Reactions of Assisted Living Staff to Behavioral and Psychological Symptoms of Dementia

McKenzie, Glenise; Teri, Linda; Pike, Kenneth C.; LaFazia, David; Leynseele, June van

doi:10.1016/j.gerinurse.2011.12.004

Cited by 16 publications

(16 citation statements)

References 33 publications

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“…Persons living with dementia can have complex physical health concerns, comorbid medical conditions, and exhibit behavioral and psychological symptoms of dementia (BPSD) [4-11]. In fact, professional caregivers of persons living with dementia already note that responding to BPSD is one of the greatest care challenges and can negatively affect the health of caregivers [12-14] especially in long-term health care facilities, where two-thirds of residents have dementia [9,13,15,16]. Family caregivers of persons living with dementia are also are at risk for higher rates of depression, health and sleep issues, social isolation, and mortality [14,17].…”

Section: Introductionmentioning

confidence: 99%

Using Computer Tablets to Improve Moods for Older Adults With Dementia and Interactions With Their Caregivers: Pilot Intervention Study

Gilson¹,

Dodds²,

Kaur³

et al. 2019

JMIR Form Res

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Background Persons living with dementia represent a significant and growing segment of the older adult (aged 65 years and older) population. They are often challenged expressively and may experience difficulties with sharing their feelings or moods. Availability of, and easy access to, tablets facilitates the use of information and communication technologies (ICTs) as a delivery mechanism for nonpharmacological interventions, especially for persons living with dementia. Evidence of the impact of ICTs in different community settings on mood with older adults and the impact of engagement on their caregivers is needed to promote broader adoption and sustainment of these technologies in the United States. Objective This study aimed to determine the extent of the effects of tablets on positive mood change and examine the effects of study variables on care recipients’ mood changes and caregivers’ daily interactions. Methods The tablet intervention was developed and evaluated in five programs. The primary outcome was caregivers’ assessment of care recipients’ mood (n=1089) before and after a tablet engagement session using an eight-point mood visual analog scale. Session influence on caregivers’ daily activities was captured for a subsample of participants (n=542). Frequency distributions were computed for each study variables. Chi-square tests of association were calculated to determine the association of the variables on mood changes for all care recipients, as well as those being treated in skilled nursing facilities and in-home, and then for those that affected caregivers’ daily activities. Results The study sample comprised 1089 care recipient and caregiver engagement sessions. Cumulatively, 50.78% (553/1089) of care recipients showed a transition from negative to positive moods, whereas another 41.78% (455/1089) maintained an already-positive mood after the caregiver engagement session. Chi-square analyses demonstrated that positive mood changes resulted from using music (χ210=72.9; P<.001), using YouTube as the sole app (χ212=64.5; P<.001), using multiple engagement strategies (χ22=42.8; P<.001), and when cared for in a skilled nursing facility (χ24=236.8; P<.001) across the entire care recipient sample. In addition, although many features of the engagement session positively influenced the caregivers’ day, the largest effect was observed when care recipients’ mood was considered to have improved following the session (χ24=234.7; P<.001). Conclusions The study is one of the first in the United States to explore the impact of ICTs, in particular managed tablets and Web-based video services that can be used on a tablet through an app, on improving mood in persons living with dementia, and enhancing caregivers’ perceptions about their care recipient interactions. Importantly, these pilot data substantiate ICTs as part of a personalized engagement approach, as beneficial alternatives to pharmaceutical interventions for mood enhancement. However, a more comprehensive study that explores the ICT’s impact on additional clinical outcomes is needed to confirm these preliminary findings.

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Section: Introductionmentioning

confidence: 99%

Using Computer Tablets to Improve Moods for Older Adults With Dementia and Interactions With Their Caregivers: Pilot Intervention Study

Gilson¹,

Dodds²,

Kaur³

et al. 2019

JMIR Form Res

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“…This dramatic rise will place a major burden on long-term care facilities such as nursing homes (NHs) and assisted living communities (ALCs). Studies suggest that between 42% and 67% of residents living in ALCs have some form of moderate-to-severe cognitive impairment [5-7]. The state of Wisconsin is experiencing similar trends.…”

Section: Introductionmentioning

confidence: 99%

“…Aggression, agitation, anxiety, or sundown syndrome are examples of behavioral and psychological symptoms of dementia (BPSD). These symptoms are frequently exhibited by individuals with moderate-to-severe dementia [5,9-12], can disrupt residents’ care, and negatively impact staff and residents’ quality of life (QOL). Although medications can control the physical aspects of BPSD, the medications may impact residents’ health, diminish a resident’s ability to participate in life events, and accelerate the disease [13-15].…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Impact of Music & Memory’s Personalized Music and Tablet Engagement Program in Wisconsin Assisted Living Communities: Pilot Study

Ford¹,

Dodds²,

Hyland³

et al. 2019

JMIR Aging

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Background Individuals with Alzheimer disease or related dementia represent a significant and growing segment of the older adult (aged 65 years and above) population. In addition to physical health concerns, including comorbid medical conditions, these individuals often exhibit behavioral and psychological symptoms of dementia (BPSD). The presence of BPSD in long-term care residential facilities can disrupt resident’s care and impact staff. Nonpharmacological interventions such as personalized music and tablet engagement maintain cognitive function, improve quality of life (QOL), and mitigate BPSD for older adults with dementia. Evidence of the impact of such interventions in assisted living communities (ALCs) is needed for widespread adoption and sustainment of these technologies. Objective The aim of this study was to assess the impact of Music & Memory’s personalized music and tablet engagement (PMATE) program on QOL, agitation, and medication use for residents living in 6 Wisconsin ALCs. Methods The data collected were on the utilization of iPods and iPads by the residents. Residents’ outcomes were assessed using the Pittsburgh Agitation Scale, the Quality of Life in Late Stage Dementia scale, and self-reported medication use. A mixed-methods approach was utilized to examine the impact of the PMATE program on these outcomes. Descriptive statistics were calculated. A paired t test explored changes in residents’ QOL. A 1-way analysis of variance was utilized to examine changes in resident’s agitation and QOL based on the resident’s utilization of the PMATE program. Qualitative interviews were conducted with the individuals responsible for PMATE implementation in the ALC. Residents excluded from the analysis were those who passed away, were discharged, or refused to participate. Results A total of 5 apps, based on average times used by residents, were identified. In all, 4 of the 5 apps were rated as being useful to promote residents’ engagement. PMATE utilization was not associated with changes in the residents’ agitation levels or antipsychotic medication use over time. Over a 3-month period, the change in residents’ QOL was significant ( P =.047), and the differences across ALCs were also significant ( F 25 =3.76, P =.02). High utilizers of the PMATE program (>2500 min over 3 months) showed greater improvements in QOL as compared with low utilizers (a change of −5.90 points vs an increase of 0.43 points). The difference was significant ( P =.03). Similar significant findings were found between the high- and midutilizers. Conclusions The study is one of the first to explore the impact of Music & Memory’s PMATE program on residents living in ALCs. Findings suggest that higher utilization over time improves residents’ QOL. However, a ...

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“…Behavioral and psychological symptoms of dementia can adversely affect the quality of life and morbidity of people with dementia, can also contribute to carer burden, and can be the precipitant of transition to residential care . For formal carers, such as staff who work in residential care facilities, BPSD may be associated with burnout and job dissatisfaction . These behaviors are also manifest in people who have other psychiatric conditions such as schizophrenia, depression, and bipolar disorder.…”

Section: Introductionmentioning

confidence: 99%

“…6 For formal carers, such as staff who work in residential care facilities, BPSD may be associated with burnout and job dissatisfaction. 7 These behaviors are also manifest in people who have other psychiatric conditions such as schizophrenia, depression, and bipolar disorder.…”

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confidence: 99%

A pilot study investigating the feasibility of symptom assessment manager (SAM), a Web‐based real‐time tool for monitoring challenging behaviors

Loi

Wanasinghage

Goh

et al. 2017

Int J Geriat Psychiatry

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Reactions of Assisted Living Staff to Behavioral and Psychological Symptoms of Dementia

Cited by 16 publications

References 33 publications

Using Computer Tablets to Improve Moods for Older Adults With Dementia and Interactions With Their Caregivers: Pilot Intervention Study

Using Computer Tablets to Improve Moods for Older Adults With Dementia and Interactions With Their Caregivers: Pilot Intervention Study

Evaluating the Impact of Music & Memory’s Personalized Music and Tablet Engagement Program in Wisconsin Assisted Living Communities: Pilot Study

A pilot study investigating the feasibility of symptom assessment manager (SAM), a Web‐based real‐time tool for monitoring challenging behaviors

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