Dementia In Care Settings Research Articles

Technological interventions in European dementia care: a systematic review of acceptance and attitudes among people living with dementia, caregivers, and healthcare workers.

Alzheimer's and other neurodegenerative forms of dementia affect 8 million Europeans. Assistive technologies are suggested to reduce the burden of care and improve the quality of life of person living with dementia. Nonetheless, the acceptance and attitudes toward technological interventions pose challenges not only for people living with dementia and caregivers but also for healthcare workers. This review specifically aims to investigate how these key groups perceive and accept technology in European dementia care settings. This systematic review was conducted to identify studies, published between 2013 and 2023, that examined the acceptance and attitude of assistive technologies in Alzheimer's and other dementia European settings, following the PRISMA guidelines. Rayyan AI was used for data extraction, and bias was assessed using the Mixed Methods Appraisal Tool. Among the 1,202 identified articles, 13 met the inclusion criteria, revealing a prevailing positivity toward technological interventions in dementia care. Nonetheless, several barriers to adoption, including technological unfamiliarity, and specific dementia-related symptoms that complicate usage were identified. They also unveiled varying attitudes, influenced by factors such as familiarity with technologies, perceived usefulness, and the broader context of the COVID-19 pandemic which accelerated telemedicine and digital solution acceptance during restricted mobility and social distancing. Understanding attitudes toward technology in dementia care is crucial as it influences the adoption and utilization of tech-based interventions, impacting symptom management and quality of life. Addressing these attitudes through tailored interventions and education can enhance well-being and quality of life for people living with dementia, caregivers, and healthcare professionals.

Sensory attunements of caregivers and care receivers: the value of an embodied and emplaced approach in everyday care encounters

ABSTRACT This paper underlines the role of the senses in everyday care encounters within hospice and dementia care settings. We bring together two ethnographic studies, which adopted embodied, emplaced, and sensory approaches to understanding everyday life and care. We draw on existing conceptualizations of bodywork, and theorizations of sensory atmospheres of care, to extend ideas about the relationality of experience shared between those receiving and providing care. Our analysis illuminates the entanglement of the sensory within care relationships, as we appreciate the ways in which atmospheres are lived and felt in relation to others. We consider the environments and engagements between staff, patients, and residents, which facilitate restorative and supportive connections, as well as disrupt feelings about identity and choice. Appreciating the interconnected nature of care, this paper sheds light on the sensory, embodied, and material practices that shape atmospheres in hospice and dementia care settings.

Associations between specialized dementia care, COVID-19 and central nervous system medication use in assisted living: a population-based repeated cross-sectional study

BackgroundAssisted living (AL) is an increasingly common residential setting for persons with dementia; yet concerns exist about sub-optimal care of this population in AL given its lower levels of staffing and services. Our objectives were to (i) examine associations between AL setting (dementia care vs. other), COVID-19 pandemic waves, and prevalent antipsychotic, antidepressant, anti-dementia, benzodiazepine, and anticonvulsant drug use among residents with dementia/cognitive impairment, and (ii) explore associations between resident and home characteristics and prevalent medication use.MethodsWe conducted a population-based, repeated cross-sectional study using linked clinical and health administrative databases for all publicly funded AL homes in Alberta, Canada, examined between January 2018 - December 2021. The quarterly proportion of residents dispensed a study medication was examined for each setting and period (pandemic vs. comparable historical [2018/2019 combined]) focusing on four pandemic waves (March-May 2020, September 2020-February 2021, March-May 2021, September-December 2021). Log-binomial GEE models estimated prevalence ratios (PR) for period (pandemic vs. historical periods), setting (dementia care vs. other) and period-setting interactions, adjusting for resident (age, sex) and home (COVID-19 cases, health region, ownership) characteristics.ResultsOn March 1, 2020, there were 2,779 dementia care and 3,013 other AL residents (mean age 83, 69% female) with dementia/cognitive impairment. Antipsychotic use increased during waves 2–4 in both settings, but this was more pronounced in dementia care than other AL during waves 3 and 4 (e.g., adjusted [adj]PR 1.20, 95% CI 1.14–1.27 vs. adjPR 1.09, 95% CI 1.02–1.17, interaction p = 0.023, wave 3). Both settings showed a statistically significant but modest increase in antidepressant use and decrease in benzodiazepine use. For dementia care AL residents only, there was a statistically significant increase in gabapentinoid use during several waves (e.g., adjPR 1.32, 95% CI 1.10–1.59, wave 3). Other than a modest decrease in prevalent anti-dementia drug use for both settings in wave 2, no other significant pandemic effects were observed.ConclusionsThe persistence of the pandemic-associated increase in antipsychotic and antidepressant use in AL residents coupled with a greater increase in antipsychotic and gabapentinoid use for dementia care settings raises concerns about the attendant risks for residents with cognitive impairment.

Nursing strategies for enhancing calm in older Arabs with dementia: integrating Snoezelen methods, aromatherapy, and personal items to reduce agitation

BackgroundAgitation significantly impacts Arab elders with dementia. Multisensory stimulation, such as Snoezelen, shows promise but lacks exploration in Arab contexts. ObjectiveEvaluate a culturally adapted multisensory intervention—combining Snoezelen, aromatherapy, and personal items—on agitation in Arab elders with dementia. MethodsA quasi-experimental design assessed 31 patients receiving the intervention against 31 controls. Agitation, quality of life, and neuropsychiatric symptoms were measured using the Cohen-Mansfield Agitation Inventory (CMAI) and the Neuropsychiatric Inventory (NPI). ResultsThe intervention group exhibited notable reductions in CMAI scores for aggression and agitation behaviors (p < 0.001) and improvements in quality of life and NPI scores for agitation/aggression and depression/dysphoria (p < 0.001). ConclusionThis culturally tailored multisensory approach effectively reduced agitation and improved well-being in Arab dementia patients. The findings advocate for further research and suggest such interventions can be beneficial in culturally diverse dementia care settings. Trial registrationClinicalTrials.gov, ID NCT06216275

Using PARO, a robotic seal, to support people living with dementia: ‘what works’ in inpatient dementia care settings?

Abstract Introduction: The robotic seal PARO has received increased attention as a new technology to support people living with dementia in terms of emotional and physiological outcomes. However, little research has been conducted to improve understanding of how and why PARO may work within inpatient dementia care. We investigate for whom PARO works best in this setting, and why PARO may work. Methods: Informed by principles from realist methodology, qualitative interviews were conducted with healthcare professionals, participants with dementia and their relatives to explore experiences related to the delivery and receipt of an intervention using PARO in an inpatient dementia ward in the United Kingdom (UK). Observations of PARO intervention sessions were conducted to gain further insight into provision and implementation of sessions using PARO in ‘real time’. Data were analysed using thematic analysis, and using the process of configuration mapping, we constructed a visualisation of our findings framed within the Intervention-Context-Actor-Mechanisms-Outcomes (ICAMO) model. Results: The visualisation of our findings framed within the ICAMO model suggests that PARO may result in positive outcomes within inpatient dementia care due to a range of potential mechanisms, including enhancement of social interactions, developing a sense of attachment, evoking emotive memories, physical interaction, and perceiving the robotic animal as a live being. For these mechanisms to be activated, the sessions should be structured but participant-led, and be delivered as needed in a one-to-one setting by a skilled facilitator. Conclusion: Using PARO in an inpatient dementia care context appeared promising and well-received in this small observational study. This study explicitly considers the context and mechanisms of using PARO within inpatient dementia care settings, presenting findings in a structured visualisation framed within the ICAMO model and offering a theoretical basis for future intervention research.

Working with a robot in hospital and long-term care homes: staff experience

Although there is a growing literature on the use of telepresence robots in institutional dementia care settings, limited research focused on the perspectives of frontline staff members who deliver dementia care. Our objective was to understand staff perspectives on using telepresence robots to support residents with dementia and their families. Guided by the Consolidated Framework for Implementation Research, we conducted four focus groups and 11 semi-structured interviews across four long-term care (LTC) homes and one hospital in Canada. We included 22 interdisciplinary staff members (e.g., registered nurses, social workers, occupational therapists, recreational therapists) to understand their experiences with telepresence robots. Thematic analysis identified three key themes: 1) Staff Training and Support; 2) Robot Features; 3) Environmental dynamics for Implementation. Our results underscore the imperative of structural support at micro-, meso- and macro-levels for staff in dementia care settings to effectively implement technology. This study contributes to future research and practice by elucidating factors facilitating staff involvement in technology research, integrating staff voices into technology implementation planning, and devising strategies to provide structural support to staff, care teams, and care homes.

Subliminal linguistic effects in dementia interaction

Subliminal linguistic effects occur when words or phrases that are overheard by an interlocutor become subconsciously assimilated into their ongoing talk. Such effects are a common feature of everyday interaction. Yet by their nature they are ephemeral, extremely difficult to capture empirically and have not previously been studied at the micro-interactional level. However, broader ethnographic observations made in dementia care settings appear to indicate that subliminal linguistic effects are operationalised differently in people who have dementia, when compared to those without cognitive problems. This exploratory study focuses on over 200 hours of naturalistic multiparty field recordings collected in two UK dementia care settings. It utilises conversation analysis (CA) to examine the reproduction of naturally occurring subliminal linguistic effects in the speech and communication patterns of people with dementia and provides the first systematic micro-analysis of the phenomenon. The position of subliminal linguistic effects in relation to existing sociolinguistic research on overhearing and repetition and the role that features such as intonational emphasis may play in generating subliminal cues are discussed. The study confirms that it is possible to capture examples of subliminal linguistic effects in naturalistic settings and that there are potentially a number of micro-interactional features associated with the phenomenon in dementia communication which could form the basis of a novel, non-intrusive measure of cognitive impairment.

Facilitators, barriers and impacts to implementing dementia care training for staff in long-term care settings by using fully immersive virtual reality: a scoping review protocol

IntroductionThe rapid growth of the ageing population underscores the critical need for dementia care training among care providers. Innovative virtual reality (VR) technology has created opportunities to improve dementia care...

Triadic Communication in Medical Encounters Including Individuals With Dementia: A Scoping Review.

The overall goal of this review was to identify what is known about triadic (clinician-patient-caregiver) communication in mild cognitive impairment (MCI) and dementia care settings throughout the care continuum. Using a structured search, we conducted a systematic scoping review of relevant published journal articles across 5 databases. Study titles/abstracts and selected full-text articles were screened by 2 investigators in Covidence systematic review software. Articles were excluded if they were not about clinical communication, focused only on caregiver-patient communication or communication in residential care, were interventional, lacked empirical data, or were not in English. Extracted data were documented using Google Forms. The study team screened 3426 article titles and abstracts and 112 full-text articles. Forty-four articles were included in the final review. Results were categorized by 3 communication scenarios: diagnostic communication (n=22), general communication (n=16), and advanced care planning communication (n=6). Across the included articles, the conceptualization and assessment of communication lacked homogeneity. Future directions include addressing these research gaps, establishing recommendations for clinicians to effectively communicate with individuals with dementia and caregivers, and creating and testing communication skills trainings for caregivers/family members, clinicians, and/or individuals with dementia to facilitate effective communication.

Life story templates in dementia care: Ambiguous direction and purpose.

The use of life stories in dementia care has been described as a way of seeing every person as an individual, looking beyond their dementia. Life stories have become synonymous with high-quality care, while in Sweden their mere existence in dementia care settings is taken to indicate quality in national comparisons. Such life stories are often standardised, generated by a family member answering predetermined questions in a template. Using a constructionist approach, this study will (1) chart what versions of a person's life story the templates produce, and (2) establish the intended purpose of such life stories, as communicated by the templates. This study departs from the assumption that life story templates communicate something about the conceptions of people living with dementia. The thematic analysis used data comprising 30 blank templates, totalling about 1,700 questions. The life story templates were found to generate two very different versions of the individual: (1) a person before symptoms of dementia or (2) a patient with dementia. We also found contradictions about what information should be included, whose life story it was, and the intended use. Despite strong pressure on dementia care providers to collect life stories from residents, the life story templates they use are without clear direction, ideology, or purpose. The lack of direction is key given that life stories can be considered actants that shape assumptions about people with dementia and construct realities in dementia care settings. We highlight the need to develop ethical guidelines for life story template design, matched with guidelines for their intended use.

Understanding interaction in problematic dementia and social care encounters: Protocol for a micro-level study combining video-ethnography and Conversation Analysis (CA).

It is well established that the actions and behaviour of dementia care workers are fundamental to the wellbeing of the people they care for. Not only do they deal with basic healthcare needs, but they also perform a vital psycho-social function by providing-through their regular presence-an underlying continuity for residents. This has been shown to improve well-being, particularly for those in the advanced stages of dementia. It has also been suggested that there are additional psycho-social benefits of such contact which can directly influence the need for anti-psychotic medication. However, unlike most other healthcare and medical settings, the specialised and often difficult interactions that dementia care workers handle every day have not yet been the subject of detailed micro-level analysis. This is particularly significant because much of the impact that care-workers have relates to the way in which they interact with the people they care for. Not having a clear understanding of how their interactions 'work' at the micro-level-particularly ones that are specific to dementia care settings, and that care workers report to be difficult or challenging-means that any training interventions that are developed may not resonate with their real-world experience, and ultimately run the risk of failing. This video-based observational study aims to provide a detailed micro-exploration of problematic and challenging interactions involving care-workers and people living with dementia. The study is based in the UK and will involve up to 20 dementia care staff and 60 people living with dementia. Fieldwork will be conducted in 5 dementia care home and community-based dementia day care settings using naturalistic observational methods (primarily video-ethnography). Data will be analysed using Conversation Analysis (CA).

Potential of virtual reality to meaningfully engage adults living with dementia in care settings: A scoping review.

Older adults living with dementia in residential aged care homes receive physical care but may have limited access to meaningful engagement. Due to its multimodal and versatile nature, virtual reality (VR) is speculated to be an effective means of meaningfully engaging residents individually and/or in groups. However, there is little evidence regarding its efficacy as a means of meaningfully engaging older adults living with dementia. The objective of this scoping review is to identify and synthesise published research investigating the use of VR technology in promoting the meaningful engagement of older adults living with dementia in residential aged care facilities. A scoping review following Arksey and O'Malley's (2005) established process was conducted and included identifying and selecting relevant studies from seven databases (i.e., AgeLine, CINAHL, Medline, Cochrane, Embase, PsycINFO and Scopus), data charting, and collating, summarising and reporting findings. Two independent reviewers used Covidence and Excel to support data extraction and analysis. The 20 eligible studies revealed discrepancies in the classification of VR and strengths, weaknesses, opportunities and threats associated with its implementation. Findings indicate that the most influential factor in eliciting meaningful engagement is when VR use facilitates interpersonal interactions and opportunities for human connection. Although VR seems to be a promising medium in engaging older adults living with dementia, the efficacy of implementing VR technology within care facilities should be considered alongside potential environmental enablers and barriers. The apparent strength of implementing VR as a means of encouraging restoration, pleasure and productivity in older adults living with dementia lies in the fact that it creates opportunities for meaningful engagement on social and occupational levels.

COVID-19 AND PSYCHOTROPIC DRUG USE IN ASSISTED LIVING RESIDENTS: VARIATION BY WAVE AND SETTING TYPE

Abstract The onset of COVID-19 was associated with significant, albeit modest, increases in the use of psychotropics and opioids in nursing home residents. Little research exists on whether similar trends occurred among older residents of publicly funded assisted living (AL) homes, a growing and poorly investigated setting. We examined the impact of pandemic wave (1 to 4) and setting type (dementia designated spaces [AL-D] vs other [AL-O]) on prevalent antipsychotic, antidepressant, benzodiazepine, opioid and anticonvulsant use in AL residents from Alberta, Canada. Using linked population-based clinical and health administrative databases, we conducted a repeated cross-sectional study of quarterly medication prevalence from January 2018 to December 2021. Log-binomial GEE models estimated prevalence ratios (PR) for 4 waves (vs 2018-19 historical months) and setting (AL-D vs AL-O) and period-setting interactions. On March 1, 2020, there were 2,874 AL-D and 6,611 AL-O residents in our cohorts (mean age 82.4 vs 79.9 years and 93.5% vs 42.6% with dementia, respectively). Antipsychotic prevalence increased during waves 2-4 for both settings but this increase was significantly greater for AL-D than AL-O in later waves (e.g., AL-D: PR 1.21, 95%CI 1.14-1.27; AL-O: 1.12 (1.07-1.17) for March-May 2021 vs 2018-19). For both settings, there was a significant but modest increase in antidepressants but a decrease in benzodiazepines during several waves. No pandemic effect was observed for opioids in either setting. The AL resident and home characteristics associated with these medication trends, concerns about medication risks (particularly for dementia care settings), and consequent health outcomes for residents require further study.

Low‐resource long‐term dementia care settings: Identifying key features and strategies for research recruitment

AbstractBackgroundLow‐resource long‐term care (LTC) settings serve older adults who are at high risk for health inequities in dementia care, including individuals who are socioeconomically disadvantaged and live in rural areas. With the growing demand for dementia care and increasing diversity of LTC residents, identifying and partnering with low‐resource LTC settings is critical for dementia care research. However, low‐resource LTC settings are not well defined or understood. Drawing on data from a larger study of person‐centered dementia care, this study describes key features of low‐resource long‐term dementia care settings in two U.S. states and processes for identifying and recruiting these settings for research engagement.MethodPrimary and secondary data and purposive sampling with maximum variation were used to identify low‐resource LTC settings that serve residents with dementia in two states and to target sites for recruitment. Input from local ombudsmen and publicly available data were used to identify sites that served residents with dementia, accepted Medicaid, and were located in federally designated medically underserved areas. Sites were recruited via phone and email contacts. Following study orientation site visits, researchers developed site descriptions which were verified by each site.ResultFour LTC settings (two nursing home; two assisted living) that serve residents with dementia participated. All four settings were in federally designated medically underserved areas with two settings each in rural and urban areas. Facility size ranged from 19 to 105 residents. The assisted living settings accepted Medicaid waivers and at least one‐third of their residents received financial assistance through Medicaid or other subsidies. Most residents in the nursing homes were Medicaid beneficiaries. Residents at the sites had a wide range of socio‐demographic characteristics and physical and cognitive impairments. All settings noted staffing challenges and considerable variation in retention strategies were reported.ConclusionIdentifying and partnering with low‐resource LTC settings is critical for research on equity in dementia care. This presentation describes key features of low‐resource LTC settings that serve residents with dementia and strategies for identifying and recruiting them for research. Additional work is needed to expand on these descriptive findings and to broaden generalizability to other LTC settings.

What can we learn from play? A comparative analysis of creative play and ‘playing along’ in dementia care environments

In this article, I explore play in dementia care settings, specifically two types: creative play (play that engages creativity and imagination) and ‘playing along’. Acknowledging debates on truth-telling in dementia care, I consider how engagement-focused approaches in dementia contexts employ play to encourage connection, communication and care. To do so, I explore the work of researchers and applied theatre creatives in two projects, the Playful Engagement and Dementia Project and TimeSlips, alongside the communication strategy validation therapy. Considering the relational qualities and use of play in all three, I ask whether, in dementia care settings, embracing the flexible way in which play deals with the divide between fiction and reality can, without harm, address the needs of individuals living with dementia.

Psychotropic, Anticonvulsant, and Opioid Use in Assisted Living Residents Before and During the COVID-19 Pandemic

ObjectivesTo examine the associations between COVID-19 pandemic waves (1–4) and prevalent antipsychotic, antidepressant, benzodiazepine, anticonvulsant, and opioid use among assisted living (AL) residents, by setting (dementia care vs other). DesignPopulation-based, repeated cross-sectional study. Setting and ParticipantsLinked clinical and health administrative databases for residents of all publicly subsidized AL homes (N = 256) in Alberta, Canada, examined from January 2018 to December 2021. Setting-specific quarterly cohorts of residents were derived for pandemic (starting March 1, 2020) and comparable historical (2018/2019 combined) periods. MethodsThe quarterly proportion of residents dispensed an antipsychotic, antidepressant, benzodiazepine, anticonvulsant, or opioid was examined for each setting and period. Log-binomial generalized estimating equations models estimated prevalence ratios (PR) for period (pandemic vs historical quarterly periods), setting (dementia care vs other AL), and period-setting interactions. ResultsOn March 1, 2020, there were 2874 dementia care and 6611 other AL residents (mean age 82.4 vs 79.9 years, 68.2% vs 66.1% female, 93.5% vs 42.6% with dementia, respectively). Antipsychotic use increased during waves 2 to 4 for residents of both settings, but this increase was significantly greater for dementia care than other AL residents during waves 3 and 4 (eg, wave 3, PR 1.21, 95% CI 1.14–1.27 vs PR 1.12, 95% CI 1.07–1.17, interaction term P = .029). In both settings, there was a significant but modest increase in antidepressant use and a significant decrease in benzodiazepine use during several pandemic waves. For other AL residents only, there was a small statistically significant increase in anticonvulsant use during waves 2 to 4. No significant pandemic effect was observed for prevalent opioid use in either setting. Conclusions and ImplicationsThe persistence of the pandemic-associated increase in antipsychotic, antidepressant, and anticonvulsant use in AL residents, and greater increase in antipsychotic use for dementia care settings, raises concerns about the attendant risks for residents, especially those with dementia.

Culture Change in Older Adult Care Settings: A Bibliometric Review.

We systematically analyzed research on the culture change movement, in the context of global efforts to transform the provision of older adult care in institutional settings. Using Web of Science and Scopus publications relevant to person-centered care, culture change, or older adult care settings, we built bibliometric networks for keywords and terms extracted from titles and abstracts. Overlays depicted corresponding authors' countries, publication recency, funding, scientific impact, and concept use. The keyword network for 337 publications revealed variability in culture change settings and study indexing. Term network overlays showed geographical and chronological research variation. Corresponding authors from 14 countries contributed publications, mostly from the United States (69% of publications), Canada (9%), and Australia (5%). Social environment and person-centeredness studies, particularly in dementia care settings, were more recent than studies on physical environment, quality, organizational culture, turnover, and staffing. Scholars listed funding sources for 38% of publications; funding and scientific impact did not always overlap. Well-cited studies on standards of care and policy were funded at a lower rate than topics of lower impact. Over 60% of titles, abstracts, or keywords referred to quality and person-centeredness. Originating in the 1990s in the United States, culture change quickly became an international phenomenon, drawing researchers' attention. Change research has deep roots in quality improvement and person-centered philosophy. We offered practical strategies for querying this hard to access literature. With some database-related limitations, empirical data on scientific impact can be used to allocate research funding.

Conversation Analysis Based Simulation (CABS): A method for improving communication skills training for healthcare practitioners.

Actors portraying simulated patients are widely used in communication skills training in healthcare, but debates persist over the authenticity of these interactions. However, healthcare professionals value simulation-based training because of the opportunity to think and react in real time, which alternatives cannot provide. To describe a method for the use of simulation which maximises authenticity by grounding training in real, observed, patterns of patient communication. Naturally occurring care interactions were video recorded and analysed using conversation analysis (CA) to identify communication patterns. We focused on sites of recurring interactional trouble as areas for training, and identified more and less effective ways of dealing with these. We used the CA findings to train actors portraying simulated patients, based on the observed interactional patterns. Patients living with dementia and healthcare practitioners (HCPs) on two acute healthcare of the elderly wards in the English East Midlands. One month later HCPs reported using the skills learned in clinical practice. Masked-ratings of before and after simulated patient encounters confirmed these self-reports in relation to one key area of training. The Conversation Analysis Based Simulation (CABS) method used in this setting showed positive results across a range of quantitative and qualitative outcome measures. What is significant for the transferability of the method is that qualitative feedback from trainees highlighted the ability of the method to not only illuminate their existing effective practices, but to understand why these were effective and be able to articulate them to others. While the CABS method was piloted in the dementia care setting described here, it has potential applicability across healthcare settings where simulated consultations are used in communication skills training. Grounding simulated interaction in the observed communication patterns of real patients is an important means of maximising authenticity. The VideOing to Improve dementia Communication Education (VOICE) intervention which piloted the CABS method was developed by a multidisciplinary team, including three carers of people with dementia. People living with dementia were involved in the rating of the before and after video simulation assessments.

Projections of costs and quality adjusted life years lost due to dementia from 2020 to 2050: A population-based microsimulation study.

Efficient healthcare planning requires reliable projections of the future increase in costs and quality-adjusted life years (QALYs) lost due to dementia. We used the microsimulation model MISCAN-Dementia to simulate life histories and dementia occurrence using population-based Rotterdam Study data and nationwide birth cohort demographics. We estimated costs and QALYs lost in the Netherlands from 2020 to 2050, incorporating literature estimates of cost and utility for patients and caregivers by dementia severity and care setting. Societal costs and QALYs lost due to dementia are estimated to double between 2020 and 2050. Costs are incurred predominantly through institutional (34%), formal home (31%), and informal home care (20%). Lost QALYs are mostly due to shortened life expectancy (67%) and, to a lesser extent, quality of life with severe dementia (14%). To limit healthcare costs and quality of life losses due to dementia, interventions are needed that slow symptom progression and reduce care dependency.

Where is the Evidence on Acoustic Considerations for Dementia Care Settings: A Scoping Review

Where is the Evidence on Acoustic Considerations for Dementia Care Settings: A Scoping Review