Despite the substantial improvement in apathy scores during the course of the study, there was no clear advantage to the reminiscence-based intervention over the time and attention, one-on-one control intervention. More research is needed to develop specific behavioral interventions for apathy in patients with dementia.
Although televisions are commonplace in many long-term care facilities for people with dementia, little research has been done on the possible effects of television viewing on residents' behaviors. The authors' study aims were to document observable behaviors and activities of residents before, during, and after viewing television programs and to determine whether programs had an observable effect on behaviors. The authors enrolled 22 residents in a residential dementia care facility (4 to 5 people in each of the five residential wings). Two raters completed systematic observations for 5 consecutive days at baseline, during the presentation of eight television programs, and for 30 minutes following the program. The authors found that "dozing" was the most common activity during program viewing. In addition, many participants remained in the television area, "watching" a blank television screen in the 30 minutes following the program viewing. Further investigation on television's effect on sleep or participation in other social activities is needed.
As persons with dementia regress, there is an increasing challenge to identify appropriate activities. A therapeutic activity approach that can benefit persons with dementia is sensory stimulation. This article will review the meaning of sensory stimulation, for whom it is appropriate, and the benefits. The activity assessment is integral in determining activities that are successful in stimulating the senses. The different ways to implement sensory stimulation are discussed. The writer refers to his own clinical experience of more than 10 years in the practical implementation of sensory stimulation activities. The 6 different types of sensory stimulation and the outcomes of sensory stimulation are described.
Behavior and psychological symptoms of dementia are common in residential care facilities. These symptoms not only detract from the quality of life of the resident with dementia, but they can be disruptive to the unit and result in harm to staff and other residents. With the trend away from pharmacological management, other creative psychosocial-environmental strategies are being explored. One innovative approach involves the use of the club concept, where selected agitated residents spend a portion of the day in a separate structured environment. This program combines trained staff and tailored activities that optimize mental stimulation, functional independence, and self-esteem. Benefits include reduced incidents of aggressive behaviors and use of psychoactive medications, as well as enhanced quality of life. Not only do the participants benefit from time spent in this specialized setting, but the therapeutic milieu of the facility is also enhanced. Further evaluation of such strategies is needed to quantify the benefits of targeted behavioral interventions for those with cognitive impairment.
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