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Distress in dementia care

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https://www.readbyqxmd.com/read/28332736/dementia-related-restlessness-relationship-to-characteristics-of-persons-with-dementia-and-family-caregivers
#1
Natalie G Regier, Laura N Gitlin
OBJECTIVE: Dementia-related restlessness is commonly endorsed by caregivers but not well understood. This study examines differences in characteristics (demographics, cognitive status, physical function, pain, and mood) of persons with dementia whose caregivers endorse restlessness versus those who do not. We also examine the relationship of restlessness to caregiver well-being including burden, upset with behaviors, mastery, and depressive symptomatology. METHODS: We combined baseline data from three caregiver intervention studies of community-dwelling persons with dementia who exhibited neuropsychiatric symptoms (n = 569) as measured by the Agitated Behaviors in Dementia Scale...
March 23, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28323838/bupropion-for-the-treatment-of-apathy-in-huntington-s-disease-a-multicenter-randomised-double-blind-placebo-controlled-prospective-crossover-trial
#2
Harald Gelderblom, Torsten Wüstenberg, Tim McLean, Lisanne Mütze, Wilhelm Fischer, Carsten Saft, Rainer Hoffmann, Sigurd Süssmuth, Peter Schlattmann, Erik van Duijn, Bernhard Landwehrmeyer, Josef Priller
OBJECTIVE: To evaluate the efficacy and safety of bupropion in the treatment of apathy in Huntington's disease (HD). METHODS: In this phase 2b multicentre, double-blind, placebo-controlled crossover trial, individuals with HD and clinical signs of apathy according to the Structured Clinical Interview for Apathy-Dementia (SCIA-D), but not depression (n = 40) were randomized to receive either bupropion 150/300mg or placebo daily for 10 weeks. The primary outcome parameter was a significant change of the Apathy Evaluation Scale (AES) score after ten weeks of treatment as judged by an informant (AES-I) living in close proximity with the study participant...
2017: PloS One
https://www.readbyqxmd.com/read/28286969/involving-people-with-dementia-in-developing-an-interactive-web-tool-for-shared-decision-making-experiences-with-a-participatory-design-approach
#3
Marijke Span, Marike Hettinga, Leontine Groen-van de Ven, Jan Jukema, Ruud Janssen, Myrra Vernooij-Dassen, Jan Eefsting, Carolien Smits
PURPOSE: The aim of this study was at gaining insight into the participatory design approach of involving people with dementia in the development of the DecideGuide, an interactive web tool facilitating shared decision-making in their care networks. METHOD: An explanatory case study design was used when developing the DecideGuide. A secondary analysis focused on the data gathered from the participating people with dementia during the development stages: semi-structured interviews (n = 23), four focus group interviews (n = 18), usability tests (n = 3), and a field study (n = 4)...
March 12, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28237746/cognitive-behavioral-treatment-for-depressed-patients-with-alzheimer-s-disease-an-open-trial
#4
José María García-Alberca
BACKGROUND: Depression has a high prevalence among patients with Alzheimer's disease, and it has a significant negative impact on their functioning. However, despite its significant impact and challenge, few treatment outcomes data are available to guide clinical care of depression among this population. We developed a cognitive-behavioral intervention to persons with AD. In this paper, we describe the intervention and results of an open trial evaluating its feasibility and utility. SETTING: Dementia Unit...
February 14, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28212496/antipsychotic-use-in-dementia
#5
Julia Kirkham, Chelsea Sherman, Clive Velkers, Colleen Maxwell, Sudeep Gill, Paula Rochon, Dallas Seitz
Antipsychotics are necessary for many older adults to treat major mental illnesses or reduce distressing psychiatric symptoms. Current controversy exists over the role of antipsychotics in the management of neuropsychiatric symptoms (NPS) in persons with dementia. Although some NPS may be appropriately and safely treated with antipsychotics, a fine balance must be achieved between the benefits of these medications, which are often modest, and adverse events, which may have significant consequences. Approximately one-third of all persons with dementia are currently prescribed antipsychotic medications, and there is significant variation in the use of antipsychotics across care settings and providers...
March 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28203628/the-structured-interview-for-insight-and-judgment-in-dementia-development-and-validation-of-a-new-instrument-to-assess-awareness-in-patients-with-dementia
#6
Teresa Parrao, Simone Brockman, Romola S Bucks, David G Bruce, Wendy A Davis, Katherine K Hatch, Tammy L Leavy, Christine A P Axten, Sergio E Starkstein
INTRODUCTION: Poor insight about their cognitive and functional deficits is highly prevalent in patients with Alzheimer's disease (AD); however, there is a lack of reliable, valid instrumentation to measure this construct. The aim of this study was to develop and validate a semistructured interview to assess insight and judgment in patients with AD and to provide information regarding the assessment of competency and risk in this population. METHODS: We validated the Structured Clinical Interview for Insight and Judgment in Dementia (SIJID) in a consecutive series of 124 patients with probable AD...
2017: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
https://www.readbyqxmd.com/read/28134558/a-randomized-pilot-trial-of-a-telephone-based-collaborative-care-management-program-for-caregivers-of-individuals-with-dementia
#7
Shahrzad Mavandadi, Erin M Wright, Meagan M Graydon, David W Oslin, Laura O Wray
Dementia care is largely provided in primary care settings. This article describes a pilot project aimed at evaluating the effectiveness of an accessible, telephone-based, patient- and caregiver (CG)-centered, collaborative care management program that involves CG education and psychosocial support in improving CG and patient outcomes. CGs (n = 75) of older veterans with dementia receiving care from Veterans Affairs (VA) Medical Center primary care practices were randomized to receive either dementia care management or usual care (UC)...
February 2017: Psychological Services
https://www.readbyqxmd.com/read/28112072/physicians-perceptions-of-suffering-in-people-with-dementia-at-the-end-of-life
#8
Jenny T van der Steen, Luc Deliens, Raymond T C M Koopmans, Bregje D Onwuteaka-Philipsen
OBJECTIVE: Our aim was to describe physicians' perceptions of the suffering of their patients who are dying with dementia, many of whom are incompetent with regard to decision making and have difficulty with communicating about the source of their distress and with identifying related factors. METHOD: We analyzed data from the nationally representative observational Dutch End-of-Life in Dementia (DEOLD) cohort study (2007-2011), which involved 34 long-term care facilities...
January 23, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28088926/proxy-rated-quality-of-life-of-care-home-residents-with-dementia-a-systematic-review
#9
Sarah Robertson, Claudia Cooper, Juanita Hoe, Olivia Hamilton, Aisling Stringer, Gill Livingston
BACKGROUND: Quality of life (QoL) is an important outcome for people with dementia living in care homes but usually needs to be rated by a proxy. We do not know if relative or paid carer proxy reports differ. We conducted the first systematic review and meta-analysis of data investigating whether and how these proxy reports of QoL differ. METHODS: We searched four databases: Medline, Embase, PsychInfo, and CINAHL in October 2015 with the terms: dementia, QoL, proxy, and care home...
January 16, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28086861/managing-shades-of-grey-a-focus-group-study-exploring-community-dwellers-views-on-advance-care-planning-in-older-people
#10
Natasha Michael, Clare O'Callaghan, Emma Sayers
BACKGROUND: Community-dwelling consumers of healthcare are increasing, many aging with life-limiting conditions and deteriorating cognition. However, few have had advance care planning discussions or completed documentation to ensure future care preferences are acted upon. This study examines the awareness, attitudes, and experiences of advance care planning amongst older people and unrelated offspring/caregivers of older people residing in the community. METHODS: Qualitative descriptive research, which included focus groups with older people (55+ years) and older people's offspring/caregivers living in an Australian city and surrounding rural region...
January 13, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28074409/management-of-depression-in-patients-with-dementia-is-pharmacological-treatment-justified
#11
REVIEW
Andrew H Ford, Osvaldo P Almeida
Depression in the context of dementia is common and contributes to poorer outcomes in individuals and those who care for them. Non-pharmacological treatments are the preferred initial approach to managing these symptoms but data in support of these are scarce. There are a number of pharmacological treatment options available to clinicians but efficacy is uncertain and concern about potential side effects in an aging and vulnerable population needs to be taken into consideration. This review aims to provide a concise overview of pharmacological treatments for depression in dementia...
February 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28065176/behavioural-and-psychological-symptoms-in-general-hospital-patients-with-dementia-distress-for-nursing-staff-and-complications-in-care-results-of-the-general-hospital-study
#12
J B Hessler, M Schäufele, I Hendlmeier, M N Junge, S Leonhardt, J Weber, H Bickel
AIMS: Little is known about how behavioural and psychological symptoms of dementia (BPSD) manifest in the general hospital. The aim was to examine the frequency of BPSD in general hospitals and their associations with nursing staff distress and complications in care. METHODS: Cross-sectional representative study with 1469 patients aged ≥65, including 270 patients with dementia, of 33 randomly selected general hospitals in Germany. BPSD and complications were reported by nurses...
January 9, 2017: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/28056843/the-influence-of-day-care-centres-designed-for-people-with-dementia-on-family-caregivers-a-qualitative-study
#13
Signe Tretteteig, Solfrid Vatne, Anne Marie Mork Rokstad
BACKGROUND: Dementia is one of the most challenging age-related illnesses for family caregivers, whose care-related burden is well known. Research indicates that day care centres (DCCs) can reduce the caregiver burden and help family caregivers to cope with demands; however, the current body of knowledge is still tentative and inconsistent, and more research is recommended. The aim of this study is to provide an extended understanding of the situation of family caregivers and to examine to what extent DCCs can meet their need for support and respite...
January 5, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28049547/palliative-care-during-the-final-week-of-life-of-older-people-in-nursing-homes-a-register-based-study
#14
Jonas Smedbäck, Joakim Öhlén, Kristofer Årestedt, Anette Alvariza, Carl-Johan Fürst, Cecilia Håkanson
OBJECTIVE: Our aim was to explore the presence of symptoms, symptom relief, and other key aspects of palliative care during the final week of life among older people residing in nursing homes. METHOD: Our study employed data from the Swedish Palliative Care Register on all registered individuals aged 60 and older who had died in nursing homes during the years 2011 and 2012. Variables pertaining to monitoring and treatment of symptoms, end-of-life discussions, circumstances around the death, and the individual characteristics of deceased individuals were explored using descriptive statistics...
January 4, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28008609/randomized-trial-of-the-family-intervention-telephone-tracking-caregiver-for-dementia-caregivers-use-of-community-and-healthcare-resources
#15
Geoffrey Tremont, Jennifer D Davis, Brian R Ott, Rachel Galioto, Cara Crook, George D Papandonatos, Richard H Fortinsky, Pedro Gozalo, Duane S Bishop
OBJECTIVES: To examine the effects of a telephone-delivered intervention, Family Intervention: Telephone Tracking-Caregiver (FITT-C), on community support and healthcare use by dementia caregivers. DESIGN: Randomized, controlled trial. SETTING: Academic medical center. PARTICIPANTS: Dyads (n = 250) of distressed informal dementia caregivers and care recipients. INTERVENTION: Caregivers were randomly assigned to receive the FITT-C (n = 133) or telephone support (TS; n = 117)...
December 23, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27998370/understanding-delirium-trajectory-and-its-importance-in-care-provision-for-older-people
#16
Guk-Hee Suh, Lina Gega
Delirium significantly increases morbidity and mortality in older people, especially those affected by other organic disorders, notably dementia (Siddiqi et al., 2006; Davis et al., 2012; Martins and Fernandes, 2012). Both delirium and dementia are characterized by cognitive decline through disintegration of brain functions, i.e. a "brain failure." Delirium has been described as an acute brain failure, in contrast to dementia being a chronic brain failure (Berrios, 1981). If we consider any other organ failure, for example that of kidneys, delirium superimposed on dementia resembles acute renal exacerbation superimposed on chronic renal failure...
January 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/27855633/care-recipients-physical-frailty-is-independently-associated-with-subjective-burden-in-informal-caregivers-in-the-community-setting-a-cross-sectional-study
#17
Thom J Ringer, Afeez Abiola Hazzan, Courtney C Kennedy, Sarah Karampatos, Christopher Patterson, Sharon Marr, Brian Misiaszek, Tricia Woo, George Ioannidis, Alexandra Papaioannou
BACKGROUND: Physical frailty is associated with significant morbidity and mortality in community-dwelling older adults. Burden in informal caregivers of older adults causes significant physical and psychological distress. However, the relationship between these two clinical phenomena has not been extensively studied. This cross-sectional study evaluated the relationship between physical frailty of community-dwelling older adults attending an outpatient geriatric clinic and the subjective burden reported by their informal caregivers...
November 17, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27743840/teaching-caregivers-of-persons-with-dementia-to-address-pain
#18
Mark E Kunik, A Lynn Snow, Nancy Wilson, Amber B Amspoker, Shubhada Sansgiry, Robert O Morgan, Jun Ying, Gayle Hersch, Melinda A Stanley
OBJECTIVES: To compare the efficacy of Preventing Aggression in Veterans with Dementia (PAVeD) with that of usual care in decreasing incidence of aggression (primary outcome) and pain and improving depression, pleasant events, caregiver burden, and patient-caregiver relationship quality (secondary outcomes). DESIGN: Randomized controlled trial with assessments at baseline and 3, 6, 9, and 12 months SETTING: Houston, TX. PARTICIPANTS: A total of 203 community-dwelling veterans with pain and dementia and their caregivers...
February 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27740877/transgender-mental-health-and-older-people-an-appreciative-approach-towards-working-together
#19
Sean Page, Jenny Burgess, Ian Davies-Abbott, Debbie Roberts, Jaanika Molderson
It cannot be assumed by healthcare providers that transgender people routinely receive care and treatment that is of the quality and sensitivity that should be expected. In particular there are concerns from within the transgender community that they experience discrimination and disrespect from both individual practitioners and the healthcare system as a whole. This causes an avoidance of contact that is undesirable for both users and providers of healthcare services. Older transgender people are vulnerable to a range of mental health problems and, like all elderly, increasingly to dementia; failure to access specialist services in a timely manner may result in unnecessary distress and potentially to crisis...
December 2016: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/27716667/modeling-the-distress-of-spousal-caregivers-of-people-with-dementia
#20
Emilie Wawrziczny, Guillaume Berna, Francine Ducharme, Marie-Jeanne Kergoat, Florence Pasquier, Pascal Antoine
BACKGROUND: The progressive mobilization of spouse caregivers who take care of a person with dementia (PWD) can lead to situations of distress. OBJECTIVE: The current study sought to investigate the influence of the characteristics of the caregiving context on spousal caregiver distress. METHODS: 125 spousal caregivers participated in this study. The characteristics of the caregiving context were assessed using questionnaires. We examined a moderated-mediator model (Step 1) in which we hypothesized that PWD and caregiver characteristics and dyadic determinants contribute to spousal caregiver distress...
2017: Journal of Alzheimer's Disease: JAD
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