Showing papers in "American Journal of Alzheimers Disease and Other Dementias in 1994"
TL;DR: Lawton as discussed by the authors pointed out that "despite two decades of activity, very few relevant findings are available from traditional research" on their therapeutic and quality of life effects, and suggested that the expert opinion survey method employed by
Abstract: Writing on design features in Alzheimer special care units (SCUs) Lawton1 laments that \"despite two decades of activity, very few relevant findings are available from traditional research\" on their therapeutic and quality of life effects. 2 3 Ohta and Ohta, Hyde and Cohen & Weisman4 have also commented on the lack of available data on the effects of SCU design on residents. Lawton suggests that the expert opinion survey methodemployed by
72 citations
TL;DR: The impact of caring for a spouse with a progressive dementia on caregiver's health behaviors and health status was examined and caregivers rated their own health as poorer than their spouse's health.
Abstract: The impact of caring for a spouse with a progressive dementia on caregiver's health behaviors and health status was examined. Data collected from 44 spouse caregivers indicates that:• Providing ful...
71 citations
TL;DR: In this paper, a strategy to increase family/staff cooperation in the care of persons institutionalized with Alzheimer's disease is presented, which is specifically designed to provide a partnership role with staff for families whose relatives with AD are institutionalized.
Abstract: This article has set forth a strategy to increase family/staff cooperation in the care of persons institutionalized with AD. The FIC program was developed as an outgrowth of research that demonstrated family member dissatisfaction with their roles. It is specifically designed to provide a partnership role with staff for families whose relatives with AD are institutionalized. Hypothesized outcomes include the reduction of stress in caregiving, increased satisfaction in role and improved patient cognitive and functional outcomes. Testing of the FIC is currently underway.
44 citations
TL;DR: In this article, the authors examined the characteristics and experiences of young adults in caring for Alzheimer's type dementia (ATD) victims, and found that 14 adolescents aged 14-18 were interviewed and asked a series of semi-structured questions regarding their feelings of burden and satisfaction.
Abstract: The burden of caregiver stress has been well documented in the literature. While attention has been paid to caregiving spouses and adult children, few studies have examined the impact of family caregiving on adolescents. With the rise in adult child caregivers simultaneously raising children of their own, increasingly greater numbers of young adults will be involved in caring for Alzheimer's type dementia (ATD) victims. This study examined the characteristics and experiences of these young adults. Specifically, 14 adolescents aged 14-18 were interviewed and asked a series of semi-structured questions regarding theirfeelings of burden and satisfaction as they related to caregiving. Employing features of content analysis methodology, all interviews were audiorecorded and transcribed. The results merged intofive primary categories:• Positive caregiving outcomes;• Negative caregiving consequences;• Peer group support;• Teacher support; and• Patient behavior management.These results are discussed within the co...
19 citations
TL;DR: In this article, the authors presented empirical evidence derived from the discourse of two Alzheimer's disease (AD) sufferers and found that there are aspects of "relative well-being" which are preserved in dementia patients despite the loss of individual cognitive abilities as measured by standard tests.
Abstract: Empirical evidence derivedfrom the discourse of two Alzheimer's disease (AD) sufferers is presented and found to support the notion proposed by Kitwood and Bredin1 that there are aspects of “relative well-being” which are preserved in Alzheimer's disease sufferers despite the loss of a variety of individual cognitive abilities as measured by standard tests. The present in-depth case studies also reveal that aspects of relative well-being can be supported by the social environment in which the afflicted person lives. It is proposed that supporting the afflicted person's remaining intact abilities, as seen in the signs of relative well-being, can enhance the interactions between the caregiver and AD sufferer, and thus be a source of benefit to both.
14 citations
TL;DR: Comparisons showed that families who used one of the three support services differed in the use of other services, service attitudes, past service experiences, and reasons for support service use.
Abstract: One goal of support services for family members of Alzheimer's patients is to facilitate the use of other formal services. Few existing studies empirically test the relationship between support service use and the use of other community or residential services. This research describes the relationship between support and other service use by comparing families who used three types of support services:• Information and referral• Educational programs; and• Support groups.Data from in-person interviews with 127 family caregivers showed that families who used one of the three support services differed in the use of other services, service attitudes, past service experiences, and reasons for support service use. Results profile the characteristics of families who turn to different types of support services and illustrate the importance of past service characteristics for explaining current and future utilization.Information and referral (I & R), educational programs, and support groups are commonly provided su...
12 citations
TL;DR: Clinicians appropriately balance their use of psychosocial and psychopharmacologic interventions with AD patients by using a frame of reference that includes patients' ability to communicate, learn and comprehend.
Abstract: The behavioral and emotional symptoms of Alzheimer's disease (AD) are frequently the most important clinical considerations for physicians, who can choose to employ behavioral/environmental (psychosocial) or psychopharmacologic measures to deal with such symptoms. The appropriate use of these modalities to treat behavioral/emotional symptoms isfacilitated by using a frame of reference that includes information as to where, when, and with whom symptoms occur, with what medication or medical condition, how often, and how troubling or dangerous to patient, caregiver; or others. It should also include patients' ability to communicate, learn and comprehend. This frame of reference can help clinicians appropriately balance their use of psychosocial and psychopharmacologic interventions with AD patients.
10 citations
TL;DR: Using multiple methods, the authors conducted a review and analysis of 20 contemporary environments for people with dementia as discussed by the authors, and briefly reviewed some of the major trends and developments in these environments.
Abstract: Using multiple methods, the authors conducted a review and analysis of 20 contemporary environmentsfor people with dementia This article briefly reviews some of the major trends and developments in...
10 citations
TL;DR: The authors reviewed current knowledge about the impact of Alzheimer's disease on sexuality and highlighted the major effects of the disease on the sexual responses of affected individuals and their spouses, and recommended guidelines for interventions by social workers and other professionals who work with these couples.
Abstract: Sexual problems encountered by married couples coping with Alzheimer's disease appear to be a fairly common, yet seldom addressed consequence of the disease. This article reviews current knowledge about the impact of Alzheimer's disease on sexuality. The major effects of the disease on the sexual responses of affected individuals and their spouses are discussed and highlighted through examples. Guidelines for interventions by social workers and other professionals who work with these couples are recommended.
10 citations
TL;DR: A 12-point Alzheimer's disease Bill of Rights is proposed to serve as a touchstone for families, professionals, and in some cases those with the disease to evaluate quality of care.
Abstract: New trends in Alzheimers disease research, treatment, and care suggest that the 1980's emphasis on caregivers will shift to a greater focus in the 1990's on the individual with dementia. A 12-point Alzheimer's disease Bill of Rights is proposed to serve as a touchstone for families, professionals, and in some cases those with the disease to evaluate quality of care. The authors note that the rights are not absolute and must be applied in the context of each individual's cognitive abilities and medical situation.
9 citations
TL;DR: In this paper, the effects of the intensive exercise therapy (IET) on the cognitive levels offunctioning of elderly persons monitored for three years were examined for the purpose of examining the effect of IET on cognitive abilities for elderly persons.
Abstract: The purpose of this study was to examine the effects of the Intense Exercise Therapy (IET) on the cognitive levels offunctioning of elderly persons monitored for three years The study was based on the premise that daily group exercise enhances physiological as well as psychological processes and consequently may improve cognitive abilities for elderly persons The study hypothesized that the cognitive functioning level of elderly persons participating in the IET would be significantly higher than the level of those persons in the no treatment control group A previous study by Lindenmuth and Moose' indicated a positive effect of exercise therapy on cognitive functioning for Alzheimer patientsThe sample consisted of 82 elderly (64-98 years old) residents of eight separate personal care facilities in Pennsylvania Residents who volunteered attended by choice either group exercise therapy or a no treatment control group A pretest, posttest experimental design was utilized in an attempt to control extraneo
TL;DR: In this article, the authors describe a program designed to enhance residents' communication skills and interactions, creating opportunities for decision-making which in turn promote optimal use of their residual cognitive abilities.
Abstract: The dismantling of language characteristic of people with Alzheimer's disease and related disorders has a profound effect on their quality of life and on their interactions with family, staff andpeers in the nursing home environment. Recognition that the ability to articulate our experiences enqbles us to sustain connections with other people and ourselves, speech pathologists are challenged to develop innovative therapies to compensate for the ravages the disease inflicts on language and communication. This article describes a program designed to enhance residents' communication skills and interactions, creating opportunities for decision-making which in turn promote optimal use of their residual cognitive abilities.
TL;DR: In this article, the authors focus on efforts to involve the black clergy in disseminating information about Alzheimer's disease and caregiver's support services to African American caregivers of Alzheimer patient, focusing on the role of black clergy.
Abstract: This paper focuses on efforts to involve the black clergy in disseminating information about Alzheimer's disease and caregiver's support services to African American caregivers of Alzheimer patient...
TL;DR: In this paper, the authors explore the beliefs of key decision makers about deficits in older persons who are declared legally incompetent and placed under guardianship, and identify the deficits in self-care, safety, cognition, changes in self, emotion, physical status, interpersonal relationships, trust, social isolation, social nuisance, and context.
Abstract: The purpose of this study was to explore the beliefs of key decision makers about deficits in older persons who are declared legally incompetent and placed under guardianship. Grounded theory was used for qualitative data generation and analysis. Three focus group discussions were held with a total of twenty participants (seven legal professionals; seven health and social services professionals; and six family caregivers) who had been involved in guardianship proceedings for persons 65 years old and older Deficits identified were in self-care, safety, cognition, changes in self, emotion, physical status, interpersonal relationships, trust, social isolation, social nuisance, and context.
TL;DR: A relationship was inferred between the presence of an infection (as suggested by antibiotic medication use) and higher levels of agitation in three highly agitated cognitively impaired nursing home residents.
Abstract: Agitation is a major problem in the demented elderly, and may be related to pain and discomfort. The aim of this article is to investigate the relationship between agitation and infection in three highly agitated cognitively impaired nursing home residents. Agitation was assessed using the Agitation Behavior Mapping Instrument (ABMI), a nonobtrusive assessment tool used for direct observation and recording ofagitated behaviors. Information concerning antibiotic drug use was extractedfrom the participants'charts.A relationship was inferred between the presence of an infection (as suggested by antibiotic medication use) and higher levels of agitation. Elucidating the possible antecedents of the agitated behaviors is the first step in the management of these disruptive behaviors.
Abstract: Little research has been conducted involving the effects that knowledge of Alzheimer's disease has on caregivers as well as the possible consequences of this knowledge. The major purpose of the current study was to determine the amount of knowledge caregivers possessed. The second purpose was to explore possible correlates of knowledge of Alzheimer's disease. One hundred and one caregivers participated in the study. Participants were given a 30 item test which consisted of 15 multiple choice items and 15 true/false items. The caregivers answered an average of 46 percent of the items correctly. Female caregivers answered more questions correctly compared to male caregivers. Additional results are presented in the paper Itappears that education about Alzheimer's disease is needed, especially in caregivers of patients diagnosed with possible or probable Alzheimer's disease. Strategies and suggestions for dissemination of this information are presented.
TL;DR: It is found that adult day care services as transitional care allows patients with Alzheimer's disease to remain in the community for a longer period of care, than would otherwise be possible.
Abstract: Increasingly adult day care services will provide transitional care for Alzheimer's disease patients in mild or moderate stages of the disease. The following small scale studyfinds that adult day care services as transitional care allows patients with Alzheimer's disease to remain in the community for a longer period of care, than would otherwise be possible. The quality of life of patients appears to be highest in private (mostly voluntary) adult day care centers. The most comprehensive case management is found in private (voluntary and proprietary) adult day care centers rather than in public adult day care centers. Such private centers seem to have a more positive impact on behavioralfunctioning than the less comprehensive approach utilized by the public centers. Also, even where adult day care services are provided, informal caregivers are better able to function when they have an informal system of support offamily members and/or neighbors. In addition to adult day care service, family caregivers als...
TL;DR: The virtual silence in the literature regarding palliative care and Alzheimer's disease is explored, primarily with the images and metaphors surrounding the advancing stages of the disease.
Abstract: This paper provides a discussion of some of the issues surrounding the provision of palliative care for Alzheimer's sufferers and their families during the final stages of the disease. Five nurses working in dementia care institutions in Australia were invited to tell their story about the experience of caring for people in a twilight zone, where the sufferer is suspended in a world that is at the edge of existence.This paper explores the virtual silence in the literature regarding palliative care and Alzheimer's disease. However, it is primarily concemed with the images and metaphors surrounding the advancing stages of the disease. The images and the issues raised during the conversations with these nurses are discussed, together with recommendations for future research in this area.
TL;DR: This paper proposes some guidelines for testing the demented person in ways that clarify interpretation of performance, and suggests a number of approaches that should be considered.
Abstract: As part of a broad evaluation of dementia that includes a medical and neurological examination, neuropsychological assessment provides standardized ways to understand the nature and extent of cognitive deficits, and is a powerful adjunct in establishing a diagnosis. Also, neuropsychological assessment is a quantitative measure of disease progression and an indicator of the efficacy of interventions, and consequently, directly hinges on crucial issues of treatment and behavior management. Administering tests to elderly demented patients requires special skills from an examiner Attention must be paid to the needs of elderly people as well as to those people with an insidious, emotionally charged illness. This paper proposes some guidelines for testing the demented person in ways that clarify interpretation of performance.
TL;DR: In this article, the ability of patients with Alzheimer's disease to recognize bath day through specific visual cues was tested by using a pictorial cue reinforced on a daily basis for four weeks.
Abstract: This study tested the ability of mid-stage Alzheimer's disease patients to recognize bath day through specific visual cues. Reisberg's theory of global cognitive deterioration in concert with Piaget's staging of cognitive development guided this study. A convenience sample of 16 nursing home residents received the MSQ and calendar recognition chart as preand post-test. Eight subjects, randomly assigned to the experimental group, received the intervention of a pictorial cue reinforced on a daily basis for four weeks. The control group was exposed to the bath calendar only during the first week and on post-test. Gain scores on the recognition chart from preto post-test were clearly higherfor the experimental group. A Kruskal-Wallis 1-Way ANOVA of 12.1739 p < .005 demonstrated a direct relationship between pictorial cue reinforcement and recognition of bath day.
TL;DR: Overall, results of this survey indicate that staff of ADC and SCU have relatively positive attitudes toward the provision of nutritional care for those with dementia and that they enjoy situations that allow positive interactions with clients.
Abstract: Patients with Alzheimer's disease (AD) are particularly vulnerable to many of the risk factors of malnutrition. The delivery of nutritional care to these patients is an essential component in reversing or averting the development of malnutrition in this population group. The attitudes of the staff involved in the care of these patients may greatly influence the quality of care provided. Staff of special care units (SCU) for dementia patients and of adult day care programs (ADC) filled out a questionnaire designed to determine their attitudes towards the provision of nutritional care to AD patients. SCU staff scored significantly higher (p < .05) than ADC staff in only two of the twenty attitude statements: “Iprefer feeding residents who are restrained” and “I am concerned about the nutritional status of the residents” which may be explained by the possible differences in the severity of the disease of the client population served. Overall, results of this survey indicate that staff of ADC and SCU have rel...
TL;DR: What caregivers need to do both before initiating placement as well as after placement has been implemented is discussed, hoping that the availability of such guidelines will diminish the stress associated with decision-making concerning institutional placement.
Abstract: This paper discusses guidelines for institutional placement of elderly demented patients. It recognizes that there are both emotional and rational issues involved, for family and professional caregivers alike. Criteria for institutional placement are derived from the condition of the patient as well as the circumstances of the caregiver. A number of options for placement are available in most communities, ranging from generalized assisted living facilities to dementia-specific care units in nursing homes. The paper discusses what caregivers need to do both before initiating placement as well as after placement has been implemented. It is hoped that the availability of such guidelines will diminish the stress associated with decision-making concerning institutional placement.
TL;DR: Initial results from the research component of this project document positive effects on medication use, resident survival time and residentfunctional status.
Abstract: The Alzheimer Demonstration Project of Rhode Island is a statewide effort to nurture the development of Alzheimer's disease special care units in both public and private long term carefacilities. Since 1986, the effort has resulted in the establishment of eight special care units, the training of over four hundred health care professionals in both nursing homes, senior citizen centers and adult day carefacilities, the education and involvement offamily caregivers, and the implementation of a research protocol designed to evaluate the effectiveness of these facilities in improving patient outcomes. The project team has also developed special activity programsfor Alzheimer's disease residents, protocols for medication, regimen evaluation and alteration, as well as training materials for professional and family caregivers. Initial resultsfrom the research component of this project document positive effects on medication use, resident survival time and residentfunctional status.
TL;DR: In this paper, the authors describe the rationale for, and results of implicit memory research in patients with Alzheimer's disease and discuss the implications of research into the implicit-memory abilities of AD patients.
Abstract: Patients with Alzheimer's disease (AD) exhibit impaired performance on tests of recall and recognition. Recall and recognition require conscious, or intentional, recollection of a previous experience and have been labeled explicit memory tests. Recently, researchers have studied the performance of AD patients on tests that do not require conscious recollection of previous learning so-called implicit memory tests. This paper describes the rationale for, and results of implicit-memory research in patients with this type of dementia. It appears that studies of implicit memory have produced mixed results. Implications of research into the implicit-memory abilities of AD patients will be discussed.
TL;DR: In this article, the authors examined professionals' utilization of a helpline operated by the Alzheimer's Association of Eastern Massachusetts (AAEM) and found that professionals who had had specialized training in Alzheimer's disease tended to score higher in overall k...
Abstract: The literature has well documented the needs of family caregivers of persons with Alzheimer's disease. Little attention, however, has been devoted to the needs of the professionals who serve this population. This study begins to address those needs by examining professionals' utilization of a helpline operated by the Alzheimer's Association of Eastern Massachusetts. The Association's stated mission is to provide access to comprehensive services as well as to offer support to family and professional caregivers.Helpline volunteers and staff members screened for professional callers who sought information during Fall 1992. About 69 percent (49) of the callers consented to a follow-up telephone interview by graduate social work students during January 1993. Approximately 55 percent of the callers identified social work as their professional discipline. About 61 percent reported that they had participated in specialized training in Alzheimer's disease. Those who had training tended to score higher in overall k...
TL;DR: Self-soothing behaviors are viewed as a series of learned behavioral mechanisms by which the individual achieves a state of calm, quiet and restfulness as discussed by the authors, which is a relatively new concept and is viewed as one of the adaptive behaviors in the repertoire of a well-functioning and healthy infant.
Abstract: Self-soothing behaviors are viewed as a series of learned behavioral mechanisms by which the individual achieves a state ofcalm, quiet and restfulness. The term, \"selfsoothing\" represents a relatively new concept; self-soothing is viewed as one of the adaptive behaviors in the repertoire of a well-functioning and healthy infant. The infant learns to gain a sense of calm and master distress. Other populations can also become so agitated, distressed and up-