Search

This article describes a pilot project involving training, case consultations, and administrative coaching over a period of 1 year aimed at introducing palliative care in 2 nursing homes among 31 residents with advanced dementia. Resident outcomes that examined numerous clinical measures were assessed at 3 points in time. Changes in the knowledge and attitudes of 80 staff members and 33 family members who participated in the multimodal intervention were also assessed at 3 points in time. Limited improvements were demonstrated on measures for residents, staff members, and family members at the first nursing home (site 1) and significant improvements were demonstrated at the other nursing home (site 2). Top leadership turned over 3 times at site 1 which limited the integration of palliative care, whereas leadership of site 2 remained stable. Implications for implementing a program of palliative care in nursing homes are discussed.

Purpose: This exploratory study compared three methods of assessing dementia specific quality of life, corresponding to the perspectives of residents, staff members, and trained observers., Design and Methods: We collected data on 172 residents with dementia in four special care nursing facilities and three assisted living facilities. Analyses assessed the relationship of each quality-of-life method or perspective to the others and to resident characteristics such as cognitive and functional status., Results: The relationship of staff quality-of-life measures to resident characteristics varied by care setting while no significant relationships were found for resident quality-of-life measures. Staff and observational measures were moderately correlated in both settings. Moderate correlations of resident measures with staff and observational measures were found in the assisted living sample., Implications: Each perspective is relatively independent and somewhat unique. Measures that focus on specific aspects of quality of life may be more appropriate to use with assisted living residents than with residents of special care facilities.

This study evaluated five dementia-specific quality of life (DQOL) measures including client interviews, staff proxies, and observations with 54 clients in three adult day centers. Also, the relationship of cognitive and functional status to each of the DQOL measures was assessed. Client interviews correlated well with each other, but not with other measures. Staff proxies were strongly correlated with each other and moderately correlated with the observational measure. On average, clients rated their DQOL higher than staff. Analyses suggest that functional impairment is associated with poorer DQOL as indicated by staff and observer measures. Possible explanations and implications are explored.

This study examined the quality of life of 131 persons with dementia living in 10 assisted livingfacilities in a Midwestern state, using the observational method known as Dementia Care Mapping (DCM). Trained observers collected detailed information on the types of interactions and activities taking place among residents and staff on a given day. Key differences were noted between residents living in small, dementia-specific sites (10 to 28 residents) and those living in large sites that were not dementia-specific (40 to 63 residents). The latter group fared better overall with respect to quality of life and diversity of interactions and activities. Additional methods of examining quality of life among persons with dementia will be helpful to explain these differences.

Introduction Dementia Care Mapping (DCM) was originally developed as a clinical tool but has attracted interest as a potential observational measure of quality of life (QOL) and well-being of long-term care residents with dementia. DCM coding involves continuous observation over a 6-h period, with observers recording a Behavior Category Code (BCC, a recording of activity/interaction) and a Well/Ill Being (WIB) score at 5 min intervals. Method Descriptive data from several different research teams on the distribution and psychometric properties of DCM data were compiled and summarized. Results Issues and problems identified include: complex scoring algorithms, inter-rater reliability of the BCCs, limited variability of WIB values, associations between resident characteristics and DCM assessments, rater time burden, and comparability of results across study settings. Conclusions Despite the identified limitations, DCM has promise as a research measure, as it may come closer to rating QOL from the perspective of persons with dementia than other available measures. Its utility will depend on the manner in which it is applied and an appreciation of the measure's strength and limitations. Possible changes that might improve the reliability, validity, and practicality of DCM as a research tool include coding the predominant event (rather than the ‘best’ event), shortening the observation period, and adding ‘0’ as a neutral WIB coding option. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This article describes the results of an educational intervention for family caregivers of persons in the early stages of Alzheimer's disease. A total of 45 family caregivers participated in this intervention that consisted of five weekly educational sessions about the disease and aspects of caring for someone in the early stages. Measures of knowledge about Alzheimer's disease, self-efficacy, reactions to patients' memory impairment, and level of depression at pretest and posttest were analyzed. Participants' knowledge about the disease improved substantially, self-efficacy and reactions to patients' impairments improved moderately, and level of depression showed no significant improvement. Results suggest that this intervention has merit for family caregivers coping with the early stages of Alzheimer's disease. Implications for implementation and evaluation are discussed. [ABSTRACT FROM AUTHOR]

The influence of cognitive impairment, functional impairment, and care setting on participation in activities has not been examined. To better understand these relationships, data were collected for 166 persons with dementia in 3 types of care settings. Residents of nursing homes and those with highest levels of cognitive and functional impairment had the lowest level of participation in staff-led activities and the greatest frequency of sleeping. In contrast, persons with mild dementia and those attending adult day centers had the highest level of participation in staff-led activities and the lowest frequency of sleeping. Implications for practice are discussed. [ABSTRACT FROM AUTHOR]

Alzheimer's disease is the most common type of dementia, currently affecting an estimated five million Americans including as many as one million persons who live alone. The numbers of individuals with the disease and those who care for them are expected to grow dramatically in the coming decades. Social workers encountering people with the disease and their families in a variety of settings must be aware of the disease, its effects on individuals and families, and appropriate resources. This article provides an overview of the medical, social and psychological aspects of the disease. Common challenges of individuals with the disease are illustrated through the case of a woman living alone in the community who was helped to maintain her quality of life through psychotherapy and a variety of supportive services. [ABSTRACT FROM PUBLISHER]

Persons with Alzheimer's disease and related dementias who express themselves in intimate and sexual ways while living in care facilities often pose dilemmas for staff members and families. This article aims to explore such dilemmas and promote the healthy self-expression of intimacy and sexuality by persons with dementia. Awareness of one's biases about the intimacy and sexual needs of older people, particularly those disabled by dementia, is necessary to address these needs in a sensitive and respectful manner. [ABSTRACT FROM AUTHOR]

Presents the poem "In Memory of Auguste D.," by Daniel Kuhn.