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Abstract
The purpose of this study was to determine if telephone support groups for dementia caregivers have an effect on bother with patient behaviours, burden, depression, and general well-being. The randomized controlled trial compared telephone support groups (15 groups of 5 or 6 caregivers) with control groups (print materials). Groups met 14 times over 1 year. The 1-hour sessions included content on education, coping skills, and support. Data were collected at baseline and at 6 and 12 months. The sample comprised 154 caregivers, 77 per arm, providing care to veterans with dementia or a veteran caregiver. Bother was found to differ significantly at baseline. There were no significant treatment effect differences between study arms. Participants anecdotally reported improvement. It was concluded that telephone support groups are an efficient way to interact with caregivers. Further research should test different models of care. Interventions that are targeted to specific needs or occur frequently may provide better support for caregivers of individuals with a worsening condition.
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152
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Werner S. [Case discussion as a part of nursing care planning: planning nursing care is team work]. Pflege Z 2014; 67:216-219. [PMID: 24826426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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153
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Rullière N. [Privacy and dignity in nursing homes]. Rev Infirm 2014:37-38. [PMID: 24881244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The care provided to the residents of the Alzheimer's unit of the Pont-de-Veyle nursing home follows four main ethical principles: dignity, autonomy, beneficence and non-maleficence. The team demonstrates flexibility with regard to the washing and dressing of the residents, meal times and the organisation of activities. It does not resort to restraint. The respect of the person's dignity and privacy is maintained not only during nursing care but in all other aspects of their life.
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154
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Affiliation(s)
- Marjorie S Rosenthal
- The Robert Wood Johnson Foundation Clinical Scholars Program and Division of General Pediatrics, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
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155
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Schmidt SG, Dichter MN, Schwab CGG, Bartholomeyczik S, Hasselhorn HM. [Satisfaction with the quality of care in nursing homes--the nurses' perspective]. Pflege Z 2014; 67:170-174. [PMID: 24783344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND In Germany, the number of residents in Nursing Homes (NH) has increased in recent years, residents become older, increasingly multimorbid and suffer more from dementia. In parallel demands concerning the quality of care in NH have increased. The vivid poltical and public debate about quality of care, however, widely disregards the perception of nurses. The aim of this study is to investigate the nurses' satisfaction with the quality of care in their NH and potential psychological consequences. METHODS Secondary questionnaire data from 1489 nurses in 88 NH of the German 3Q-study (www.3q-studie.de) were used from the 2011 investigation. Questions regarding satisfaction enquire satsifaction in five nursing work domains. Descriptive analyses as well Chi2-tests were performed. RESULTS The majority of nurses were satisfied in the subdomain "overall quality of care" and "physical care" (80% each). 67% were satisfied with "the quality of care for residents with dementia" and 64% with "end-of-life care". Only 56% of the nurses were satisfied with "mental care". If nurses were unsatisfied with the quality of care, this was mostly perceived as a psychological stressor. Subgroup analysis showed a pattern for four of the five domains: dissatisfied nurses were older, better qualified, worked more than 25 hours per week and worked in larger NH. No such pattern was found for "quality of care for residents with dementia". CONCLUSIONS Nurses' satisfaction with the quality of care has shown to be a relevant work factor and potential stressor deserving more scientific and clinical attention. For NH it could constitute a core indicator for internal quality management as well as for human resource management. Research in work, health and economy in NH should also consider this factor.
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156
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Marquardt G. [Rooms for patients with dementia. Creating an comprehensible environment]. Pflege Z 2014; 67:142-145. [PMID: 24783338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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157
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Tannen A. [Self perception and coping strategies of patients with dementia]. Pflege Z 2014; 67:175. [PMID: 24783345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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158
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Werner S. [Prurigo in the elderly. When the skin itches and burns]. Pflege Z 2014; 67:184-185. [PMID: 24783348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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159
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Möhler R, Meyer G. [Individually adapted activities for patients with dementia in inpatient geriatric nursing. Interests, preferences and wishes]. Pflege Z 2014; 67:146-150. [PMID: 24783339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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160
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Jackson GA. Drug treatments for Alzheimer's disease. Nurs Times 2014; 110:24-26. [PMID: 24754108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This article discusses the development and progress of treatment for Alzheimer's disease. Medical treatments have not changed since the late 1990s and have limited effects. They treat the symptoms patients experience but do not reverse the effects or repair neurological damage caused by Alzheimer's disease. Updated NICE guidance and likely future advances in treatment are also
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161
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Porsteinsson AP, Drye LT, Pollock BG, Devanand D, Frangakis C, Ismail Z, Marano C, Meinert CL, Mintzer JE, Munro CA, Pelton G, Rabins PV, Rosenberg PB, Schneider LS, Shade DM, Weintraub D, Yesavage J, Lyketsos CG. Effect of citalopram on agitation in Alzheimer disease: the CitAD randomized clinical trial. JAMA 2014; 311:682-91. [PMID: 24549548 PMCID: PMC4086818 DOI: 10.1001/jama.2014.93] [Citation(s) in RCA: 315] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE Agitation is common, persistent, and associated with adverse consequences for patients with Alzheimer disease. Pharmacological treatment options, including antipsychotics are not satisfactory. OBJECTIVE The primary objective was to evaluate the efficacy of citalopram for agitation in patients with Alzheimer disease. Key secondary objectives examined effects of citalopram on function, caregiver distress, safety, cognitive safety, and tolerability. DESIGN, SETTING, AND PARTICIPANTS The Citalopram for Agitation in Alzheimer Disease Study (CitAD) was a randomized, placebo-controlled, double-blind, parallel group trial that enrolled 186 patients with probable Alzheimer disease and clinically significant agitation from 8 academic centers in the United States and Canada from August 2009 to January 2013. INTERVENTIONS Participants (n = 186) were randomized to receive a psychosocial intervention plus either citalopram (n = 94) or placebo (n = 92) for 9 weeks. Dosage began at 10 mg per day with planned titration to 30 mg per day over 3 weeks based on response and tolerability. MAIN OUTCOMES AND MEASURES Primary outcome measures were based on scores from the 18-point Neurobehavioral Rating Scale agitation subscale (NBRS-A) and the modified Alzheimer Disease Cooperative Study-Clinical Global Impression of Change (mADCS-CGIC). Other outcomes were based on scores from the Cohen-Mansfield Agitation Inventory (CMAI) and the Neuropsychiatric Inventory (NPI), ability to complete activities of daily living (ADLs), caregiver distress, cognitive safety (based on scores from the 30-point Mini Mental State Examination [MMSE]), and adverse events. RESULTS Participants who received citalopram showed significant improvement compared with those who received placebo on both primary outcome measures. The NBRS-A estimated treatment difference at week 9 (citalopram minus placebo) was -0.93 (95% CI, -1.80 to -0.06), P = .04. Results from the mADCS-CGIC showed 40% of citalopram participants having moderate or marked improvement from baseline compared with 26% of placebo recipients, with estimated treatment effect (odds ratio [OR] of being at or better than a given CGIC category) of 2.13 (95% CI, 1.23-3.69), P = .01. Participants who received citalopram showed significant improvement on the CMAI, total NPI, and caregiver distress scores but not on the NPI agitation subscale, ADLs, or in less use of rescue lorazepam. Worsening of cognition (-1.05 points; 95% CI, -1.97 to -0.13; P = .03) and QT interval prolongation (18.1 ms; 95% CI, 6.1-30.1; P = .01) were seen in the citalopram group. CONCLUSIONS AND RELEVANCE Among patients with probable Alzheimer disease and agitation who were receiving psychosocial intervention, the addition of citalopram compared with placebo significantly reduced agitation and caregiver distress; however, cognitive and cardiac adverse effects of citalopram may limit its practical application at the dosage of 30 mg per day. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00898807.
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Affiliation(s)
- Anton P. Porsteinsson
- University of Rochester School of Medicine and Dentistry,
Rochester, NY, USA
- Corresponding author Anton P. Porsteinsson,
M.D., Department of Psychiatry, University of Rochester School of Medicine and
Dentistry, 435 East Henrietta Road, Rochester, NY 14620 Phone (585) 760-6550 Fax
(585) 760-6572 ()
| | - Lea T. Drye
- Johns Hopkins Bloomberg School of Public Health, Baltimore,
MD, USA
| | - Bruce G. Pollock
- Campbell Institute, CAMH, University of Toronto, Toronto,
ON, Canada
| | - D.P. Devanand
- Division of Geriatric Psychiatry, New York State
Psychiatric Institute and College of Physicians and Surgeons of Columbia University,
New York, NY, USA
| | | | - Zahinoor Ismail
- Departments of Psychiatry and Neurology, Hotchkiss Brain
Institute, University of Calgary, Calgary, AB, Canada
| | - Christopher Marano
- Johns Hopkins Bayview and Johns Hopkins School of Medicine,
Baltimore, MD, USA
| | | | - Jacobo E. Mintzer
- Clinical Biotechnology Research Institute, Roper St.
Francis Healthcare, Charleston, SC, USA
| | - Cynthia A. Munro
- Johns Hopkins Bayview and Johns Hopkins School of Medicine,
Baltimore, MD, USA
| | - Gregory Pelton
- Division of Geriatric Psychiatry, New York State
Psychiatric Institute and College of Physicians and Surgeons of Columbia University,
New York, NY, USA
| | - Peter V. Rabins
- Johns Hopkins Bayview and Johns Hopkins School of Medicine,
Baltimore, MD, USA
| | - Paul B. Rosenberg
- Johns Hopkins Bayview and Johns Hopkins School of Medicine,
Baltimore, MD, USA
| | - Lon S. Schneider
- University of Southern California Keck School of Medicine,
Los Angeles, CA, USA
| | - David M. Shade
- Johns Hopkins Bloomberg School of Public Health, Baltimore,
MD, USA
| | - Daniel Weintraub
- Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, PA, USA
| | - Jerome Yesavage
- Stanford University School of Medicine and VA Palo Alto
Health Care System, Stanford, CA, USA
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162
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Angelovski I. [Leading a diverse team]. Pflege Z 2014; 67:108-111. [PMID: 24730330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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163
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Kleeberg C. ["For coworker satisfaction there is no patent prescription"]. Pflege Z 2014; 67:112-113. [PMID: 24730331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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164
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Narayan MC. Alzheimer's be not proud. Home Healthc Nurse 2014; 32:130-131. [PMID: 24492274 DOI: 10.1097/nhh.0000000000000021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Mary Curry Narayan
- Mary Curry Narayan, MSN, RN, HHCNS-BC, is a Home Health Clinical Nurse Specialist and leads Narayan Associates, Vienna, Virginia. Narayan Associates provides quality, education, and consulting services and patient/clinician resources and tools to home healthcare agencies
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165
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Galindo-Garre F, Hendriks SA, Volicer L, Smalbrugge M, Hertogh CMPM, van der Steen JT. The Bedford Alzheimer nursing-severity scale to assess dementia severity in advanced dementia: a nonparametric item response analysis and a study of its psychometric characteristics. Am J Alzheimers Dis Other Demen 2014; 29:84-9. [PMID: 24085256 PMCID: PMC11008015 DOI: 10.1177/1533317513506777] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
The Bedford Alzheimer Nursing-Severity Scale (BANS-S) assesses disease severity in patients with advanced Alzheimer's disease. Since Alzheimer is a progressive disease, studying the hierarchy of the items in the scale can be useful to evaluate the progression of the disease. Data from 164 Alzheimer's patients and 186 patients with other dementia were analyzed using the Mokken Scaling Methodology to determine whether respondents can be ordered in the trait dementia severity, and to study whether an ordering between the items exist. The scalability of the scale was evaluated by the H coefficient. Results showed that the BANS-S is a reliable and medium scale (0.4≤H<0.5) for the Alzheimer group. All items with the exception of the item about mobility could be ordered. When later item was eliminated from the scale, the H coefficient decreased indicating that the scalability of the scale in the original form is more accurate than in the shorter version. For the other dementia group, the BANS-S did not fit any of the Mokken Scaling models because the scale was not unidimensional. In this group, a shorter version of the scale without the sleeping cycle item and the mobility item has better reliability and scalability properties than the original scale.
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Affiliation(s)
- Francisca Galindo-Garre
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Simone A. Hendriks
- Department of General Practice & Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Ladislav Volicer
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Martin Smalbrugge
- Department of General Practice & Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Cees M. P. M. Hertogh
- Department of General Practice & Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Jenny T. van der Steen
- Department of General Practice & Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
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166
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Werner S. [MDK wants it this way]. Pflege Z 2014; 67:122-123. [PMID: 24730334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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167
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Hazif-Thomas C, Cornec G, Coppens M, Walter M. [Global approach to mental healthcare for the elderly]. Soins Psychiatr 2014:12-15. [PMID: 24620542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Mental health must be distinguished from the medical discipline of psychiatry, especially with regard to elderly patients, for whom, all too often, the care approach consists in admission to an institution. All sectors of psychiatry must be concerned by the mental health of the elderly.
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168
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Dennison R. Rethinking dementia. Br J Community Nurs 2014; 19:5. [PMID: 24800320 DOI: 10.12968/bjcn.2014.19.1.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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169
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Ledesma E. [Coordinated course and collaborative work]. Soins Psychiatr 2014:11. [PMID: 24620541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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170
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König M, Pfarr C, Zweifel P. Mutual altruism: evidence from Alzheimer patients and their spouse caregivers. Adv Health Econ Health Serv Res 2014; 24:141-160. [PMID: 25244908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Preferences of both Alzheimer patients and their spouse caregivers are related to a willingness-to-pay (WTP) measure which is used to test for the presence of mutual (rather than conventional unilateral) altruism. METHODOLOGY Contingent valuation experiments were conducted in 2000-2002, involving 126 Alzheimer patients and their caregiving spouses living in the Zurich metropolitan area (Switzerland). WTP values for three hypothetical treatments of the demented patient were elicited. The treatment Stabilization prevents the worsening of the disease, bringing dementia to a standstill. Cure restores patient health to its original level. In No burden, dementia takes its normal course while caregiver's burden is reduced to its level before the disease. FINDINGS The three different types of therapies are reflected in different WTP values of both caregivers and patients, suggesting that moderate levels of Alzheimer's disease still permit clear expression of preference. According to the WTP values found, patients do not rank Cure higher than No burden, implying that their preferences are entirely altruistic. Caregiving spouses rank Cure before Burden, reflecting less than perfect altruism which accounts for some 40 percent of their total WTP. Still, this constitutes evidence of mutual altruism. VALUE: The evidence suggests that WTP values reflect individuals' preferences even in Alzheimer patients. The estimates suggest that an economically successful treatment should provide relief to caregivers, with its curative benefits being of secondary importance.
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171
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Tappen RM, Valentine K. Building and sustaining a caring-based nurse-managed center. Pa Nurse 2014; 69:16-21. [PMID: 25134235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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172
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Dysken MW, Sano M, Asthana S, Vertrees JE, Pallaki M, Llorente M, Love S, Schellenberg GD, McCarten JR, Malphurs J, Prieto S, Chen P, Loreck DJ, Trapp G, Bakshi RS, Mintzer JE, Heidebrink JL, Vidal-Cardona A, Arroyo LM, Cruz AR, Zachariah S, Kowall NW, Chopra MP, Craft S, Thielke S, Turvey CL, Woodman C, Monnell KA, Gordon K, Tomaska J, Segal Y, Peduzzi PN, Guarino PD. Effect of vitamin E and memantine on functional decline in Alzheimer disease: the TEAM-AD VA cooperative randomized trial. JAMA 2014; 311:33-44. [PMID: 24381967 PMCID: PMC4109898 DOI: 10.1001/jama.2013.282834] [Citation(s) in RCA: 347] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Although vitamin E and memantine have been shown to have beneficial effects in moderately severe Alzheimer disease (AD), evidence is limited in mild to moderate AD. OBJECTIVE To determine if vitamin E (alpha tocopherol), memantine, or both slow progression of mild to moderate AD in patients taking an acetylcholinesterase inhibitor. DESIGN, SETTING, AND PARTICIPANTS Double-blind, placebo-controlled, parallel-group, randomized clinical trial involving 613 patients with mild to moderate AD initiated in August 2007 and concluded in September 2012 at 14 Veterans Affairs medical centers. INTERVENTIONS Participants received either 2000 IU/d of alpha tocopherol (n = 152), 20 mg/d of memantine (n = 155), the combination (n = 154), or placebo (n = 152). MAIN OUTCOMES AND MEASURES Alzheimer's Disease Cooperative Study/Activities of Daily Living (ADCS-ADL) Inventory score (range, 0-78). Secondary outcomes included cognitive, neuropsychiatric, functional, and caregiver measures. RESULTS Data from 561 participants were analyzed (alpha tocopherol = 140, memantine = 142, combination = 139, placebo = 140), with 52 excluded because of a lack of any follow-up data. Over the mean (SD) follow-up of 2.27 (1.22) years, ADCS-ADL Inventory scores declined by 3.15 units (95% CI, 0.92 to 5.39; adjusted P = .03) less in the alpha tocopherol group compared with the placebo group. In the memantine group, these scores declined 1.98 units less (95% CI, -0.24 to 4.20; adjusted P = .40) than the placebo group's decline. This change in the alpha tocopherol group translates into a delay in clinical progression of 19% per year compared with placebo or a delay of approximately 6.2 months over the follow-up period. Caregiver time increased least in the alpha tocopherol group. All-cause mortality and safety analyses showed a difference only on the serious adverse event of "infections or infestations," with greater frequencies in the memantine (31 events in 23 participants) and combination groups (44 events in 31 participants) compared with placebo (13 events in 11 participants). CONCLUSIONS AND RELEVANCE Among patients with mild to moderate AD, 2000 IU/d of alpha tocopherol compared with placebo resulted in slower functional decline. There were no significant differences in the groups receiving memantine alone or memantine plus alpha tocopherol. These findings suggest benefit of alpha tocopherol in mild to moderate AD by slowing functional decline and decreasing caregiver burden. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00235716.
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Affiliation(s)
| | - Mary Sano
- James J. Peters VA Medical Research Center, New York, New York
| | - Sanjay Asthana
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | - Julia E Vertrees
- Cooperative Studies Program Clinical Research Pharmacy Coordinating Center, Albuquerque, New Mexico
| | - Muralidhar Pallaki
- Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio6Case Western Reserve University School of Medicine, Cleveland, Ohio
| | | | - Susan Love
- Minneapolis VA Health Care System, Minneapolis, Minnesota
| | | | | | | | | | - Peijun Chen
- Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio6Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - David J Loreck
- VA Maryland Healthcare System, Baltimore11University of Maryland Medical School, Department of Psychiatry, Baltimore
| | | | | | - Jacobo E Mintzer
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina14Department of Health Studies, Medical University of South Carolina, Charleston15Roper St Francis Healthcare, Charleston, South Carolina
| | | | | | | | - Angel R Cruz
- Bay Pines VA Healthcare System, Bay Pines, Florida
| | | | | | | | - Suzanne Craft
- VA Puget Sound Health Care System, Seattle, Washington21Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
| | - Stephen Thielke
- VA Puget Sound Health Care System, Seattle, Washington21Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
| | - Carolyn L Turvey
- Iowa City VA Medical Center, Iowa City, Iowa23University of Iowa, Iowa City
| | - Catherine Woodman
- Iowa City VA Medical Center, Iowa City, Iowa23University of Iowa, Iowa City
| | | | - Kimberly Gordon
- W. G. (Bill) Hefner VA Medical Center, Salisbury, North Carolina
| | - Julie Tomaska
- Minneapolis VA Health Care System, Minneapolis, Minnesota
| | - Yoav Segal
- Minneapolis VA Health Care System, Minneapolis, Minnesota
| | - Peter N Peduzzi
- Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven26Yale University School of Public Health, New Haven, Connecticut
| | - Peter D Guarino
- Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven26Yale University School of Public Health, New Haven, Connecticut
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173
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How can a caregiver get over the daily fatigue that comes with caring for a person with dementia? Johns Hopkins Med Lett Health After 50 2014; 25:7. [PMID: 24809127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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174
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Brunner P. [Whole individuals to the last day]. Krankenpfl Soins Infirm 2014; 107:64-67. [PMID: 25438417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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175
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Schmid R. [Challenging behavior in dementia: nursing care instead of drugs]. Krankenpfl Soins Infirm 2014; 107:35. [PMID: 24683797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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176
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Flynn Longmire CV, Drye LT, Frangakis CE, Martin BK, Meinert CL, Mintzer JE, Munro CA, Porsteinsson AP, Rabins PV, Rosenberg PB, Schneider LS, Weintraub D, Lyketsos CG. Is sertraline treatment or depression remission in depressed Alzheimer patients associated with improved caregiver well being? Depression in Alzheimer's Disease Study 2. Am J Geriatr Psychiatry 2014; 22:14-24. [PMID: 24314887 PMCID: PMC3910508 DOI: 10.1016/j.jagp.2013.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 02/11/2013] [Accepted: 02/15/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE We wanted to assess if sertraline treatment (versus placebo) or remission of depression at 12 weeks (versus nonremission) in Alzheimer patients is associated with improved caregiver well being. METHODS We conducted a randomized, double-blind, placebo-controlled clinical trial of the efficacy and safety of sertraline for the treatment of depression in individuals with Alzheimer disease in five clinical research sites across the United States. Participants were caregivers of patients enrolled in the Depression in Alzheimer's Disease Study 2 (N = 131). All caregivers received standardized psychosocial support throughout the study. Caregiver outcome measures included depression (Beck Depression Inventory), distress (Neuropsychiatric Inventory), burden (Zarit Burden Interview), and quality of life (Medical Outcomes Study Short Form Health Survey). RESULTS Fifty-nine percent of caregivers were spouses, 63.4% were women, and 64.1% were white. Caregivers of patients in both treatment groups had significant reductions in distress scores over the 24-week study period, but there was not a greater benefit for caregivers of patients taking sertraline. However, caregivers of patients whose depression was in remission at week 12 had greater declines in distress scores over the 24 weeks than caregivers of patients whose depression did not remit by week 12. CONCLUSION Patient treatment with sertraline was not associated with significantly greater reductions in caregiver distress than placebo treatment. Distress but not level of depression or burden lessened for all caregivers regardless of remission status and even more so for those who cared for patients whose depression remitted. Results imply an interrelationship between caregiver distress and patient psychiatric outcomes.
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177
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Anchisi A, Lambrigger N. [Accompanying Alzheimer patients and their caregivers: when dementia takes a vacation]. Krankenpfl Soins Infirm 2014; 107:60-61. [PMID: 24640850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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178
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Zimmermann ML. [Accompanying patients with the heart]. Krankenpfl Soins Infirm 2014; 107:11-83. [PMID: 25141502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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179
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Jaunin MK. [Nursing care of residents with diabetes. More autonomy in managing diabetes despite dementia]. Krankenpfl Soins Infirm 2014; 107:11-80. [PMID: 25327118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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180
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Abstract
Alzheimer's disease (AD) has high economic impact and places significant burden on patients, caregivers, providers and healthcare delivery systems, fostering the need for an evaluation of alternative approaches to healthcare delivery for dementia. Collaborative care models are team-based, multicomponent interventions that provide a pragmatic strategy to deliver integrated healthcare to patients and families across a wide range of populations and clinical settings. Healthcare reform and national plans for AD goals to integrate quality care, health promotion and preventive services, and reduce the impact of disease on patients and families reinforcing the need for a system-level evaluation of how to best meet the needs of patients and families. We review collaborative care models for AD and offer evidence for improved patient- and family-centered outcomes, quality indicators of care and potential cost savings.
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Affiliation(s)
- James E Galvin
- Center for Cognitive Neurology & Alzheimer Disease Center, Departments of Neurology, Psychiatry, & Population Health, New York University School of Medicine, New York, NY 10016, USA
| | - Licet Valois
- Center for Cognitive Neurology & Alzheimer Disease Center, Departments of Neurology, Psychiatry, & Population Health, New York University School of Medicine, New York, NY 10016, USA
| | - Yael Zweig
- Center for Cognitive Neurology & Alzheimer Disease Center, Departments of Neurology, Psychiatry, & Population Health, New York University School of Medicine, New York, NY 10016, USA
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181
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Ornstein K, Gaugler JE, Devanand DP, Scarmeas N, Zhu C, Stern Y. The differential impact of unique behavioral and psychological symptoms for the dementia caregiver: how and why do patients' individual symptom clusters impact caregiver depressive symptoms? Am J Geriatr Psychiatry 2013; 21:1277-86. [PMID: 24206939 PMCID: PMC3543497 DOI: 10.1016/j.jagp.2013.01.062] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 05/24/2012] [Accepted: 06/27/2012] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The behavioral and psychological symptoms associated with dementia (BPSD) are highly burdensome to caregivers. While BPSD consist of a wide variety of patient behaviors including depression, physical aggression, and paranoid delusions, it remains unclear whether specific symptoms have a differential impact on caregivers. The aims of this study were 1) to assess how individual BPSD, categorized based on how they may affect caregivers, impact depressive symptoms for dementia patient caregivers and 2) to test the pathways by which BPSD clusters impact caregiver depressive symptoms. DESIGN Cross-sectional analysis of data from a longitudinal study of patients with Alzheimer disease and dementia with Lewy bodies. SETTING Multiple U.S. dementia clinics. PARTICIPANTS One hundred sixty patient-caregiver dyads. METHODS Using multivariate generalized estimating equation logistic models, we analyzed the relationship between four BPSD clusters (patient depressive symptoms, accusatory/aggressive behaviors, nonthreatening psychotic symptoms, and difficult to manage behaviors) and caregiver depressive symptoms and assessed mediators of these relationships. RESULTS Only the presence of patient depressive symptoms was associated with caregiver depression (odds ratio: 1.55; 95% confidence interval: 1.14-2.1). This relationship was mediated by caregiver report of both the symptom's impact on the patient and perceived burden to caregivers. CONCLUSION Patient depressive symptoms may be the most important driver of the relationship between BPSD and caregiver depression. Research in this field should further test the effects of individual BPSD and also consider how symptoms may negatively impact caregivers by increasing burden and evoking empathy for the patient.
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Affiliation(s)
- Katherine Ornstein
- Geriatrics Department, The Mount Sinai School of Medicine, New York, NY.
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182
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Kondo S, Kondo Y, Kitagawa C, Katsuta S. [Assessment of the association between nursing care services, hypertension, and Alzheimer's disease in elderly patients with late-stage diabetes]. Gan To Kagaku Ryoho 2013; 40 Suppl 2:180-182. [PMID: 24712138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In an aging society with fewer children, diabetes self-control is difficult for elderly patients. Under these circumstances, it is expected that living in care homes for the elderly and institutions where nursing care services could be provided will help improve the prognosis of diabetic patients. Therefore, we assessed whether HbA(1c). levels (National Glycohemoglobin Standardization Program : NGSP) in 121 elderly patients with late-stage diabetes receiving home medical care in our clinic from March 2008 to March 2013 improved with nursing care services.
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183
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Abstract
With the aging of the population and the projected increase of dementia in the coming years, it is crucial that we understand the needs of people with dementia (PWD) in order to provide appropriate care. The aim of this study is to determine, using the best evidence possible, the care needs of PWD living in long-term care (LTC). A total of 68 studies, published between January 2000 and September 2010, were identified from six databases. From the selected studies, 19 needs of PWD were identified. The existing evidence suggests that psychosocial needs such as the need to engage in daily individualized activities and care must not be ignored in LTC. This review aims to provide a clearer picture of the needs of this growing patient population.
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Affiliation(s)
- Marie-Andrée Cadieux
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Linda J. Garcia
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Jonathan Patrick
- Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
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184
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Abstract
TOPIC Concept analysis of temporality. PURPOSE To develop a comprehensive definition of temporality applicable to nursing care. SOURCE Published literature. CONCLUSIONS Temporality is a central component of our experience of the world. Phenomena such as the passage of time, time cycles, the trajectory of aging, transitions toward something, something being, and life as a limited time are integral to human experience. Temporality could be seen as lived time, and as such it is subjective time as opposed to clock time or objective time. The temporal dimensions of past, present, and future constitute the perspective of a person's temporal world.
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185
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Irwin SA, Mausbach BT, Koo D, Fairman N, Roepke-Buehler SK, Chattillion EA, Dimsdale JE, Patterson TL, Ancoli-Israel S, Mills PJ, von Känel R, Ziegler MG, Grant I. Association between hospice care and psychological outcomes in Alzheimer's spousal caregivers. J Palliat Med 2013; 16:1450-4. [PMID: 24093721 PMCID: PMC3822398 DOI: 10.1089/jpm.2013.0130] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2013] [Indexed: 11/13/2022] Open
Abstract
CONTEXT Dementia care giving can lead to increased stress, physical and psychosocial morbidity, and mortality. Anecdotal evidence suggests that hospice care provided to people with dementia and their caregivers may buffer caregivers from some of the adverse outcomes associated with family caregiving in Alzheimer's Disease (AD). OBJECTIVES This pilot study examined psychological and physical outcomes among 32 spousal caregivers of patients with AD. It was hypothesized that caregivers who utilized hospice services would demonstrate better outcomes after the death of their spouse than caregivers who did not utilize hospice. METHODS The charts of all spousal caregivers enrolled in a larger longitudinal study from 2001 to 2006 (N=120) were reviewed, and participants whose spouse had died were identified. Of these, those who received hospice care (n=10) were compared to those who did not (n=22) for various physiological and psychological measures of stress, both before and after the death of the care recipient. An Analysis of Covariance (ANCOVA), with postdeath scores as the dependent variable and pre-death scores as covariates, was used for all variables. RESULTS Significant group differences were found in postdeath depressive symptoms (HAM-D; F(1,29)=6.10, p<0.05) and anxiety symptoms (HAM-A; F(1,29)=5.71, p<0.05). Most psychological outcome variables demonstrated moderate effect sizes with a Cohen's d of>0.5 between groups. CONCLUSIONS These data suggest that hospice enrollment may ameliorate the detrimental psychological effects in caregivers who have lost a spouse with Alzheimer's Disease. Based on these pilot data, further prospective investigation is warranted.
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Affiliation(s)
- Scott A. Irwin
- Department of Psychiatry and Psychosocial Services, San Diego Hospice and The Institute for Palliative Medicine, San Diego, California
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Brent T. Mausbach
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Derek Koo
- Department of Psychiatry and Psychosocial Services, San Diego Hospice and The Institute for Palliative Medicine, San Diego, California
| | - Nathan Fairman
- Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, Sacramento, California
| | | | - Elizabeth A. Chattillion
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California
| | - Joel E. Dimsdale
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Thomas L. Patterson
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Sonia Ancoli-Israel
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Paul J. Mills
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Roland von Känel
- Department of Psychiatry, University of California, San Diego, La Jolla, California
- Department of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Michael G. Ziegler
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Igor Grant
- Department of Psychiatry, University of California, San Diego, La Jolla, California
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186
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187
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Tappen RM, Hain D. The effect of in-home cognitive training on functional performance of individuals with mild cognitive impairment and early-stage Alzheimer's disease. Res Gerontol Nurs 2013; 7:14-24. [PMID: 24131045 DOI: 10.3928/19404921-20131009-01] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 09/26/2013] [Indexed: 11/20/2022]
Abstract
This intervention study compared an in-home cognitive training program to life story interview in 68 individuals with mild cognitive impairment or early-stage Alzheimer's disease. Family caregivers participated in sessions and reinforced learning between sessions. Analyses of covariance controlling for baseline levels were conducted. In comparison with the life story group, participants in the cognitive training group demonstrated significant improvement in all face-name association measures, several of the money-related tasks, and one of two event-related memory tasks. There were no differences in language outcomes or caregiver ratings of functional tasks except shopping. Caregivers in the life story group reported higher perceived satisfaction from being a caregiver. Comparison with earlier studies suggests in-home training is modestly more effective than office-based intervention. Results suggest that improvements are related to specific training and do not generalize to other tasks. Focusing on tasks of critical significance to participant and caregiver is recommended.
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188
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Werner S. [What does (loss of) autonomy mean for patients with dementia. Self determination as long as possible]. Pflege Z 2013; 66:594-597. [PMID: 24199363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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189
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Höwler E. [Closeness and distance - a problem in nursing: nursing relations in balance]. Pflege Z 2013; 66:604-606. [PMID: 24199366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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190
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Aka S. Dance with me. Can Nurse 2013; 109:30-31. [PMID: 24283151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Sharon Aka
- Humber Institute of Technology & Advanced Learning in Toronto
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191
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Angelica J. Children of heroes: Alzheimer's disease--a path toward healing and wholeness for caregivers. J Pastoral Care Counsel 2013; 67:6. [PMID: 24720237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Conventional wisdom postulates that Alzheimer's steals personhood and destroys our opportunities to heal, reconcile, and deepen our relationships with persons who have this disease. In this article, children of Alzheimer's Heroes who have answered the call to love, challenge this conventional wisdom. With clarity, confidence, and courage, we bear witness to the mythic power of Alzheimer's and express gratitude for the surprising gifts that have transformed our lives.
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192
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Boulinguez J, Meulnotte J. [Nurses' perspectives on Alzheimer's disease]. Soins Gerontol 2013:11-14. [PMID: 24187787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Nurses' perspective on Alzheimer's disease still needs to evolve in order to ensure that adapted support is provided. It is a question of gaining a better understanding of the disease and its consequences. This cannot be done without taking into account the suffering of the teams and that of the people affected by this disease.
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193
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Perfecto K, Ahern NR. Early assessment for Alzheimer's disease and dementia: comparison of two metamemory diagnostic tests. J Psychosoc Nurs Ment Health Serv 2013; 51:17-21. [PMID: 23938066 DOI: 10.3928/02793695-20130731-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Alzheimer's disease (AD) is a growing problem in the United States. Because of the inability of the Mini-Mental State Examination to detect AD in the early stages, other avenues of assessment must be explored. Two subjective assessment tests have been proposed to help evaluate progression from nonclinical to clinical AD: the Feeling-of-Knowing and Judgment-of-Learning tests. Currently, no conclusive evidence exists as to which test is better suited to assess for progression toward AD. These tests, however, have been reliable when used to assess metamemory. A decrease in metamemory can be an indicator of nonclinical AD. This article provides practice implications for mental health nurses in administering either test and calculating scores over time. The hope is that by using these two assessment tests, patients with AD may be diagnosed earlier and subsequently lead longer, better quality lives.
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194
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Andrews J. Maintaining continence in people with dementia. Nurs Times 2013; 109:20-21. [PMID: 23957127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Incontinence is not an inevitable consequence of having dementia, but continence can be an issue. Nurses need to have strategies in place to provide supportive continence care for people with dementia not only in hospitals, care homes and day care services, but also for those living at home alone or with a carer. For this to happen, the patient and home environment need to be assessed. This article explores steps that can be taken to preserve the dignity of people with dementia if they become incontinent. The role of health professionals in hospitals is discussed, as well as changes that can be made in patients' own homes.
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Affiliation(s)
- June Andrews
- Dementia Services Development Centre, University of Stirling
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195
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Hochgraeber I. [Behavior and well-being of people with dementia in a social care group. Observation study with dementia care mapping]. Pflege Z 2013; 66:408-413. [PMID: 23866542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Social care groups for people with dementia areone way to relieve family caregivers and to activate individuals with dementia. This study aimed to describe one social care group and investigate the well-being of the groups members. The research question therefore was: What are people with dementia doing and how do they feel in a social care group? In this descriptive observation study we observed three group sessions in one social care group with five members in North Rhine-Westphalia (Germany) using Dementia Care Mapping (DCM). The results show that there was a special course of action fixed by meals, welcoming and farewell. The behaviour and well-being varied. Leisure like doing handicraft and interaction were depicted as main activities. The well-being was high, if participants had energetic activities and the course of action of the different group members was similar. Interestingly one person was excluded from almost all activities. It is important for staff to know the constellation of the group and to include all visitors.
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196
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Kamphausen U. [Reflecting on nursing care. Violence in routine nursing - Pflegezeitschrift author Ulrich Kamphausen points out fateful interventions and behaviors]. Pflege Z 2013; 66:394-396. [PMID: 23866539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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197
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[A digital platform for caregivers]. Soins Psychiatr 2013;:6. [PMID: 23951733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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198
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Carson VB. Managing your loved one from a distance. Caring 2013; 32:40-41. [PMID: 24069796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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199
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Licina S. [The bottom line is positive]. Pflege Z 2013; 66:324-328. [PMID: 23798167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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200
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Bartholomeyczik S. [Benefit assessment in nursing research: illustrative examples and questions left unanswered]. Z Evid Fortbild Qual Gesundhwes 2013; 107:242-247. [PMID: 23790705 DOI: 10.1016/j.zefq.2013.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Questions in nursing research are often studied in heterogeneous and instable fields such as nursing homes and use highly complex interventions. With the usual designs the mechanisms of their effects are difficult to evaluate. These interventions usually cannot be completely standardised. Comparison with 'care as usual' is hardly possible, since 'care as usual' can vary a lot. Moreover, the motivation to participate in a study with the chance of not getting an intervention is very low. Control groups with an active intervention, however, involve the risk that effects cannot be distinguished. This is why process evaluation and implementation research using multi-method approaches and triangulation are central to evaluating the effects of complex interventions. A solid theoretical foundation is the key to the proper interpretation of empirical results. (As supplied by publisher).
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Affiliation(s)
- Sabine Bartholomeyczik
- Universität Witten/Herdecke, Department für Pflegewissenschaft, Stockumer Strasse 12, Witten.
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