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"Case management" or "care management" and "dementia"

J Lagarde, M Sarazin
Frontotemporal degeneration (FTD) in its behavioral variant (bvFTD) is probably one of the conditions that best illustrates the links between psychiatry and neurology. It is indeed admitted that between a third and half of patients with this condition, especially in early-onset forms, receive an initial diagnosis of psychiatric disorder (depression, schizophrenia, bipolar disorder) and are then referred to a psychiatric ward. BvFTD can thus be considered a neurological disorder with a psychiatric presentation...
October 20, 2016: L'Encéphale
Julia Granerod, Nicholas W S Davies, Parashar P Ramanuj, Ava Easton, David W G Brown, Sara L Thomas
The true extent of sequelae in encephalitis survivors relative to rates within the general population is not known. This study aimed to quantify increased risks of epilepsy, depressive disorders, anxiety disorders, psychotic disorders, bipolar disorder, cognitive problems, dementia, headache, and alcohol abuse among encephalitis cases. 2460 exposed individuals diagnosed with incident encephalitis in the Clinical Practice Research Datalink and 47,914 unexposed individuals without a history of encephalitis were included...
October 20, 2016: Journal of Neurology
Tammy Vu Bach, Jonathan Pan, Anne Kirstein, Cindy Joanne Grief, Daphna Grossman
Palliative care clinicians are increasingly involved in the care of elderly patients suffering from chronic malignant and nonmalignant illnesses, of which neuropathic pain is a prevalent problem. As a person becomes more frail, pain medications such as opioid analgesics and adjuvant pain medications can result in unwanted effects such as sedation, confusion, and increased risk of falls. Treating pain in patients with advanced dementia or neurodegenerative diseases that can affect swallowing is particularly challenging because most adjuvant pain medications used to ameliorate neuropathic pain must be taken orally...
October 11, 2016: Journal of Palliative Medicine
Ala Szczepura, Deidre Wild, Amir J Khan, David W Owen, Thomas Palmer, Tariq Muhammad, Michael D Clark, Clive Bowman
OBJECTIVES: To assess associations between the launch of the National Dementia Strategy (NDS) and antipsychotic prescribing in long-term residential care (LTC) in England. SETTING AND PARTICIPANTS: Retrospective analysis of prescribing patterns in 616 LTC institutions (31 619 residents) following launch of the NDS, using information from electronic medicines management system. PRIMARY AND SECONDARY OUTCOME MEASURES: Antipsychotic prescribing point prevalence (PP) for all residents in a cross section of LTC settings over a 4-year period following NDS launch...
2016: BMJ Open
R Liisa Jaakkimainen, Susan E Bronskill, Mary C Tierney, Nathan Herrmann, Diane Green, Jacqueline Young, Noah Ivers, Debra Butt, Jessica Widdifield, Karen Tu
BACKGROUND: Population-based surveillance of Alzheimer's and related dementias (AD-RD) incidence and prevalence is important for chronic disease management and health system capacity planning. Algorithms based on health administrative data have been successfully developed for many chronic conditions. The increasing use of electronic medical records (EMRs) by family physicians (FPs) provides a novel reference standard by which to evaluate these algorithms as FPs are the first point of contact and providers of ongoing medical care for persons with AD-RD...
August 10, 2016: Journal of Alzheimer's Disease: JAD
Clarissa M Giebel, Susan Davies, Paul Clarkson, Caroline Sutcliffe, David Challis
Effective home support in dementia is key in delaying nursing home admission. However, home support is frequently not tailored to the individual needs of people with dementia. Staff allocating home support services may not identify important care needs, which only be recognised by informal carers. The purpose of this study was to explore the balance of informal and formal home support and their associated costs from the perspectives of both informal carers and paid staff. Five case vignettes of people with dementia were designed based on an existing English data set from a European study into transition into long-term care (the RightTimePlaceCare programme), representing 42 per cent of the English sample...
August 22, 2016: Dementia
Valentina Lichtner, Dawn Dowding, Nick Allcock, John Keady, Elizabeth L Sampson, Michelle Briggs, Anne Corbett, Kirstin James, Reena Lasrado, Caroline Swarbrick, S José Closs
BACKGROUND: Pain is often poorly managed in people who have a dementia. Little is known about how this patient population is managed in hospital, with research to date focused mainly on care homes. This study aimed to investigate how pain is recognised, assessed and managed in patients with dementia in a range of acute hospital wards, to inform the development of a decision support tool to improve pain management for this group. METHODS: A qualitative, multi-site exploratory case study...
2016: BMC Health Services Research
Tamara Backhouse, Anne Killett, Bridget Penhale, Richard Gray
BACKGROUND: antipsychotic medications have been used to manage behavioural and psychological symptoms of dementia (BPSD). Due to the potential risks associated with these medications for people with dementia, non-pharmacological interventions (NPIs) have been recommended as safer alternatives. However, it is unknown if, or how, these interventions are used in care homes to help people experiencing BPSD. AIM: to explore the use of NPIs in care homes to manage BPSD...
August 18, 2016: Age and Ageing
Riccardo De Giorgi, Hugh Series
Inappropriate sexual behavior (ISB) is a relatively common and potentially disruptive form of behavior in people with dementia. It can cause considerable distress and put placements and people at risk. Yet it is poorly researched and understood. In addition to non-pharmacological approaches to management, a wide range of classes of medication has been used in ISB, and the results have been reported as single cases or short series, though none has been the subject of a randomized clinical trial, in part because of the lack of a well-defined method of observing and measuring ISB, as well as the significant ethical considerations...
September 2016: Current Treatment Options in Neurology
April Ka Sin Phua, Win King Goh, Serrie Platero Suministrado, Saima Hilal, Mohammad Kamran Ikram, Narayanaswamy Venketasubramanian, Xin Xu, Christopher Li-Hsian Chen
OBJECTIVES: Promoting public awareness about dementia has been part of global initiatives in recent years; however, the impact on patterns of patient visits in memory clinics has not been investigated in Asian countries. Hence, the present study sought to investigate longitudinal patterns of patient characteristics among consecutive referrals to a memory clinic in Singapore from 2009 to 2015. METHODS: Consecutive first-visit patients who attended the National University Hospital memory clinic between 2009 and 2015 through referrals from primary and secondary health care services were included in the study...
September 1, 2016: Journal of the American Medical Directors Association
Yvonne J F Kerkhof, Maud J L Graff, Ad Bergsma, Hilde H M de Vocht, Rose-Marie Dröes
BACKGROUND: To offer good support to people with dementia and their carers in an aging and Internet society the deployment of hand-held touch screen devices, better known as tablets, and its applications (apps) can be viable and desirable. However, at the moment it is not clear which apps are usable for supporting people with dementia in daily life. Also, little is known about how people with dementia can be coached to learn to use a tablet and its apps. METHODS: A person-centered program, with tools and training, will be developed that aims to support people with mild dementia and their (in)formal carers in how to use the tablet for self-management and meaningful activities...
July 18, 2016: International Psychogeriatrics
Nick Courtier, Rebecca Milton, Amanda King, Rosie Tope, Susan Morgan, Jane Hopkinson
OBJECTIVE: Patients with comorbid cancer and dementia have poorer outcomes than those without dementia. We observe oncology teams managing patients with dementia and memory loss and explore these patients' needs and experiences of outpatient cancer services. METHODS: A single site investigation of case study design to examine practices in four clinics using multi-methods of data collection: retrospective note review, observation, interviews, and recorded consultations...
September 2016: Psycho-oncology
Tony Kendrick, Magdy El-Gohary, Beth Stuart, Simon Gilbody, Rachel Churchill, Laura Aiken, Abhishek Bhattacharya, Amy Gimson, Anna L Brütt, Kim de Jong, Michael Moore
BACKGROUND: Routine outcome monitoring of common mental health disorders (CMHDs), using patient reported outcome measures (PROMs), has been promoted across primary care, psychological therapy and multidisciplinary mental health care settings, but is likely to be costly, given the high prevalence of CMHDs. There has been no systematic review of the use of PROMs in routine outcome monitoring of CMHDs across these three settings. OBJECTIVES: To assess the effects of routine measurement and feedback of the results of PROMs during the management of CMHDs in 1) improving the outcome of CMHDs; and 2) in changing the management of CMHDs...
2016: Cochrane Database of Systematic Reviews
Neil Drummond, Richard Birtwhistle, Tyler Williamson, Shahriar Khan, Stephanie Garies, Frank Molnar
BACKGROUND: The proportion of Canadians living with Alzheimer disease and related dementias is projected to rise, with an increased burden on the primary health care system in particular. Our objective was to describe the prevalence and management of dementia in a community-dwelling sample using electronic medical record (EMR) data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), which consists of validated, national, point-of-care data from primary care practices...
April 2016: CMAJ Open
M Rozsa, A Ford, L Flicker
BACKGROUND: A cross-sectional survey of all patients reviewed by the aged care assessment team (ACAT) service and memory clinics between 1 January and 31 December 2012. The ACAT catchment included an estimated 14 325 people over the age of 70. AIMS: To determine the numbers and outcomes of assessments for cognitive problems by the ACAT and hospital memory clinics for patients within a single ACAT catchment area. METHODS: Data collected included patient demographics, diagnoses, referral and pharmacological treatment...
September 2016: Internal Medicine Journal
Jan R Oyebode, Sahdia Parveen
An influential review in 2010 concluded that non-pharmacological multi-component interventions have positive effects on cognitive functioning, activities of daily living, behaviour and mood of people with dementia. Our aim here is to provide an up-to-date overview of research into psychosocial interventions and their impact on psychosocial outcomes. We focused on randomised controlled trials, controlled studies and reviews published between October 2008 and August 2015, since the earlier review. The search of PsychInfo, Medline and the Cochrane database of systematic reviews yielded 61 relevant articles, organised into four themes echoing key phases of the care pathway: Living at home with dementia (five reviews, eight studies), carer interventions (three reviews, four studies), interventions in residential care (16 reviews, 12 studies) and end-of-life care (three reviews, two studies), along with an additional group spanning community and institutional settings (six reviews, two studies)...
July 4, 2016: Dementia
Daniela Koller, Tammy Hua, Julie P W Bynum
OBJECTIVES: To evaluate frequency of use of two anti-dementia drug classes approved for treatment of symptoms, whether populations most likely to benefit are treated, and correlates of treatment initiation. DESIGN: Nationally representative cohort study. SETTING: Fee-for-service Medicare. PARTICIPANTS: Elderly adults with dementia enrolled in Medicare Parts A, B, and D in 2009 (N = 433,559) and a subset with incident dementia (n = 185,449)...
August 2016: Journal of the American Geriatrics Society
J J Sandra Kooij, Marieke Michielsen, Henk Kruithof, Denise Bijlenga
INTRODUCTION: ADHD is an often heritable, neurodevelopmental disorder with a prevalence of 4-5% in children and adults and about 3% in older adults. The disorder in older adults (> 55 years) is accompanied by similar comorbidities such as anxiety and depression, and social impairment as in younger age groups. AREAS COVERED: An overview of the literature on diagnostic assessment, differential diagnosis, and treatment of older adults with ADHD is described. Case studies show that stimulant treatment is beneficial for ADHD in old age, but randomized controlled trials are lacking...
July 4, 2016: Expert Review of Neurotherapeutics
Bannin De Witt Jansen, Kevin Brazil, Peter Passmore, Hilary Buchanan, Doreen Maxwell, Sonja J Mcilfatrick, Sharon M Morgan, Max Watson, Carole Parsons
AIMS AND OBJECTIVES: To explore hospice, acute care and nursing home nurses' experiences of pain management for people with advanced dementia in the final month of life. To identify the challenges, facilitators and practice areas requiring further support. BACKGROUND: Pain management in end-stage dementia is a fundamental aspect of end of life care; however, it is unclear what challenges and facilitators nurses experience in practice, whether these differ across care settings, and whether training needs to be tailored to the context of care...
June 21, 2016: Journal of Clinical Nursing
P Boersma, J C M van Weert, B van Meijel, R M Dröes
AIMS AND OBJECTIVES: To perform a process analysis of the implementation of the Veder contact method for gaining insight into factors that influence successful implementation. BACKGROUND: Research showed that the original Veder method, which is a 'living-room theatre performance' provided by actors, positively influenced mood and quality of life of people with dementia. Training caregivers to execute such 'performances' and accomplish the same effects as actors proved difficult...
June 20, 2016: Journal of Clinical Nursing
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