Characteristics of Activities for Persons With Dementia at the Mild, Moderate, and Severe Stages

Regier, Natalie G.; Hodgson, Nancy; Gitlin, Laura N.

doi:10.1093/geront/gnw133

Cited by 42 publications

(47 citation statements)

References 43 publications

(41 reference statements)

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“…Family carers focused on the need for activities to be engaging for people with moderate dementia and pleasurable for those with severe dementia. These reports are reflected in activity plans written by occupational therapists for people living with dementia in the community (Regier, Hodgson, & Gitlin, ). Goal‐related activities were typically planned for those with mild dementia, occasionally for those with moderate dementia and rarely for people with severe dementia.…”

Section: Discussionmentioning

confidence: 99%

Enjoyable, engaging and individualised: A concept analysis of meaningful activity for older adults with dementia

Tierney

Beattie

2020

Int J Older People Nursing

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Aim:The term "meaningful activity" is widely used in policy, practice and the research literature. However, definition and use of the term is unclear and inconsistent. A concept analysis was conducted to explore the fundamental attributes that make an activity meaningful for older adults with dementia and propose a conceptual model for understanding "meaningful activity" in this population. Methods: This study followed Walker and Avant's method of concept analysis. Searches were conducted in the Scopus, MEDLINE, CINAHL, PubMed, Academic Search Elite and Web of Science databases for literature using the term "meaningful activity." Papers published before 1996 were excluded. Results: Twenty-nine papers concerned with "meaningful activity" were analysed. This analysis identified five attributes that make activities meaningful for people with dementia: (a) enjoyable; (b) suited to the individual's skills, abilities and preferences; (c) related to personally relevant goals; (d) engaging; and (e) related to an aspect of identity. The conceptual model illustrates how individual and opportunity factors influence participation in "meaningful activity" and the consequences of this participation as discussed in the existing literature. Conclusion: The findings of this concept analysis provide insight into what characteristics make an activity meaningful. Specific activities that are meaningful are different for each person and participation in personally 'meaningful activities' has the potential to positively impact the lives of people with dementia. Implications for practice: This understanding of 'meaningful activity' can be used by those involved in research, planning or delivery of services and care for people with dementia to encourage and support participation in activities that are meaningful to individuals. K E Y W O R D S concept analysis, dementia, meaningful activity, older adults, person-centred care

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Section: Discussionmentioning

confidence: 99%

Enjoyable, engaging and individualised: A concept analysis of meaningful activity for older adults with dementia

Tierney

Beattie

2020

Int J Older People Nursing

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“…Guidance for using pleasant activity as a therapeutic intervention in dementiaFigure inspired by Regier et al(421) …”

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confidence: 99%

Dementia prevention, intervention, and care

et al. 2017

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People with dementia are usually older, often have co-morbidities and may need help in coping with these illnesses. A third of older people now die with dementia and all professionals working in endof-life care need to make this a central part of their planning and communication. In this commission, we have detailed evidence-based approaches to dementia and its symptoms. Services should be available, scalable and give value. As there are limited resources, professionals and services need to use what works, not use what is ineffective, and be aware of the difference. Overall, there is good potential for prevention and, once someone develops dementia, for care to be high-quality, accessible, and give value to an under-served, growing population. Effective dementia prevention and care could transform the future for society and vastly improve living and dying for individuals with dementia and their families. Acting now on what we already know can make this difference happen. Key Messages 1 There are increasing numbers of people with dementia globally although incidence in some countries has decreased. 2 Be ambitious about prevention: We recommend energetically treating hypertension in middle aged and older people without dementia to reduce dementia incidence. Interventions for other risk factors, including more childhood education, exercise, maintaining social engagement, reducing smoking, and management of hearing loss, depression, diabetes and obesity; may have the potential of delaying or preventing a third of dementias. 3 Treat cognitive symptoms: To maximise cognition, people with Alzheimer's dementia or Dementia with Lewy Bodies should be offered Cholinesterase Inhibitors (ChEIs)at all stages, or memantine for severe dementia. ChEIs are not effective in Mild Cognitive Impairment. 4 Individualise dementia care: Good dementia care spans medical, social and supportive care, should be tailored to unique individual and cultural needs, preferences, priorities, and should incorporate support for the family carers 5 Care for family carers. Family carers are at high risk of depression. Effective interventions reduce the risk and treat the symptoms, include START (Strategies for Relatives) or REACH (Resources for Enhancing Alzheimer's Caregiver Health intervention) and should be made available. 6 Plan for the future. People with dementia and their families value discussions about the future and decisions about possible attorneys to make decisions. Clinicians should consider capacity to make different types of decisions at diagnosis. 7 Protect people with dementia. People with dementia and society require protection from possible risks of the condition, including self-neglect, vulnerability including to exploitation, managing money, driving or using weapons. Risk assessment and management at all stages of the disease is essential but it should be balanced against the persons' right to autonomy. 8 Manage neuropsychiatric symptoms. Management of the neuropsychiatric symptoms of dementia including agitation, low mood or psyc...

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“…Previous studies have reported that physical activity may be provided more easily if the dementia is severe. [ 24 ] Physical NPI has also been reported to improve cognitive function in mild to severe patients with CI. [ 43 ] Physical NPI may be easy to provide for NH residents with CI who have particularly low orientation, comprehension, and naming.…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies on people with CI, analyses using tests and maximum likelihood estimations have primarily been used as conventional statistical methods. [ 24 , 25 ] However, the interpretation of the results of conventional statistical methods is not intuitive, and overfitting is frequently carried out in analyses that combine several types of probability distributions to reflect background information and hypotheses. Therefore, in recent years, Bayesian analyses have garnered attention as a statistical method that is intuitive and easy to interpret, while enabling stable estimation even for complex models.…”

Section: Introductionmentioning

confidence: 99%

Bayesian analysis of the association between effective strategies of multimodal nonpharmacological intervention and characteristics of cognitive function in nursing home residents with cognitive impairment

Yorozuya

Yamane

Nobuhisa³

et al. 2020

Medicine

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The cognitive function of nursing home (NH) residents with cognitive impairment (CI) tends to decline over time. An effective multimodal non-pharmacological intervention (MNPI) strategy is needed to improve the cognitive function of NH residents with CI. The aim of this study was to clarify the cognitive function characteristics of NH residents with CI in whom a non-pharmacological intervention (NPI) can be implemented, consisting of MNPI using a Bayesian analysis, and to incorporate suggestions to make the MNPI strategy as effective as possible. This study had a cross-sectional design. The 61 subjects were selected from the residents of 5 NHs, of whom 90.16% were female, and the mean (standard deviation) age was 87.20 ± 6.90. Analyses were performed using a hierarchical Bayesian model, and the global and specific cognitive functions as assessed by the Japanese version of the Neurobehavioral Cognitive Status Examination were the response variables. Three types of NPI (cognitive enhancement NPI, physical NPI, psychological and psychosocial NPI), and activities of daily living (ADL), as assessed by the Barthel index, were the explanatory variables. Cognitive enhancement NPI was revealed to have no association with any cognitive function. Physical NPI was negatively associated with orientation [OR 0.31 (95% credible interval (95% CI) –2.33, –0.10)], comprehension [OR 0.16 (95% CI –2.78, –0.95)] and naming [OR 0.49 (95% CI –1.47, –0.02)]. Psychological and psychosocial NPI was positively associated with comprehension [OR 3.67 (95% CI 0.52, 2.13)]. Barthel index was positively associated with total Japanese version of the Neurobehavioral Cognitive Status Examination [OR 1.74 (95% CI 0.08, 2.12)], comprehension [OR 3.49 (95% CI 0.45, 4.67)], repetition [OR 10.07 (95% CI 0.53, 9.01)], naming [OR 2.24 (95% CI 0.07, 3.20)], and calculations [OR 18.82 (95% CI 2.71, 9.40)]. The implementation of MNPI should be preceded by cognitive enhancement NPI and physical NPI. Providing ADL enhancing NPI in response to cognitive improvement may be an effective strategy. Providing cognitive enhancement NPI, physical NPI, psychological, and psychosocial NPI, as well as ADL-enhancing NPI at the same time, is also an effective strategy for subjects with mild dementia who are considered to have relatively high cognitive functions.

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Characteristics of Activities for Persons With Dementia at the Mild, Moderate, and Severe Stages

Abstract: Type of activity, recommended cueing, and engagement time differed by dementia stage. Findings provide guidance as to how to use and set up activities across the dementia trajectory.

Cited by 42 publications

References 43 publications

Enjoyable, engaging and individualised: A concept analysis of meaningful activity for older adults with dementia

Enjoyable, engaging and individualised: A concept analysis of meaningful activity for older adults with dementia

Dementia prevention, intervention, and care

Bayesian analysis of the association between effective strategies of multimodal nonpharmacological intervention and characteristics of cognitive function in nursing home residents with cognitive impairment

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