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Management of challenging behaviour in dementia

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https://www.readbyqxmd.com/read/28914217/-unexplained-behaviour-and-dementia
#1
C M P M Hertogh, J Klijnman, J F Bastiaans
Behavioural changes, often resulting in negative or challenging behaviour, are highly prevalent in patients with dementia. Here we describe two patients in whom challenging behaviour was the first sign of an evolving dementia process. We discuss the relevance of a multifactorial approach in analysis and treatment, starting from a biopsychosocial model of behaviour in dementia. One pitfall is underestimating the contribution of physical co-morbidity to challenging behaviour in these patients; a further pitfall is the 'attribution phenomenon', i...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28858007/the-management-of-sleep-disorders-in-dementia-an-update
#2
Kirsi M Kinnunen, Anastasia Vikhanova, Gill Livingston
PURPOSE OF REVIEW: Sleep disorders in dementia cause distress and may lead to families being unable to care for someone with dementia at home. Recent Cochrane reviews found no interventions of proven effectiveness. There was no effect of light therapy and moderate evidence that melatonin was ineffective both given without knowledge of the patient's circadian rhythm. The current article updates this review by considering newer publications on interventions for sleep disorders or abnormalities of the sleep-wake cycle in people with dementia living in the community...
September 6, 2017: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/28857263/psychosocial-behaviour-management-programme-for-home-dwelling-people-with-dementia-a-cluster-randomized-controlled-trial
#3
REVIEW
Miharu Nakanishi, Kaori Endo, Kayo Hirooka, Eva Granvik, Lennart Minthon, Katarina Nägga, Atsushi Nishida
Little is known about the effectiveness of a psychosocial behaviour management programme on home-dwelling people with dementia. We developed a Behaviour Analytics & Support Enhancement (BASE) programme for care managers and professional caregivers of home care services in Japan. We investigated the effects of BASE on challenging behaviour of home-dwelling people with dementia. METHODS: A cluster-randomized controlled trial was conducted with home care providers from 3 different districts in Tokyo...
August 31, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28806934/development-and-evaluation-of-the-content-validity-practicability-and-feasibility-of-the-innovative-dementia-oriented-assessment-system-for-challenging-behaviour-in-residents-with-dementia
#4
Margareta Halek, Daniela Holle, Sabine Bartholomeyczik
BACKGROUND: One of the most difficult issues for care staff is the manifestation of challenging behaviour among residents with dementia. The first step in managing this type of behaviour is analysing its triggers. A structured assessment instrument can facilitate this process and may improve carers' management of the situation. This paper describes the development of an instrument designed for this purpose and an evaluation of its content validity and its feasibility and practicability in nursing homes...
August 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28805188/managing-faecal-incontinence-in-people-with-advanced-dementia-resident-in-care-homes-finch-study-a-realist-synthesis-of-the-evidence
#5
Claire Goodman, Christine Norton, Marina Buswell, Bridget Russell, Danielle Harari, Rowan Harwood, Brenda Roe, Jo Rycroft-Malone, Vari M Drennan, Mandy Fader, Michelle Maden, Karen Cummings, Frances Bunn
BACKGROUND: Eighty per cent of care home residents in the UK are living with dementia. The prevalence of faecal incontinence (FI) in care homes is estimated to range from 30% to 50%. There is limited evidence of what is effective in the reduction and management of FI in care homes. OBJECTIVE: To provide a theory-driven explanation of the effectiveness of programmes that aim to improve FI in people with advanced dementia in care homes. DESIGN: A realist synthesis...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28599594/stress-as-experienced-by-people-with-dementia-an-interpretative-phenomenological-analysis
#6
Barbara K Sharp
Health and social care research on stress in dementia has predominantly considered the stress experienced by family and professional carers. Focus on the person with dementia has frequently laid emphasis on the impact of stress-related behaviour on others and how such behaviour might be 'managed'. This paper describes a qualitative study which gives voice to people with dementia on the subject of stress and responds to the need for a better understanding of stress as it is experienced by people with dementia themselves...
January 1, 2017: Dementia
https://www.readbyqxmd.com/read/28595550/new-tracers-and-new-perspectives-for-molecular-imaging-in-lewy-body-diseases
#7
Matteo Bauckneht, Dario Arnaldi, Flavio Nobili, Dag Aarsland, Silvia Morbelli
The term Lewy body diseases (LBDs) refers to a subset of neurodegenerative disorders that share the accumulation of the so-called Lewy bodies (LB) including: Parkinson's disease (PD), dementia with Lewy bodies (DLB), and PD later characterized by the occurrence of dementia (PDD). Moreover, multiple system atrophy (MSA) and idiopatic Rem Sleeping behaviour disorders (RBD) complete the group of synucleinopathies and have also common symptoms with respect to LBDs. The clinical diagnosis of LBDs can be challenging for physicians, particularly in the early stages of disease...
June 8, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28553880/dementia-behaviour-management-programme-at-home-impact-of-a-palliative-care-approach-on-care-managers-and-professional-caregivers-of-home-care-services
#8
Miharu Nakanishi, Kaori Endo, Kayo Hirooka, Taeko Nakashima, Yuko Morimoto, Eva Granvik, Lennart Minthon, Katarina Nägga, Atsushi Nishida
OBJECTIVES: Care managers and professional caregivers of home care services are sometimes unaware of the psychosocial approaches to the challenging behaviour of dementia. Therefore, we developed a Behaviour Analytics & Support Enhancement (BASE) programme. We investigated the effects of the programme on the attitudes towards dementia care among professionals. METHOD: Forty-six participants in Japan received training in August 2016. The ongoing monitoring and assessment system was introduced to the participants for repeated measures of challenging behaviour...
May 29, 2017: Aging & Mental Health
https://www.readbyqxmd.com/read/28532475/-we-re-certainly-not-in-our-comfort-zone-a-qualitative-study-of-gps-dementia-care-educational-needs
#9
Tony Foley, Siobhán Boyle, Aisling Jennings, W Henry Smithson
BACKGROUND: Rising dementia prevalence rates rise combined with the policy objective of enabling people with dementia to remain living at home, means that there will be a growing demand for dementia care in the community setting. However, GPs are challenged by dementia care and have identified it as an area in which further training is needed. Previous studies of GPs dementia care educational needs have explored the views of GPs alone, without taking the perspectives of people with dementia and family carers into account...
May 22, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28509367/measuring-change-in-perceived-well-being-of-family-caregivers-validation-of-the-spanish-version-of-the-perceived-change-index-pci-s-in-chilean-dementia-caregivers
#10
José M Aravena, Cecilia Albala, Laura N Gitlin
OBJECTIVE: Few instruments evaluate family caregiver perceptions of challenges caring for persons with dementia and improvement or worsening in these areas. To address this measurement gap, we examine psychometric properties of a Spanish version of the 13-item Perceived Change Index (PCI-S), originally validated with English-speaking caregivers. METHODS: Cross-sectional study with 94 caregivers of persons with mild to moderate dementia in Chile. Interviews included caregiver demographics, burden, health perception, distress with behaviours, dementia severity, behavioural symptoms and functionality...
May 16, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28260613/sexual-harassment-in-care-work-dilemmas-and-consequences-a-qualitative-investigation
#11
Maj Britt D Nielsen, Susie Kjær, Per T Aldrich, Ida E H Madsen, Maria K Friborg, Reiner Rugulies, Anna P Folker
BACKGROUND: Care workers are often exposed to sexual harassment from patients. Research shows that such exposure may have detrimental effects on mental health of the care workers. Inappropriate sexual behaviour from patients is a particular challenge for formal and informal care workers alike. There is a scarceness of studies investigating the experience and the handling of sexual harassment from patients. OBJECTIVES: To investigate the experience and handling of sexual harassment from patients in care work...
February 24, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28177148/when-walking-becomes-wandering-representing-the-fear-of-the-fourth-age
#12
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
#13
REVIEW
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
#14
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
#15
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
#16
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
#17
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)...
February 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/27412879/intimacy-between-care-home-residents-with-dementia-findings-from-a-review-of-the-literature
#18
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
#19
RANDOMIZED CONTROLLED TRIAL
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
#20
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
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