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Nursing home AND dementia

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https://www.readbyqxmd.com/read/28813236/ethics-and-intimate-sexual-activity-in-long-term-care
#1
Eran Metzger
A case is presented in which the staff of a long-term care facility discovers that the husband of a resident with dementia is engaged in sexual activity with her. The case illustrates a dilemma for long-term care facilities that create a home-like environment with a goal of maximizing residents' autonomy while ensuring their safety. An approach to assessing capacity to consent to intimate sexual activity is described, followed by guidelines that nursing homes can implement to support residents who wish to engage in sexual activity...
July 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28807457/identification-of-pseudobulbar-affect-symptoms-in-the-nursing-home-setting-development-and-assessment-of-a-screening-tool
#2
Carrie Allen, Barbara Zarowitz, Terrence O'Shea, Edward Peterson, Charles Yonan, Fanta Waterman
Pseudobulbar Affect (PBA) is a neurologic condition characterized by involuntary outbursts of crying and/or laughing disproportionate to patient mood or social context. Although an estimated 9% of nursing home residents have symptoms suggestive of PBA, they are not routinely screened. Our goal was to develop an electronic screening tool based upon characteristics common to nursing home residents with PBA identified through medical record data. Nursing home residents with PBA treated with dextromethorphan hydrobromide/quinidine sulfate (n = 140) were compared to age-, gender-, and dementia-diagnosis-matched controls without PBA or treatment (n = 140)...
August 11, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28807433/influences-on-decision-making-regarding-antipsychotic-prescribing-in-nursing-home-residents-with-dementia-a-systematic-review-and-synthesis-of-qualitative-evidence
#3
REVIEW
Kieran A Walsh, Rebecca Dennehy, Carol Sinnott, John Browne, Stephen Byrne, Jennifer McSharry, Eoin Coughlan, Suzanne Timmons
BACKGROUND: Antipsychotic prescribing is prevalent in nursing homes for the management of behavioral and psychological symptoms of dementia (BPSD), despite the known risks and limited effectiveness. Many studies have attempted to understand this continuing phenomenon, using qualitative research methods, and have generated varied and sometimes conflicting findings. To date, the totality of this qualitative evidence has not been systematically collated and synthesized. AIMS: To synthesize the findings from individual qualitative studies on decision-making and prescribing behaviors for antipsychotics in nursing home residents with dementia, with a view to informing intervention development and quality improvement in this field...
August 11, 2017: Journal of the American Medical Directors Association
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/28806278/ce-original-research-the-experience-of-transitioning-to-a-caregiving-role-for-a-family-member-with-alzheimer-s-disease-or-related-dementia
#5
Kathleen Czekanski
Study findings suggest several areas for further research. ABSTRACT: Background: Alzheimer's disease is a chronic, debilitating disease that currently affects an estimated 5.5 million Americans. The majority are being cared for at home by family caregivers, who are known to have higher levels of burden than any other group of caregivers. PURPOSE: The purpose of this phenomenological study was to explore the lived experiences of people who transition to the role of caregiver for a family member with Alzheimer's disease or a related dementia...
August 10, 2017: American Journal of Nursing
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
#6
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/28801438/associations-between-polypharmacy-and-treatment-intensity-for-hypertension-and-diabetes-a-cross-sectional-study-of-nursing-home-patients-in-british-columbia-canada
#7
Rita McCracken, James McCormack, Margaret J McGregor, Sabrina T Wong, Scott Garrison
OBJECTIVES: Describe nursing home polypharmacy prevalence in the context of prescribing for diabetes and hypertension and determine possible associations between lower surrogate markers for treated hypertension and diabetes (overtreatment) and polypharmacy. DESIGN: Cross-sectional study. SETTING: 6 nursing homes in British Columbia, Canada. PARTICIPANTS: 214 patients residing in one of the selected facilities during data collection period...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28800895/a-randomized-trial-of-a-web-based-platform-to-help-families-manage-dementia-related-behavioral-symptoms-the-wecareadvisor%C3%A2
#8
Laura N Gitlin, Helen J Kales, Katherine Marx, Barbara Stanislawski, Constantine Lyketsos
Dementia-related behavioral symptoms are challenging clinical features occurring across etiologies and disease progression. They are associated with increased healthcare utilization, nursing home placement, family upset and burden. Families typically manage behavioral symptoms without requisite knowledge, skills and guidance. We designed WeCareAdvisor™ as an easy-to-use, evidence-informed web-based platform. It provides families knowledge about dementia, daily tips, and a systematic approach to describe behaviors, investigate modifiable contributors, create treatment plans (WeCareAdvisor™ Prescription) consisting of management tips tailored to symptom presentation, and evaluate effectiveness...
August 8, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28800328/effects-of-exercise-on-cognitive-function-in-older-people-with-dementia-a-randomized-controlled-trial
#9
Annika Toots, Håkan Littbrand, Gustaf Boström, Carl Hörnsten, Henrik Holmberg, Lillemor Lundin-Olsson, Nina Lindelöf, Peter Nordström, Yngve Gustafson, Erik Rosendahl
BACKGROUND: Although physical exercise has been suggested to influence cognitive function, previous exercise studies show inconsistent results in people with dementia. OBJECTIVES: To investigate effects of exercise on cognitive function in people with dementia. METHOD: The Umeå Dementia and Exercise (UMDEX) study, a cluster-randomized controlled trial, was set in 16 nursing homes in Umeå, Sweden. One hundred-and-forty-one women and 45 men with dementia; mean age of 85 y and mean Mini-Mental State Examination (MMSE) score of 15, were randomized to a High-Intensity Functional Exercise program or a seated attention control activity...
August 8, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28797857/level-of-care-preferences-among-nursing-home-residents-with-advanced-dementia
#10
Susan L Mitchell, Jennifer A Palmer, Angelo E Volandes, Laura C Hanson, Daniel Habtemariam, Michele L Shaffer
CONTEXT: Delivering goal-directed care is a hallmark of high quality palliative care, but requires an understanding of preferences. OBJECTIVES: To describe and identify factors associated with level of care preferences among proxies of nursing home residents with advanced dementia. METHODS: Nursing home residents with advanced dementia and their proxies (N=402 dyads) were recruited from 62 Boston-area facilities as part of an ongoing randomized clinical trial...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28793949/insights-into-care-providers-understandings-of-life-story-work-with-persons-with-dementia-findings-from-a-qualitative-study
#11
Charlotte Berendonk, Vera Caine
BACKGROUND AND PURPOSE: In Germany, life story work, an approach which acknowledges humans as narrative beings and honors biographies, is required by health authorities to be integrated in care provided in nursing homes. Insufficient attention to life story work could place residents at risk of dehumanization, particularly residents with dementia, who depend on support of others to tell and make meaning of their life experiences. METHODS: We conducted a qualitative study to gain insights into care providers' perceptions and practices of life story work with persons with dementia...
August 1, 2017: Research and Theory for Nursing Practice
https://www.readbyqxmd.com/read/28793905/the-liverpool-care-pathway-a-systematic-review-discarded-in-cancer-patients-but-good-enough-for-dying-nursing-home-patients
#12
Bettina S Husebø, Elisabeth Flo, Knut Engedal
BACKGROUND: The Liverpool Care Pathway (LCP) is an interdisciplinary protocol, aiming to ensure that dying patients receive dignified and individualized treatment and care at the end-of-life. LCP was originally developed in 1997 in the United Kingdom from a model of cancer care successfully established in hospices. It has since been introduced in many countries, including Norway. The method was withdrawn in the UK in 2013. This review investigates whether LCP has been adapted and validated for use in nursing homes and for dying people with dementia...
August 9, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28791690/apathy-risk-factor-for-mortality-in-nursing-home-patients
#13
Johanna M H Nijsten, Ruslan Leontjevas, Ron Pat-El, Martin Smalbrugge, Raymond T C M Koopmans, Debby L Gerritsen
OBJECTIVES: To determine the prognostic value of apathy for mortality in patients of somatic (SC) and dementia special care (DSC) nursing home (NH) units. DESIGN: Longitudinal design, secondary analyses of a 2-year, cluster-randomized trial with six measurements, approximately 4 months in between. SETTING: SC and DSC-units of Dutch NHs. PARTICIPANTS: NH-patients of seventeen SC-units (n = 342) and sixteen DCS-units (n = 371)...
August 9, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28772095/advance-directives-among-nursing-home-residents-with-mild-moderate-and-advanced-dementia
#14
Jennifer Tjia, Marisa Dharmawardene, Jane L Givens
OBJECTIVE: To describe prevalence and content of AD documentation among NH residents by dementia stage. BACKGROUND: The prevalence of advance directives (ADs) among nursing home (NH) residents with mild, moderate, and advanced dementia remains unclear. METHODS: Population-based, cross-sectional study of all licensed NHs in five U.S. states. Subjects included all long-stay (>90 day) NH residents with dementia, aged ≥65 years, and a Cognitive Performance Scale (CPS) score ≥1 from the 2007 to 2008 Minimum Data Set 2...
August 3, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28768251/a-randomized-controlled-trial-examining-the-effect-of-acupressure-on-agitation-and-salivary-cortisol-in-nursing-home-residents-with-dementia
#15
Rick Yiu Cho Kwan, Mason Chin Pang Leung, Claudia Kam Yuk Lai
BACKGROUND: Acupressure has been used to manage agitation in people with dementia because it is safe and inexpensive. However, its effect on agitation and at the biochemical level is uncertain. METHODS: This randomized controlled trial examined the effect of acupressure on agitation, as measured by the Cohen-Mansfield Agitation Inventory (CMAI); and on salivary cortisol, as measured at baseline (T0) and in the 3rd (T1), 5th (T2), and 8th (T3) weeks. There were 119 agitated residents with dementia randomized into 3 groups: acupressure (n = 39), sham (n = 41), and usual-care group (n = 39)...
July 29, 2017: Dementia and Geriatric Cognitive Disorders
https://www.readbyqxmd.com/read/28754043/care-staff-perspective-on-use-of-texture-modified-food-in-care-home-residents-with-dysphagia-and-dementia
#16
Lise Birgitte Austbø Holteng, Christina Tølbøl Frøiland, Anne Corbett, Ingelin Testad
BACKGROUND: Dysphagia and dementia are conditions, which combined, can lead to complications for the person and require good nutritional care. There is very little evidence-based literature regarding nutritional care for people with dysphagia and dementia. It is clear that care staff plays a vital role, and that communication and informed decision-making are critical to the process, yet little is known regarding the use of available interventions such as texture modified food (TMF), and their acceptability and feasibility for care staff and residents...
October 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28752771/psychomotor-functional-and-cognitive-profiles-in-older-people-with-and-without-dementia-what-connections
#17
Ana Morais, Sofia Santos, Paula Lebre
Background In typical aging, it is possible to observe a decline in psychomotor domains, such as balance or global and fine motor skills as well as a cognitive and functional decline. Although, it is not clear which psychomotor domains are mostly affected in elderly with dementia and the association with the cognitive and functional level. Objective To identify the correlation between psychomotor, cognitive, and functional skills, and seeking whether there are differences among persons with and without dementia...
January 1, 2017: Dementia
https://www.readbyqxmd.com/read/28752589/frailty-and-potentially-inappropriate-medication-use-at-nursing-home-transition
#18
Laura C Maclagan, Colleen J Maxwell, Sima Gandhi, Jun Guan, Chaim M Bell, David B Hogan, Nick Daneman, Sudeep S Gill, Andrew M Morris, Lianne Jeffs, Michael A Campitelli, Dallas P Seitz, Susan E Bronskill
BACKGROUND/OBJECTIVES: To estimate the prevalence of potentially inappropriate medication (PIM) use among older adults with cognitive impairment or dementia prior to and following admission to nursing homes and in relation to frailty. DESIGN: Retrospective cohort study using health administrative databases. SETTING: Ontario, Canada. PARTICIPANTS: 41,351 individuals with cognitive impairment or dementia, aged 66+ years newly admitted to nursing home between 2011 and 2014...
July 28, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28746708/effectiveness-and-safety-of-dementia-care-management-in-primary-care-a-randomized-clinical-trial
#19
Jochen René Thyrian, Johannes Hertel, Diana Wucherer, Tilly Eichler, Bernhard Michalowsky, Adina Dreier-Wolfgramm, Ina Zwingmann, Ingo Kilimann, Stefan Teipel, Wolfgang Hoffmann
Importance: Dementia care management (DCM) can increase the quality of care for people with dementia. Methodologically rigorous clinical trials on DCM are lacking. Objective: To test the effectiveness and safety of DCM in the treatment and care of people with dementia living at home and caregiver burden (when available). Design, Setting, and Participants: This pragmatic, general practitioner-based, cluster-randomized intervention trial compared the intervention with care as usual at baseline and at 12-month follow-up...
July 26, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28745420/reasons-for-not-discontinuing-antipsychotics-in-dementia
#20
Sarah I M Janus, Jeannette G van Manen, Sytse U Zuidema, Carina Snijder, Constance H C Drossaert, Maarten J Ijzerman
BACKGROUND: The gap between high antipsychotic prescription rates for patients with dementia and the guidelines' advice to prescribe cautiously indicates that barriers to discontinuation exist. This exploratory study used the theory of planned behaviour to give a first overview of the factors that influence physicians to discontinue antipsychotics in nursing home patients with dementia. METHODS: Forty-one physicians in the Netherlands completed an online survey based on the theory of planned behaviour...
July 26, 2017: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
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