Quality of Life and Quality of Care for People With Dementia Receiving Long Term Institutional Care or Professional Home Care: The European RightTimePlaceCare Study

Beerens, Hanneke C.; Sutcliffe, Caroline; Renom‐Guiteras, Anna; Soto, María; Suhonen, Riitta; Zabalegui, Adela; Bökberg, Christina; Saks, Kai; Hamers, Jan P.H.

doi:10.1016/j.jamda.2013.09.010

Cited by 142 publications

(151 citation statements)

References 38 publications

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“…Considering that dementia has no cure, it is imperative to maintain or enhance the quality of life (QoL) for persons with dementia. However, determining what constitutes QoL from the perspective of a person with dementia is challenging, especially in the later stages of this disease [5, 6]. According to Lawton [7], in persons with dementia, QoL includes the ability to perform activities of daily living (ADL), engaging in social behaviour, balanced positive emotions, and an absence of negative emotions.…”

Section: Introductionmentioning

confidence: 99%

Associations between Pain and Quality of Life in Severe Dementia: A Norwegian Cross-Sectional Study

Rostad

Puts

Småstuen

et al. 2017

Dement Geriatr Cogn Disord Extra

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Background/Aims: Many variables influence the quality of life in older adults with dementia. We aim to quantify how the relationship between pain and quality of life in nursing home residents with severe dementia can be explained by neuropsychiatric symptoms, depressive symptoms, and activities of daily living. Methods: This article presents cross-sectional baseline data from a cluster randomised controlled trial. Results: The total and direct effects of pain on quality of life were statistically significant. Both neuropsychiatric and depressive symptoms partially mediated the relationship between pain and quality of life. Activities of daily living acted as a mediator only when modelled together with depressive symptoms. Conclusion: Pain, neuropsychiatric symptoms, and depressive symptoms appear to be important factors that influence the quality of life for nursing home residents with severe dementia. Therefore, multidimensional interventions may be beneficial for maintaining or improving quality of life in this population.

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Section: Introductionmentioning

confidence: 99%

Associations between Pain and Quality of Life in Severe Dementia: A Norwegian Cross-Sectional Study

Rostad

Puts

Småstuen

et al. 2017

Dement Geriatr Cogn Disord Extra

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“…Information regarding the use of physical restraints in Spanish long-term care centers is scarce [16, 17]. This is a moderately aged country with 18.2% of the population 65 years and older.…”

Section: Introductionmentioning

confidence: 99%

The use of physical restraints in long-term care in Spain: a multi-center cross-sectional study

et al. 2017

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BackgroundPhysical restraint is a procedure used frequently in long-term care. It is a controversial practice because its use is associated with numerous complications and also affects freedom and individual autonomy. The objective of this study was to examine the use of physical restraint of long-term care residents with the ability to move voluntarily.MethodsWe conducted a cross-sectional observational and correlational multi-center study. Nine centers agreed to participate. Of the 1,200 people present at the time of data collection, those without voluntary movement or in the facility for less than a month were excluded. Thus, the final sample was 920 residents. Data on the use of restraints was collected by direct observation. Information about the age, gender, length of stay, falls, mobility, cognition and functional status of residents was gathered by reviewing clinical records and interviewing nursing staff. A descriptive analysis of the data obtained was conducted. The generalized linear model was used, considering only the principal effects of each variable and using the logit link function. The model has been adjusted for clusters and for other possibly confounding factors. For all analyses, a confidence interval (CI) of 95% was estimated.ResultsThe prevalence of residents with at least one physical restraint was 84.9% (95% CI: 81.7–88.1), with variability between centers of 70.3 to 96.6% (p-value Kruskal Wallis test <0.001). Full-enclosure side rails were most often used (84.5; 95% CI: 81.1–87.9), but other types of restraints were also used frequently. Multivariate analysis showed that the degree of functional impairment increased the probability of the use of restraint. A significant association was also found between restraint use and the impaired cognitive status of residents.ConclusionsThe prevalence was higher than in studies from other countries. The results emphasize the need to improve the training of nursing staff in the care of residents with impairments in functional and cognitive status. The use of alternative devices and nurse consultants need to be evaluated, and the introduction of specific laws considered.

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“…Because there is no cure for dementia, care, research and management in long-term care facilities (LTCFs) are primarily focused on improving or maintaining quality of life (QOL) in these vulnerable persons [3,4]. In the general population, QOL is often defined as ‘individuals' perception of their position in life in the context of the culture and the value systems in which they live and in relation to their goals, expectations, standards and concerns [5].…”

Section: Introductionmentioning

confidence: 99%

“…However, no consistent association has been found between socio-demographic factors (age, gender, race, marital status) and QOL in persons with dementia [10,11,12,13]. On the other hand, psychosocial factors such as sadness [14], depression [4,10,15,16] and agitation [10,16,17] have a negative association with QOL, whereas functional characteristics (e.g. ADL impairment and dementia severity) show inconclusive evidence for associations with QOL [10,12,18,19,20].…”

Section: Introductionmentioning

confidence: 99%

Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study

Klapwijk

Caljouw

Pieper

et al. 2016

Dement Geriatr Cogn Disord

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Background: To determine which characteristics are associated with quality of life (QOL) in residents with moderate to very severe dementia in long-term care facilities (LTCFs). Material and Methods: This was a cross-sectional analysis of a cluster randomized controlled study in 12 Dutch LTCFs that enrolled 288 residents, with moderate to severe dementia assessed with the Reisberg Global Deterioration Scale (Reisberg GDS) and QOL with the QUALIDEM. Characteristics that were hypothesized to be associated with the six domains of QOL (applicable to very severe dementia) included demographic variables, activities of daily living (Katz ADL), cognitive performance (Cognitive Performance Scale; CPS), pain (Pain Assessment Checklist for Seniors with Limited Ability to Communicate; PACSLAC-D), neuropsychiatric symptoms (Neuropsychiatric Inventory-Nursing Home Version; NPI-NH) and comorbidities. Results: Multivariate logistic regression modelling showed associations with age in the domain Social isolation [odds ratio, OR, 0.95 (95% confidence interval, CI, 0.91-0.99)], ADL level in the domain Positive affect [OR 0.89 (95% CI 0.83-0.95)] and the domain Social relations [OR 0.87 (95% CI 0.81-0.93)], severity of dementia in the domain Social relations [OR 0.28 (95% CI 0.12-0.62)] and in the domain Social isolation [OR 2.10 (95% CI 1.17-3.78)], psychiatric disorders in the domain Positive affect [OR 0.39 (95% CI 0.17-0.87)] and pulmonary diseases in the domain Negative affect [OR 0.14 (95% CI 0.03-0.61)] of the QUALIDEM. Neuropsychiatric symptoms were independently associated with all six domains of the QUALIDEM [OR 0.93 (95% CI 0.90-0.96) to OR 0.97 (95% CI 0.95-0.99)]. Pain was associated with the domains Care relationship [OR 0.92 (95% CI 0.84-1.00)] and Negative affect [OR 0.92 (95% CI 0.85-1.00)]. Conclusion: QOL in dementia is independently associated with age, ADL, dementia severity, pain, psychiatric disorders, pulmonary diseases and neuropsychiatric symptoms. It is possible to detect persons with dementia at risk for a lower QOL. This information is important for developing personalized interventions to improve QOL in persons with dementia in LTCFs.

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Quality of Life and Quality of Care for People With Dementia Receiving Long Term Institutional Care or Professional Home Care: The European RightTimePlaceCare Study

Cited by 142 publications

References 38 publications

Associations between Pain and Quality of Life in Severe Dementia: A Norwegian Cross-Sectional Study

Associations between Pain and Quality of Life in Severe Dementia: A Norwegian Cross-Sectional Study

The use of physical restraints in long-term care in Spain: a multi-center cross-sectional study

Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study

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