scholarly journals Effectiveness of the Care of Persons With Dementia in Their Environments Intervention When Embedded in a Publicly Funded Home- and Community-Based Service Program

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Richard H Fortinsky ◽  
Laura N Gitlin ◽  
Laura T Pizzi ◽  
Catherine Verrier Piersol ◽  
James Grady ◽  
...  
Keyword(s):  
Psychological Symptoms ◽  
Pragmatic Trial ◽  
Well Being ◽  
Functional Independence ◽  
Evidence Based ◽  
Publicly Funded ◽  
Long Term Effects ◽  
Community Based ◽  
Activity Engagement ◽  
Behavioral And Psychological Symptoms

Abstract Background and Objectives In the absence of effective pharmacotherapy, there is an urgent need to test evidence-based dementia care interventions using pragmatic trial approaches. We present results from a study in which an evidence-based, nonpharmacologic intervention for persons living with Alzheimer’s disease and related dementia (ADRD) and their informal caregivers, Care of Persons with Dementia in their Environments (COPE), was tested in a Medicaid and state revenue-funded home and community-based service (HCBS) program. Research Design and Methods Using pragmatic trial design strategies, persons living with ADRD and their caregivers were randomly assigned as dyads to receive COPE plus usual HCBS (COPE; n = 145 dyads) or usual HCBS only (Usual Care or UC; n = 146 dyads). Outcomes were measured prerandomization, and 4 and 12 months postrandomization. Outcomes for persons living with ADRD included functional independence, activity engagement, self-reported quality of life, and behavioral and psychological symptoms. Caregiver outcomes included perceived well-being, confidence using dementia management strategies, and degree of distress caused by behavioral and psychological symptoms. Results After 4 months, caregivers receiving COPE reported greater perceived well-being (least squares mean = 3.2; 95% CI: 3.1–3.3) than caregivers receiving UC (3.0; 2.9–3.0; p < .001), and persons living with ADRD receiving COPE, compared to those receiving UC, showed a strong trend toward experiencing less frequent and less severe behavioral and psychological symptoms (9.7; 5.2–14.2 vs 12.7; 8.3–17.1; p = .07). After 12 months, persons living with ADRD receiving COPE were more engaged in meaningful activities (2.1; 2.0–2.1 vs 1.9; 1.9–2.0; p = .02) than those receiving UC. Discussion and Implications Embedding COPE in a publicly funded HCBS program yielded positive immediate effects on caregivers’ well-being, marginal positive immediate effects on behavioral and psychological symptoms, and long-term effects on meaningful activity engagement among persons living with ADRD. Findings suggest that COPE can be effectively integrated into this service system, an important step towards widespread adoption. Clinical Trials Registration Number NCT02365051.

Experiences of Family Caregivers of People with Dementia during the COVID-19 Pandemic

2021 ◽  
pp. 019394592110557
Author(s):  
Melissa L. Harris ◽  
Marita G. Titler
Keyword(s):  
Family Caregivers ◽  
Psychological Symptoms ◽  
Behavioral Responses ◽  
Well Being ◽  
Comparative Methods ◽  
People With Dementia ◽  
Effective Care ◽  
Exploratory Approach ◽  
Person With Dementia ◽  
Behavioral And Psychological Symptoms

Although behavioral and psychological symptoms are burdensome for people with dementia and their caregivers, perceptions of family caregivers regarding management of these symptoms are unclear. This study explored the experiences of family caregivers regarding behavioral and psychological symptoms experienced by relatives with dementia, management of these symptoms, and changes in their experiences during the COVID-19 pandemic. A qualitative, exploratory approach using constant comparative methods was used; 21 family caregivers were interviewed virtually. The following 10 major themes emerged: (1) Emotional and psychological experiences of caregiver, (2) emotional, psychological, and behavioral responses of person with dementia, (3) cognition of person with dementia, (4) loss, (5) concerns for the future, (6) reliance, (7) learning to caregive, (8) rewarding aspects of caregiving, (9) caregiver perspectives, and (10) care strategies. Caregivers described many challenges to care before and during the pandemic. Acceptable and effective care strategies are needed to promote the well-being of families living with dementia.

scholarly journals “I’ve learned to just go with the flow”: Family caregivers’ strategies for managing behavioral and psychological symptoms of dementia

Dementia ◽  
2018 ◽  
Vol 19 (3) ◽  
pp. 590-605 ◽  
Author(s):  
Courtney A Polenick ◽  
Laura M Struble ◽  
Barbara Stanislawski ◽  
Molly Turnwald ◽  
Brianna Broderick ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Psychological Symptoms ◽  
Clinical Care ◽  
Well Being ◽  
Dementia Caregivers ◽  
Targeted Interventions ◽  
Care Partners ◽  
Group Data ◽  
Focus Group Data ◽  
Behavioral And Psychological Symptoms

Background and objectives Behavioral and psychological symptoms of dementia are highly prevalent, stressful, and challenging to manage. Caregivers’ approaches for handling these behaviors have implications for both care partners’ well-being. Yet the specific strategies that caregivers use in their daily management of behavioral and psychological symptoms of dementia are relatively unknown. This study used in-depth focus group data to examine family caregivers’ strategies for managing behavioral and psychological symptoms of dementia. Design As part of a larger study (NINR R01NR014200), four focus groups were conducted with a total of 26 family caregivers of older adults with dementia. Caregivers were asked to describe the strategies they use to manage behavioral and psychological symptoms of dementia. Data from audio-recorded sessions were transcribed, coded to identify relevant concepts, and reduced to determine major categories. Results Caregivers managed behavioral and psychological symptoms of dementia through (1) modifying interactions within the care dyad (e.g., simplifying communication); (2) modifying the care environment (e.g., using written prompts); (3) activity engagement; (4) humor; (5) self-care; and (6) social support. Conclusion Family caregivers manage behavioral and psychological symptoms of dementia using strategies to minimize stress and address the needs of both care partners. Caregivers’ own accounts of these approaches reveal a window into their everyday management of difficult behaviors. The present findings generate key information for routine clinical care and targeted interventions to promote caregiver well-being.

Behavioral and psychological symptoms of dementia: prevalence, symptom groups and their correlates in community-based older adults with dementia in Singapore

2017 ◽  
Vol 29 (8) ◽  
pp. 1363-1376 ◽  
Author(s):  
Janhavi Ajit Vaingankar ◽  
Siow Ann Chong ◽  
Edimansyah Abdin ◽  
Louisa Picco ◽  
Anitha Jeyagurunathan ◽  
...  
Keyword(s):  
Older Adults ◽  
Formal Education ◽  
Psychological Symptoms ◽  
Factor Scores ◽  
Community Based ◽  
Never Married ◽  
Dementia Prevalence ◽  
Physical Conditions ◽  
And Behavior ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground:This study assessed the prevalence and factor structure of behavioral and psychological symptoms of dementia (BPSD) in a community-based sample of older adults with dementia and identified their correlates.Methods:Data collected from 399 Singapore residents with dementia aged 60 years and above, interviewed along with a family/friend during a national survey, were used for this analysis. Neuropsychiatric Inventory Questionnaire assessed older adults’ BPSD. Other data included socio-demographics, dementia severity, cognition, chronic physical conditions, disability, and caregivers’ burden. Exploratory factor analysis assessed BPSD sub-groups, factor scores of which were used to identify socio-demographic, and clinical correlates.Results:Prevalence of BPSD was 67.9% and 30% of the population had experienced three or more BPSD in the past month. Two distinct and moderately correlated symptom groups representing “psychosis and behavior dysregulation” and “mood disturbance and restlessness” were identified. As factor scores for both the groups increased with older age, poor cognition and caregiver burden, the former was also related to being never married and having no formal education.Conclusions:Study provides evidence of two distinct groups of BPSD and their important correlates. Clinicians treating BPSD should consider their age and cognitive impairment and be cognizant of their caregivers’ burden.

scholarly journals Tele-Savvy: An Online Program for Dementia Caregivers

2018 ◽  
Vol 33 (5) ◽  
pp. 269-276 ◽  
Author(s):  
Patricia C. Griffiths ◽  
Mariya Kovaleva ◽  
Melinda Higgins ◽  
Ashley H. Langston ◽  
Kenneth Hepburn
Keyword(s):  
Psychological Symptoms ◽  
Well Being ◽  
Advanced Dementia ◽  
Online Program ◽  
Dementia Caregivers ◽  
Convenience Sample ◽  
Program Evaluations ◽  
Care Recipients ◽  
Person With Dementia ◽  
Behavioral And Psychological Symptoms

Introduction: This study examined the feasibility and efficacy of Tele-Savvy, an online version of the Savvy Caregiver Program, a psychoeducation program for caregivers caring for a person with dementia. Methods: A convenience sample of 22 caregivers from the Atlanta VA and 42 caregivers from 14 different states enrolled in Tele-Savvy. Pre- and post-program evaluations assessed caregiver burden, caregiver competency, and frequency of behavioral and psychological symptoms of dementia (BPSD). Results: Fifty-seven caregivers completed the 6-week Tele-Savvy program. Caregivers whose care recipients exhibited higher average BPSD frequency at baseline demonstrated significantly greater burden decreases post-program. Caregivers of care recipients in more advanced dementia stages demonstrated a significantly greater improvement in caregiver competence. Discussion: The results point to the feasibility of achieving significant results in caregivers’ well-being and care recipients’ BPSD with a fully online program. Tele-Savvy may be particularly efficacious for caregivers whose care recipients exhibit higher BPSD frequency and are in later dementia stages.

scholarly journals Pharmacologic management of behavioral and psychological symptoms of major neurocognitive disorder

2018 ◽  
Vol 8 (6) ◽  
pp. 284-293 ◽  
Author(s):  
Monica Mathys
Keyword(s):  
Psychological Symptoms ◽  
Psychotropic Medications ◽  
Evidence Based ◽  
Neurocognitive Disorder ◽  
Medication Regimen ◽  
First Line ◽  
Risks And Benefits ◽  
Pharmacologic Management ◽  
Behavioral And Psychological Symptoms ◽  
First Line Treatment

Abstract Behavioral and psychological symptoms of dementia (BPSD) occur in approximately 80% of patients who receive a diagnosis of major neurocognitive disorder. Nonpharmacologic strategies are the first-line treatment for BPSD. However, psychotropic medications are often necessary when nonpharmacologic methods are not effective in treating symptoms that are distressing or are causing behaviors that are dangerous to the patient or the patient's caregivers. The article provides a review of evidence-based recommendations for the use of antipsychotics, cognitive enhancers, and serotonin reuptake inhibitors for the treatment of BPSD. Different pharmacologic approaches are demonstrated through 2 patient cases in which nonpharmacologic management was not effective. The severity of BPSD must be weighed against the risks and benefits of pharmacologic intervention in order to implement an optimal medication regimen.

Managing behavioral and psychological symptoms in Chinese elderly with dementia via group-based music intervention: A cluster randomized controlled trial

Dementia ◽  
2018 ◽  
Vol 18 (7-8) ◽  
pp. 2785-2798 ◽  
Author(s):  
Rainbow TH Ho ◽  
Ted CT Fong ◽  
CY Sing ◽  
Pandora HT Lee ◽  
Alice BK Leung ◽  
...  
Keyword(s):  
Psychological Symptoms ◽  
Well Being ◽  
Pharmacological Intervention ◽  
Control Group ◽  
Music Intervention ◽  
Intervention Effects ◽  
Chinese Elderly ◽  
Cluster Randomized ◽  
And Control ◽  
Behavioral And Psychological Symptoms

The present study aimed to evaluate the effects of a group music intervention in managing behavioral and psychological symptoms in Chinese elderly with dementia. This cluster randomized trial recruited 73 elderly participants with moderate dementia from 10 elderly residential homes and assigned them to the intervention ( n = 40) and control ( n = 33) group. The intervention included 16 half-hour sessions of music intervention with multi-sensory components over eight weeks and control group received standard care. Participants’ levels of subjective moods and neuropsychiatric symptoms such as agitation, aberrant motor behaviors, dysphoria, and irritability were assessed at baseline, the 2nd, 4th, 6th, and the end of the intervention. Controlling for baseline outcomes, latent growth modeling revealed significant intervention effects for agitation ( B = −1.03, SE = 0.30, p < 0.01), aberrant motor behavior ( B = −1.80, SE = 0.66, p < 0.01), and dysphoria ( B = −0.79, SE = 0.36, p < 0.05), with the intervention group showing improvements compared to no substantial changes in the control group. There were no significant intervention effects on irritability or subjective mood ( p > 0.05). The music intervention showed significant reduction in the behavioral and psychological symptoms in Chinese elderly patients with dementia. Elderly homes could adopt this practical non-pharmacological intervention as a strategy to improve the well-being of the elderly.

A pragmatic trial testing a tailored non pharmacologic therapies on nocturnal behavioral and psychological symptoms associated with dementia

2022 ◽  
Vol 43 ◽  
pp. 85-90
Author(s):  
Thierry Bautrant ◽  
Caroline Franqui ◽  
Hossein Clément ◽  
Maurice Rabault ◽  
Faima Masseboeuf ◽  
...  
Keyword(s):  
Psychological Symptoms ◽  
Pragmatic Trial ◽  
Trial Testing ◽  
Behavioral And Psychological Symptoms ◽  
Pharmacologic Therapies
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