Intensive rehabilitation for dementia improved cognitive function and reduced behavioral disturbance in geriatric health service facilities in <scp>J</scp>apan

Toba, Kenji; Nakamura, Yu; Endo, Hideki; Okochi, Jiro; Tanaka, Yukiko; Inaniwa, Chiyako; Takahashi, A; Tsunoda, Naoko; Higashi, Kentaro; Hirai, Makoto; Hirakawa, Hiromasa; Yamada, Shizuru; Maki, Yohko; Yamaguchi, Tomoharu; Yamaguchi, Hideyo

doi:10.1111/ggi.12080

Cited by 37 publications

(36 citation statements)

References 30 publications

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“…The present study was conducted in geriatric health service facilities (Roken in Japan) established by the Japanese government under the long-term care insurance scheme to provide medical treatment, nursing care, and rehabilitation to older people who need assistance with ADL [16]. The national average number of occupational therapists working in a typical geriatric health service facility is 1.2 [17], and occupational therapy or physical therapy is conducted for 20 minutes twice a week with each individual.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness and Cost-Effectiveness of Occupation-Based Occupational Therapy Using the Aid for Decision Making in Occupation Choice (ADOC) for Older Residents: Pilot Cluster Randomized Controlled Trial

et al. 2016

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BackgroundCare-home residents are mostly inactive, have little interaction with staff, and are dependent on staff to engage in daily occupations. We recently developed an iPad application called the Aid for Decision-making in Occupation Choice (ADOC) to promote shared decision-making in activities and occupation-based goal setting by choosing from illustrations describing daily activities. This study aimed to evaluate if interventions based on occupation-based goal setting using the ADOC could focus on meaningful activities to improve quality of life and independent activities of daily living, with greater cost-effectiveness than an impairment-based approach as well as to evaluate the feasibility of conducting a large cluster, randomized controlled trial.MethodIn this single (assessor)-blind pilot cluster randomized controlled trial, the intervention group (ADOC group) received occupational therapy based on occupation-based goal setting using the ADOC, and the interventions were focused on meaningful occupations. The control group underwent an impairment-based approach focused on restoring capacities, without goal setting tools. In both groups, the 20-minute individualized intervention sessions were conducted twice a week for 4 months.Main Outcome MeasuresShort Form-36 (SF-36) score, SF-6D utility score, quality adjusted life years (QALY), Barthel Index, and total care cost.ResultsWe randomized and analyzed 12 facilities (44 participants, 18.5% drop-out rate), with 6 facilities each allocated to the ADOC (n = 23) and control (n = 21) groups. After the 4-month intervention, the ADOC group had a significantly greater change in the BI score, with improved scores (P = 0.027, 95% CI 0.41 to 6.87, intracluster correlation coefficient = 0.14). No other outcome was significantly different. The incremental cost-effectiveness ratio, calculated using the change in BI score, was $63.1.ConclusionThe results suggest that occupational therapy using the ADOC for older residents might be effective and cost-effective. We also found that conducting an RCT in the occupational therapy setting is feasible.Trial RegistrationUMIN Clinical Trials Registry UMIN000012994

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Section: Methodsmentioning

confidence: 99%

Effectiveness and Cost-Effectiveness of Occupation-Based Occupational Therapy Using the Aid for Decision Making in Occupation Choice (ADOC) for Older Residents: Pilot Cluster Randomized Controlled Trial

et al. 2016

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“…7) Recently, Roken have been required to facilitate more patients to return home. Hamaoka et al 8) surveyed changes in independence levels of daily living for community-dwelling chronic stroke patients.…”

Section: Introductionmentioning

confidence: 99%

Life-space and Related Factors for the Elderly in a Geriatric Health Service Facility

Tanaka

Yamagami

2018

PRM

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Objective: To investigate (1) the concurrent validity of the Nursing Home Life-Space Diameter (NHLSD) and the Home-based Life-Space Assessment (Hb-LSA), (2) the correlated factors of life-space, and (3) the factors that affected the NHLSD score for the elderly in a geriatric health service facility, or Roken. Methods: This cross-sectional study included 32 participants in a Roken. Staff members, who had received essential guidance for assessment, examined the cognitive function, physical function, mood, communication ability, objective quality of life, vitality, and daily behavior of the participants. Correlation analysis between NHLSD and other measurements and multiple regression analysis with NHLSD as a dependent variable were conducted. Results: NHLSD and Hb-LSA were significantly correlated (r=0.710, P<0.01). NHLSD was significantly correlated with more measurements than Hb-LSA was; i.e., NHLSD was significantly correlated with communication ability, independence of daily living (Barthel Index; BI), maximum knee extension strength, grip strength, function in daily living, and three QOL measurements: positive affects, ability to communicate, and spontaneity and activity. A stepwise multiple regression analysis indicated that the BI total score, the maximum knee extension strength, and spontaneity and activity (one of the QOL items) were significantly correlated with the NHLSD score. Conclusions: NHLSD can measure the mobility levels of elderly persons in Roken. In addition to physical conditions and dependence of ADLs, spontaneity (or low levels of apathy) may be an important factor for promoting physical activity in Roken.

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“…Therefore, a hospital visit has the effect of conversation, physical contact, and attentiveness. "Progression of abnormal behavior" was also related to the care-related factor "support of hobby activities," and BPSD has been shown to be improved by psychosocial interventions, music therapy, and rehabilitation (Chen et al, 2014;Toba et al, 2014;Ueda, Suzukamo, Sato, & Izumi, 2013). It is not feasible for caregivers to support hobby activities of patients with dementia at home.…”

Section: Evaluation Of Resultsmentioning

confidence: 99%

Health Conditions, Treatment, and Care of Residents With Dementia in Group Living–Based Care Facilities (Group Homes): Perspectives of Group Home Managers, Japan

Takada

Sekita²,

Meguro

2014

Care Management Journals

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Group living-based care facilities for patients with dementia (group homes [GH]) aim to support patients to live with dignity in a familiar environment in their community. However, although some residents may be cared for well, their dementing disease may be untreated because of insuffi cient differential diagnosis and a lack of consultation with specialists. We previously sent a questionnaire on the status of GH management to 550 facilities in Tohoku District to investigate the effects of the 2006 revision of Long-Term Care Insurance. This study is a secondary analysis performed to evaluate the relationship of health conditions in residents with treatment and care. The results showed that resident-related factors of "physical dysfunction" and "health care" were not related to medical factors of "working with a supporting physician" and "working with a supporting physician and nurse." Similarly, the resident-related factor, "progression of dementia," was not related to the medical factor, "working with a dementia specialist." However, signifi cant relationships were found between "progression of dementia" and a care-related factor, "support for going out"; between a resident-related factor, "progression of abnormal behavior," and a medical factor, "hospital visit assistance"; and between care-related factors of "support of hobby activities" and "support for going out." This analysis was performed based on data from a survey of GH managers. We conclude that it is important for GH managers and medical staff to understand each other and work together to strengthen the link between treatment and care of GH residents.

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Intensive rehabilitation for dementia improved cognitive function and reduced behavioral disturbance in geriatric health service facilities in Japan

Cited by 37 publications

References 30 publications

Effectiveness and Cost-Effectiveness of Occupation-Based Occupational Therapy Using the Aid for Decision Making in Occupation Choice (ADOC) for Older Residents: Pilot Cluster Randomized Controlled Trial

Effectiveness and Cost-Effectiveness of Occupation-Based Occupational Therapy Using the Aid for Decision Making in Occupation Choice (ADOC) for Older Residents: Pilot Cluster Randomized Controlled Trial

Life-space and Related Factors for the Elderly in a Geriatric Health Service Facility

Health Conditions, Treatment, and Care of Residents With Dementia in Group Living–Based Care Facilities (Group Homes): Perspectives of Group Home Managers, Japan

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