Testing the Implementation of EIT-4-BPSD
DementiaBehavioral and Psychological Symptoms of Dementia (BPSD)This pragmatic trial focuses on implementation of an evidence based process to increase person-centered management of behavioral and psychological symptoms of dementia (BPSD) in nursing homes, referred to as EIT-4-BPSD. The findings from this study will add to what is known about implementation of effective interventions in nursing homes, will serve as a model for other programs and care approaches, and will help facilities and staff implement quality person-centered care, which is the goal of the National Partnership to Improve Dementia Care and Reduce Antipsychotic Use in Nursing Homes.
Empowerment Intervention for Persons With Young Onset Dementia
DementiaEmpowermentThe purpose of this study is to evaluate the effects of an empowerment intervention for community-dwelling persons with young onset dementia and their informal caregivers.
Testing Tele-Savvy, an On-line Psychoeducation Program for Dementia Family Caregivers
Alzheimer DiseaseDementiaThe purpose of this study is to test the psychoeducational program "Tele-Savvy." Tele-Savvy is an internet based, group education program developed from an in person program called Savvy Caregiver. Participants will be randomly assigned to either the Tele-Savvy group (receiving only the Tele-Savvy education) or the Healthy Living Education Program (receiving healthy lifestyle education and then Tele-Savvy education 6 months later) or a usual care group (receiving Tele-Savvy education 6 months later). Each program takes 43 days to complete.
The Model and Effect Assessment of Training General Practitioner for Dementia Early Recognition...
DementiaWith the number of aged people increasing and the lifespan lengthen, dementia is becoming a great public challenge in China. Early recognition of dementia is crucial to improve the prognosis of dementia patients and decrease the society disease burden. It is a pity that the early recognition rate of dementia is less than 7% in China. Most of the aged people live in the community and general practitioners (GP) in community provide health service much more frequently than other medical workers. It is suggested that GPs should be the best one to screen dementia in its early period. However, most of GPs have not receive any training about dementia early recognition in China. It is imperative and meaningful to provide training to GPs for improve GPs' knowledge and skills about dementia early recognition. How to train GPs for early recognizing dementia and how about the training effect? Which training model may be better? We did not find consistent conclusion about these questions in China. This study aims to set up an effective and convenient model to training GPs in dementia early recognition. A total of 152 GPs in Beijing will be enrolled and be randomly divided into two groups. One group will firstly have lessons about dementia early recognition and then receive face-to-face supervision and key messages by Wechat about dementia early recognition once a month in the following 6 months. Another group will firstly have lessons about dementia early recognition and then receive face-to-face supervision and key messages by Wechat about dementia early recognition once a month in the following 3 months. The score of knowledge and attitude about dementia early recognition, the accuracy of analyzing dementia cases, the usage of dementia screening scales and the referral rate of dementia will be evaluated at different time point respectively. This study will provide evidence for training GPs effectively in dementia early recognition in the future and will promote dementia early recognition in community.
Delivery Models of Caregiver Support and Education
DementiaThe proposed study seeks to compare usual care and two different interventions for caregivers (CGs) of Veterans with dementia that are brief and administered by telephone. In the first intervention, care management (i.e., assistance from a nurse or social worker who works with the CG and Veteran's primary care providers), support, psychoeducation, and skills training are tailored to each individual CG and delivered on an individual basis. In the second intervention, care management is tailored and delivered to each individual CG, but support, psychoeducation, and skills training are delivered (also by phone) in a group format. This study will allow us to examine the added benefit of participating in a CG group that provides mutual peer support and feedback. The investigators also will evaluate the extent to which spousal vs. adult child CGs respond differently to the two interventions. Findings will help refine patient/CG-centered care management and support programs designed to facilitate access to services and improve the quality of life of Veterans with dementia and their families.
MEMENTO-VAScular COmponents of Dementia
Alzheimer's Disease (AD)Alzheimer's Disease (AD) Related DisordersA Multicenter national longitudinal cohort study including at least 800 individuals recruited from French Research Memory Centers and followed up over 36 months and included in Memento.
Music Based Caregiving in Patients With Pain and Dementia
PainDementia4 moreThe main objective of this study is to evaluate the pain-relieving effect of a well-characterized non-pharmacological treatment program, music-based caregiving (MBC), to patients in nursing homes with dementia and pain. Patients with dementia disease will be recruited from nursing homes in Trondheim and Oslo, and each ward at the nursing homes will be cluster randomized into intervention - or control wards. Then the health care personnel in the intervention wards will receive education in MBC and perform the intervention during eight weeks. The hypothesis is that this non-pharmacological intervention will reduce pain intensity and improve general activity, as well as reduce other symptoms in nursing home patients with dementia and pain compared to baseline.
Hydration Care in Dementia Care Homes
DementiaThe study aimed to provide evidence of the feasibility of implementing a multi-component intervention for optimising hydration in people with dementia living in care homes. To undertake a multi method feasibility study to investigate the suitability of methods and outcome measures for future research. Objectives: Explore personal barriers experienced by people with dementia regarding drinking in care home contexts Explore professional and organisational perspectives of approaches to optimal hydration of residents with dementia and the barriers in everyday practice Develop a multi-component intervention to enhance hydration for residents in collaboration with care home staff, mental health and geriatric specialists, and residents' family Assess the feasibility of implementing the intervention in care homes, and impact on recommended daily intake of fluids Explore the impact of the intervention on daily fluid intake, and designing suitable secondary outcome measures - admission to hospital due to dehydration, falls, laxative use, urinary tract infection, upper respiratory tract infection and skin breakdown.
Reducing Behavioral and Psychological Symptoms of Dementia: Hospital Caregivers (Aim 2)
Alzheimer's Disease and Related DementiasPersons with Alzheimer's Disease and Related Dementias (ADRD) account for 3.2 million hospital admissions per year and have over three times more hospitalizations than those without cognitive impairment, yet hospital caregivers (HCGs) are ill-prepared to manage patients with ADRD with less than 5% reporting mandatory dementia care training. Three-quarters of hospitalized persons with ADRD display Behavioral and Psychological Symptoms of Dementia (BPSD) associated with functional and cognitive decline, increased resource consumption, institutionalization, premature death, and caregiver burden. The overall objective is to test the preliminary efficacy of an innovative model of care, PES-4-BPSD, for reducing BPSD by empowering Patient Engagement Specialists (PES) to deliver dementia care for acutely-ill patients with ADRD. Traditionally, mental health assistants with training in crisis-prevention techniques provide care to psychiatric patients. On the intervention unit, these mental health assistants, as PES, purposefully engage patients with BPSD. In the pilot study, investigators found patients with cognitive impairment admitted to the PES unit were significantly less likely to require constant observation, chemical and physical restraints, suggesting improved management of BPSD. The central hypothesis is that PES-4-BPSD will improve the ability of PES to create an "enabling" milieu that addresses factors leading to BPSD and improves the experience of hospital caregivers. Guided by a social-ecological framework, PES-4-BPSD incorporates dementia education and training, environmental modifications-cohorting, increased staffing-PES, and staff support. The investigators' multidisciplinary research team is well-positioned to accomplish the following: Aim 1) Determine the preliminary efficacy of PES-4-BPSD for reducing BPSD during hospitalization (please refer to NCT# 04481568 for more details on this aim), and Aim 2) Evaluate whether dementia care training improves the perceived ability of PES staff (intervention) and nurse assistant staff (control) to care for hospitalized persons with ADRD. For Aim 1, investigators will conduct a non-randomized preliminary efficacy trial of the PES-4-BPSD intervention enrolling N=158 patients (79 control, 79 intervention). The primary outcome will be presence of BPSD during hospitalization using the Neuropsychiatric Inventory-Questionnaire (NPI-Q). In Aim 2, investigators will use survey methodology in a repeated measures design to evaluate within and between-group differences in attitudes, experience, and satisfaction toward managing patients with ADRD. Measures will be completed at baseline (T1), immediately following training (T2), and at the end of the intervention period (T3). This proposal will be the first to study an innovative model of care utilizing PES as specialized hospital caregivers for reducing BPSD in the hospital setting. The investigators' findings will lay the essential groundwork for a multi-site trial of PES-4-BPSD and inform the development of a program that can be easily implemented in other hospitals.
Effects of Tai-chi Programme on Mobility of People With Dementia
Accidental FallsThis study evaluates the feasibility and the preliminary effects of a simplified 10-step Tai-chi programme (a dyadic approach) on the mobility performance of people with mild to moderate dementia. Four community health centres were recruited and each was randomised to either the intervention group (Tai-chi) or the control group. Tai-chi group received a 16-week 10-step simplified Tai-chi training programme in which additional measures were implemented to enhance participants' engagement. The control group took part in group recreational activities organized by the community centres. It was hypothesized that the Tai-chi group would outperform the control group regarding their mobility performance.