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Management of challenging behaviour in dementia

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https://www.readbyqxmd.com/read/28177148/when-walking-becomes-wandering-representing-the-fear-of-the-fourth-age
#1
Katherine Brittain, Cathrine Degnen, Grant Gibson, Claire Dickinson, Louise Robinson
Dementia is linked to behavioural changes that are perceived as challenging to care practices. One such behavioural change is 'wandering', something that is often deeply feared by carers and by people with dementia themselves. Understanding how behavioural changes like wandering are experienced as problematic is critically important in current discussions about the behavioural and psychological symptoms of dementia. In this article we draw on our secondary analysis of qualitative interviews and focus groups with carers of people with dementia to critically question 'when does walking become wandering'? Drawing on theoretical perspectives from anthropology, sociology and human geography to explore experiences of carers and of people with dementia, we argue that a conceptual shift occurs in how pedestrian activity, usually represented as something purposeful, meaningful and healthy (walking) is seen as something threatening that needs managing (wandering)...
February 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28107848/doll-therapy-for-dementia-sufferers-a-systematic-review
#2
Qin Xiang Ng, Collin Yih Xian Ho, Shawn Shao Hong Koh, Wei Chuan Tan, Hwei Wuen Chan
Dementia affects more than 47.5 million people worldwide, and the number is expected to continue to increase as the population ages. Doll therapy is an emerging nonpharmacologic management strategy for patients with advanced dementia, especially in patients with challenging behaviours. A total of 12 published studies (mainly cohort and observational studies) were identified and discussed in this systematic review. In most instances, cognitive, behavioural and emotional symptoms were alleviated and overall wellbeing was improved with doll therapy, and dementia sufferers were found to be able to better relate with their external environment...
February 2017: Complementary Therapies in Clinical Practice
https://www.readbyqxmd.com/read/28103847/exploring-healthcare-assistants-role-and-experience-in-pain-assessment-and-management-for-people-with-advanced-dementia-towards-the-end-of-life-a-qualitative-study
#3
Bannin De Witt Jansen, Kevin Brazil, Peter Passmore, Hilary Buchanan, Doreen Maxwell, Sonja J McIlfatrick, Sharon M Morgan, Max Watson, Carole Parsons
BACKGROUND: Pain assessment and management are key aspects in the care of people with dementia approaching the end of life but become challenging when patient self-report is impaired or unavailable. Best practice recommends the use of observational pain assessments for these patients; however, difficulties have been documented with health professionals' use of these tools in the absence of additional collateral patient knowledge. No studies have explored the role, perspectives and experiences of healthcare assistants in pain assessment and management in dementia; this study provides insight into this important area...
January 19, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28043078/a-qualitative-study-investigating-training-requirements-of-nurses-working-with-people-with-dementia-in-nursing-homes
#4
Analisa Smythe, Catharine Jenkins, Magdalena Galant-Miecznikowska, Peter Bentham, Jan Oyebode
BACKGROUND: The care home workforce (over half a million people in the UK) has a pivotal role in the quality of care provided to the residents. Much care in this setting is inadequate, lacks a person-centred focus and neglects the dignity of residents. A combination of factors leads to burnout in nurses working in nursing homes, contributing to poor quality care. Recent reports have indicated that cultures of care need to be addressed through training, improved workforce support and supervision and that improving the quality of care for people with dementia can be achieved by the development of leadership in nursing and clarifying professional values...
December 22, 2016: Nurse Education Today
https://www.readbyqxmd.com/read/27995678/nursing-home-manager-s-knowledge-attitudes-and-beliefs-about-advance-care-planning-for-people-with-dementia-in-long-term-care-settings-a-cross-sectional-survey
#5
Esther-Ruth Beck, Sonja McIlfatrick, Felicity Hasson, Gerry Leavey
AIMS AND OBJECTIVES: To examine nursing home managers' knowledge, attitudes, beliefs and current practice regarding advance care planning for people with dementia in long-term care settings informed by the theory of planned behaviour. BACKGROUND: Internationally, advance care planning is advocated for people with dementia. However, evidence suggests that discussions with people with dementia are rare, particularly in long-term care settings. Whilst nursing home managers can be considered central to implementation in this setting, there is a dearth of research that has examined their perspective...
December 20, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27899689/herbal-medicine-for-management-of-the-behavioural-and-psychological-symptoms-of-dementia-bpsd-a-systematic-review-and-meta-analysis
#6
REVIEW
Anna J Hyde, Brian H May, Lin Dong, Mei Feng, Shaonan Liu, Xinfeng Guo, Anthony Lin Zhang, Chuanjian Lu, Charlie Changli Xue
Management of the behavioural and psychological symptoms of dementia remains a challenge worldwide. Herbal medicines may play a role in the development of new interventions. To determine effects of herbal medicines for management of the behavioural and psychological symptoms of dementia, meta-analysis was conducted of 31 controlled trials (3613 participants). Frequently tested herbal medicines were the Ginkgo biloba leaf extract EGb 761 (seven studies) and the multi-ingredient formula Yokukansan (eight studies)...
November 29, 2016: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/27412879/intimacy-between-care-home-residents-with-dementia-findings-from-a-review-of-the-literature
#7
Esther Wiskerke, Jill Manthorpe
BACKGROUND: There is limited research on what family members and frontline care home staff consider to be the best responses to the sexual expression of a person with dementia, whilst at the same time respecting relatives' feelings, managing their possible distress and conflict, and how good practice should be reflected in care home policy and practice guidance. METHODS: This literature review explored what is known of the views of relatives and care workers of new relationships or sexual intimacy between care home residents with dementia, whilst still married to another person...
July 13, 2016: Dementia
https://www.readbyqxmd.com/read/27406242/time-targeted-interdisciplinary-model-for-evaluation-and-treatment-of-neuropsychiatric-symptoms-protocol-for-an-effectiveness-implementation-cluster-randomized-hybrid-trial
#8
Bjørn Lichtwarck, Geir Selbaek, Øyvind Kirkevold, Anne Marie Mork Rokstad, Jūratė Šaltytė Benth, Janne Myhre, Solvor Nybakken, Sverre Bergh
BACKGROUND: Nearly all persons with dementia will experience neuropsychiatric symptoms (NPS) during the course of their disease. Clinicians and researchers emphasize the need for an evidence-informed standardized approach to managing NPS that integrates pharmacological and nonpharmacological treatments for real-world implementation. The Targeted Interdisciplinary Model for Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) represents such an approach and is a multicomponent intervention based on the theoretical framework of cognitive behavioural therapy...
July 12, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27405890/young-onset-dementia
#9
B Draper, A Withall
Young onset dementia (YOD), where symptoms of dementia have an onset before the age of 65, has become more prominent due to the population increase from the Baby Boomer generation. This clinical perspective examines key issues in the assessment, diagnosis and management of YOD. Challenges in the assessment and diagnosis of YOD are partly due to the diverse range of types of YOD, where degenerative dementias are less common and secondary dementias more common than in late onset dementia. Early symptoms are broad and include depression, behavioural change, neurological disorders, systemic disorders and mild cognitive impairment (MCI)...
July 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27374988/nursing-staff-stress-from-challenging-behaviour-of-residents-with-dementia-a-concept-analysis
#10
REVIEW
T J G M Hazelhof, L Schoonhoven, B G I van Gaal, R T C M Koopmans, D L Gerritsen
AIM: Provide insight into the concept of stress in the context of challenging behaviour of nursing home residents with dementia and its causes and consequences. BACKGROUND: Challenging behaviour is frequent in residents with dementia, but consequences for nursing staff are unclear. INTRODUCTION: Challenging behaviour of residents can be enervating for nurses and may lead to stress. Although stress in general is associated with negative outcomes, an overview of stress in this context would be a welcome addition to the field...
September 2016: International Nursing Review
https://www.readbyqxmd.com/read/27341812/evaluating-the-effectiveness-and-cost-effectiveness-of-dementia-care-mapping%C3%A2-to-enable-person-centred-care-for-people-with-dementia-and-their-carers-dcm-epic-in-care-homes-study-protocol-for-a-randomised-controlled-trial
#11
Claire A Surr, Rebecca E A Walwyn, Amanda Lilley-Kelly, Robert Cicero, David Meads, Clive Ballard, Kayleigh Burton, Lynn Chenoweth, Anne Corbett, Byron Creese, Murna Downs, Amanda J Farrin, Jane Fossey, Lucy Garrod, Elizabeth H Graham, Alys Griffiths, Ivana Holloway, Sharon Jones, Baber Malik, Najma Siddiqi, Louise Robinson, Graham Stokes, Daphne Wallace
BACKGROUND: Up to 90 % of people living with dementia in care homes experience one or more behaviours that staff may describe as challenging to support (BSC). Of these agitation is the most common and difficult to manage. The presence of agitation is associated with fewer visits from relatives, poorer quality of life and social isolation. It is recommended that agitation is treated through psychosocial interventions. Dementia Care Mapping™ (DCM™) is an established, widely used observational tool and practice development cycle, for ensuring a systematic approach to providing person-centred care...
2016: Trials
https://www.readbyqxmd.com/read/27161855/the-impact-of-staff-training-on-staff-outcomes-in-dementia-care-a-systematic-review
#12
Aimee Spector, Catherine Revolta, Martin Orrell
OBJECTIVE: Caring for people with dementia can be emotionally challenging and is often linked to low job satisfaction and burnout in care staff. Staff training within care settings is potentially valuable in improving well-being and quality of care. This review aimed to (i) establish the impact of training on staff outcomes; (ii) compare the impact of different training approaches; (iii) explore the influence of training intensity; and (iv) explore potential barriers to success. METHOD: A database search of staff training interventions revealed 207 papers, 188 of which were excluded based on prespecified criteria...
May 9, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27098423/-a-multidisciplinary-approach-for-the-optimal-treatment-of-problem-behaviour-in-dementia
#13
REVIEW
Henriëtte Ettema
Problem behaviours in one form or another are very common in nursing home residents with dementia. In order to manage these challenging behaviours pharmacological and psychosocial interventions are necessary. Psychosocial interventions have gained a more central role due to negative affects of pharmacological treatment. This case study describes the multidisciplinary approach of problem behaviour in an 85 year old nursing home patient with dementia. Those involved in caring for this patient initiated changes that led to a more adequate treatment and ultimately a decrease in the problematic behaviour...
June 2016: Tijdschrift Voor Gerontologie en Geriatrie
https://www.readbyqxmd.com/read/27044417/exploring-psychosocial-interventions-for-people-with-dementia-that-enhance-personhood-and-relate-to-legacy-an-integrative-review
#14
REVIEW
Bridget Johnston, Melanie Narayanasamy
BACKGROUND: Epidemiological predictions suggest that dementia will continue to rise and that this will have social and economic ramifications. Effective interventions, beyond pharmacological management are needed. Psychosocial interventions have largely been investigated in relation to carers of people with dementia, or with regards to their ability to manage dementia symptoms, improve cognition, and reduce challenging behaviour. However, since dementia is a life-limiting illness and people with dementia are at risk of having their personhood compromised, psychosocial interventions should seek to enhance personhood, and offer the potential for the person to leave a legacy...
April 5, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27019375/the-management-of-behavioural-and-psychological-symptoms-of-dementia-in-the-acute-general-medical-hospital-a-longitudinal-cohort-study
#15
Nicola White, Baptiste Leurent, Kathryn Lord, Sharon Scott, Louise Jones, Elizabeth L Sampson
BACKGROUND: The acute hospital is a challenging place for a person with dementia. Behavioural and psychological symptoms of dementia (BPSD) are common and may be exacerbated by the hospital environment. Concerns have been raised about how BPSD are managed in this setting and about over reliance on neuroleptic medication. This study aimed to investigate how BPSD are managed in UK acute hospitals. METHOD(S): A longitudinal cohort of 230 patients with dementia admitted to two acute NHS hospitals...
March 27, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27009145/improving-the-management-of-behaviour-that-challenges-associated-with-dementia-in-care-homes-protocol-for-pharmacy-health-psychology-intervention-feasibility-study
#16
MULTICENTER STUDY
Ian D Maidment, Rachel L Shaw, Kirsty Killick, Sarah Damery, Andrea Hilton, Jane Wilcock, Nigel Barnes, Graeme Brown, Sarah Gillespie, Chris Fox, Garry Barton, Steve Iliffe, Nichola Seare
INTRODUCTION: The inappropriate use of antipsychotics in people with dementia for behaviour that challenges is associated with an estimated 1800 deaths annually. However, solely focusing on antipsychotics may transfer prescribing to other equally dangerous psychotropics. Little is known about the role of pharmacists in the management of psychotropics used to treat behaviours that challenge. This research aims to determine whether it is feasible to implement and measure the effectiveness of a combined pharmacy-health psychology intervention incorporating a medication review and staff training package to limit the prescription of psychotropics to manage behaviour that challenges in care home residents with dementia...
March 23, 2016: BMJ Open
https://www.readbyqxmd.com/read/26989095/behavioural-and-psychological-symptoms-in-dementia-and-the-challenges-for-family-carers-systematic-review
#17
REVIEW
Alexandra Feast, Martin Orrell, Georgina Charlesworth, Nina Melunsky, Fiona Poland, Esme Moniz-Cook
BACKGROUND: Tailored psychosocial interventions can help families to manage behavioural and psychological symptoms in dementia (BPSD), but carer responses to their relative's behaviours contribute to the success of support programmes. AIMS: To understand why some family carers have difficulty in dealing with BPSD, in order to improve the quality of personalised care that is offered. METHOD: A systematic review and meta-ethnographic synthesis was conducted of high-quality quantitative and qualitative studies between 1980 and 2012...
May 2016: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/26987909/the-frontotemporal-dementia-motor-neuron-disease-continuum
#18
REVIEW
James R Burrell, Glenda M Halliday, Jillian J Kril, Lars M Ittner, Jürgen Götz, Matthew C Kiernan, John R Hodges
Early reports of cognitive and behavioural deficits in motor neuron disease might have been overlooked initially, but the concept of a frontotemporal dementia-motor neuron disease continuum has emerged during the past decade. Frontotemporal dementia-motor neuron disease is now recognised as an important dementia syndrome, which presents substantial challenges for diagnosis and management. Frontotemporal dementia, motor neuron disease, and frontotemporal dementia-motor neuron disease are characterised by overlapping patterns of TAR DNA binding protein (TDP-43) pathology, while the chromosome 9 open reading frame 72 (C9orf72) repeat expansion is common across the disease spectrum...
August 27, 2016: Lancet
https://www.readbyqxmd.com/read/26976618/professional-carers-experiences-of-caring-for-individuals-with-intellectual-disability-and-dementia-a-review-of-the-literature
#19
Josephine Cleary, Owen Doody
The number of people with intellectual disability living into old age and developing dementia continues to increase. Dementia presents a wide range of challenges for staff due to progressive deterioration. This article presents the findings from a narrative literature review of professional caregivers' experiences of caring for individuals with intellectual disability and dementia. Seven electronic databases were searched using Boolean operators and truncation to identify relevant literature. Search results were combined and narrowed to articles relevant to staff working with individuals with intellectual disability and dementia, and 14 articles met the criteria for review...
March 14, 2016: Journal of Intellectual Disabilities: JOID
https://www.readbyqxmd.com/read/26920347/appreciative-inquiry-an-alternative-to-behaviour-management
#20
Bernard McCarthy
Appreciative Inquiry is an approach to organisational change that has been effective and popular around the world for the past two decades. What could it have to offer us as an alternative to traditional 'behaviour management'? Traditionally, in modern dementia care, we take a psychiatric approach to the range of actions that people engage in when stressed or traumatised by the cognitive, social and psychological losses associated with dementia. We call them symptoms of an illness - Behavioural and Psychological Symptoms of Dementia...
February 2017: Dementia
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