Psychosocial behaviour management programme for home‐dwelling people with dementia: A cluster‐randomized controlled trial

Nakanishi, Miharu; Endo, Kaori; Hirooka, Kayo; Granvik, Eva; Minthon, Lennart; Nägga, Katarina; Nishida, Atsushi

doi:10.1002/gps.4784

Cited by 26 publications

(46 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One aspect regarded as crucial to warranty the effectiveness of psychosocial interventions is the provision of tailored activities, particularly for home-dwelling PwD ( 9 , 46 ). As the caregiver group usually varies from adolescents (including “adult children”), adults, spouses to professional care providers, individualized dyadic interventions shall be designed in any dyadic compositions to reduce the caregiver social strain ( 47 ) and improve PwD functional ability ( 47 ).…”

Section: Resultsmentioning

confidence: 99%

“…A number of them have been delivered to support caregivers ( 60 ). The types of intervention vary widely, as does the quality of the methods used ( 46 ). Person-centered care approaches designed to home settings have been performed using observational tools and practice development cycles, such as the Dementia Care Mapping™ (DCM™) ( 61 ).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

A Systematic Review of Home-Setting Psychoeducation Interventions for Behavioral Changes in Dementia: Some Lessons for the COVID-19 Pandemic and Post-Pandemic Assistance

et al. 2020

View full text Add to dashboard Cite

Background Impacts of social isolation measures imposed by COVID-19 Pandemic on mental health and quality of life of older adults living with dementia and their caregivers remain unexplored. Studies have shown that psychoeducational and psychosocial interventions can manage behavioral and psychological symptoms in dementia (BPSD) and reduce the emotional burden on family members when applied in home-setting scenarios. Method a comprehensive systematic review of useful interventions for easing the BPSD burden in patients with dementia (PwD) and their caregivers in the context of COVID-19 quarantine was performed from January 2010 to March 2020. Results From a total of 187 articles retrieved from electronic databases (MEDLINE, LILACS, Cochrane and SCOPUS), 43 studies were eligible for this review. Most of the psychosocial and psychoeducational interventions described were person-centered strategies based on the cognitive-behavioral approach or informational tools to enhance care providers’ knowledge of dementia. Most studies achieved successful results in handling BPSD and mood-anxiety symptoms of care providers, contributing to an overall improvement in dyad life quality. Conclusion Evidence from the last few years suggest that low-cost techniques, tailored to the dyad well-being, with increasing use of technology through friendly online platforms and application robots, can be an alternative to conventional assistance during COVID-19 Pandemic. Nevertheless, the world’s current experience regarding the duration of the COVID-19 Pandemic and its effects on the cognition, behavior, and life quality of PwD will demand research on preventive and protective factors of dementia and the pursue of efficient interventions in different scenarios.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Home-Setting Psychoeducation Interventions for Behavioral Changes in Dementia: Some Lessons for the COVID-19 Pandemic and Post-Pandemic Assistance

et al. 2020

View full text Add to dashboard Cite

show abstract

“…This line of research emphasizes the need for programs or interventions (e.g., formal assistance programs) to be developed to support caregiving responsibilities and ultimately reduce burden and improve outcomes among patients and caregivers alike. For example, there is a cluster-randomized study that assessed psychosocial behavior management programme for home-dwelling people living with dementia [ 58 ]. This programme reduced challenging behaviors, which were evaluated by the Neuropsychiatric Inventory.…”

Section: Discussionmentioning

confidence: 99%

Alzheimer’s disease severity and its association with patient and caregiver quality of life in Japan: results of a community-based survey

Montgomery¹,

Goren

Kahle-Wrobleski

et al. 2018

BMC Geriatr

View full text Add to dashboard Cite

BackgroundAlzheimer’s disease (AD) dementia, a progressive neurodegenerative disease, exerts significant burden upon patients, caregivers, and healthcare systems globally. The current study investigated the associations between AD dementia patient disease severity and health-related quality of life (HRQoL) of both patients (proxy report) and their caregivers living in Japan, as well as caregiving-related comorbidities such as depression.MethodsThis cross-sectional study used self-reported data from caregivers of people diagnosed with AD dementia by a healthcare provider in Japan. Caregivers were identified via online panels and invited to participate in an online survey between 2014 and 2015. Caregivers completed survey items for themselves, in addition to providing proxy measures for patients with AD dementia for whom they were caring. Patient and caregiver HRQoL was measured using the EuroQoL 5-Dimension (EQ-5D). Additional outcomes for caregivers of AD dementia patients included the Patient Health Questionnaire (PHQ-9) of depressive symptomology, as well as comorbidities experienced since initiating caregiving for their AD dementia patients. These outcomes were examined as a function of AD dementia severity, as measured by long-term care insurance (LTCI) categories. Bivariate analyses between LTCI and outcomes were conducted using independent t-tests and chi-square tests. Multivariable analyses, controlling for potential confounders, were conducted using generalized linear models (GLMs) specifying a normal distribution.ResultsAcross 300 caregiver respondents, multivariable results revealed that increasing AD dementia severity was significantly associated with poorer patient and caregiver EQ-5D scores and a high proportion of caregivers (30.0%) reported PHQ-9 scores indicative of major depressive disorder (MDD). The most frequent comorbidities experienced after becoming caregivers of AD dementia patients included hypertension (12.7%) and insomnia (11.0%). Depression and other comorbidities did not differ significantly by patient severity.ConclusionsThe current study provides unique insight into the specific degree of incremental burden associated with increasing AD dementia severity among patients and caregivers alike. Importantly, greater disease severity was associated with poorer quality of life among both patients and caregivers. These results suggest that earlier detection and treatment of AD dementia may provide an opportunity to reduce the burden of disease for patients, caregivers, and society at large.

show abstract

“…The Japanese adaptation of the BPSD-registry, called DEMBASE ® , has been developed with a focus on care managers of in-home service users with dementia. The results of a cluster-randomized controlled trial indicated a reduction in neuropsychiatric symptoms upon application of the adapted program [25], with a medium observed effect size (Cohen's d ppc = 0.52). Based on the results, the program was implemented for routine dementia care in the Tokyo metropolitan area in April 2018.…”

Section: Introductionmentioning

confidence: 98%

“…The BPSD-registry is based on an interdisciplinary team approach, and was primarily established for use in nursing homes. Adapted forms of the program have been developed in Denmark [23], the Netherlands [24], and Japan [25].…”

Section: Introductionmentioning

confidence: 99%

Time Investment for Program Implementation to Manage Neuropsychiatric Symptoms: An Observational Longitudinal Study in In-Home and Residential Care Settings

Nakanishi

Niimura

Ziylan

et al. 2020

ADR

Self Cite

View full text Add to dashboard Cite

Background: There are no studies on how the same psychosocial dementia care program is adapted to both in-home and residential care settings. Objective: To evaluate the time investment required by professionals to implement a psychosocial dementia care program to manage neuropsychiatric symptoms. Methods: A prospective observational study design was used. The program consisted of 1) a one-day training course, 2) three interdisciplinary discussion meetings in five months, and 3) a web-based tool for the continued assessment of neuropsychiatric symptoms. Care professionals implemented the intervention in in-home (19 in-home care management agencies and 14 multiple in-home service providers) and residential care settings (19 group homes and eight nursing homes) in Japan from October 2019 to February 2020. The level of neuropsychiatric symptoms for the participants was evaluated using the Neuropsychiatric Inventory (NPI: 0–144). The time investment was reported by participating professionals. A total of 125 persons with dementia were included at baseline. Results: Neuropsychiatric symptoms were significantly decreased at the final follow-up in all types of providers (Cohen’s drm = 0.44–0.61). The mean (SD) time required for the five-month implementation was 417.9 (219.8) minutes. There was a mean (SD) decrease of 8.6 (14.0) points in the total NPI score among the 103 persons with completed interventions. The time investment was significantly lower in in-home care management agencies than in group homes, and lower in follow-ups than at baseline assessment. Conclusion: The program implementation may incur a substantial time investment regardless of setting. An additional benefit scheme to reward the time investment would be helpful to encourage implementation until the follow-ups.

show abstract

Psychosocial behaviour management programme for home‐dwelling people with dementia: A cluster‐randomized controlled trial

Cited by 26 publications

References 45 publications

A Systematic Review of Home-Setting Psychoeducation Interventions for Behavioral Changes in Dementia: Some Lessons for the COVID-19 Pandemic and Post-Pandemic Assistance

A Systematic Review of Home-Setting Psychoeducation Interventions for Behavioral Changes in Dementia: Some Lessons for the COVID-19 Pandemic and Post-Pandemic Assistance

Alzheimer’s disease severity and its association with patient and caregiver quality of life in Japan: results of a community-based survey

Time Investment for Program Implementation to Manage Neuropsychiatric Symptoms: An Observational Longitudinal Study in In-Home and Residential Care Settings

Contact Info

Product

Resources

About