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Aggression in Dementia

Joanne Brooke, Claire Manneh
AIMS: To explore the lived experience of caring for a patient during an acute episode of delirium by nurses working in cardiology, elderly care, renal, or respiratory specialities. BACKGROUND: A missed or delayed diagnosis of delirium in an acute hospital setting adversely impacts on patient outcomes. Nurses are the best placed health care professionals to identify a change in patient's cognitive status but struggle to do so. DESIGN: Inductive interpretative phenomenology...
March 12, 2018: International Journal of Nursing Practice
Jesús Rivera-Navarro, Rosa Sepúlveda, Israel Contador, Bernardino Fernández-Calvo, Francisco Ramos, Miguel Ángel Tola-Arribas, Miguel Goñi
The objective of our study is to validate the Caregiver Abuse Screen (CASE) as an instrument for detecting the maltreatment of people with dementia in Spain. In total, 326 informal caregivers of people with different types of dementia were interviewed in several cities in northwest Spain. The caregivers were selected from outpatient neurology clinics and associations of relatives of people with Alzheimer's disease and other dementias. A comprehensive sociodemographic questionnaire was administered to all participants, and several standardized scales were used to assess burden, anxiety, depression, social support and resilience...
March 2018: European Journal of Ageing
Mary M Mitchell, Eric D Hansen, Tuo-Yen Tseng, Meng Shen, Cynda Rushton, Tom Smith, Nancy Hutton, Jennifer Wolfe, Lee Bone, Jeanne Keruly, Lawrence Wissow, Amy R Knowlton
CONTEXT & OBJECTIVE: Advance care planning (ACP) rates remain low, especially among people who are HIV positive, disadvantaged, and African American. While ACP can be a sensitive topic for clinicians and patients to discuss, health values clarification can be an important initial step. METHODS: Data were from the first 325 participants in the AFFIRM Care study, which enrolled adults living with HIV/AIDS in Baltimore, MD, who had histories of illicit drug use...
March 8, 2018: Journal of Pain and Symptom Management
Damiana Scuteri, Laura Rombola, Laura Tridico, Hirokazu Mizoguchi, Chizuko Watanabe, Tsukasa Sakurada, Shinobu Sakurada, Maria TIziana Corasaniti, Giacinto Bagetta, Luigi Antonio Morrone
1.1. BACKGROUND: Alzheimer's Disease (AD) accounts for approximately 50% of all cases of dementia and, in spite of the great effort for the development of disease-modifying drugs, a definitive treatment of cognitive impairment is not available yet. A perfect adherence to the current therapy of cognitive decline is needed for a better control of the disease and this is proven to reduce, though not completely abolish, the associated Behavioural and Psychological Symptoms of Dementia (BPSDs) from occurring...
March 6, 2018: Current Medicinal Chemistry
Barbara Resnick, Ann Kolanowski, Kimberly Van Haitsma, Elizabeth Galik, Marie Boltz, Jeanette Ellis, Liza Behrens, Nina M Flanagan, Karen J Eshraghi, Shijun Zhu
Behavioral and psychological symptoms of dementia (BPSD) include aggression, agitation, resistiveness to care, depression, anxiety, apathy, and hallucinations. BPSD are common in nursing home residents and can be ameliorated using person-centered approaches. Despite regulatory requirements, less than 2% of nursing homes consistently implement person-centered behavioral approaches. In a National Institute of Nursing Research-funded research protocol, we are implementing a pragmatic cluster randomized clinical trial designed to enable staff in nursing homes to reduce BPSD using behavioral approaches while optimizing function, preventing adverse events, and improving quality of life of residents...
February 27, 2018: Research in Nursing & Health
Bryan R Hansen, Nancy A Hodgson, Chakra Budhathoki, Laura N Gitlin
PURPOSE: To describe caregiver challenges with and confidence managing three aggressive behavior types in persons with dementia: verbal aggression, destroying property, and threatening to hurt others. DESIGN AND METHOD: Secondary analysis of baseline data from the 2001-2004 Resources for Enhancing Alzheimer's Caregiver Health II (REACH II) initiative. RESULTS: One or more aggressive behaviors within 1 week were reported by more than a third of caregivers, with most expressing upset but fewer expressing confidence managing the behaviors...
February 1, 2018: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
Michelle L Yakimicki, Nancy E Edwards, Elizabeth Richards, Alan M Beck
This review discusses the relationship between animal-assisted interventions (AAI) and behavioral and psychological symptoms of dementia (BPSD). A systematic search was conducted within CINAHL, Web of Science CAB Abstracts, PubMed, Abstracts in Social Gerontology, Google Scholar, and PsycINFO for primary research articles. A total of 32 studies were included in the final review. Variation was noted in study designs and in study setting. Twenty-seven of 32 studies used dogs as the intervention. Agitation/aggression showed a significant decrease in nine of 15 studies...
February 1, 2018: Clinical Nursing Research
Tamara Backhouse, Julieta Camino, Eneida Mioshi
BACKGROUND: Behavioral crises in dementia are represented by a wide variety of symptoms, regularly require external intervention from professionals, and are reported as a risk factor for hospital admission. Little is known about the factors that are associated with them. OBJECTIVE: To determine the factors associated with dementia-related behavioral crises. METHODS: We searched MEDLINE, CINAHL, PsycINFO, EMBASE, and AMED databases. An additional lateral search including reference lists was conducted...
2018: Journal of Alzheimer's Disease: JAD
Ralph Möhler, Anna Renom, Helena Renom, Gabriele Meyer
BACKGROUND: People with dementia who are being cared for in long-term care settings are often not engaged in meaningful activities. Offering them activities which are tailored to their individual interests and preferences might improve their quality of life and reduce challenging behaviour. OBJECTIVES: ∙ To assess the effects of personally tailored activities on psychosocial outcomes for people with dementia living in long-term care facilities.∙ To describe the components of the interventions...
February 13, 2018: Cochrane Database of Systematic Reviews
May Helen Midtbust, Rigmor Einang Alnes, Eva Gjengedal, Else Lykkeslet
BACKGROUND: People dying with dementia have significant healthcare needs, and palliative care, with its focus on comfort and quality of life, should be made available to these patients. The aim of this study was to explore and increase knowledge of healthcare professionals' experiences with palliative care to people with severe dementia in nursing homes. METHODS: To describe the phenomenon under investigation, we used a phenomenological research approach grounded in the philosophy of Husserl...
February 13, 2018: BMC Palliative Care
Seth A Gale, Diler Acar, Kirk R Daffner
Dementia is any decline in cognition that is significant enough to interfere with independent, daily functioning. Dementia is best characterized as a syndrome rather than as one particular disease. The causes of dementia are myriad and include primary neurologic, neuropsychiatric, and medical conditions. It is common for multiple diseases to contribute to any one patient's dementia syndrome. Neurodegenerative dementias, like Alzheimer disease and dementia with Lewy bodies, are most common in the elderly, while traumatic brain injury and brain tumors are common causes in younger adults...
February 6, 2018: American Journal of Medicine
Marike E de Boer, Marja F I A Depla, Brenda J M Frederiks, Annemarieke A Negenman, Jolanda M Habraken, Carlijn H van Randeraad-van der Zee, Petri J C M Embregts, Cees M P M Hertogh
OBJECTIVE: To avoid restraints and involuntary care caregivers should be aware if and how a patient resists care. This article focuses on behavioural expressions of people with severe dementia in nursing homes that are interpreted by their formal and informal caregivers as possible expressions of their experience of involuntary care. METHOD: Concept mapping was used, following five steps: (1) brainstorming, (2) rating, (3) sorting, (4) statistical analysis & visual representation and (5) interpretation...
February 7, 2018: Aging & Mental Health
Suhong Chen, Kai Lin, Hanxiao Wang, Miyae Yamakawa, Kiyoko Makimoto, Xiaoyan Liao
BACKGROUND: With the increasing number of dementia patients in China, there is a pressing need for a reliable and valid Chinese instrument that can measure neuropsychiatric symptoms in institutionalized dementia patients. This study examined the reliability and structural validity of the Chinese version of the Neuropsychiatric Inventory, Nursing Home version (NPI-NH), in a sample of institutionalized dementia patients in China. METHODS: A total of 112 residents with dementia (Clinical Dementia Rating = 1: 10...
February 6, 2018: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
Gen Kanayama, Marc J Kaufman, Harrison G Pope
PURPOSE OF REVIEW: To summarize recent findings regarding the public health impact of androgen abuse. RECENT FINDINGS: Abuse of androgens (also called 'anabolic-androgenic steroids') has grown into a major worldwide substance abuse problem involving tens of millions of individuals, of whom about 98% are men. Most androgen abusers are still under age 50 today, and thus, the long-term effects of these drugs are only beginning to be understood. Recent studies confirm that long-term supraphysiologic androgen exposure produces cardiovascular toxicity, characterized especially by cardiomyopathy and atherosclerotic disease...
January 24, 2018: Current Opinion in Endocrinology, Diabetes, and Obesity
Yan Xiong, Yun Lang, Zeping Yu, Hongyuan Liu, Xiang Fang, Chongqi Tu, Hong Duan
BACKGROUND: Chondroblastoma is a rare benign cartilaginous tumor, which primarily occurs in children and adolescents. Chondroblastoma commonly originates in the epiphyseal plate of long bones. An aggressive curettage treatment is recommended to manage lesion, which may jeopardize an open epiphyseal plate and result in limb shortening and deformity as the limb grows and develops. The purpose is to observe surgical effects of chondroblastoma on open epiphyseal plate of long bones in children and adolescents and explore influences on limb growth and development...
January 23, 2018: World Journal of Surgical Oncology
Annie Poirier, Philippe Voyer, France Légaré, Michèle Morin, Holly O Witteman, Edeltraut Kröger, Bernard Martineau, Charo Rodríguez, Anik Mc Giguere
To improve the care of seniors living with dementia, current initiatives typically target better identification and treatment of the patient. Our recent survey, however, shows we should also focus more on the needs of the informal caregivers who care for this population in primary care settings. This three-round Delphi survey sought caregivers' views on the most frequent and difficult decisions that seniors with dementia, their informal caregivers, and health care providers face in primary care settings in the province of Quebec...
January 22, 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Ping-Jen Chen, Fu-Wen Liang, Chung-Han Ho, Shao-Yi Cheng, Yi-Chen Chen, Yu-Han Chen, Yueh-Chun Chen
BACKGROUND: The association between palliative care and life-sustaining treatments for patients with dementia is unclear in Asian countries. AIM: To analyse the use of palliative care and its association with aggressive treatments based on Taiwanese national data. DESIGN: A matched cohort study was conducted. The association between intervention and outcome was evaluated using conditional logistic regression analyses. SETTING/PARTICIPANTS: The source population comprised 239,633 patients with dementia diagnosed between 2002 and 2013...
January 1, 2018: Palliative Medicine
Richard J Caselli, Blake T Langlais, Amylou C Dueck, Bruce R Henslin, Travis A Johnson, Bryan K Woodruff, Charlene Hoffman-Snyder, Dona E C Locke
BACKGROUND/OBJECTIVES: Behavioral problems in individuals with Alzheimer's disease (AD) impose major management challenges. Current prevention strategies are anchored to cognitive outcomes, but behavioral outcomes may provide another, clinically relevant opportunity for preemptive therapy. We sought to determine whether personality changes that predispose to behavioral disorders arise during the transition from preclinical AD to mild cognitive impairment (MCI). DESIGN: Longitudinal observational cohort study...
January 17, 2018: Journal of the American Geriatrics Society
Simon Jc Davies, Amer M Burhan, Donna Kim, Philip Gerretsen, Ariel Graff-Guerrero, Vincent L Woo, Sanjeev Kumar, Sarah Colman, Bruce G Pollock, Benoit H Mulsant, Tarek K Rajji
INTRODUCTION: Behavioural and psychological symptoms of dementia (BPSD) include agitation and aggression in people with dementia. BPSD is common on inpatient psychogeriatric units and may prevent individuals from living at home or in residential/nursing home settings. Several drugs and non-pharmacological treatments have been shown to be effective in reducing behavioural and psychological symptoms of dementia. Algorithmic treatment may address the challenge of synthesizing this evidence-based knowledge...
January 1, 2018: Journal of Psychopharmacology
Vanessa Louise Burshnic, Natalie Douglas, Robert Michael Barker
INTRODUCTION: Implementing person-centered care requires shared attitudes, beliefs, and values among all care employees. Existing research has failed to examine the attitudes of non-nursing employees. AIM: This study examined attitudes toward aggression among nursing and non-nursing employees to address gaps in existing research and assess readiness for wider adoption of person-centered frameworks. METHOD: The Management of Aggression in People with Dementia Attitude Questionnaire was used to survey attitudes of employees in Michigan-based nursing homes...
January 10, 2018: Journal of Psychiatric and Mental Health Nursing
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