilities and values, enduring traits and strengths, sense of purpose and meaning, desire to be helpful, and prosocial behavior. These themes illustrate many domains in which professional caregivers have observed positive behaviors and strengths in people with dementia living in a long-term care facility. The results of this study contribute to the growing literature pertaining to the intersection of positive psychology and dementia research and practice. Future directions include development of an assessment tool to measure positive behavior and strengths in people living with dementia.

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Mohr, David, Kim J. Curyto, Kevin W. McConeghy, Jenefer M. Jedele, and Kelly Vance. "FACILITY CHARACTERISTICS, STAFF INJURY, AND DISRUPTIVE BEHAVIOR REPORTING RATES IN VA COMMUNITY LIVING CENTERS." Innovation in Aging 3, Supplement_1 (November 2019): S631—S632. http://dx.doi.org/10.1093/geroni/igz038.2353.

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Abstract Facility characteristics’ influence on staff injuries was evaluated from 2013-2018 for 105 VA CLCs. Nursing hours, nurse skill-level, resident case-mix (percent of residents with mental health or other conditions) and facility size were evaluated in a multivariable regression model. Overall the average injury rates per year were 2.7 (standard deviation 4.3) and 1.5 (2.7) in STAR-VA enrolled vs. never enrolled sites (p=0.04). Statistically significant predictors for higher staff injury rates included percent of residents with dementia, larger bed facilities, and more mental health employee coverage. Lower staff injury rates were associated with facilities with more short-stay residents. After adjustment for facility characteristics, STAR-VA sites were not an independent predictor for staff injury rates. Sites selected for enrollment in STAR-VA have higher overall injury rates which may be due to facility differences in size, staffing and proportion of residents with dementia. Implications for training and monitoring CLC sites will be discussed.

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Sharpp, Tara J., Jeanie S. Kayser-Jones, and Heather M. Young. "Care for Residents with Dementia in an Assisted Living Facility." Research in Gerontological Nursing 5, no. 3 (April 25, 2012): 152–62. http://dx.doi.org/10.3928/19404921-20120410-01.

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Lind, Kimberly E., Leonard C. Gray, Magdalena Z. Raban, Andrew Georgiou, and Johanna I. Westbrook. "Antidementia medication use by aged care facility residents with dementia." International Journal of Geriatric Psychiatry 34, no. 7 (April 25, 2019): 1029–40. http://dx.doi.org/10.1002/gps.5105.

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Naugler, Ashley, and Joshua Griffin. "Hand-Feeding Nursing Facility Residents with Dementia Competency Training Modules." American Journal of Geriatric Psychiatry 29, no. 4 (April 2021): S62—S63. http://dx.doi.org/10.1016/j.jagp.2021.01.054.

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Kleijer, Bart C., Rob J. van Marum, Dinnus H. M. Frijters, Paul A. F. Jansen, Miel W. Ribbe, Antoine C. G. Egberts, and Eibert R. Heerdink. "Variability between nursing homes in prevalence of antipsychotic use in patients with dementia." International Psychogeriatrics 26, no. 3 (November 20, 2013): 363–71. http://dx.doi.org/10.1017/s1041610213002019.

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ABSTRACTBackground:Antipsychotic drugs (APD) are widely prescribed for people with dementia residing in long term care facilities (LTCFs). Concern has been expressed that such prescribing is largely inappropriate. The objective of this study is to examine if differences in facility-level prevalence of APD use in a sample of LTCFs for patients with dementia can be explained by patient and facility-related characteristics.Methods:A point prevalence study was conducted using data from the VU University Resident Assessment Instrument (VURAI) database from nursing homes and residential care facilities in the Netherlands. Patients were selected who had a diagnosis of dementia. LTCF and patient characteristics were extracted from the VURAI; facility-level resident satisfaction surveys were provided by the National Institute for Public Health.Results:In total, 20 LTCFs providing care for 1,090 patients with dementia were investigated. Overall, 31% of patients used an APD. In facilities with a high prevalence of APD use behavioral symptoms were present in 62% of their patients. In facilities with medium APD use behavioral problems remained frequent (57%), and in facilities with low prevalence of APD use 54% of the patients had behavioral symptoms. Facilities with a high prevalence of APD use were often large, situated in urban communities, and scored below average on staffing, personal care, and recreational activities.Conclusions:There was considerable variation between the participating LTCFs in the prevalence of APD use. Variability was related to LTCF characteristics and patient satisfaction. This indicates potential inappropriate prescribing because of differences in institutional prescribing culture.

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Smit, Dieneke, Jacomine de Lange, Bernadette Willemse, and Anne Margriet Pot. "The relationship between small-scale care and activity involvement of residents with dementia." International Psychogeriatrics 24, no. 5 (January 6, 2012): 722–32. http://dx.doi.org/10.1017/s1041610211002377.

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ABSTRACTBackground: Nursing home care for people with dementia is increasingly organized in small-scale care settings. This study focuses on the question of how small-scale care is related to the overall activity involvement of residents with dementia, and their involvement in different types of activities. As several studies have indicated, activity involvement is important for the quality of life of residents.Methods: Data were derived from the first measurement cycle (2008/2009) of the Living Arrangements for people with Dementia study, in which 136 care facilities and 1,327 residents participated. The relationship between two indicators of small-scale dementia care (group living home care characteristics, and the total number of residents with dementia in the facility) and activity involvement (Activity Pursuit Patterns of the Resident Assessment Instrument Minimum Data Set) were studied with multilevel multiple regression analyses. All analyses were adjusted for the residents' age, sex, neuropsychiatric symptoms, and dependency on the activities of daily living.Results: Residents of care facilities with more group living home care characteristics were more involved in overall and preferred activities. Furthermore, they were involved in more diverse activities. Overall, no relationship was found between the number of residents at the facility and activity involvement.Conclusions: These results indicate that small-scale dementia care has a positive effect on activity involvement of residents. The current study also sheds light on the lack of activity involvement of many residents with dementia, especially those who are older, male, and with higher dependency.

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Beattie, Elizabeth, Maria O’Reilly, Wendy Moyle, Lynn Chenoweth, Deirdre Fetherstonhaugh, Barbara Horner, Andrew Robinson, and Elaine Fielding. "Multiple perspectives on quality of life for residents with dementia in long term care facilities: protocol for a comprehensive Australian study." International Psychogeriatrics 27, no. 10 (April 22, 2015): 1739–47. http://dx.doi.org/10.1017/s1041610215000435.

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ABSTRACTBackground:Dementia is a chronic illness without cure or effective treatment, which results in declining mental and physical function and assistance from others to manage activities of daily living. Many people with dementia live in long term care facilities, yet research into their quality of life (QoL) was rare until the last decade. Previous studies failed to incorporate important variables related to the facility and care provision or to look closely at the daily lives of residents. This paper presents a protocol for a comprehensive, multi-perspective assessment of QoL of residents with dementia living in long term care in Australia. A secondary aim is investigating the effectiveness of self-report instruments for measuring QoL.Methods:The study utilizes a descriptive, mixed methods design to examine how facility, care staff, and resident factors impact QoL. Over 500 residents with dementia from a stratified, random sample of 53 facilities are being recruited. A sub-sample of 12 residents is also taking part in qualitative interviews and observations.Conclusions:This national study will provide a broad understanding of factors underlying QoL for residents with dementia in long term care. The present study uses a similar methodology to the US-based Collaborative Studies of Long Term Care (CS-LTC) Dementia Care Study, applying it to the Australian setting.

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Shields, Alison, and Alison Phinney. "The passage of a painting: The learning process of students creating art for people with dementia." International Journal of Education Through Art 16, no. 2 (June 1, 2020): 209–25. http://dx.doi.org/10.1386/eta_00027_1.

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Making Art for Making Place, a joint education and research project, engaged post-secondary fine arts students in the creation of paintings for residents of a transitional care facility. The purpose of the project was to explore how improving the living environment through art could benefit the residents with dementia while considering the impact this had on the students themselves. This article draws from participant observations and follow-up interviews to examine the learning experiences of students who created paintings for the facility. Further, it explores the impact on their learning through interactions with nurses and expert researchers who joined the class to participate in group discussions and share their expertise working with people living with dementia. The research revealed that the project fostered positive community building; engaged students in discussions and reflections about how art affects people; prompted consideration of experiences of the elderly ‐ particularly those with dementia; and expanded understandings of the roles of art in the society.

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Lalu, Jishnu S., Priya Vijayakumar, Sobha George, Amal V. Nair, and Arjun B. "Risk factors of dementia: a comparative study among the geriatric age group in Ernakulam, Southern India." International Journal Of Community Medicine And Public Health 5, no. 2 (January 24, 2018): 544. http://dx.doi.org/10.18203/2394-6040.ijcmph20180117.

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Background: Dementia is the global deterioration of the individual’s intellectual, emotional and cognitive faculties in a state of normal consciousness. Dementia impacts personal, family and societal life. It reduces life span, induces caregiver’s strain at family level and over utilizes health care facility. This study was aimed at describing the risk factors attributing to dementing disorders for developing preventive measures to slow down the incidence of dementia. Methods: The study was conducted in geriatrics OPD of a tertiary hospital in South India. A total of 50 dementia patients and 50 controls aged more than 65 years were selected for the study in a period of 6 months. A semi-structured questionnaire was used to collect data. Results: 40% in the age group of 65-74 years, 61% in the age group of 75-84 years and 63.6% in the age >85 years had dementia. 43.5% of males and 55.5% of females had dementia. Multivariate analysis was done to find out the independent predictors of dementia. Among the morbidities dyslipidemia 3.93 (1.12-13.87) and COPD/bronchial asthma 4.57 (1.02-20.55), less than 5 days of fruit consumption 14.98 (38-59), hearing loss 4.67 (1.15-18.91) were found to be independent risk factors for dementia. Living alone was found to be a protective factor 0.029 (0.003-0.29). Conclusions: Our study reported various risk factors of dementia that were in agreement with findings from other studies conducted in India. Avoidable risk factors such as living alone, fruit intake and control of comorbidities such as hypertension, dyslipidemia and COPD/bronchial asthma needs more attention in old age group.

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Van Hecke, Liesl, Iris Van Steenwinkel, and Ann Heylighen. "How Enclosure and Spatial Organization Affect Residents’ Use and Experience of a Dementia Special Care Unit: A Case Study." HERD: Health Environments Research & Design Journal 12, no. 1 (September 13, 2018): 145–59. http://dx.doi.org/10.1177/1937586718796614.

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Aim: We aim to gain insight into how a dementia special care unit is used and experienced by its residents and what design aspects are important therein. Background: In Flanders, housing for people with dementia evolves toward small-scale, homelike environments. As population aging challenges the affordability of this evolution, architects and other designers are asked to design dementia special care units that offer the advantages of small scaleness within the context of large-scale residential care facilities. How these units are used and experienced is not systematically evaluated. Method: A case study was conducted in a recently built residential care facility where a dementia special care unit was foreseen on the ground floor, yet after a few months was moved to the top floor. The case study combined architectural analysis, participant observation, and qualitative interviews with residents and care staff. Results: Comparing the original situation on the ground floor with the new situation on the top floor highlights how enclosure (physical and visual access to outside and the rest of the facility) and spatial organization affect how residents use and experience a dementia special care unit. Conclusions: Depending on the type and stage of dementia, residents may have different needs for space to move, sensory stimuli, and social contact. In order to meet these different needs, confining residents to a dementia special care unit to the top floor should be avoided unless it is carefully designed, providing sufficient freedom of movement and connection with the outside world.

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Norberg, Astrid, Britt-Marie Ternestedt, and Berit Lundman. "Moments of homecoming among people with advanced dementia disease in a residential care facility." Dementia 16, no. 5 (October 26, 2015): 629–41. http://dx.doi.org/10.1177/1471301215613699.

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This study concerns moments of homecoming among people with advanced dementia disease living in a residential care facility. Our main finding from participant observations with nine residents was that the residents showed moments of homecoming, i.e. they alternated between verbal and/or nonverbal expressions of feeling at home and of not feeling at home. If care providers understand that they can help people with advanced dementia disease experience moments of homecoming, they can focus on aspects of care that can promote these experiences.

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Lee, Sun Min, Hong-sun Song, Buong-O. Chun, Muncheong Choi, Kyunghwa Sun, Ki Sub Kim, Hyesu Jeon, et al. "Feasibility of a 12 Week Physical Intervention to Prevent Cognitive Decline and Disability in the At-Risk Elderly Population in Korea." Journal of Clinical Medicine 9, no. 10 (September 28, 2020): 3135. http://dx.doi.org/10.3390/jcm9103135.

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There is a need for measures that can prevent the onset of dementia in the rapidly aging population. Reportedly, sustained physical exercise can prevent cognitive decline and disability. This study aimed to assess the feasibility of a 12-week physical exercise intervention (PEI) for delay of cognitive decline and disability in the at-risk elderly population in Korea. Twenty-six participants (aged 67.9 ± 3.6 years, 84.6% female) at risk of dementia were assigned to facility-based PEI (n = 15) or home-based PEI (n = 11). The PEI program consisted of muscle strength training, aerobic exercise, balance, and stretching using portable aids. Feasibility was assessed by retention and adherence rates. Physical fitness/cognitive function were compared before and after the PEI. Retention and adherence rates were 86.7% and 88.3%, respectively, for facility-based PEI and 81.8% and 62.3% for home-based PEI. No intervention-related adverse events were reported. Leg strength/endurance and cardiopulmonary endurance were improved in both groups: 30 s sit-to-stand test (facility-based, p = 0.002; home-based, p = 0.002) and 2 -min stationary march (facility-based, p = 0.001; home-based, p = 0.022). Cognitive function was improved only after facility-based PEI (Alzheimer’s Disease Assessment Scale-cognitive total score, p = 0.009; story memory test on Literacy Independent Cognitive Assessment, p = 0.026). We found that, whereas our PEI is feasible, the home-based program needs supplementation to improve adherence.

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Givens, Jane L., Susan L. Mitchell, Sylvia Kuo, Pedro Gozalo, Vince Mor, and Joan Teno. "Skilled Nursing Facility Admissions of Nursing Home Residents with Advanced Dementia." Journal of the American Geriatrics Society 61, no. 10 (October 2013): 1645–50. http://dx.doi.org/10.1111/jgs.12476.

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Kopetz, Scott, Cynthia D. Steele, Jason Brandt, Alva Baker, Marcie Kronberg, Elizabeth Galik, Martin Steinberg, Andrew Warren, and Constantine G. Lyketsos. "Characteristics and outcomes of dementia residents in an assisted living facility." International Journal of Geriatric Psychiatry 15, no. 7 (2000): 586–93. http://dx.doi.org/10.1002/1099-1166(200007)15:7<586::aid-gps148>3.0.co;2-d.

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Rasin, Joyce, and Donald D. Kautz. "Knowing the Resident with Dementia: Perspectives of Assisted Living Facility Caregivers." Journal of Gerontological Nursing 33, no. 9 (September 1, 2007): 30–36. http://dx.doi.org/10.3928/00989134-20070901-06.

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Yanagimachi, Mamoru, Mikiko Irisawa, Yasuhiro Sasaki, Akira Mizuno, and Atsushi Iwata. "GP-001, a Facility-Randomized, Open-Label, Cross-Over Study to Evaluate the Effect of Pecan on Caregiver Burden Score in Nursing Care Facility for Dementia Person." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 1241. http://dx.doi.org/10.1093/cdn/nzaa057_057.

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Abstract Objectives Tree nuts such as pecan (Carya illinoinensis) have been thought to be possible dietary interventions for not only cardiovascular and metabolic disorders but also age-related brain disorders. The aim of this study was to understand the usefulness of pecan consumption to improve the burden of caregivers working in the nursing facility for the person with mild to moderate dementia. Methods Totally 36 dementia patients, with a revised version of Hasegawa's dementia scale (HDS-R) score of less than 21, were recruited from 2 nursing care facilities belonging to the Shoukyukai hospital (Iwate, Japan). They were randomly allocated into 2 groups depending on the administration: any snack chosen by caregivers as control and 5 pieces of fresh pecan per day. All patients were received everyday 10 am for 3 months with a cup of green tea to avoid mis-swallowing. After 2 months washout period, the cross-over treatment was done. As the primary endpoint, the Zarit Burden Interview, a well-known caregiver self-report measurement, was used with slight modification to detect the change in caregiver burden during 3 months consumption. Secondary endpoints were grip power test and 5 meters walking test reflecting patient's physical activity. Blood biochemical analyses including the parameters on cholesterol metabolism were also done. All parameters including HDS-R were examined at baseline and 3 months after treatment. Results with P < 0.05 were considered to be statistically significant. The study protocol was approved by the ethical committee of Shoukyukai hospital. The trial registration ID is UMIN000039229. Results Thirty-one and 33 patients completed the course of treatments for control snack and pecan, respectively. Changes in the Zarit burden interview score from baseline were significantly different between groups (control, 0.87 ± 2.92; pecan, −1.00 ± 2.98; P = 0.015), suggesting pecan consumption improved the caregiver burden in comparison to any snack chosen by caregiver. No differentiation on HDS-R and other parameters between groups was seen. Adverse event was not observed in both groups. Conclusions Pecan consumption may be useful to improve caregiver burden in the nursing facility for dementia person. Funding Sources GP-001 study was supported by the local government of City of Rikuzentakata, Iwate Prefecture, Japan.

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Spenceley, Shannon, Chad SG Witcher, Brad Hagen, Barry Hall, and Arron Kardolus-Wilson. "Sources of moral distress for nursing staff providing care to residents with dementia." Dementia 16, no. 7 (December 1, 2015): 815–34. http://dx.doi.org/10.1177/1471301215618108.

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The World Health Organization estimates the number of people living with dementia at approximately 35.6 million; they project a doubling of this number by 2030 and tripling by 2050. Although the majority of people living with a dementia live in the community, residential facility care by nursing care providers is a significant component of the dementia journey in most countries. Research has also shown that caring for persons with dementia can be emotionally, physically, and ethically challenging, and that turnover in nursing staff in residential care settings tends to be high. Moral distress has been explored in a variety of settings where nurses provide acute or intensive care. The concept, however, has not previously been explored in residential facility care settings, particularly as related to the care of persons with dementia. In this paper, we explore moral distress in these settings, using Nathaniel’s definition of moral distress: the pain or anguish affecting the mind, body, or relationships in response to a situation in which the person is aware of a moral problem, acknowledges moral responsibility, makes a moral judgment about the correct action and yet, as a result of real or perceived constraints, cannot do what is thought to be right. We report findings from a qualitative study of moral distress in a single health region in a Canadian province. Our aim in this paper is to share findings that elucidate the sources of moral distress experienced by nursing care providers in the residential care of people living with dementia.

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Viveky, Navita, Lynda Toffelmire, Lilian Thorpe, Jennifer Billinsky, Jane Alcorn, Thomas Hadjistavropoulos, and Susan J. Whiting. "Use of vitamin and mineral supplements in long-term care home residents." Applied Physiology, Nutrition, and Metabolism 37, no. 1 (February 2012): 100–105. http://dx.doi.org/10.1139/h11-141.

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Vitamin–mineral supplementation may offer older adults health and cognition-related benefits but overuse may contribute to polypharmacy. We examined the prevalence of supplement usage in long-term care facility (LTC) residents (≥65 years of age). As cognition may be affected by nutrition, we also examined use in those with diagnosis of dementia and those with no dementia diagnosis. The prevalence of supplement usage and overall “pill count” from pharmaceutical use was assessed in 189 LTC residents and a subsample of 56 older adults with dementia diagnosis, respectively. Participants were residing in an LTC facility of a mid-size metropolitan area during 2009. The average use of supplements was 1.0 per day for all residents, with 35% taking vitamin D supplements, 20% multivitamins, and 26% calcium. Supplement use was similar (p ≥ 0.05) for those with dementia diagnosis (53%, average 2.0 per day) and for those without such diagnosis (45%, average 2.2 per day). Usage ranged between 1–6 supplements per day. In both of these groups, ∼73% of users were taking vitamin D. The number of prescribed medications ranged from 4 to 24 (average 10.2) in a subsample of residents whose supplement intake was 0 to 6 (average 2). These findings suggest an overall low rate of supplement use, with no significant differences (p ≥ 0.05) in use between residents with and without dementia diagnosis. However, some residents were at risk for supplement overuse.

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Andrews, Sharon, Fran McInerney, Christine Toye, Camillus-Anthony Parkinson, and Andrew Robinson. "Knowledge of Dementia: Do family members understand dementia as a terminal condition?" Dementia 16, no. 5 (September 21, 2015): 556–75. http://dx.doi.org/10.1177/1471301215605630.

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Current research identifies advanced dementia to be the terminal phase of this progressive and incurable condition. However, there has been relatively little investigation into how family members of people with advanced dementia understand their relative’s condition. In this article, we report on semi-structured interviews with 10 family members of people with advanced dementia, in a residential aged care facility. Using a qualitative, descriptive design, we explored family members’ understandings of dementia, whether they were aware that it was a terminal condition, and the ways they developed their understandings. Findings revealed that the majority of family members could not recognize the terminal nature of dementia. Relying on predominantly lay understandings, they had little access to formal information and most failed to conceptualize a connection between dementia and death. Moreover, family members engaged in limited dialogue with aged care staff about such issues, despite their relatives being in an advanced stage of the disease. Findings from our study suggest that how family members understand their relative’s condition requires greater attention. The development of staff/family partnerships that promote shared communication about dementia and dying may enhance family members’ understandings of the dementia trajectory and the types of decisions they may be faced with during the more advanced stages of the disease.

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Bressler, Katrina, Roberta E.Redfern, and Megan Brown. "Elimination of Position-Change Alarms in an Alzheimer’s and Dementia Long-Term Care Facility." American Journal of Alzheimer's Disease & Other Dementiasr 26, no. 8 (December 2011): 599–605. http://dx.doi.org/10.1177/1533317511432730.

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In a long-term care facility, whose residents have been diagnosed with Alzheimer’s disease or dementia, falls are a particularly prominent issue. Technology in health care has continued to evolve and play a larger role in how we care for our patients, even in preventing falls. However, overreliance on these types of technologies may have detrimental effects. In our facility, it was felt that staff reliance on position-change alarms was inappropriate due to the high rate of false alarms associated with these devices. We took a tiered approach to removing position-change alarms from our facility, monitoring the fall incidence rate for a period before, during, and after the elimination of these alarms. After discontinuing their use, we found a decrease in the rate of falls, and a decrease in the percentage of our residents who fell. Staff has easily adapted and reports a calmer, more pleasant environment.

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Buller, Leonard T., Matthew J. Best, Milad Alam, Karim Sabeh, Charles Lawrie, and Stephen M. Quinnan. "The Influence of Psychiatric Comorbidity on Inpatient Outcomes following Distal Humerus Fractures." Advances in Orthopedic Surgery 2016 (April 14, 2016): 1–10. http://dx.doi.org/10.1155/2016/4913808.

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Background. The influence of psychiatric comorbidity on outcomes following inpatient management of upper extremity fractures is poorly understood. Methods. The National Hospital Discharge Survey was queried to identify patients admitted to US hospitals with distal humerus fractures between 1990 and 2007. Patients were subdivided into 5 groups: depression, anxiety, schizophrenia, dementia, and no psychiatric comorbidity. Multivariable logistic regression analysis identified independent risk factors for adverse events, requirement of blood transfusion, and discharge to another inpatient facility. Results. A cohort representative of 526,185 patients was identified as having a distal humerus fracture. Depression, anxiety, and dementia were independently associated with higher odds of in-hospital adverse events (P<0.001). Depression was associated with higher odds of inpatient blood transfusion (P<0.001). Depression, schizophrenia, and dementia were associated with higher odds of nonroutine discharge to another inpatient facility (P<0.001). Patients with a diagnosis of schizophrenia had a mean of 12 (P<0.001) more days of care than patients with no psychiatric comorbidity. Discussion. Patients with comorbid psychiatric illness who are admitted to hospitals with distal humerus fractures are at increased risk of inpatient adverse events and posthospitalization care.

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Halminen, Olli, Aino Vesikansa, Juha Mehtälä, Iiris Hörhammer, Teija Mikkola, Lauri J. Virta, Tero Ylisaukko-oja, and Miika Linna. "Early Start of Anti-Dementia Medication Delays Transition to 24-Hour Care in Alzheimer’s Disease Patients: A Finnish Nationwide Cohort Study." Journal of Alzheimer's Disease 81, no. 3 (June 1, 2021): 1103–15. http://dx.doi.org/10.3233/jad-201502.

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Background: Dementia is one of the strongest predictors of admission to a 24-hour care facility among older people, and 24-hour care is the major cost of Alzheimer’s disease (AD). Objective: The aim of this study was to evaluate the association of early start of anti-dementia medication and other predisposing factors with 2-year risk of transition to 24-hour care in the nationwide cohort of Finnish AD patients. Methods: This was a retrospective, non-interventional study based on individual-level data from Finnish national health and social care registers. The incident cohort included 7,454 AD patients (ICD-10, G30) comprised of two subgroups: those living unassisted at home (n = 5,002), and those receiving professional home care (n = 2,452). The primary outcome was admission to a 24-hour care facility. Exploratory variables were early versus late anti-dementia medication start, sociodemographic variables, care intensity level, and comorbidities. Results: Early anti-dementia medication reduced the risk of admission to 24-hour care both in patients living unassisted at home, with a hazard ratio (HR) of 0.58 (p < 0.001), and those receiving professional home care (HR, 0.84; p = 0.039). Being unmarried (HR, 1.69; p < 0.001), having an informal caregiver (HR, 1.69; p = 0.003), or having a diagnosis of additional neurological disorder (HR, 1.68; p = 0.006) or hip fracture (HR, 1.61; p = 0.004) were associated with higher risk of admission to 24-hour care in patients living unassisted at home. Conclusion: To support living at home, early start of anti-dementia medication should be a high priority in newly diagnosed AD patients.

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Wang, Jinjiao, Thomas V. Caprio, Adam Simning, jingjing Shang, Yeates Conwell, Fang Yu, and Yue Li. "ASSOCIATION BETWEEN HOME HEALTH SERVICE USE AND FACILITY ADMISSION IN OLDER ADULTS WITH AND WITHOUT DEMENTIA." Innovation in Aging 3, Supplement_1 (November 2019): S880. http://dx.doi.org/10.1093/geroni/igz038.3224.

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Abstract This study is a secondary analysis of the Outcome and Assessment Information Set (OASIS) and administrative billing records of 6,153 adults ≥ 65 years old who received home health (HH) from a not-for-profit HH agency in upstate New York in CY 2017. We evaluated the association between the use of home health services (HH) with the hazard of unplanned facility admissions among Medicare patients with and without Alzheimer’s disease and related dementia (ADRD). Outcome was time from HH start of care to an unplanned facility admission of any type, including the hospital, nursing home, or rehabilitation facility. Independent variables included weekly intensity (visits/week, hours/week) of each discipline, including skilled nursing (SN), physical therapy (PT), occupational therapy (OT), social work (SW), and home health aide (HA), separately. ADRD was identified by diagnosis (ICD-10 codes) and cognitive impairment (M1700, M1710, M1740 [OASIS]). In multivariable Cox Proportional hazard models that adjusted for time-varying effects of HH intensity, receiving the highest intensity of SN (3.3 visits of 2.78 hours per week) and PT (2.5 visits of 2 hours per week) was related to up to a 54% and 86% decrease, respectively, in the hazard of unplanned facility admission among patients with ADRD (n=1,525), and decreases of 56% and 90% respectively among patients without ADRD (n=4,628). This is the first study in the United States showing that receiving a sufficient amount and appropriate mix of HH services was associated with substantially reduced risk of unplanned facility admission among patients with ADRD by up to 86%.

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Woodis, C. Brock, David Fuentes, and Lorraine Sease. "De-escalation of antipsychotic medications in an elderly patient with Alzheimer's dementia residing in an assisted living facility." Mental Health Clinician 2, no. 5 (November 1, 2012): 115–18. http://dx.doi.org/10.9740/mhc.n127370.

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Clinicians frequently encounter the use of antipsychotic medications in elderly patients with Alzheimer's dementia (AD). The use of these agents may be a concern since they are not approved by the Food and Drug Administration (FDA) for the treatment of AD and have been shown to increase mortality in the elderly population. This case report focuses on the gradual de-escalation of antipsychotic medications in an 80 year-old female with AD residing in an assisted living facility who was prescribed three antipsychotic medications to help manage behavioral and psychotic symptoms consistent with progressing AD. Following a request by the assisted living facility, a local family medicine practice assessed the resident's treatment regimen. A collaborative consultation between the family medicine practice's clinical pharmacist, the family medicine physician, and the health care providers at the assisted living facility resulted in the decision to gradually discontinue each antipsychotic agent at subsequent facility visits by the family medicine team.

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Choukou, Mohamed-Amine, Sophia Mbabaali, and Ryan East. "Healthcare Professionals’ Perspective on Implementing a Detector of Behavioural Disturbances in Long-Term Care Homes." International Journal of Environmental Research and Public Health 18, no. 5 (March 8, 2021): 2720. http://dx.doi.org/10.3390/ijerph18052720.

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The number of Canadians with dementia is expected to rise to 674,000 in the years to come. Finding ways to monitor behavioural disturbance in patients with dementia (PwDs) is crucial. PwDs can unintentionally behave in ways that are harmful to them and the people around them, such as other residents or care providers. Current practice does not involve technology to monitor PwD behaviours. Events are reported randomly by nonstaff members or when a staff member notices the absence of a PwD from a scheduled event. This study aims to explore the potential of implementing a novel detector of behavioural disturbances (DBD) in long-term care homes by mapping the perceptions of healthcare professionals and family members about this technology. Qualitative information was gathered from a focus group involving eight healthcare professionals working in a tertiary care facility and a partner of a resident admitted in the same facility. Thematic analysis resulted in three themes: (A) the ability of the DBD to detect relevant dementia-related behavioural disturbances that are typical of PwD; (B) the characteristics of the DBD and clinical needs and preferences; (C) the integration of the DBD into daily routines. The results tend to confirm the adequacy of the DBD to the day-to-day needs for the detection of behavioural disturbances and hazardous behaviours. The DBD was considered to be useful and easy to use in the tertiary care facility examined in this study. The participants intend to use the DBD in the future, which means that it has a high degree of acceptance.

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Kapoor, Yamini, and Robin Orr. "Effect of therapeutic massage on pain in patients with dementia." Dementia 16, no. 1 (July 27, 2016): 119–25. http://dx.doi.org/10.1177/1471301215583391.

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Introduction The aim was to investigate whether therapeutic massage was effective in relieving pain in elderly residents with dementia. Methods A randomized controlled study was conducted in an aged care facility. Ten participants with dementia or advanced dementia were allocated to an intervention group or a control group. The intervention group received 10 min of massage (effleurage, kneading, and trigger point therapy) four times per week for 4 weeks. The Pain Assessment in Advanced Dementia scale was used as the outcome measure. Results No significant changes in mean outcome measure scores were found post intervention (Intervention mean = 5.0 ± 3.49; Control mean = 5.2 ± 3.49: t(8) = 0.09, p = 0.93). However, the Intervention Group had a greater magnitude of change (1.200 ± 1.78) when compared to the control group (0.800 ± 2.16). Conclusion Therapeutic massage may provide a useful adjunct to the current pain management plan of patients with dementia.

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Førsund, Linn Hege, and Siri Ytrehus. "Finding a place to connect: A qualitative study exploring the influences of the physical and social environments on spouses’ opportunities to maintain relationships when visiting a partner with dementia living in long-term care." Dementia 17, no. 7 (June 17, 2016): 858–79. http://dx.doi.org/10.1177/1471301216656087.

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The purpose of this qualitative study was to explore how physical and social environments influence spouses’ opportunities to maintain relationships when visiting a partner with dementia living in long-term care. Interviews with 15 spouses whose partners lived in long-term care facilities for persons with dementia, observations of physical environments and participant observations were conducted. The results showed how finding a place for spouses to connect in the long-term care facility was important in maintaining relationships. Access to individual rooms was an important feature that enabled connections throughout the phases of dementia, whereas common areas appeared more difficult to use because small spaces limited private interactions. Health personnel were important in sustaining spouses’ abilities to maintain their relationships in long-term care facilities for persons with dementia.

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Bell, J. Simon, Heidi T. Taipale, Helena Soini, and Kaisu H. Pitkälä. "Sedative Load among Long-Term Care Facility Residents with and without Dementia." Clinical Drug Investigation 30, no. 1 (January 2010): 63–70. http://dx.doi.org/10.2165/11531460-000000000-00000.

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Okada, Keiichi. "Feeding and Deglutition Trouble in Dementia on the Geriatric Health Services Facility." Kitakanto Medical Journal 59, no. 1 (2009): 9–14. http://dx.doi.org/10.2974/kmj.59.9.

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Lind, Kimberly E., Magdalena Z. Raban, Andrew Georgiou, and Johanna I. Westbrook. "Duration of Antipsychotic Medication Use by Aged Care Facility Residents With Dementia." Alzheimer Disease & Associated Disorders 33, no. 4 (2019): 331–38. http://dx.doi.org/10.1097/wad.0000000000000336.

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Kenny, Anne M., Sandra Bellantonio, Richard H. Fortinsky, Deborah Dauser, Alison Kleppinger, Julie Robison, Cynthia Gruman, Patricia Trella, and Stephen J. Walsh. "Factors Associated With Skilled Nursing Facility Transfers in Dementia-specific Assisted Living." Alzheimer Disease & Associated Disorders 22, no. 3 (July 2008): 255–60. http://dx.doi.org/10.1097/wad.0b013e31816c92d5.

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Blazek, Mary C., Laura Struble, Andre Cavalcante, and Johanna Masse. "Medical Students in a Dementia Care Facility: an Enhanced Geriatric Psychiatry Experience." Academic Psychiatry 40, no. 6 (May 1, 2015): 932–34. http://dx.doi.org/10.1007/s40596-015-0323-z.

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Gustin, Marija, Ivica Žuvela, Andrea Jerinić, Manuela Roso, and Ivana Kunić. "Incidence of dementia in Facility for older people in Dubrovnik - inclusion factor." Sestrinski glasnik/Nursing Journal 20, no. 2 (July 6, 2015): 121–27. http://dx.doi.org/10.11608/sgnj.2015.20.027.

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Mayes, Sheila R. "P2-281: THE ICARE APPROACH TO DEMENTIA CARE IN A HEALTHCARE FACILITY." Alzheimer's & Dementia 10 (July 2014): P579—P580. http://dx.doi.org/10.1016/j.jalz.2014.05.959.

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Nakanishi, Miharu, Yumi Shindo, and Junko Niimura. "Discharge Destination of Dementia Patients Who Undergo Intermediate Care at a Facility." Journal of the American Medical Directors Association 17, no. 1 (January 2016): 92.e1–92.e7. http://dx.doi.org/10.1016/j.jamda.2015.10.018.

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Legault, Alain, and Francine Ducharme. "Advocating for a Parent with Dementia in a Long-term Care Facility." Journal of Family Nursing 15, no. 2 (March 23, 2009): 198–219. http://dx.doi.org/10.1177/1074840709332929.

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Moyle, Wendy, Lorraine Venturato, Marie Cooke, Jenny Murfield, Susan Griffiths, Julian Hughes, and Nathan Wolf. "Evaluating the capabilities model of dementia care: a non-randomized controlled trial exploring resident quality of life and care staff attitudes and experiences." International Psychogeriatrics 28, no. 7 (March 10, 2016): 1091–100. http://dx.doi.org/10.1017/s1041610216000296.

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ABSTRACTBackground:This 12 month, Australian study sought to compare the Capabilities Model of Dementia Care (CMDC) with usual long-term care (LTC), in terms of (1) the effectiveness of the CMDC in assisting care staff to improve Quality Of Life (QOL) for older people with dementia; and (2) whether implementation of the CMDC improved staff attitudes towards, and experiences of working and caring for the person with dementia.Methods:A single blind, non-randomized controlled trial design, involving CMDC intervention group (three facilities) and a comparison usual LTC practice control group (one facility), was conducted from August 2010 to September 2011. Eighty-one staff members and 48 family members of a person with dementia were recruited from these four LTC facilities. At baseline, 6 and 12 months, staff completed a modified Staff Experiences of Working with Demented Residents questionnaire (SEWDR), and families completed the Quality of Life – Alzheimer's Disease questionnaire (QOL-AD).Results:LTC staff in the usual care group reported significantly lower SEWDR scores (i.e. less work satisfaction) than those in the CMDC intervention group at 12 months (p = 0.005). Similarly, family members in the comparison group reported significantly lower levels of perceived QOL for their relative with dementia (QOL-AD scores) than their counterparts in the CMDC intervention group at 12 months (p = 0.012).Conclusions:Although the study has a number of limitations the CMDC appears to be an effective model of dementia care – more so than usual LTC practice. The CMDC requires further evaluation with participants from a diverse range of LTC facilities and stages of cognitive impairment.

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Hamada, Shota, Taro Kojima, Yukari Hattori, Hiroshi Maruoka, Shinya Ishii, Jiro Okochi, and Masahiro Akishita. "Use of psychotropic drugs and drugs with anticholinergic properties among residents with dementia in intermediate care facilities for older adults in Japan: a cohort study." BMJ Open 11, no. 4 (April 2021): e045787. http://dx.doi.org/10.1136/bmjopen-2020-045787.

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ObjectivesTo evaluate the prescription and discontinuation of psychotropic drugs (PD) and drugs with anticholinergic properties (DAP) in residents with dementia admitted to Roken, a major type of long-term care facility in Japan.DesignCohort study.SettingA nationwide questionnaire survey across 3598 Roken in Japan in 2015 (up to five randomly selected residents per facility).ParticipantsThis study included 1201 residents from 343 Roken (response rate: 10%). We determined the presence and severity of dementia using a nationally standardised measure.Primary and secondary outcome measuresPrescriptions of PD and DAP at admission and 2 months after admission were evaluated. Multivariable logistic regression was used to evaluate the associations of residents’ baseline characteristics with prescriptions or discontinuation.ResultsPrescription rates decreased for antidementia drugs (19.4% to 13.0%), hypnotics (25.1% to 22.6%) and anxiolytics (12.3% to 10.7%), whereas those for other PD, such as antipsychotics (13.2% to 13.6%), antidepressants (7.4% to 6.7%), antiepileptic drugs (7.1% to 7.8%) and DAP (35.2% to 36.6%) did not statistically significantly decrease. Some factors were associated with the prescriptions, for example, for antipsychotics, older age (≥85 years) (adjusted OR (aOR), 0.60; 95% CI 0.43 to 0.85) and being bedridden (aOR 0.67; 95% CI 0.47 to 0.97) were associated with a lower use of antipsychotics, whereas severe dementia was associated with a higher use of antipsychotics (aOR 3.26; 95% CI 2.26 to 4.70). At an individual level, a quarter of residents prescribed PD or DAP at admission had discontinued at least one PD or DAP, respectively, 2 months after admission. Antidementia drug use in severe dementia (aOR 1.86; 95% CI 1.04 to 3.31) and PD use in older age (aOR 1.61; 95% CI 1.00 to 2.60; in residents with disabling dementia) were associated with discontinuation.ConclusionsThere is possible scope for deprescribing PD and DAP in Roken residents with dementia to mitigate the risks of adverse events.

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Giebel, Clarissa, Caroline Sutcliffe, Hilde Verbeek, Adelaida Zabalegui, Maria Soto, Ingalill Rahm Hallberg, Kai Saks, Anna Renom-Guiteras, Riitta Suhonen, and David Challis. "Depressive symptomatology and associated factors in dementia in Europe: home care versus long-term care." International Psychogeriatrics 28, no. 4 (December 11, 2015): 621–30. http://dx.doi.org/10.1017/s1041610215002100.

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ABSTRACTBackground:This study forms part of a larger European programme investigating the transition from home care to long-term care (LTC) facility in people with dementia (PwD) at the margins of LTC. The aim of this study was to explore the factors associated with depressive symptomatology in PwD in different settings.Methods:A total of 1,538 PwD, of which 957 received home care and 581 lived in a LTC facility, and their carers were interviewed. The Cornell Scale for Depression in Dementia (CSDD) measured depressive symptomatology. PwD completed measures of cognition and quality of life (QoL), and informal or formal carers completed measures on the PwD’ QoL, neuropsychiatric behavior, activities of daily living, comorbidities, pain, and falls. Logistic regression was used to assess which factors contributed to depressive symptomatology in the two settings.Results:Those receiving home care, living in Germany, and with severe dementia, showed the highest prevalence of depressive symptomatology. In the home care group, high levels of pain, neuropsychiatric behavior, and comorbidity, as well as low self- and proxy-rated QoL were factors associated with depressive symptomatology. In the LTC group, low proxy-rated QoL, more severe neuropsychiatric behavior, being a male informal carer and living in Germany were associated with depressive symptomatology.Conclusions:Evidence highlights the need for targeting different aspects in the management of depression in dementia, including offering improved pain management for those living in the community. Further research needs to explore cultural variations and carer gender factors associated with higher levels of depressive symptomatology.

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Journal articles on the topic 'Dementia facility'

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