Assessment and treatment of behavior problems in dementia in nursing home residents: a comparison of the approaches of physicians, psychologists, and nurse practitioners

Cohen‐Mansfield, Jiska; Jensen, Barbara; Resnick, Barbara; Norris, Margaret P.

doi:10.1002/gps.2699

Cited by 19 publications

(46 citation statements)

References 44 publications

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“…In some cases, such approaches are sub-optimal due to inadequate/ineffective communication, organisational/disciplinary boundaries which inhibit effective working, and issues of co-ordination [71,105]. Furthermore, establishing and sustaining joint working and/or multidisciplinary approaches can be challenging, and there is a need for more specific and appropriate commissioning [48,103].…”

Section: Resultsmentioning

confidence: 99%

Evidence of what works to support and sustain care at home for people with dementia: a literature review with a systematic approach

et al. 2015

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BackgroundThis paper synthesises research evidence about the effectiveness of services intended to support and sustain people with dementia to live at home, including supporting carers. The review was commissioned to support an inspection regime and identifies the current state of scientific knowledge regarding appropriate and effective services in relation to a set of key outcomes derived from Scottish policy, inspection practice and standards. However, emphases on care at home and reduction in the use of institutional long term care are common to many international policy contexts and welfare regimes.MethodsSystematic searches of relevant electronic bibliographic databases crossing medical, psychological and social scientific literatures (CINAHL, IngentaConnect, Medline, ProQuest, PsychINFO and Web of Science) in November 2012 were followed by structured review and full-text evaluation processes, the latter using methodology-appropriate quality assessment criteria drawing on established protocols.ResultsOf 131 publications evaluated, 56 were assessed to be of ‘high’ quality, 62 of ‘medium’ quality and 13 of ‘low’ quality. Evaluations identified weaknesses in many published accounts of research, including lack of methodological detail and failure to evidence conclusions. Thematic analysis revealed multiple gaps in the evidence base, including in relation to take-up and use of self-directed support by people with dementia, use of rapid response teams and other multidisciplinary approaches, use of technology to support community-dwelling people with dementia, and support for people without access to unpaid or informal support.ConclusionsIn many areas, policy and practice developments are proceeding on a limited evidence base. Key issues affecting substantial numbers of existing studies include: poorly designed and overly narrowly focused studies; variability and uncertainty in outcome measurement; lack of focus on the perspectives of people with dementia and supporters; and failure to understanding the complexities of living with dementia, and of the kinds of multifactorial interventions needed to provide holistic and effective support. Weaknesses in the evidence base present challenges both to practitioners looking for guidance on how best to design and deliver evidence-based services to support people living with dementia in the community and their carers and to those charged with the inspection of services.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-015-0053-9) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Evidence of what works to support and sustain care at home for people with dementia: a literature review with a systematic approach

et al. 2015

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“…12 Two-thirds of the MDs were male compared with 41% of the PhDs and only 2% of the NPs. While the true response rate cannot be computed, because it is unknown how many received the e-mails or how many in the mailing lists actually worked in nursing homes, the response rates relative to the number of addresses in the mailing lists were 3%, 16%, and 7%, respectively.…”

Section: Resultsmentioning

confidence: 99%

Quality of Nursing Home Care

Cohen‐Mansfield

Jensen

Resnick

et al. 2012

Journal of Nursing Care Quality

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Physicians, psychologists, and nurse practitioners rated the quality of nursing home care and the importance and feasibility of improvement strategies. Overall care was rated better than care of residents, followed by treatment of staff. Physicians rated care highest and nurse practitioners rated it lowest. In terms of suggestions for quality improvement, improving treatment of frontline staff and of families was rated as most important overall. We found differences across professional groups in recommended improvements, a finding that suggests the importance of interdisciplinary communication and developing an integrated viewpoint in optimizing care for older persons.

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“…72 Interdisciplinary team members who work with persons with dementia would benefit from education about the stigma of dementia and how this might inhibit PwD’s willingness to share symptoms with others. As previously discussed, persons with dementia will sometimes deny their diagnosis and avoid medical care because they are uncertain about treatment options that could help them to age in place, and are unaware of medications 66 or other interventions that could help control troubling symptoms such as anxiety.…”

Section: Case Study—partmentioning

confidence: 99%

Anxiety and Stigma in Dementia

Riley¹,

Burgener²,

Buckwalter³

2014

Nursing Clinics of North America

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Synopsis The number of Americans with dementia is expected to increase as the population ages. Developing dementia is feared by many older adults and may result in anxiety in persons with dementia (PwD). This article focuses on anxiety, one of the least understood symptoms associated with dementia in community-dwelling older adults, the stigma of dementia, and the relationship between anxiety and stigma in dementia. When undetected and untreated, anxiety and associated stigma can adversely affect quality of life and the ability to age in place. The paper begins by describing dementia-related anxiety. Next, based on research by the authors and others, the association between stigma and anxiety is examined. The paper concludes with recommendations for assessment and treatment of anxiety and stigma in persons with dementia that will better allow them to age in place.

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Assessment and treatment of behavior problems in dementia in nursing home residents: a comparison of the approaches of physicians, psychologists, and nurse practitioners

Abstract: Awareness of similarities and differences in the approaches of different health professionals can facilitate interdisciplinary interaction in providing care for dementia-associated behavior problems in nursing home residents.

Cited by 19 publications

References 44 publications

Evidence of what works to support and sustain care at home for people with dementia: a literature review with a systematic approach

Evidence of what works to support and sustain care at home for people with dementia: a literature review with a systematic approach

Quality of Nursing Home Care

Anxiety and Stigma in Dementia

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