Aging & mental health
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Aging & mental health · May 2014
Quality palliative care for cancer and dementia in five European countries: some common challenges.
There is a growing consensus worldwide that palliative care needs to be both more inclusive of conditions other than cancer and to improve. This paper explores some common challenges currently faced by professionals providing palliative care for patients with either cancer or dementia across five countries. ⋯ These are not problems distinct to palliative care, but they may have different origins and explanations compared to other areas of health care. This paper explored deeper themes hidden behind a discourse about barriers and facilitators to improving care.
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The literature was reviewed to gather original research on a family approach to delirium and determine its applicability to current practice. The review had the following objectives: (1) evaluate the current state of research into delirium management (prevention, identification, or treatment of delirium) with family approaches or involvement, (2) identify gaps and areas that require investigation, and (3) determine a future course of research. ⋯ The literature review revealed that this topic is emergent and requires substantial additional research. The aspects of delirium care that researchers investigated were diverse and included bedside interventions (n = 3), screening strategies (n = 4), family education (n = 2), and care that employed multiple components (n = 2). Delirium outcomes improved significantly in two high-quality studies: one multi-component intervention and one bedside intervention program. Other noteworthy findings of lower quality studies warrant further examination. The review of the articles did not determine if the involvement of families in delirium management improves patient outcomes; however, the review revealed potential for program development and future courses of research.
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Aging & mental health · Mar 2014
Randomized Controlled TrialThe association between mild cognitive impairment and doing housework.
The ability to perform instrumental activities of daily living (IADL) is thought to be relatively intact for people with mild cognitive impairment (MCI). Doing housework as part of IADL is an important skill needed for older people to live independently and successfully. A limited number of studies explore the association between MCI and doing housework. The aim of this study was to assess the association between MCI and doing housework among old people. ⋯ MCI is associated with doing less housework. The deterioration in the ability to do housework is a potentially important indicator of evolving cognitive impairment in some old people.
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Aging & mental health · Mar 2014
Behavioural and psychological symptoms of dementia and their management in care homes within the East of England: a postal survey.
To determine the prevalence of antipsychotic use in care homes. To explore which behaviours care home staff can find difficult to manage and which non-pharmacological interventions are currently used within care homes to help cope with behavioural and psychological symptoms of dementia. ⋯ This survey was a first attempt to estimate the use of antipsychotics in care homes. Despite measures to reduce antipsychotic use for all people with dementia in England, we found that 12% of care home residents were still prescribed antipsychotic medication. Around half of all care home managers reported they had experienced behaviours they found difficult. Antipsychotic medications and a variety of non-pharmacological interventions appear to be used concurrently in many care homes.
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Aging & mental health · Jan 2014
Randomized Controlled TrialCognitive-behavioural group therapy improves a psychophysiological marker of stress in caregivers of patients with Alzheimer's disease.
Family caregivers of patients with dementia frequently experience psychological stress, depression and disturbed psychophysiological activity, with increased levels of diurnal cortisol secretion. ⋯ Psychoeducation for caregivers may contribute to a reduction of neuropsychiatric symptoms of AD patients while CBT additionally attenuates psychophysiological responses to stressful situations in caregivers, by reducing diurnal cortisol levels. This may lead to a positive impact in the general health of the caregiver, eventually resulting in better care of the AD patient.