Do Reports on Personal Preferences of Persons with Dementia Predict Their Responses to Group Activities?

Predicting Activation Liking of People With Dementia

Physical, social and cognitive activation is an important cornerstone in non-pharmacological therapy for People with Dementia (PwD). To support long-term motivation and well-being, activation contents first need to be perceived positively. Prompting for explicit feedback, however, is intrusive and interrupts the activation flow. Automated analyses of verbal and non-verbal signals could provide an unobtrusive means of recommending suitable contents based on implicit feedback. In this study, we investigate the correlation between engagement responses and self-reported activation ratings. Subsequently, we predict ratings of PwD based on verbal and non-verbal signals in an unconstrained care setting. Applying Long-Short-Term-Memory (LSTM) networks, we can show that our classifier outperforms chance level. We further investigate which features are the most promising indicators for the prediction of activation ratings of PwD.

Israeli nursing home staff perspectives on challenges to quality care for residents with dementia

This study examines nursing home employees' perspectives concerning barriers to quality care for people with dementia. Data were derived from observations of care units and interviews with forty-one employees, including chief executive officers, social workers, nurses, occupational therapists, activity workers and nursing assistants at five Israeli nursing homes. Residents' behavior was reported as challenging for staff. Physical restraints and psychotropic medication were commonly used to address behavioral challenges, while few staff acknowledged these practices as problematic. Staff complained that some co-workers were insufficiently caring and wages and overall funding were inadequate, resulting in unsatisfactory staffing levels and insufficient activities for residents. Rigid care routines failed to meet resident needs, and staff failed to notice the relationship between care practices and resident behavior. While problems were described concerning multiple aspects of care, the root causes seemed to include the need for additional funding and for greater expertise in dementia care.

Facilitators and Barriers to Attendance in a Nursing Home Exercise Program

Women and residents in Certified Nursing Homes (CNHs) with higher star ratings had better attendance in exercise and social engagement programming (ie, Bingocize) than men and residents in CNHs with lower ratings.

OBJECTIVE

The purpose of the current study was to determine whether resident factors and nursing home star ratings influenced attendance in Bingocize, a therapeutic exercise program that incorporates opportunities for social engagement in nursing homes.

DESIGN

This is a descriptive study of data collected across multiple nursing homes over 17 months.

SETTING AND PARTICIPANTS

Data were collected from residents in 25 certified nursing homes in the mid-southern United States.

METHODS

The program consisted of two 45-60-minute sessions each week. Bingocize attendance was recoded as number of sessions attended each month from September 2017 to February 2019 in 25 nursing homes. The impact of gender, age, cognitive functioning, and Nursing Home Star Ratings on adherence to the program based on percentage of Bingocize sessions attended was analyzed.

RESULTS

A total of 1165 residents of certified nursing homes were recruited and participated in Bingocize; 55% of participants attended Bingocize infrequently or had poor attendance, 21% of the participants had average attendance, and 24% had good attendance. The association between gender and level of attendance was significant (P = .045). The star rating of the nursing home also affected attendance. As star level of the nursing home increased, the percentage of good attendance increased (P < .001): 19.12% (1 star), 20.69% (2 stars), 23.57% (3 stars), 33.76% (4 stars), and 36.63% (5 stars). Neither age nor cognitive functioning [based on Brief Interview of Mental Status (BIMS)] had a significant impact on attendance.

CONCLUSIONS AND IMPLICATIONS

We examined adherence to an exercise program called Bingocize based on percentage of sessions attended in 25 nursing homes. Women and residents in nursing homes with higher star ratings were reported to have better attendance in Bingocize than men or residents in nursing homes with lower ratings, respectively. Residents of all ages and cognitive ability can successfully participate in the Bingocize program.

Improving Engagement of Mild to Moderate Dementia Alzheimer's Disease Patients Using Evidence-Based Visual Cognitive Stimulation Exercises

INTRODUCTION

Different studies have proven the effectiveness of cognitive stimulation (CS) for people with mild to moderate dementia, but further research is needed to gain insight into how CS interventions should be designed and developed.

OBJECTIVES

The objective of this study was to gather and analyze data about the development of a series of CS sessions with Alzheimer's disease (AD) patients, to gain insight into how different individuals engage to different CS activities.

METHODS

24 AD patients with mild to moderate dementia (GDS = 4 and 5) participated in the study. Twelve different sessions were held with a different stimulation exercise each. Information about the achievement and engagement for each of the exercises were recorded for each patient.

RESULTS

A significant correlation was found between the global engagement and the GDS level, and between engagement and gender (and also with educational level) for one of the exercises. These results may be useful for designing CS sessions depending on the composition of the group. For example, five exercises got very different engagement results when comparing patients with GDS = 4 and GDS = 5; if the session group consists of patients with both GDS levels, these kinds of exercises should be avoided to gain homogeneity in the engagement and prevent discouragement.

CONCLUSIONS

The type and characteristics of CS exercises have an impact on the engagement level of AD patients with mild to moderate dementia. Further studies are necessary to better understand which characteristics of the exercises affect the engagement of the patient according to their particularities. This kind of study may help the design of CS sessions and improve the results obtained.