The hypothesis that PCC+PCE would improve quality of life and agitation even further was not supported, even though there were improvements in the quality of care interactions and resident emotional responses to care for some of this group. The Australian New Zealand Clinical Trials Registry Number is ACTRN 12608000095369.

Background: A large and growing number of people with dementia are being cared for in long-term care. The empirical literature on the design of environments for people with dementia contains findings that can be helpful in the design of these environments. A schema developed by Marshall in 2001 provides a means of reviewing the literature against a set of recommendations. The aims of this paper are to assess the strength of the evidence for these recommendations and to identify those recommendations that could be used as the basis for guidelines to assist in the design of long term care facilities for people with dementia.Methods: The literature was searched for articles published after 1980, evaluating an intervention utilizing the physical environment, focused on the care of people with dementia and incorporating a control group, pre-test-post-test, cross sectional or survey design. A total of 156 articles were identified as relevant and subjected to an evaluation of their methodological strength. Of these, 57 articles were identified as being sufficiently strong to be reviewed.Results: Designers may confidently use unobtrusive safety measures; vary ambience, size and shape of spaces; provide single rooms; maximize visual access; and control levels of stimulation. There is less agreement on the usefulness of signage, homelikeness, provision for engagement in ordinary activities, small size and the provision of outside space.Conclusions: There is sufficient evidence available to come to a consensus on guiding principles for the design of long term environments for people with dementia.

Objective-Depressed mothers of children with psychiatric illness struggle with both their own psychiatric disorder and the demands of caring for ill children. When maternal depression remains untreated, mothers suffer, and psychiatric illness in their offspring is less likely to improve. This randomized, controlled trial compared the interpersonal psychotherapy for depressed mothers (IPT-MOMS), a nine-session intervention based on standard interpersonal psychotherapy, to treatment as usual for depressed mothers with psychiatrically ill offspring.Method-Forty-seven mothers meeting DSM-IV criteria for major depression were recruited from a pediatric mental health clinic where their school-age children were receiving psychiatric treatment and randomly assigned to IPT-MOMS (N=26) or treatment as usual (N=21). Mother-child pairs were assessed at three time points: baseline, 3-month follow-up, and 9-month follow-up. Child treatment was not determined by the study.Results-Compared to subjects assigned to treatment as usual, subjects assigned to IPT-MOMS showed significantly lower levels of depression symptoms, as measured by the Hamilton Depression Rating Scale, and higher levels of functioning, as measured by the Global Assessment of Functioning, at 3-month and 9-month follow-ups. Compared to the offspring of mothers receiving treatment as usual, the offspring of mothers assigned to IPT-MOMS showed significantly lower levels of depression as measured by the Children's Depressive Inventory at the 9-month follow-up.Conclusions-Assignment to IPT-MOMS was associated with reduced levels of maternal symptoms and improved functioning at the 3-and 9-month follow-ups compared to treatment as usual. Maternal improvement preceded improvement in offspring, suggesting that maternal changes may mediate child outcomes.Major depressive disorder is a common, debilitating illness, affecting one of five women in their lifetime (1). Many women who suffer from depression are mothers. Because of shared genetic and environmental risk factors, the offspring of depressed mothers have a two-to fivefold increased risk of experiencing a psychiatric illness relative to the offspring of unaffected parents (2,3). In a negatively reinforcing cycle, depressed mothers whose children develop psychiatric illness find it difficult to juggle the mental health treatment needs of multiple affected family members, often putting their own care behind that of their children (4). Consequently, maternal depression remains untreated (5), with attendant impairment in a range of functions that have been implicated in both poor maternal and child outcomes, including maternal interpersonal functioning (6,7) and parenting skills (8). Even when children receive psychiatric treatment, the likelihood of favorable responses decreases in the face of persistent maternal depressive symptoms (9).Depressed mothers with psychiatrically ill children present both challenges and opportunities. On one hand, if maternal illness is untreated, it is likely to have a negative e...

Successful knowledge translation of the person-centered model starts with managerial leadership and support; it is sustained when staff are educated and assisted to apply the model, and, along with families, come to appreciate the benefits of flexible care services and teamwork in achieving resident well-being. The Australian New Zealand Clinical Trials Registry number is ACTRN 12608000095369.

Purpose – The purpose of this paper is to assess the empirical support for the use of assistive technology in the care of people with dementia as an intervention to improve independence, safety, communication, wellbeing and carer support. Design/methodology/approach – A total of 232 papers were identified as potentially relevant. Inclusion criteria were: studies published between 1995 and 2011, incorporated a control group, pre-test-post-test, cross sectional or survey design, type of interventions and types of participants. The 41 papers that met criteria were subjected to an assessment of their validity using the model provided by Forbes. Following the assessment seven papers were considered as strong, ten moderate and 24 weak. The review is presented around the following topics: independence, prompts and reminders; safety and security; leisure and lifestyle, communication and telehealth; and therapeutic interventions. Findings – The literature exploring the use of assistive technologies for increasing independence and compensating for memory problems illustrate the problems of moving from the laboratory to real life. The studies are usually limited by very small samples, high drop-out rates, very basic statistical analyses and lack of adjustment for multiple comparisons and poor performance of the technology itself. Originality/value – Research to date has been unable to establish a positive difference to the lives of people with dementia by the general use of the assistive technology reviewed here.