The effectiveness of interventions to improve the care and management of people with dementia in general hospitals: A systematic review

Abstract

Background People with dementia are at greater risk of being admitted to hospital where care may not be tailored to their needs. Interventions improving care and management are vital. Aim Assess the effectiveness of interventions designed to improve the care and management of people with dementia in hospital. Method Six medical and trial registry, and grey literature databases were searched (1999‐1998/2018). Search terms included “Dementia,” “Hospital,” and “Intervention” and limited to experimental designs. Interventions designed to improve the care and management of people with dementia in the general hospital setting were examined. Outcomes included behavioural and psychological symptoms of dementia (BPSD), psychosocial, clinical, staff knowledge, and length of hospital stay. The CASP tools, Cochrane risk of bias tool, and GRADE system assessed methodological quality and certainty of evidence. Results 9003 unique citations were identified; 24 studies were included. Studies were limited in study design and their conduct was at a risk of bias. There is very low‐quality evidence that multisensory behaviour therapy reduces BPSD. There is low‐quality evidence that a multidisciplinary programme reduces postoperative complications and that robot‐assisted therapy, music therapy, multimodal‐comprehensive care, person‐centred care, and family‐centred function‐focused care interventions improved staff knowledge, competence, efficacy, and communication. No studies reported reduced length of stay. Conclusions Whilst we found that these interventions improved the care and management of people with dementia in hospital, it was low‐ to very low‐quality evidence. New clinical recommendations cannot be made based on current evidence, and robust trial designs are necessary to inform evidence‐based care.

Efeitos da música na comunicação do idoso: panorama das pesquisas brasileiras

“…O presente estudo revisou temas consideráveis para a fonoaudiologia nos aspectos terapêuticos evolutivos da música no âmbito da melhora na comunicação, fala espontânea, linguagem, cognição e prosódia [2][3][4][5] . A tríade fonoaudiologia/ música/ neurociência, fundamenta uma importante abordagem de estimulação nos casos de pacientes acometidos por doenças neurodegenerativas, ou simplesmente para a população adulta e idosa, considerando o processo progressivo da senescência natural.…”

“…A compreensão sobre a influência da música para o espelhamento neuronal ativo, englobando a comunicação [4][5][6] , é de suma importância para agregar técnicas e estratégias para a terapia fonoaudiológica.…”

“…Estudos da neurociência demostram os efeitos da música no cérebro humano. A música possibilita intervenção dinâmica, favorecendo a saúde no idoso, estimulando melodias entonadas, ritmos variados, escalas musicais, afim de proporcionar o equilíbrio da circulação sanguínea, os batimentos cardíacos, harmonizando os efeitos fisiológicos nos cuidados paliativos 4,5 .…”

Robot Therapy Program for Patients with Dementia: Its Framework and Effectiveness

“…Meanwhile, several studies have suggested that the robots used in robot therapy can improve the cognitive level and reduce the Behavioral and Psychological Symptoms of Dementia (BPSD) in patients [10,11]. However, none of the studies have tested the robots on a large sample, meaning that their findings have limited generalizability [12]. Yokoyama reported the caregiver must play an intermediary role during robot therapy for older people with dementia [13].…”

A systematic review of interventions to improve acute hospital care for people with dementia

“…on educational and training interventions 15 or on special care units for patients with dementia. 16 The systematic review by Feast et al 17 describes the effectiveness of different interventions. However, it is restricted with regard to reported outcomes.…”