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Wang, Qiong. "Computer Internet of Things-Based Intelligent Medical System to Be Applied in Home Care of Senile Dementia Patients." Wireless Communications and Mobile Computing 2022 (May 9, 2022): 1–12. http://dx.doi.org/10.1155/2022/1374835.
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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.
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Melkina, L. "Role of district nurse in the organization of care for elderly and senile patients with dementia." Medsestra (Nurse), no. 1 (January 1, 2020): 20–23. http://dx.doi.org/10.33920/med-05-2001-03.
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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.
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Hong, Yeo Shin, Sun Ja Lee, Hyeoun Ae Park, Nam Ok Cho, and Jin Ju Oh. "Study on the Effectiveness of Care Giver Education Program on the Home Care of Senile Dementia Patients." Journal of Nurses Academic Society 25, no. 1 (1995): 45. http://dx.doi.org/10.4040/jnas.1995.25.1.45.
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Wrigley, Margo, and Colm Cooney. "Diogenes syndrome — an Irish series." Irish Journal of Psychological Medicine 9, no. 1 (May 1992): 37–41. http://dx.doi.org/10.1017/s0790966700013896.
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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.
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Капранов, Олександр. "The Framing of Dementia in Scientific Articles Published in ‘Alzheimer’s and Dementia’ in 2016." East European Journal of Psycholinguistics 3, no. 2 (December 22, 2016): 32–48. http://dx.doi.org/10.29038/eejpl.2016.3.2.kap.
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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.
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Rosin, A. J., L. Abramowitz, J. Diamond, and P. Jesselson. "Environmental Management of Senile Dementia." Social Work in Health Care 11, no. 1 (December 12, 1985): 33–43. http://dx.doi.org/10.1300/j010v11n01_03.
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Vernooij-Dassen, Myrra, Frans Huygen, Albert Felling, and Jean Persoon. "HOME CARE FOR DEMENTIA PATIENTS." Journal of the American Geriatrics Society 43, no. 4 (April 1995): 456–57. http://dx.doi.org/10.1111/j.1532-5415.1995.tb05829.x.
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O'Connor, Thomas St James. "Ministry without a Future: A Pastoral Care Approach to Patients with Senile Dementia." Journal of Pastoral Care 46, no. 1 (March 1992): 5–12. http://dx.doi.org/10.1177/002234099204600103.
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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.
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Kuznetsova, Olga Yu, and Irina E. Moiseeva. "Features of palliative care for patients with dementia." Russian Family Doctor 21, no. 2 (June 15, 2017): 5–12. http://dx.doi.org/10.17816/rfd201725-12.
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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.
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MIYAHARA, Shinji, Sachie YAMASHITA, and Takako TSUKAHARA. "What Makes Long-Term Home Care Possible for People with Senile Dementia." JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE 60, no. 4 (November 30, 2011): 507–15. http://dx.doi.org/10.2185/jjrm.60.507.
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Sun, Wei, Jinxia Liu, Lihua Liu, and Xiuzhi Wang. "Management Strategy of Alzheimer’s Patients under the Medical-Care Integration Model Based on Big Data Evaluation." BioMed Research International 2022 (October 11, 2022): 1–11. http://dx.doi.org/10.1155/2022/9896935.
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In the context of the era of big data, the management of Alzheimer’s patients has aroused widespread concern in the society. What should the elderly and people with dementia do and how the society should accommodate these special groups have aroused heated discussions in the society. The goal of the medical-nursing integration model is to realize the integrated model of medical care-nursing-rehabilitation-old care, and to better satisfy the needs by providing medical services, rehabilitation care, and health management. The medical needs of the elderly can help the elderly maintain a healthy state; the elderly care needs can be better met through elderly care services, and the burden on families and society can be reduced. With the advancement of the medical-care integration model, new solutions have been provided for the management of senile dementia patients. Therefore, under the medical-care integration model, this paper managed Alzheimer’s patients based on the big data algorithm based on association rules and compared it with the management of Alzheimer’s patients under the traditional model, and drew the following conclusions: compared with the management satisfaction of Alzheimer’s patients under the traditional model, family members and patients’ total satisfaction with nursing management under the medical-care integration model was greatly improved; compared with the management of Alzheimer’s patients under the traditional model, the incidence of adverse events in the management of Alzheimer’s patients under the medical-care integration model was greatly reduced, which was reduced to 17.6%; under the medical-care integration model, the anxiety and depression scores of the elderly patients with dementia decreased rapidly; under the medical-care integration model, the living ability of senile dementia patients has been greatly improved; the use of the medical-care integration model to manage senile dementia patients has greatly improved the sleep quality, mental quality, and quality of life of senile dementia patients.
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Nikmat, Azlina Wati, Graeme Hawthorne, and S. Hassan Al-Mashoor. "Quality of life in dementia patients: nursing home versus home care." International Psychogeriatrics 23, no. 10 (June 24, 2011): 1692–700. http://dx.doi.org/10.1017/s1041610211001050.
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ABSTRACTBackground: Care management providing a high quality of life (QoL) is a crucial issue in dealing with increasing numbers of dementia patients. Although the transition from informal (home-based) care to formal (institutional) care is often a function of dementia stage, for those with early dementia there is currently no definitive evidence showing that informal or formal care provides a higher QoL, particularly where informal care is favored for local cultural reasons. This paper outlines the research protocol for a study comparing formal and informal care in Malaysia. It seeks to provide evidence regarding which is more appropriate and results in higher QoL in early dementia.Methods: This is a quasi-experimental study design involving 224 early dementia patients from both nursing home and community settings. Participants will be assessed for cognitive severity, QoL, needs, activities of daily living, depression and social isolation/connectedness by using the Mini-Mental State Examination (MMSE), Cognitive Impairment Scale – 4 items (CIS-4), EUROPE Health Interview Survey-Quality of Life (WHO8), Assessment of Quality of Life (AQoL8), Camberwell Assessment of Need for the Elderly – Short Version (CANE-S), Barthel Index (BI), Cornell Scale for Depression (CSDD), Geriatric Depression Scale – 15 items (GDS-15), and Friendship Scale (FS) respectively.Conclusion: This study aims to provide a better understanding of care needs in early dementia. Given population aging, the study findings will provide evidence assisting decision-making for policies aimed at reducing the burden of caregiving and preserving the QoL of dementia patients.
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乔, 疏桐. "Meta Analysis of Intervention Effect of Hospice Care on Senile Dementia Patients." Nursing Science 11, no. 05 (2022): 700–709. http://dx.doi.org/10.12677/ns.2022.115110.
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Wada, Kazuyoshi, Takanori Shibata, Takashi Asada, and Toshimitsu Musha. "Robot Therapy for Prevention of Dementia at Home – Results of Preliminary Experiment." Journal of Robotics and Mechatronics 19, no. 6 (December 20, 2007): 691–97. http://dx.doi.org/10.20965/jrm.2007.p0691.
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In robot therapy for senile dementia patients, a seal-like robot, Paro, was left in patients’ homes for a week to determine its neuropsychological influence. Efficacy was evaluated by the diagnosis method of neuronal dysfunction (DIMENSION), which detects a lack of smoothness of scalp potential distribution resulting from cortical neuronal impairment by analyzing recorded a patient’s electroencephalogram (EEG). Interaction with Paro by patients was observed by their families. In a preliminary experiment, 5 subjects were studied after informed consent was received from them or their families in accordance with the medical ethics committee of the University of Tsukuba and the AIST ethics committee.
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Andersson, M., and C. G. Gottfries. "Dementia Syndromes in Nursing Home Patients." International Psychogeriatrics 4, no. 2 (September 1992): 241–52. http://dx.doi.org/10.1017/s1041610292001078.
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Patients (n = 191) living in four comparable somaic nursing homes (NH) (nursing homes for physical illness) were studied in order to evaluate dementia syndromes. Dementia and symptoms of depressed mood occurred frequently (72% and 63%, respectively). Dementia was often undiagnosed at admittance. Neither the length of time spent in institutions, nor marital status, age, or sex seemed to be of more than minor importance to the prevalence of dementia syndromes. Concerning functional impairment, convergence of findings across the societies studied indicates that psychiatric symptoms and psychopathology are intrinsic parts of long-term care of the elderly.
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Greer, A., D. H. McBride, and A. Shenkin. "Comparison of the Nutritional State of New and Long-term Patients in a Psychogeriatric Unit." British Journal of Psychiatry 149, no. 6 (December 1986): 738–41. http://dx.doi.org/10.1192/bjp.149.6.738.
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Nutritional deficiencies have been implicated in the pathophysiology of various mental disorders. Life in institutions has been associated with development of nutritional deficiencies, the elderly being most at risk especially those with senile dementia. In this study nutritional status, particularly vitamin and essential mineral status was assessed in a group of 64 new admissions to a psychogeriatric unit and 49 long-term patients.The results indicated that psychogeriatric patients were at risk of experiencing nutritional deficiencies and those with senile dementia were likely to have more abnormalities than those with functional illnesses. Those patients in long-term care would appear to have a better nutritional state than those on admission.
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Yamanaka, Takashi, Maiko Mizuki, Kiwami Kidana, Ryonosuke Yamaga, and Masahiro Akishita. "CHARACTERISTICS OF LONG-TERM HOME CARE PATIENTS WITH DEMENTIA." Innovation in Aging 6, Supplement_1 (November 1, 2022): 524. http://dx.doi.org/10.1093/geroni/igac059.1998.
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Abstract This study aimed to clarify the characteristics of older adults with dementia receiving physician home visits. We prospectively registered 179 patients aged ≥65 years, estimated to receive physician home visits for over 6 months, in a clinic in Chiba, Japan, in 2020–2021. The patients’ mean (±SD) age was 85.1±7.4 years and ranged from 68 to 102 years. Out of the total patients, 57.5% were men. We collected clinical information; employed the Dementia Assessment Sheet in Community-based Integrated Care System 21 items (DASC-21) and EuroQOL five dimensions 5-level (EQ-5D-5L) every 6 months; and calculated the incidence of death. Eighty-two patients (45.8%) were diagnosed with dementia at the commencement of physician home visits. The characteristics of older adults diagnosed with dementia (D+ group) were compared with the characteristics of those who were not (D- group). The D+ group was older than the D- group (86.4±6.6 years vs. 84.1±8.0 years, p=0.04118). Total cholesterol levels and DASC-21 scores were higher in the D+ group compared to the D- group (180.2±41.7 vs. 163.7±51.2, p=0.04091; 62.3±14.5 vs. 50.2±16.2, p=0.00004, respectively). The EQ-5D-5L was not significantly different between the groups (0.439±0.255 vs. 0.397±0.267, p=0.32409). The proportion of those living in assisted living facilities or fee-based homes for the elderly was higher in the D+ group (χ2=8.5177, df=2, p=0.01414, V=0.2258). The mortality rate after 6 months was 20.7% in the D+ group and 16.5% in the D- group (χ2=0.5305, df=1, p=0.46641). In conclusion, the characteristics of patients with dementia should be further elucidated to provide better care.
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Jarrín, Olga F., Abner Nyandege, Robert J. Rosati, and Tami J. Videon. "IDENTIFYING PATIENTS WITH PROBABLE DELIRIUM AND DEMENTIA FROM ROUTINE HOME HEALTH CARE ASSESSMENTS." Innovation in Aging 3, Supplement_1 (November 2019): S121. http://dx.doi.org/10.1093/geroni/igz038.443.
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Abstract Timely education of patients and their family caregivers on dementia disease management and health behavior changes and referral to additional resources is an essential part of age-friendly and high quality care. Nearly one out-of-three home health care patients has been diagnosed with dementia, however, family members and front-line health care providers are frequently unaware that a diagnosis of dementia has made, and what to do. The aim of this study was to identify a small set of questions that are routinely collected during home health care assessment which can be used to rapidly identify patients with suspected dementia, who may benefit from additional screening and services. We developed the preliminary model from 100% national home health care assessment data from 2014 (4.1 million people). We validated the model with a sample of nearly 27,000 patients who received a new (start-of-care) home health assessment in 2016, from four home health agencies that share a common data warehouse. The final model consisting of five questions, performed well in national data (AUC 0.85) predicting any diagnosis of dementia contained in the Medicare Chronic Conditions warehouse or home health record. The final model performed similarly (AUC 0.87) in the validation sample, predicting a diagnosis of dementia or history of dementia medication during a 3-year window of time from clinical data warehouse. The potential applications of this model have the potential to accelerate timely identification of patients with probable dementia or delirium, patient and family caregiver education, and referral to rehabilitative and supportive services.
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Aasgaard, Heid Svenkerud, Lisbeth Fagerstrom, and Bjørg Landmark. "Nurses’ Experiences of Providing Care to Dementia Patients Through Home Health Care." Home Health Care Management & Practice 26, no. 4 (April 28, 2014): 230–38. http://dx.doi.org/10.1177/1084822314530992.
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Yeh, Tzu-Pei, Hsing-Chia Chen, and Wei-Fen Ma. "A Qualitative Exploration of the Needs of Community-Dwelling Patients Living with Moderate Dementia." International Journal of Environmental Research and Public Health 18, no. 17 (August 24, 2021): 8901. http://dx.doi.org/10.3390/ijerph18178901.
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Few studies have focused on developing a better understanding of the needs of patients with moderate-stage dementia. This study aimed to explore the needs of people living with moderate dementia and receiving home-care services from a local mental hospital. The study adopted a descriptive qualitative approach with purposive sampling to recruit patients with moderate dementia and receiving home-care services. Data were collected by face-to-face interviews and content analysis was used to interpret the experiences in the dialogue data. The results showed that the needs of people living with moderate dementia receiving home-care services contained four themes: the demand for company and care, the wish to recall familiar images, the need of reaffirming life purpose and value through reflection and reminiscence, and the desire for making autonomous end-of-life decisions. In addition to daily care, people living with moderate dementia crave companionship, expect meaningful exchanges of experiences to share their life, and have demands to have a voice in going through the final stage of life. The participants tended to focus more on issues related to the connections between living and dying. The results provide caregivers and home-care service providers with some insights into offering better care for people living with moderate dementia.
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Luth, Elizabeth A., and David Russell. "RISK FACTORS FOR DISENROLLMENT AMONG HOME HOSPICE PATIENTS WITH DEMENTIA." Innovation in Aging 3, Supplement_1 (November 2019): S791. http://dx.doi.org/10.1093/geroni/igz038.2911.
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Abstract Hospice delivers care to a substantial and growing number of individuals with primary and comorbid dementia diagnoses. Dementia diagnosis and racial/ethnic minority status are risk factors for hospice disenrollment. However, little research examines racial/ethnic disparities and other risk factors for hospice disenrollment among hospice patients with dementia. This paper uses multinomial logistic regression to explore sociodemographic and functional status risk factors for hospice disenrollment among 3,949 home hospice recipients with primary or comorbid dementia. Results indicate that patients with a primary dementia diagnosis, racial/ethnic minority groups, and those higher functional status have elevated risk of disenrollment due to hospitalization, disqualification, and electively leaving hospice care. Additional research is needed to understand why primary dementia diagnosis and underrepresented racial/ethnic status are associated with multiple kinds of hospice disenrollment so that hospice practice can be tailored to respond to the needs of these individuals.
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Noel, Margaret A., Thomas S. Kaluzynski, and Virginia H. Templeton. "Quality Dementia Care." Journal of Applied Gerontology 36, no. 2 (July 9, 2016): 195–212. http://dx.doi.org/10.1177/0733464815589986.
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Absent a cure or effective disease modifying treatment for dementia, developing cost-effective models of care that address the needs of caregivers alongside the medical management of the disease is necessary to maximize quality of care, address safety issues, and enhance the patient/caregiver experience. MemoryCare, a community-based non-profit organization, has 15 years of experience delivering a medical and care management model for persons with Alzheimer’s disease and other types of dementia. Designed to supplement primary care services, the average annual cost-per-patient is US$1,279. Observational data on 967 patients and 3,251 caregivers served by the program in 2013 reveal high levels of satisfaction, increased dementia-specific knowledge, improved perceived ability to manage challenging behavioral aspects of dementia, and lengthened perceived time in the home setting. Data suggest lower hospitalization rates and related cost savings. These findings warrant a further study of broader integration of caregivers into clinical care models for persons with dementia.
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Byrne, E. Jane. "Dementia with Lewy bodies." Advances in Psychiatric Treatment 4, no. 6 (November 1998): 360–63. http://dx.doi.org/10.1192/apt.4.6.360.
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Dementia with cortical Lewy bodies (LBD) was first described by Okazakiet alin 1961 and is now recognised as a relatively common cause of the dementia syndrome. The true prevalence of LBD is unknown. In post-mortem studies of patients diagnosed as having dementia in life, the mean frequency of Lewy body dementia is 12.5% (Byrne, 1997). Clinically diagnosed LBD (using operational clinical criteria) is found in 10–23% of patients presenting to, or in the care of, psychogeriatric services (Collertonet al, 1996). What is not yet certain is its nosological status; opinion is divided between regarding it as a variety of Alzheimer's disease (the Lewy body variant), a distinct disease (senile dementia of the Lewy body type) or a spectrum disorder related to both Parkinson's disease and to Alzheimer's disease (Byrne, 1992).
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Muthukrishnan, Sabarigirivasan, Kate Hydon, Lucy Young, and Cristie Howells. "345 - 7 Critical factors for safely supporting dementia patients in mental health crisis in community." International Psychogeriatrics 32, S1 (October 2020): 105–6. http://dx.doi.org/10.1017/s1041610220002458.
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Background:Best practice in dementia care is support in the home. Yet, crisis is common and can result in hospital admission. Home-treatment of crisis is an alternative to hospital admission that can have better outcomes and is the preference of people living with dementia.Purpose:To report an investigation of the management of crisis for people with dementia living at home and managed by a Home Treatment Crisis Team.Objective:To identify critical factors for successful resolution of crisis and avoidance of hospital admissionMethods:The research was mixed-methods case study design. It was an in depth investigation of what happens during crisis in people with dementia and how it is managed by a home treatment crisis team to resolution and outcome at six weeks and six months. Methods were observation of the management of crisis in the home setting for 15 people with dementia (max 3 per person, total 41 observations), interviews with people with dementia (n=5), carers (n=13), and 14 professionals (range 1 to 6 per person, total 29), a focus group with professionals (n=9) and extraction from medical records of demographics and medical history.The analysis focused on the identification of key treatments, behaviours, education and context important for home treatment to prevent hospital admission.Findings:The study recruited 15 of the 88 accepted referrals to the service for management of a crisis in a person with dementia.The seven key factors key for crisis resolution were a systems approach with embedded respect for personhood,attention to carer needs independently of the person with dementia,review and monitoring of the effect of medications,awareness and promotion of potential benefits with treatment at home,education of the health and social care workforce in dementia care,local availability of respite and other social care services.a dynamic and flexible working ethos and meaningful MDT working with flattened hierarchyThe Home Treatment Crisis Team created a ‘Safe Dementia Space’ for the person with dementia in crisis. In the first instance, this was immediate but temporary with on-going assessment and intervention until negotiated permanent support was in place coproduced and agreed by stakeholders to be a sustainable dementia space with acceptable risk of harm to the person with dementia or others. The approach enabled avoidance of hospital admission in more than 80% of referrals.Conclusion:This is the first study to collect data during crisis at home for people with dementia and to investigate process and management. It reveals the Home Treatment Crisis Team created sustainable ‘Safe Dementia Space’ to enable the person with dementia to continue to live in the community during and after crisis, thus avoiding hospital admission. The identified key components of the management approach for crisis resolution are important considerations in the design and delivery of home treatment services for people with dementia in the UK and beyond.
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RN, Sture Åström. "Health care students' attitudes towards, and intention to work with, patients suffering from senile dementia." Journal of Advanced Nursing 11, no. 6 (November 1986): 651–59. http://dx.doi.org/10.1111/j.1365-2648.1986.tb03382.x.
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Tännsjö, Torbjörn. "Informal Coercion in the Physical Care of Patients Suffering from Senile Dementia or Mental Retardation." Nursing Ethics 6, no. 4 (July 1999): 327–36. http://dx.doi.org/10.1177/096973309900600408.
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This article discusses under what circumstances patients who are suffering from senile dementia or mental retardation should be submitted to coercive care, who should decide about this kind of coercion, and in what legal framework it should take place. A distinction is drawn between modest (i.e. of moderate degree) and meddlesome coercion. The use of modest coercion is defended. It is argued that medical personnel ought to decide exclusively about the use of modest coercion. However, no law should render legitimate the use of even modest coercion. It is conceded that to prohibit the use of a kind of coercion that is expected to take place is hypocrisy. It is argued that this is, however, an acceptable form of hypocrisy.
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Knox, Sara, Brian Downer, Allen Haas, Addie Middleton, and Kenneth Ottenbacher. "FUNCTIONAL STATUS ASSOCIATED WITH RISK OF READMISSION DURING HOME HEALTH CARE FOR PATIENTS WITH DEMENTIA." Innovation in Aging 3, Supplement_1 (November 2019): S823. http://dx.doi.org/10.1093/geroni/igz038.3033.
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Abstract Approximately 14.0% of Medicare beneficiaries are readmitted to a hospital within 30-days of home health admission. Individuals with dementia account for 30% of all home health care admissions and are at high-risk for rehospitalizations. Our primary objective was to determine the association between functional status and social support at admission to home health and 30-day potentially preventable readmissions (PPR) during home health care. We conducted a retrospective cohort study of 124,119 Medicare beneficiaries receiving home health (7/2013 – 6/2015) and diagnosed with dementia (ICD-9 codes). Approximately 65% of participants were over the age of 81, 61% were female, and 80% were Caucasian. The primary outcome was 30-day PPR during home health. OASIS items were used to create mobility, self-care, social support, and cognition categories. The overall rate of 30-day PPR was 7.6% (95% CI: 7.4-7.7) but varied by patient and health care utilization characteristics. After adjusting for sociodemographic and clinical characteristics, the odds ratios (OR) for the most dependent score quartile versus the most independent was 1.68(1.56,1.80 95% CI) for mobility, 1.78 (95% CI: 1.66- 1.91) for self-care, and 1.10(95%CI: 1.03-1.17) for social support. The OR for impaired versus intact cognition was 1.12 (95% CI: 1.05-1.20). Impaired functional and cognitive status as well as limited social support at admission to home health care are associated with increased risk of PPR for individuals with dementia. Future research is needed to determine if strategies targeted at mobility and self-care can decrease PPR during home health for individuals with severe dementia.
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VERNOOIJ-DASSEN, MYRRA, ALBERT FELLING, and JEAN PERSOON. "PREDICTORS OF CHANGE AND CONTINUITY IN HOME CARE FOR DEMENTIA PATIENTS." International Journal of Geriatric Psychiatry 12, no. 6 (June 1997): 671–77. http://dx.doi.org/10.1002/(sici)1099-1166(199706)12:6<671::aid-gps599>3.0.co;2-g.
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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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Yamanaka, Takashi, Maiko Mizuki, Kiwami Kidana, and Ryonosuke Yamaga. "Characteristics and Prognoses of Long-Term Home Care Patients." Innovation in Aging 5, Supplement_1 (December 1, 2021): 612. http://dx.doi.org/10.1093/geroni/igab046.2341.
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Abstract With demographic aging, many older adults require home medical care. Although home-based primary care is promoted in the United States and Japan, there is insufficient evidence about it. We aimed to study the characteristics and prognoses of long-term home care patients. We prospectively registered 151 patients, estimated to receive physician home visits for more than six months, in a clinic in Chiba, Japan, in 2020. The mean (±SD) age was 83.9±10.0 years and ranged from 31 to 102 years. Most patients were men (60.3%) and aged 65 years or above (95.3%). We investigated clinical information, the Edmonton Symptom Assessment System Revised Japanese version (ESAS-r-J), Dementia Assessment Sheet in Community-based Integrated Care System 21 items (DASC-21), EuroQOL 5 dimensions 5-level (EQ-5D-5L) every six months, and the incidence of hospital admission, death, and patient transportation by ambulance. The most frequent diagnoses were dementia (31.1%), bone and articular diseases (17.2%), cerebrovascular diseases (11.9%), organ failure (9.3%), and neurological diseases (9.3%). Most patients (78.2%) showed more than 30 points on the DASC-21, suggesting cognitive impairment. Worse wellbeing, drowsiness, tiredness, anxiety, depression, and pain were the most prevalent symptoms. EQ-5D-5L index values were distributed around–0-0.2 and 0.4-0.7. During the first three months of physician home visits, 21.9% of patients had hospital admissions, 12.5% of them died, and 11.7% required hospital transportation by an ambulance. In this study, most long-term home care patients suffered from cognitive impairment. In addition to receiving care for daily life, these patients require intensive medical management.
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Schwarzkopf, Larissa, Rolf Holle, and Michaela Schunk. "Effects of Nursing Home Residency on Diabetes Care in Individuals with Dementia: An Explorative Analysis Based on German Claims Data." Dementia and Geriatric Cognitive Disorders Extra 7, no. 1 (February 10, 2017): 41–51. http://dx.doi.org/10.1159/000455071.
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Aims: This claims data-based study compares the intensity of diabetes care in community dwellers and nursing home residents with dementia. Methods: Delivery of diabetes-related medical examinations (DRMEs) was compared via logistic regression in 1,604 community dwellers and 1,010 nursing home residents with dementia. The intra-individual effect of nursing home transfer was evaluated within mixed models. Results: Delivery of DRMEs decreases with increasing care dependency, with more community-living individuals receiving DRMEs. Moreover, DRME provision decreases after nursing home transfer. Conclusion: Dementia patients receive fewer DRMEs than recommended, especially in cases of higher care dependency and particularly in nursing homes. This suggests lacking awareness regarding the specific challenges of combined diabetes and dementia care.
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Singh, Inderpal, Daniel Duric, Alfe Motoc, Chris Edwards, and Anser Anwar. "Relationship of Prevalent Fragility Fracture in Dementia Patients: Three Years Follow up Study." Geriatrics 5, no. 4 (November 30, 2020): 99. http://dx.doi.org/10.3390/geriatrics5040099.
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Introduction: dementia increases the risk of falls by 2–3 times and cognitively impaired patients are three times more likely to have hip fracture following a fall when compared to cognitively intact individuals. However, there is not enough evidence that explores the relationship between dementia and fragility fractures. The aim of this study is to explore the relationships of prevalent fragility fracture in patients with dementia admitted with an acute illness to the hospital. Methods: the existing Health Board records were reviewed retrospectively for all patients admitted diagnosed with dementia in the year 2016. All patients were followed up for a maximum of three years. All of the the dementia patients were divided into three groups: group 1—“no fractures”; group 2—“all fractures”; group 3—“fragility fractures”. Clinical outcomes were analysed for hospital stay, discharge destination (new care home), post-discharge hip fracture data, and mortality. Results: dementia patients with a prevalent fracture were significantly older, 62% were women. A significantly higher proportion of dementia patients with prevalent fractures were care home residents and taking a significantly higher number of medications. The mean Charlson comorbidity index was similar in patients with or without fracture. Dementia patients with a prevalent fracture required a new care home and this is significantly higher when compared to those with no fracture. Mortality at one year and three year was not statistically different in patients with or without prevalent fractures. A significantly higher number (21.5%) of dementia patients with prevalent fragility fracture sustained a new hip fracture when compared to those with no prevalent osteoporotic fracture (2.9%) over the three years follow up (p < 0.0001). Conclusion: dementia patients with a prevalent fragility fracture is associated with a statistically significant higher risk of a new care home placement following acute hospital admission. This sub-group is also at risk of a new hip fracture in the next three years. Whilst clinical judgement remains crucial in the care of frail older people, it is prudent to consider medical management of osteoporosis in dementia if deemed to be beneficial following the comprehensive geriatric assessment.
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Knox, Sara, Brian Downer, Allen Haas, Addie Middleton, and Kenneth Ottenbacher. "GREATER DEMENTIA SEVERITY IS ASSOCIATED WITH INCREASED RISK OF POTENTIALLY PREVENTABLE READMISSIONS DURING HOME HEALTH CARE." Innovation in Aging 3, Supplement_1 (November 2019): S119—S120. http://dx.doi.org/10.1093/geroni/igz038.439.
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Abstract Approximately 14.0% of Medicare beneficiaries are readmitted to a hospital within 30-days of home health admission. Individuals with dementia account for 30% of all home health care admissions and are at high-risk for rehospitalizations. Our primary objective was to determine the association between dementia severity at admission to home health and 30-day potentially preventable readmissions (PPR) during home health care. A secondary objective was to develop a dementia severity category from OASIS items based on the Functional Assessment Staging Tool (FAST). Retrospective cohort study of 124,119 Medicare beneficiaries receiving home health (7/2013 – 6/2015) and diagnosed with dementia (ICD-9 codes). The primary outcome was 30-day PPR during home health. The predictor variable of dementia severity was categorized into six levels (non-affected to severe). The overall rate of 30-day PPR was 7.6% (95% CI 7.4, 7.7) but varied by patient and health care utilization characteristics. After adjusting for sociodemographic and clinical characteristics, patients classified as stage 6 and stage 7 had 1.36 (95% CI 1.28, 1.45) and 1.90 (95% CI 1.59, 2.26) times higher odds to experience a 30-day PPR compared to patients classified as stage 1-2. Dementia severity in the later stages is associated with increased risk for PPR. Development of a dementia severity category based on OASIS items and the FAST is feasible. Future research is needed to determine effective strategies for decreasing PPR during home health for individuals with severe dementia. Future research is needed to validate the proposed dementia severity categories used in this study.
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Mehta, Hemalkumar B., Yong-Fang Kuo, Jordan Westra, Mukaila Raji, and James S. Goodwin. "TRENDS IN OPIOID USE IN LONG-TERM CARE NURSING HOME RESIDENTS WITH DEMENTIA." Innovation in Aging 3, Supplement_1 (November 2019): S709. http://dx.doi.org/10.1093/geroni/igz038.2605.
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Abstract We examined opioid use in long-term care nursing home residents with dementia. This retrospective cohort study used Minimum Data Set linked Medicare data, 2011-2016, and included long-term care episodes for residents 65+ years who survived 100+ days each year (592,211 episodes for 256,207 residents). Cognitive status at first annual assessment was classified as none/mild, moderate and severe impairment. Overall opioid use, prolonged opioid use (prescription supply 90+ days) and long-acting opioid use were identified from Medicare part D. Descriptive statistics were used to describe opioid use by cognitive impairment. Cochrane Armitage trends test was used to determine trends in opioid use. 114,622 (19%) patients had severe and 129,257 (22%) had moderate dementia. Overall opioid (none/mild=15.4%, moderate=13.9%, severe=9%), prolonged opioid (none/mild=5.2%, moderate=4.5%, severe=3.2%) and long-acting opioid use (none/mild=1.1%, moderate=0.9%, severe=0.3% ) were lower in patients with advanced dementia. Opioid use was significantly higher in females and Whites and varied by states. Substantial increase was found in overall opioid and prolonged opioid use from 2011 to 2016, with greater increase in none/mild and moderate dementia patients. For example, prolonged opioid use increased by 69% in none/mild and 71% in moderate dementia patients compared to 52% in severe dementia patients (p<0.0001). Long-acting opioid use decreased, with a greater decline in none/mild (69%) and moderate (71%) dementia patients compared to severe dementia patients (58%) (p<0.0001). Contrary to decreasing opioid use in community setting, overall and prolonged opioid use increased in nursing home residents. Future studies should identify the reasons behind increased use.
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Ornstein, Katherine, Bruce Leff, Jennifer Reckrey, Evan Bollens-Lund, Margaret Salinger, Yihan Wang, and Christine Ritchie. "WHO CAN BENEFIT FROM HOME-BASED MEDICAL CARE?" Innovation in Aging 6, Supplement_1 (November 1, 2022): 414. http://dx.doi.org/10.1093/geroni/igac059.1627.
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Abstract Leaving the home to access medical care may result in undue burden for patients with dementia and other serious illnesses and their caregivers. While home-based medical care (HBMC) may be beneficial for many older adults, it is not clear how to best identify individuals who could benefit from such services. Using the 2015 NHATS linked to Medicare claims we estimated prevalence across multiple overlapping subtypes: Individuals who have moderate/severe dementia; are homebound; have serious illness; are frail; rely on assistive devices; have high caregiving needs; those with minimal primary care and high ED use; and those who met previously established criteria for Independence at home. Using these criteria, more than half of community-dwelling older adults could benefit from HBMC and more than 25% meet multiple criteria. Medicare and other payers can benefit from targeted identification of patients who could benefit from HBMC.
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van der Plas, Annicka GM, Mariska G. Oosterveld-Vlug, H. Roeline W. Pasman, and Bregje D. Onwuteaka-Philipsen. "Relating cause of death with place of care and healthcare costs in the last year of life for patients who died from cancer, chronic obstructive pulmonary disease, heart failure and dementia: A descriptive study using registry data." Palliative Medicine 31, no. 4 (January 6, 2017): 338–45. http://dx.doi.org/10.1177/0269216316685029.
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Background: The four main diagnostic groups for palliative care provision are cancer, chronic obstructive pulmonary disease, heart failure and dementia. But comparisons of costs and care in the last year of life are mainly directed at cancer versus non-cancer or within cancer patients. Aim: Our aim is to compare the care and expenditures in their last year of life for Dutch patients with cancer, chronic obstructive pulmonary disease, heart failure or dementia. Design: Data from insurance company Achmea (2009–2010) were linked to information on long-term care at home or in an institution, the National Hospital Registration and Causes of Death-Registry from Statistics Netherlands. For patients who died of cancer ( n = 8658), chronic obstructive pulmonary disease ( n = 1637), heart failure ( n = 1505) or dementia ( n = 3586), frequencies and means were calculated, Lorenz curves were drawn up and logistic regression was used to compare patients with high versus low expenditures. Results: For decedents with cancer and chronic obstructive pulmonary disease, the highest costs were for hospital admissions. For decedents with heart failure, the highest costs were for the care home (last 360 days) and hospital admissions (last 30 days). For decedents with dementia, the highest costs were for the nursing home. Conclusion: Patients with dementia had the highest expenditures due to nursing home care. The number of dementia patients will double by the year 2030, resulting in even higher economic burdens than presently. Policy regarding patients with chronic conditions should be informed by research on expenditures within the context of preferences and needs of patients and carers.
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Theuns, J., and C. Van Broeckhoven. "Genes for Alzheimer Dementia." Acta Neuropsychiatrica 11, no. 2 (June 1999): 60–62. http://dx.doi.org/10.1017/s0924270800036176.
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Alzheimer disease (AD), the most common form of dementia in the elderly, is rapidly becoming a major health problem in developed countries where the number of elderly people continuously grows due to improved medical care. Consequently, the number of AD patients is increasing and thus far no effective therapies are available. Clinically the disease can be diagnosed with 90% reliability on the basis of neurological examination, neuropsychological testing and brain imaging techniques. A definite diagnosis, however, requires the post-mortem detection of senile plaques (SPs) and neurofibrillary tangles (NFTs) in the brain. The SPs are extracellular deposits mainly composed of amyloid P (Ap) surrounded by dystrophic neurites. NFT are intraneural inclusions of paired helical filaments composed of hyperphosphorylated tau.Although age is the major risk factor for AD, population survey and family studies have provided substantial evidence that genetic factors are major contributors to the expression of AD.
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Luth, Elizabeth, David Russell, Holly Prigerson, Kathryn Bowles, and Miriam Ryvicker. "Nurse Visits, Site of Care, and Hospitalization Among Hospice Patients With Dementia." Innovation in Aging 4, Supplement_1 (December 1, 2020): 493. http://dx.doi.org/10.1093/geroni/igaa057.1595.
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Abstract Persons with dementia comprise up to 50% of hospice patients and face an increased risk of burdensome, disruptive, and costly discharge from hospice due to hospitalization. The relationship between timing, dose and site of hospice care provided, all modifiable factors, and risk of hospitalization is poorly understood. We use a retrospective cohort analysis of 2,692 electronic health records of hospice patients with dementia who received care from a large hospice agency in New York City between 2013-2017 to determine the relationship between hospice service delivery (e.g., number and timing of nurse visits, home vs. facility-based) and risk of hospitalization (vs death). We control for demographic and clinical characteristics of patients. 9.36% of patients with dementia were hospitalized. Hospice service delivery factors were significantly associated with risk of hospitalization. Each additional nurse visit was associated with a 5% decrease in risk of hospitalization (AOR: 0.95, 95% CI: 0.92-0.98). Each additional day between last nurse visit and discharge was associated with a 7% increase in risk of hospitalization (AOR: 1.07, 95% CI: 1.04-1.11). Home hospice was associated with 97% higher odds of hospitalization (AOR: 1.97, 95% CI: 1.19-2.09). Hospice patients with dementia who receive services at home, receive fewer nursing visits, and have increased time between nursing visits are at increased risk for hospitalization. Research is needed to determine if increasing the number and timing of nursing visits can reduce risk of hospitalization in this population.
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Singh, Inderpal, Chris Edwards, Daniel Duric, Aman Rasuly, Sabdat Oziohu Musa, and Anser Anwar. "Dementia in an Acute Hospital Setting: Health Service Research to Profile Patient Characteristics and Predictors of Adverse Clinical Outcomes." Geriatrics 4, no. 1 (January 2, 2019): 7. http://dx.doi.org/10.3390/geriatrics4010007.
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Introduction: Patients with dementia often have other associated medical co-morbidities resulting in adverse outcomes. The National Audit of Dementia (NAD) in the UK showed a wide variation in the quality and clinical care for acute dementia patients. This study aims to record the clinical profile and benchmark clinical outcomes of acute dementia patients admitted within Aneurin Bevan University Health Board, Wales (UK). Methods: This was a retrospective observational study based on analysis of the existing data for all acute dementia patients. Ethical approval was not required for this service evaluation. Results: In 2016, a total of 1770 dementia patients had 2474 acute admissions. We studied 1167 acute admissions (953 dementia patients) from 1st January 2016–30th June 2016. The mean age was 84.5 ± 7.8 years (females = 63.5%). Mean Charlson comorbidity index and the number of drugs were 6.0 ± 1.5 and 5.1 ± 2.1. 15.4% (147/953) patients were on antipsychotics. Overall mean hospital stay was 19.4 ± 27.2 days. 30-days readmission rate was 17.2% (138/800) with a mean hospital stay of 14.6 ± 17.9 days. 3.4% (32/953) patients were excluded due to a coding error. 70.3% (n = 670/953) were previously living in their own homes and only 26.3% (n = 251/953) were admitted from care homes. 59.5% patients (n = 399/670) were discharged back to their homes and 21.6% (145/670) were discharged to a new care home, which represents an approximately 1.68 times higher rate of new care home occupancy than the patients being originally admitted from a care home. Overall inpatient was 16.0% (153/953). 30-days and one-year mortality were 22.3% (213/953) and 49.2% (469/953) respectively. The observed mortality rates between patients admitted from home or from a care home were highly significant for one-year mortality (p < 0.001). The inpatient falls rate was significantly higher (1.8 times) as compared to overall general medical inpatient falls rate. Conclusion: Acute patients with dementia have a higher risk of adverse outcomes and the impact of hospitalisation. Prompt comprehensive geriatric assessment and quality improvement initiatives are needed to improve clinical outcomes and to enhance the quality of care.
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Smith, Cathryn, and Gina Newbury. "Palliative care for community patients diagnosed with dementia: a systematic review." British Journal of Community Nursing 24, no. 12 (December 2, 2019): 570–75. http://dx.doi.org/10.12968/bjcn.2019.24.12.570.
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Despite many efforts made by health organisations to deliver effective end-of-life care to patients with dementia, research indicates that palliative care is predominantly aimed at patients with terminal cancer, and that patients with dementia face challenges in accessing end-of-life care. This article explores the views of health professionals on providing palliative care to those patients diagnosed with dementia within the community setting. A systematic review of seven qualitative studies was performed to identify the best available evidence. The findings show that effective palliative care for patients with dementia continues being affected by many barriers and challenges. Good practice seems to be inconsistent and fragmented throughout the UK and European countries, and many health professionals are faced with difficulties associated with services and financial implications, training and education, staff support, communication, family support and dementia care.
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Samus, Quincy M., Nancy Hodgson, and Joseph E. Gaugler. "HOME IS WHERE THE HEART IS: OPTIMIZING AND TAILORING HOME AND COMMUNITY-BASED SUPPORT FOR DEMENTIA CAREGIVERS." Innovation in Aging 3, Supplement_1 (November 2019): S549—S550. http://dx.doi.org/10.1093/geroni/igz038.2026.
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Abstract Family caregivers, often “de facto” members of the care team for persons with dementia, play a central role in ensuring safety, support, quality of life, and continuity of care. Most often, they provide this care for loved ones at home and over a long period of time, as the illness progresses and care need intensifies. This session will provide a unique understanding of potential ways to optimize support for family caregivers in provision of day-to-day care in the home by examining often-overlooked factors influential in the health and wellbeing for both caregiver and persons with dementia. Presentations will draw from three large community-based trials testing interventions to support dementia caregivers. Drs. Samus and Sloan will present on common unmet needs identified by family caregivers and explore how needs differ by disease stage and race. Dr. Fortinsky will present baseline caregiver care-related challenges in a diverse cohort of caregivers and the effects of a caregiver intervention designed to mitigate these challenges. Dr. Hodgson will present the common symptoms clusters among home-dwelling persons with dementia patients and how these are associated with caregiver distress. Dr. Jutkowitz will discuss factors influencing dementia caregiver’s willingness to pay for help at home. Findings from this session will help elucidate care needs that matter most to family caregivers in diverse community-living cohorts and how we might optimize and tailor supportive home-based interventions to target these needs and challenges.
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TSUKAHARA, Takako, Shinzi MIYAHARA, and Yukie YAMASITA. "Factors Conducive to Continuation of Home Nursing Care of Advanced Dementia Patients." JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE 59, no. 4 (2010): 461–69. http://dx.doi.org/10.2185/jjrm.59.461.
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Hanrahan, Patricia, and Daniel J. Luchins. "Feasible Criteria for Enrolling End-Stage Dementia Patients in Home Hospice Care." Hospice Journal 10, no. 3 (September 1995): 47–54. http://dx.doi.org/10.1080/0742-969x.1995.11882798.
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Sullivan, Rachel, Clodagh Power, Elaine Greene, and Roisin Purcell. "142 Advance Care Planning in Patients with Dementia: An Audit on End of Life Care in Hospital Deaths." Age and Ageing 48, Supplement_3 (September 2019): iii1—iii16. http://dx.doi.org/10.1093/ageing/afz102.29.
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Abstract Background End of life care (EOLC) planning is a difficult and often neglected area in dementia. Advanced care discussions play an important role in the planning of future care for patients with dementia. The NICE guidelines recommend that patients with dementia should be given every opportunity to discuss their wishes and preferences regarding their future care. The goal of our study was to explore the extent of EOLC planning in patients with dementia who died in hospital. Methods Patients with dementia who died in a large tertiary referral hospital in 2017 were identified via the Hospital Inpatient Enquiry (HIPE) database. A retrospective chart review was completed examining the documentation of Advance Care Planning (ACP) and discussions around end of life care. Charleston Comorbidity Index (CCI) was used to predict 1 year mortality. Results HIPE identified 49 patients with dementia who died in hospital. The average age was 84 and 53% were female. The commonest cause of death was respiratory (79.5%). Two thirds lived at home and 30% were nursing home residents. The mean CCI was 3.97 indicating 52% 1-year mortality, however only 34% were hospitalized in the last year. Only 14% had an ACP. Only 22% had resuscitation status recorded on admission. The majority had resuscitation status documented 15 days prior to death. In these cases 70% had clearly documented the discussion with family or patient and 84% documented ceilings of care 6 days prior to death. Palliative care were involved in 40% of cases. Two patients did not have resuscitation status documented prior to death and 3 received CPR. Conclusion Our study highlights the urgent need to facilitate conversations around end-of-life care with people with dementia. Advance care planning reduces the use of burdensome treatments, ensures dignity and comfort is prioritized enabling patients to live well until they die.
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Ritchie, Karen. "Behavioral Disturbances of Dementia in Ambulatory Care Settings." International Psychogeriatrics 8, S3 (May 1997): 439–42. http://dx.doi.org/10.1017/s1041610297003803.
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Behavioral disturbances are a primary reason elderly patients with dementia are admitted to long-term care facilities. Blackwood and colleagues found that 58% of 130 consecutive patients admitted to a nursing home because of a behavioral disorder had a principal diagnosis of dementia. Similarly, in a study of long-stay institutional care for persons with dementia in France, the author and colleagues found that 67% of 352 patients had been admitted because of a social or behavioral problem. Thus, outpatient management of behavioral disturbances would appear to play a central role in determining whether a patient with dementia can remain in the community.
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Simsek Yurt, Nur, and Erdinc Yavuz. "Assessment of the Burden of Care and Burnout Level in Caregivers of Dementia Patients in a Home Care Setting." Eurasian Journal of Family Medicine 11, no. 4 (December 30, 2022): 189–96. http://dx.doi.org/10.33880/ejfm.2022110402.
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Aim: This study aims to evaluate the factors affecting the care burden and burnout levels of caregivers with dementia patients receiving home care services. Methods: This descriptive study was conducted in Samsun Training and Research Hospital Home Care Services which paid a visit at home between March 20 and June 20, 2021. The caregivers of the patients who were followed up by the diagnosis of dementia were included in the study after having agreed to participate in the study with their written informed consents. The 'Socio-demographic Data Form', 'Zarit Burden Interview' and 'Maslach Burnout Inventory’ were administered to caregivers during face-to-face interviews. Results: A total of 157 caregivers were included in our study, of which 70.1% (n=110) were women. 68.2% (n=107) were in the 40-64 years age group. The mean Zarit Burden Interview score was calculated as 47.10±16.14 (min=21, max=85). 76.4% of caregivers had moderate to severe escalated care burden. Once the impact of the increase in caregiver burden score on Maslach Burnout Inventory subgroups was examined, the relationship was found to be positively significant with emotional exhaustion and depersonalization, and negatively significant with personal achievement. Conclusion: As the burden of care increases, the level of burnout of individuals increases. Female gender, illiteracy, lack of income, duration of care given which is prolonged for more than one year, and daily care duration exceeding 12 hours were determined as outstanding factors that increase the care burden and level of burnout. Keywords: home care services, caregivers, dementia, caregiver burnout
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Adler, Geri, Linda Ott, Mary Jelinski, James Mortimer, and Renee Christensen. "Institutional Respite Care: Benefits and Risks for Dementia Patients and Caregivers." International Psychogeriatrics 5, no. 1 (March 1993): 67–77. http://dx.doi.org/10.1017/s1041610293001401.
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Thirty-seven dementia patients and their caregivers were studied before and after a two-week in-hospital respite stay. Institutional respite care did not alter behavior problems in dementia patients, nor did changes in performance of activities of daily living (ADLs) by Alzheimer's disease (AD) patients exceed those expected from disease progression. Caregivers exhibited an improvement in burden and depression during the respite study, but levels returned to baseline following the patient's return home.
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Dening, Karen Harrison. "Recognition and assessment of dementia in primary care." British Journal of Community Nursing 24, no. 8 (August 2, 2019): 383–87. http://dx.doi.org/10.12968/bjcn.2019.24.8.383.
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The majority of patients are diagnosed within a memory assessment service or a neurology clinic. However, early detection of a possible dementia is often done in a primary care setting. Dementia diagnosis has been seen by some as a ‘tick-box exercise’ but there are significant benefits to patients and their families when screening or testing for dementia is carried out early, especially in supporting the patients management of other comorbid or long-term conditions. Community nurses have a key role in identifying patients who may have the signs and symptoms of dementia by enabling them to access a timely diagnosis.
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Palmer, Sarah Jane. "Faecal incontinence management in dementia patients." British Journal of Community Nursing 27, no. 11 (November 2, 2022): 534–38. http://dx.doi.org/10.12968/bjcn.2022.27.11.534.
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Faecal incontinence is a complex issue faced by many older adults. This article will provide an overview of this condition and its causes. It will also provide policy and guidance on the subject, its general management, complications, the support available for carers, and the issue of faecal incontinence in someone who has dementia.
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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.