Academic literature on the topic 'Senile dementia – Patients – Home care'

It was to explore the accuracy of intelligent home medical system based on Internet of Things (IoT) technology and its application value in home care of senile dementia patients. Based on IoT, 5th generation wireless systems (5G), and smart wearable technology, intelligent home medical system was designed from the perspectives of system environment and system design. Smart wearable technology-based wearable smart clothes could recognize and collect electrocardiosignal, breathing signal, body sway signal, and body temperature signal. The data were transmitted to the application layer through the information transmission and processing modules of middle layer, and the extraction accuracy of behavioral features and behavior correct recognition rate of the system were analyzed. 64 senile dementia patients treated in the hospital between January 2019 and June 2020 were selected as the research objects. They were divided into control group (routine family care) and observation group (intelligent medical care system) according to different nursing methods. Each group included 32 cases. Activity of daily living (ADL) scores, nursing satisfaction, and the accidents during care of the patients in two groups before and after care were summarized. The results showed that the behavioral feature extraction accuracy of intelligent home medical system was above 74.59% and its correct recognition rate of different behaviors reached over 98.5%. ADL score in the observation group was lower than that in the control group 3 months after care ( P < 0.05 ). ADL score in the observation group was significantly lower than that in the control group ( P < 0.01 ) 6 months after care. The satisfaction of the observation group was 78.13% (25 cases), which was remarkably higher than that of the control group (31.25%, 10 cases) ( P < 0.001 ). The total satisfaction of the observation group amounted to 93.75% (30 cases), which was higher than that of the control group (68.75%, 22 cases) ( P < 0.01 ). The total incidence of accidents in the control and observation groups was 28.13% and 3.13%, respectively. Obviously, the total incidence of accidents in the observation group was higher than that in the control group ( P < 0.001 ). The above results showed that the established intelligent medical care system demonstrated potential application values in home care, which provided a new idea for the nursing methods for senile dementia patients.

The article is devoted to the study of the problem of dementia in elderly and senile patients and the role of the district nurse in organizing care for patients and helping family members at home. In the practical part, the organization of work in the district and the analysis of statistical indicators in the district for 2018 are shown. Information material for patients and their families in the form of information notes have been created as a result of the work.

AbstractObjective: Diogenes syndrome or the senile squalor syndrome is characterised by gross self neglect, domestic squalor and social withdrawal. Two series of such patients have been described in Britain. This paper examines the frequency and characteristics of the syndrome in an Irish urban population and discusses the management issues involved. Method: Detailed demographic, social, medical and psychiatric data was collected on all patients fulfilling the criteria for Diogenes syndrome who were referred to the North Dublin Old Age Psychiatry Service over a two year period 1989-1990. Results: Twenty nine cases (5% of all referrals) were identified giving an incidence rate of 0.5% per annum. Most were single or widowed (83%), and living alone (72%). 79% were known to the public health nurse and 59% had at least one medical problem. The commonest reason for referral was self-neglect. Thirteen suffered from senile dementia, three had schizophrenia, three were alcohol dependent and 10 had no psychiatric diagnosis. Subsequently, 12 patients remained at home, 12 moved into residential care and five died. Conclusion: The patients in this Irish series resemble those in the two British series. Management issues emphasised are the need to consider each patient as an individual and to balance risk with the right to self-determination. The role of care teams for the elderly in overall management is discussed.

The present article involves a qualitative study of the framing of dementia in ‘Alzheimer’s and Dementia’, the Journal of the Alzheimer’s Association, published in 2016. The aim of this study is to elucidate how dementia is framed qualitatively in the corpus consisting of scientific articles involving dementia published in ‘Alzheimer’s and Dementia’. The results of the qualitative analysis indicate that dementia is represented in ‘Alzheimer’s and Dementia’ in 2016 as the frames associated with gender, age, costs, caregiver and care-recipients, disability and death, health policy, spatial orientation, medical condition, and ethnic groups. These findings are further discussed in the article. References Andrews, J. (2011). We need to talk about dementia. Journal of Research in Nursing, 16(5),397–399. Aronowitz, R. (2008). Framing Disease: An Underappreciated Mechanism for the SocialPatterning Health. Social Science & Medicine, 67, 1–9. Bayles, K. A. (1982). 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(2017). The language of dementia science and the science of dementia language:Linguistic interpretations of an interdisciplinary research field. Journal of Language andSocial Psychology, 36(1), 80–95. Wu, Y. T., Fratiglioni, L., Matthews, F. E., Lobo, A., Breteler, M. M., Skoog, I., & C. Brayne(2016). Dementia in western Europe: epidemiological evidence and implications for policymaking. The Lancet Neurology, 15(1), 116–124. Yuan, J., Zhang, Z., Wen, H., Hong, X., Hong, Z., Qu, Q., Li, H., & J.L. Cummings (2016).Incidence of dementia and subtypes: A cohort study in four regions in China. Alzheimer’s &Dementia, 12(3), 262–271. Zwijsen, S. A., van der Ploeg, E., & C.M. Hertogh (2016). Understanding the world ofdementia. How do people with dementia experience the world?. Internationalpsychogeriatrics/IPA, 1–11.

Describes the nature of senile dementia and discusses how different ways of thinking, relating, and using traditional religious symbols are needed by the pastoral caregiver in order to offer effective pastoral care to these patients. Focuses on two specific cases to illustrate the author's clinical experiences with senile dementia patients.

The article presents some features of palliative care for elderly and senile patients with dementia. The types and purposes of palliative care for patients with cognitive impairment, the principles of planning of palliative care, the features of nutrition of patients with dementia, the issues of assessing the pain syndrome and the treatment of co-morbidities in patients with dementia are considered.

A sample of 22 persons who care for relatives exhibiting initial symptoms of senile dementia were administered paper-and- pencil questionnaires to determine their level of subjective burden and psychological symptomatology. Each participant's attributional style was measured on an internal-external dimension, and their causal attributions regarding their relative's symptomatic behaviors were assessed. Results indicated that attributional style did not predict specific attributions about illness-related behaviors, but the tendency to not blame an afflicted relative for their behavior was predictive of subjective burden and symptoms of depression and anxiety. Subjective burden was found to predict feelings of hostility in caregivers.

This research project was a systematic evaluation of the effects of a personalized system of prosthetic aids to memory established in the home environment for individuals with mild to moderate dementia. The system of aids developed were in the form of a free-standing "Memory Center" unit. Caregivers were responsible for actively training their relatives to use the aids to compensate for deficits in orientation and memory for information necessary for daily functioning. The investigation was conducted in two phases, using a modified multiple baseline across subjects design. The two clients in Phase I met research criteria for Alzheimer type dementia and received a clinical dementia rating of moderate progression. Of the three clients in Phase II, two satisfied research criteria for Alzheimer type dementia, while one met research criteria for vascular dementia. All three were determined to have mild dementia. The effects of the intervention on the clients and the caregivers were examined over a four week intervention period and at a one month follow-up. The primary question addressed was whether clients could be trained to effectively use the prosthetic aids to orient themselves and compensate for deficits in memory function. This was assessed via daily assessments of verbal orientation. Weekly ratings of the behavioral functioning of clients were provided by the caregivers. And finally, caregivers rated their own stress and mood levels on a weekly basis throughout the study. Although the rates of learning varied, all of the clients increased their levels of verbal orientation following the introduction of the prosthetic aids and training. Evidence for generalized effects on the behavioral functioning of the clients was found. Overall, the clients were rated as expressing fewer negative emotions and as evidencing more oriented behaviors and less confused and disturbed behaviors during the intervention and at follow-up. Overall, the caregivers reported a consistent pattern of decline in their levels of stress and dysphoric mood. A common area of improvement was a reduction in negative emotions felt and expressed toward their relatives. Factors related to the success of the intervention and potential causal elements of change were discussed. Finally, recommendations for clinical practice and future research were provided.
Ph. D.

There is an increasing body of research evidence to support the use of music as a therapeutic modality in reducing the agitated behaviour frequently associated with late-stage dementia. Although much of this evidence suggests that music interventions are most effective when they are “individualized”, this type of intervention is often difficult to implement in large, busy, aged care facilities where residents may be located together in communal areas during the day. The challenge therefore is to try and identify a particular musical genre which, when played as “ambient” or “background” music, demonstrates a consistent capacity to reduce agitated behaviour in late-stage dementia across resident populations in multiple facilities. This study was designed to test the comparative utility of three different types of background music identified in the existing research literature as being of possible benefit in this context. These three types of music were: gentle classical music, familiar music and baroque music. Using a sample of 65 older people with late-stage dementia living in a total of eight residential aged care facilities, this quasi-experimental study used quantitative measures to assess a specific range of agitated behaviours over a one week intervention period. The specific agitated behaviours were documented using the Scale for the Observation of Agitation in Persons with Dementia (SOAP-D) scale (Hurley, Volicer, Camberg, Ashley, Woods, Odenheimer, Ooi, McIntyre, & Mahoney, 1999). In addition, the Quality of Life in Alzheimer’s Disease (QoL-AD) tool (Logsdon, 1999) was used to collect collateral information from family members or experienced care staff at each of the participating facilities about whether they perceived that the playing of music exerted any influence on the quality of life of participants. Participants were randomly assigned to one of five experimental subgroups of equal size. Participants in three of the five groups received exposure to audio recordings of music. Participants in one of the two remaining sub-groups were exposed to a non-musical intervention (audio recordings of storybooks) at the same time of day as the participants in the three music groups. Data relating to behaviour and perceived quality of life were recorded in the same manner for this group. The final group of participants acted as the control group for the study. Quantitative data were collected in the same manner for this group: however, they were exposed to no intervention. In addition, a series of structured interviews was undertaken with experienced care providers at each of the participating residential aged care facilities. The purpose of this procedure was to determine whether the experiences and subjective opinions of staff regarding the utility of music as an intervention to settle agitated behaviour in late-stage dementia and improve quality of life were consistent with the observational data recorded using the SOAP-D scale in conjunction with the proxy-rated QoL-AD scale. Results of the study indicated that overall levels of agitated behaviour were less within the three groups exposed to music compared with the nonmusic intervention group and the control. However, perceived quality of life was not measurably improved in any of the three music intervention groups. This study supports the continued use of music as a therapeutic intervention in the management of maladaptive behaviour associated with late-stage dementia, although the results do not support the preferential use of any of the three selected music forms.

The purpose of this study was to evaluate the recreational activities provided in special care units located in the Inland Empire. The population that this study sought to assist was patients diagnosed with Alzheimer's disease and living in an Alzheimer's special care unit.

The purpose of the study was to develop a behavioral nursing intervention strategy for specific deficits in grooming performance of elders with dementia. A quasi-experimental two-group design using switching replications with removed intervention was employed. Three residents with severe cognitive impairments and three residents with mild cognitive impairments were chosen from a special dementia care unit of a long-term care facility. Three residents among six residents were randomly selected to receive the behavioral intervention early. Baseline and post-intervention assistance was provided by nurse aides. Each resident was asked to wash hands, brush teeth, wash face, and comb hair in a sequence. Ten intervention sessions were conducted by the trained intervener for two consecutive weeks. The intervention consisted systematic prompting and social reinforcement. A total of 21 sessions were collected in the morning using videotape recordings. Interobserver agreement for the instruments designed by the investigator was measured by the trained observers. Data were analyzed in two phases. First, the quantitative data were analyzed to determine the independent functional behaviors of individuals, and the change in the intensity of nursing effort associated with grooming of elders with dementia. Data were examined by individual graphic display throughout the three phases (baseline, nursing intervention, post-intervention). Second, the qualitative data were analyzed to determine the antecedents, consequences, and resident responses associated with grooming, the caregiver problem behaviors, and resident problem behaviors associated with grooming performance. The results show that the functional behaviors of even severely demented elders can be promoted, indicating the effectiveness of nursing care strategies on the ADL task of grooming. The data in this research suggest that maintaining or improving functional ability is possible with a behavioral nursing intervention, which was a highly structured and systematic approach that involved modifying the environmental and behavioral context, through strategies such as prompting and social reinforcement, when necessary. Furthermore, through the qualitative analysis, the functional relationships between antecedents, consequences, and behaviors of demented elders allowed the investigator to analyze the caregiver problem behaviors and resident behavior problems associated with grooming.

Thesis (Ph.D.) -- La Trobe University, 2004.
"A thesis submitted in total fulfillment of the requirements for the degree of Doctor of Philosophy, School of Public Health, Faculty of Health Sciences, La Trobe University, Bundoora." Research. Includes bibliographical references (leaves 343-362). Also available via the World Wide Web.

The purpose of this study was to determine if distinct subgroups of patients with Senile Dementia of the Alzheimer Type (SDAT) could be identified using seven scales of the Cognitive Behavior Rating Scale (CBRS). Ward's method of cluster analysis was used to group 104 patients with a probable diagnosis of SDAT into subtypes.The following three clusters were identified: (a) Moderately Impaired, (b) Severely Impaired, and (c) Emotionally Intact which displayed differences in symptom severity. Clusters could be partially defined by the amount of time they had been diagnosed with the disease. Differences in the cluster's configuration of scores had little/no descriptive utility. Subsequent discrimination analyses indicated that patient demographics were not as useful as the CBRS in classification of patients.This study provided evidence for the CBRS's ability to differentially portray SDAT patients' profiles. Results provide partial support for a stage model of SDAT. Implications of existing subgroups in SDAT are discussed as they pertain to patient management issues.
Department of Counseling Psychology and Guidance Services

Objective: To synthesis evidence from systematic reviews at international level to explore effective community and home based care interventions for family caregivers (FCGs), which may affect quality of life of persons with dementia (PWDs) and their FCGs in China. Methods: A systematic review of reviews was conducted. Studies were identified through Scopus, PubMed and EBSCO databases. Non-pharmacological interventions targeted on FCGs with outcome domains related to psychological health or quality of life of PWDs and/or their FCGs were within this review scope. Quality of systematic reviews was evaluated by AMSTAR. Quality of primary studies included in the systematic reviews was assessed by their internal and external validity. Results: Three systematic reviews of moderate to high quality with 74 publications were included in this systematic review. Among the primary studies, about 60% were conducted by randomized controlled design, and about 85% were carried out in high-income countries. Results at review level suggested that communication skills training, internet-based care management, coping strategy, individual behavioral management techniques were effective interventions for FCGs of PWDs. In contrast, most of the primary studies reported that community or home based interventions positively affected FCGs and/or PWDs. Those interventions included communication skills training, internet-based care management, supportive therapy, educational intervention, coping strategy, behavioral management techniques; yet the effects yielded statistically insignificant in most of the trials. In particular, significant effects of community care interventions were found in 8 of 69 trials on FCGs’ psychological health, 3 of 4 trials on FCGs’ competence, 0 of 2 trials on FCGs’ quality of life, and 3 of 7 trials on PWDs’ quality of life. Combination of those community care intervention components was observed in most of the trials with significant effects. Conclusion: Communication skills training, internet-based care management, supportive therapy, educational intervention, coping strategy, behavioral management techniques had positive effects on FCGs of PWDs living in the community. The combination among those intervention components and designing intervention model in FCG needs-oriented manner underpinned a potential significant effect. Given distinguished social economic contexts in urban and rural areas, implementation of community care interventions specific to FCGs in China should be handled with cautions and strengthened by policy supports to empower aging at home.
published_or_final_version
Public Health
Master
Master of Public Health

The United States population of elderly persons is growing quickly, causing an increase in concern for their health care needs. Dementia is a condition that affects the elderly. With an increase in persons with dementia, there is also an increase in apprehension of care choices. National data and published literature were used to study dementia and its effects on the patient and their family caretakers. The study concluded that minority families were less likely to institutionalize elderly dementia patients into nursing care due to a variety of cultural biases. White dementia patients had the highest number of admittance into nursing homes. This was also prevailing in the specialty care unit for dementia patients. Understanding the cultural differences and needs of the minority patient can help organizations improve the disparity among dementia patients admitted into nursing homes.

AbstractThis paper aims at understanding the social behavior of people with dementia through the use of technology, specifically by analyzing localization data of patients of an Alzheimer’s assisted care home in Italy. The analysis will allow to promote social relations by enhancing the facility’s spaces and activities, with the ultimate objective of improving residents’ quality of life. To assess social wellness and evaluate the effectiveness of the village areas and activities, this work introduces measures of sociability for both residents and places. Our data analysis is based on classical statistical methods and innovative machine learning techniques. First, we analyze the correlation between relational indicators and factors such as the outdoor temperature and the patients’ movements inside the facility. Then, we use statistical and accessibility analyses to determine the spaces residents appreciate the most and those in need of enhancements. We observe that patients’ sociability is strongly related to the considered factors. From our analysis, outdoor areas result less frequented and need spatial redesign to promote accessibility and attendance among patients. The data awareness obtained from our analysis will also be of great help to caregivers, doctors, and psychologists to enhance assisted care home social activities, adjust patient-specific treatments, and deepen the comprehension of the disease.

AbstractIn the health care sector, person-centred treatment approaches have shown the potential to improve treatment outcomes and quality of life of patients. In particular, this applies where patients are living with complex conditions like multimorbid older patients with Mild Cognitive Impairment (MCI) or mild dementia. Such treatment approaches quite often include input from modern health technologies like health/home monitoring platforms which also offer services to patients for self-management of their conditions. This approach is also followed in the research project CAREPATH (An Integrated Solution for Sustainable Care for Multimorbid Patients with Dementia). To achieve acceptance of such complex health technologies, their services must be beneficial in the eyes of target end users which included in the case of CAREPATH, the patient’s informal caregivers. Therefore, understanding the user requirements of patients and their informal caregivers is of utmost importance which was achieved in CAREPATH by interviews. These revealed that patients’ preferences in regard to what services and information shall be provided to them shall be limited to what they deem necessary which is highly personal. Informal caregivers as opposed to patients, are much interested in receiving most possible information about their care-dependent’s health status. Thus, provision of services and information for these user groups need to be highly customizable to their personal preferences and needs.

The astonishing expansion of Internet of Things has opened a lot of opportunities for related domains to employ strategies that were successfully used for the “things” governance. Furthermore, because of the technology blending in the most common household devices and wearable items, it becomes very easy for the computers to sense the surrounding environment and to collect information about the inhabitants, therefore transforming the intelligent house in a Home Care System (HCS). For medical conditions like dementia and its associated diseases, it is very convenient to monitor the patients in their living space because the patient will benefit from their home comfort. In addition, the costs for in hospital monitoring will decrease. This chapter proposes an Internet of Things Governance Architecture that can be used to sustain and monitor a complex e-health system, with application especially for patients with dementia and its associated diseases.

The astonishing expansion of Internet of Things has opened a lot of opportunities for related domains to employ strategies that were successfully used for the “things” governance. Furthermore, because of the technology blending in the most common household devices and wearable items, it becomes very easy for the computers to sense the surrounding environment and to collect information about the inhabitants, therefore transforming the intelligent house in a Home Care System (HCS). For medical conditions like dementia and its associated diseases, it is very convenient to monitor the patients in their living space because the patient will benefit from their home comfort. In addition, the costs for in hospital monitoring will decrease. This chapter proposes an Internet of Things Governance Architecture that can be used to sustain and monitor a complex e-health system, with application especially for patients with dementia and its associated diseases.

The first part of this chapter reviews the design, implementation, and customer experience with the OLDES SW tele-care platform developed within the EU project Older people’s e-services at home. The OLDES solution has been successfully tested at two different locations: in Italy with the participation of a group of 100 seniors (including 10 senior citizens suffering from heart disease), and in the Czech Republic, with the involvement of a group of 10 diabetic patients. The suggested OLDES approach proved to be an effective solution for municipalities, hospitals, and their contact centres for providing health and social services. The project partners therefore decided to develop a second generation of the system called SPES (Support to Patients through E-Service Solutions), which started in April 2011. The SPES project aims at transferring the original approach and results achieved in implementing the OLDES focusing on new target problem domains: dementia, mobility-challenged persons, respiratory problems, and social exclusion.

In the Netherlands, there is currently an ongoing transition whereby a relevant part of long-term institutionalized care for dementia patients is being shifted to care at home. Legislation was changed in 2015 to achieve this goal. However, primary and nursing home care still needs to be redesigned to meet the needs of dementia patients and society. Improving network care holds great promise for this transition, as current dementia care in the Netherlands still falls short in terms of fragmentation of care, ad hoc collaboration, lack of feedback on quality and efficiency of care to healthcare professionals involved, and inadequate implementation of established multidisciplinary guidelines.

In the United Arab Emirates (UAE), members of the extended family play a key role in caring for people with dementia. Culture has a strong influence on family caregivers’ motivation, and Emirati people believe strongly that it is their (religious) duty to provide care for their parents and other family members, including those with dementia. This setup contributes positively to keeping elderly people living at home. However, maintaining health and independence in old age will become increasingly challenging in the future, with the increasing ageing population in the UAE, which is expected to reach up to 11% by 2032. Currently, the UAE has no National Dementia Care Strategy, and epidemiological data on dementia in the country are scarce. However, Dubai is known to have a more or less comprehensive system of care for geriatric patients, including dementia care facilities. These dementia care facilities are available free of charge to Emirati citizens.

The main caregivers of elderly people with dementia in Singapore are the family. In recent years, community services like day care centres, home care, respite care, and nursing homes have expanded. Non-governmental organizations are actively involved in providing a spectrum of services, ranging from medical, nursing, physiotherapy, occupational therapy, and counselling. General hospitals have set up geriatric and psycho-geriatric teams for dementia patients. There is now a focus on dementia prevention, and a successful prevention programme has been extended to three additional community centres. The challenge ahead is not only having sufficient dementia services, but also ensuring there are sufficient trained health professionals to provide the services. Current strengths in dementia care include strong emphasis on family care, increased availability of dementia community services like day care centres, and increased number of health professionals trained in dementia care. Future priorities include integrating hospital care into the community, keeping down the cost of dementia care, and creating dementia-friendly environments.

Background: In the last 10 months, amid the Covid-19 pandemic, several studies have demonstrated the viability of health education and virtual support strategies for caregivers of dementia patients to provide home care. Low and middle-income countries in particular, have sought to use these approaches to reduce the daily burden of caregivers, through virtual meetings providing education and support. Objectives: To present the feasibility of a pilot study on the use of a care support action under the CAAD Project - indirect costs of dementia – run by the HC-FMUSP. Methods: An observational study of 93 caregivers invited to participate in virtual 1-hour meetings three times a week was conducted. Results: Of the 93 family members who took part, 42 answered the eight questions about the effectiveness of the action after 3 months. The rate of positive responses for program satisfaction was high, ranging from 86% to 100%. Conclusion: The study results of this simple intervention suggest the utility of the program for caregivers of dementia patients in primary care. The intervention can provide a better understanding of difficulties faced by caregivers in their daily care of dementia patients and daily management guidance on a case-by-case basis. The program also promoted the implementation of an education strategy on the importance of understanding and recognizing anatomical-physiological changes in the aging process and their implications for the invisible line between senescence and senility. This process empowers the caregiver to feel able to protect both the patient and themselves by preventing the emergence of common diseases in this age group. Further studies are needed to explore this non-pharmacological support approach.