scholarly journals Hallucinations in a Patient with Alzheimer’s Disease During the COVID-19 Crisis: A Case Study

2020 ◽  
Vol 4 (1) ◽  
pp. 455-458
Author(s):  
Mohamad El Haj ◽  
Frank Larøi ◽  
Karim Gallouj
Keyword(s):  
Mental Health ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Family Members ◽  
Physical Contact ◽  
Daily Activities ◽  
Social Distancing

While social distancing may be deemed necessary in order to avoid COVID-19 infections, the lockdown may impact mental health of patients with Alzheimer’s disease (AD). We present a case study involving hallucinations in a patient with AD who lives in a nursing home during the COVID-19 crisis. We compared this patient’s hallucination scores before and during the lockdown. We observed increased hallucinations during, compared to before, the lockdown. These increased hallucinations can be attributed to a number of elements such as the decreased in daily activities, social distancing, lack of physical contact with family members, and loneliness during the lockdown.

Families, Alzheimer's Disease, and Nursing Homes

1988 ◽  
Vol 7 (3) ◽  
pp. 331-349 ◽  
Author(s):  
Nathan L. Linsk ◽  
Baila Miller ◽  
Roberta Pflaum ◽  
Anna Ortigara-Vicik
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Nursing Homes ◽  
Care Center ◽  
Family Members ◽  
Nursing Home Care ◽  
Demonstration Program ◽  
Home Setting

The Alzheimer's Disease Family Care Center program was established within an intermediate care teaching nursing home as a demonstration program to investigate ways to involve families in care of their relatives. In total, 45 family members participated in a program including an orientation session; a preliminary family involvement interview; contracts with family members, in which they chose specific tasks to engage in during visits; a five-session course on Alzheimer's disease and how families may be partners in care within the facility; and an ongoing family support group. Evaluation data sources include a baseline and 9-month follow-up questionnaire completed by families, preliminary and follow-up family interviews conducted by project codirectors, records of family visits, and family choices on contracts. Findings from the 23 family members who contracted for tasks during their visits and from the follow-up questionnaire completed by 25 family members showed that most sought social and emotional interactions with relatives, some maintained direct personal care activities, and only a few identified interest in extensive involvement with staff and facility. At follow-up, family members involved in the program reported they continued to feel close to their relatives. Many felt that their relatives were generally stable or improved with regard to cognitive function, but over a third noted difficulties in communicating. Participating family members reported that the program of staff supports helped them to feel more integral to the unit. They expressed a need for more education and support for their involvement in the nursing home setting. Project findings confirm previous studies recommending that programming at nursing homes needs to include specific institutional and staff supports to maintain and enhance family contributions to the long-term nursing home care of their relatives.

scholarly journals Predictors of nursing home admission among Alzheimer's disease patients with psychosis and/or agitation

2010 ◽  
Vol 23 (1) ◽  
pp. 44-53 ◽  
Author(s):  
Edward Alan Miller ◽  
Lon S. Schneider ◽  
Robert A. Rosenheck
Keyword(s):  
Mental Health ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Health Utility Index ◽  
Health Utility ◽  
Community Dwelling ◽  
Nursing Home Admission ◽  
Outpatient Mental Health ◽  
Nursing Home Entry

ABSTRACTBackground: The purpose of this study is to identify factors that predict nursing home placement among community-dwelling Alzheimer's disease (AD) patients with psychosis and/or agitation in a randomized clinical trial (ClinicalTrials.gov number, NCT00015548).Methods: 418 participants with AD enrolled in the Clinical Antipsychotic Trial of Intervention Effectiveness – AD (CATIE-AD) trial of anti-psychotic medications and having no evidence of nursing home use at baseline were followed at 9 months post-random assignment using data provided by caregiver proxy. χ2 tests, t-tests and Cox proportional hazard modeling were used to examine the baseline correlates of nursing home use.Results: Of outpatients with no prior nursing home use, 15% were placed in a nursing home in the 9 months following baseline, with the average time to placement being 122 days. Bivariate analyses indicate that those with prior outpatient mental health use at study entry were more likely to be admitted; so too were those with worse physical functioning – i.e. lower scores on the AD Cooperative Study Activities of Daily Living Scale (ADCS-ADL), lower utility scores on the Health Utility Index (HUI)-III, and worse cognition on the Mini-mental State Examination. Controlling for other factors, non-Hispanic white race (hazard ratio [HR] = 2.16) and prior mental health use (HR = 1.87) increased the likelihood of admission. Those with higher ADCS-ADL scores were less likely to be placed (HR = 0.97).Conclusions: Factors leading to nursing home entry among psychotic/agitated AD patients are similar to the general population, though high incidence of nursing home entry highlights the importance of accounting for such utilization in health economic studies of AD outcomes. It also highlights the importance of using information on ADLs and other characteristics to develop profiles identifying those at greater or lesser risk of nursing home entry and, in so doing, inform population planning associated with AD and identification of those patients and caregivers who might benefit most from interventions to prevent eventual placement.

scholarly journals O ETHOS DISCURSIVO EM INTERAÇÕES DE UM GRUPO DE APOIO A FAMILIARES DE PESSOAS COM A DOENÇA DE ALZHEIMER

2019 ◽  
pp. 195
Author(s):  
Fernanda Ferreira Gimenes ◽  
Caio César Costa Ribeiro Mira
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Support Groups ◽  
Support Group ◽  
Family Members ◽  
Institutional Context ◽  
The Elderly ◽  
Daily Activities ◽  
Video Recordings

Resumo:No Brasil, o contingente da população acometida pela Doença de Alzheimer (DA), é responsável por cerca de 50-70% das demências em idosos (BURLA et al., 2013), fator que limita ou dificulta as atividades diárias e tem impactos diretos na qualidade de vida da pessoa acometida pela patologia e por seus familiares. Nesse contexto, os Grupos de Apoio (GA) constituem espaços importantes de socialização onde familiares e cuidadores podem compartilhar experiências de cuidado e de convívio com a pessoa acometida pela DA. Este artigo visa à análise da noção de ethos discursivo em interações ocorridas no contexto institucional de um Grupo de Apoio. O referencial teórico deste trabalho está fundamentando no campo Análise do Discurso, especificamente nos estudos acerca da noção de ethos desenvolvidos por Maingueneau (1997; 2011) e Amossy (2005). Analisamos um corpus proveniente de gravações de vídeo de reuniões do GA, que são mediadas por um médico neurogeriatra. Os resultados de nossas análises demonstram que ocorre uma alternância de imagens discursivas do médico, revelando a autoridade enunciativa do profissional de saúde e a aproximação com os interlocutores no contexto interacional do GA.Palavras chave: doença de alzheimer; ethos; grupo de apoio. DISCURSIVE ETHOS IN INTERACTIONS OF A SUPPORT GROUP FOR FAMILY OF PEOPLE WITH ALZHEIMER'S DISEASEAbstract:In Brazil, the contingent of the population affected by Alzheimer's disease, according Burlá et al (2013), accounts for about 50-70% of dementias in the elderly, a factor that limits or hinders daily activities and has direct impacts over the life’s quality of the person affected by the disease and his relatives. In this context, Support Groups are important spaces of socialization where family members and caregivers can share experiences of care in the search for a better acceptance. This article aims to demonstrate the notion of discursive ethos in interactions that occurred in the institutional context of a Support Group for family members and caregivers of people affected by Alzheimer 's disease. The theoretical reference of this work is based on the Discourse Analysis field, specifically in the ethos studies of Maingueneau (1997,2011) and Amossy (2005). We analyzed a corpus derived from video recordings of meetings of this group, mediated by a neurogeriatric. The analysis of GA interactions demonstrates the physician as an enunciator of authority through what is enunciated by him, as well as an approximation of the pre-discursive ethos which is revealed in the enunciation scene.Keywords: Alzheimer’s disease; ethos; support groups.

scholarly journals Higher Depression of Patients with Alzheimer’s Disease During than Before the Lockdown

2021 ◽  
pp. 1-5
Author(s):  
Mohamad El Haj ◽  
Ahmed A. Moustafa ◽  
Karim Gallouj
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Family Members ◽  
Physical Contact ◽  
Restrictive Measures

We assessed depression in 72 patients with Alzheimer’s disease (AD) who live in retirement homes during the COVID-19-related lockdown. We invited caregivers of 72 patients with AD who live in retirement homes to rate depression in the patients both before and during the lockdown. Analysis demonstrated increased depression in the patients during the lockdown. We attribute this increased depression to the restrictive measures on activities, visits, and physical contact between patients with AD and family members during the lockdown.

scholarly journals Overlap of Pain and Depression Among Nursing Home Residents With Advanced Alzheimer’s Disease and Related Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 42-43
Author(s):  
Emmanuelle Belanger ◽  
Richard Jones ◽  
Gary Epstein-Lubow ◽  
Kate Lapane
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Depressive Symptoms ◽  
Hospice Care ◽  
Care Delivery ◽  
Nursing Home Residents ◽  
National Sample ◽  
Fee For Service ◽  
Minimum Dataset

Abstract Physical and psychological suffering are interrelated and should be assessed together as part of palliative care delivery. We aimed to describe the overlap of pain and depressive symptoms among long-stay nursing home (NH) residents with advanced Alzheimer’s disease and related dementia (ADRD), and to determine the incidence of pain and depressive symptoms. We conducted a retrospective study of a US national sample of fee-for-Service Medicare beneficiaries who became long-stay NH residents in 2014-2015, had two consecutive quarterly Minimum Dataset assessments (90 and 180 days +/- 30 days), and had a diagnosis of ADRD in the Chronic Condition Warehouse and moderate to severe cognitive impairment (N= 92,682). We used descriptive statistics and Poisson regression models to examine the incidence of each symptom controlling for age, sex, and concurrent hospice care. Sub-groups with self-reported and observer-rated symptoms (pain/PHQ-9) were modelled separately, as were those switching between the two. The prevalence of depressive symptoms was low (5.7%), while pain was more common (18.2%). Across various subgroups, 2% to 4% had both pain and depression, but between 20% and 25% were treated with both antidepressants and scheduled analgesia. Depressed residents at baseline had an incidence rate ratio (IRR) of pain of 1.2 at the second assessment, while the residents with pain at baseline had an IRR of depressive symptoms of 1.3 at the second assessment. Our results support the expected relationship between pain and depressive symptoms in a national sample of long-stay NH residents with advanced ADRD, suggesting the need for simultaneous clinical management.

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