Dementia In Aged Care Facilities Research Articles

Deploying Robot-Led Activities for People with Dementia at Aged Care Facilities: A Feasibility Study

ObjectivesTo explore the feasibility of deploying robot-led activities for people with dementia living in aged care facilities. DesignEmbedded mixed-methods design. Setting and ParticipantsEleven residents (aged ≥65 years) with mild to moderate cognitive impairment were recruited from 2 aged care facilities in Brisbane, Australia. MethodsWe implemented a novel control logic, “Adam Program,” for a human-like robot to provide proactive robot activities for people with dementia. Participants individually participated in a nonfacilitated robot intervention thrice a week for 5 weeks from November to December 2022. We video-recorded each intervention session and quantified participants’ visual, behavioral, and verbal engagement. A semi-structured interview was conducted at the end of the 5-week intervention. The treatment fidelity strategies and finances were reported and evaluated. The Bowen Feasibility Framework guided data analysis into 6 focus areas: acceptability, demand, implementation, efficacy, integration, and practicality. ResultsBased on participants’ perceptions, findings demonstrated adequate acceptability and demand for robot-led activities. Findings reported a high level of visual engagement (98.54%) and an increased trend of behavior engagement over 5 weeks. Participants independently communicated with Adam, with most (97.02%) verbal engagements free of human facilitation. The treatment fidelity strategies regarding the activity delivery, intervention received, and intervention skills are provided alongside the equipment expenses, revealing the feasibility of integrating robot-led activities for people with dementia in aged care facilities. Conclusions and ImplicationsUsing human-like robots to independently lead interactive activities for people with dementia at aged care facilities is feasible and acceptable. Although robot-led activities require further improvement, this study explored a practical-driven solution that provided guidelines for developing and implementing robot-led activities in aged care settings. Future studies could replicate similar robot-led activities for further investigation and evaluation. Strategies for multilevel determinants of Adam's implementation based on a context assessment are recommended for future research.

Striking the Balance: A Human Rights Approach to Consent for People with Dementia in Residential Aged Care

Older people are often stigmatised as ageless and sexless individuals. This perception, and the increasing need for care as people age, means that many older people are subjected to prejudices when entering residential aged care facilities, and denied opportunities for sexual expression. This paper considers the often-forgotten human dignity of people with dementia in aged care facilities, and the need to provide opportunities for sexual expression. The paper considers the broad capacity spectrum for individuals with cognitive impairments and the difficulties of assessing decision-making abilities. Drawing on international human rights instruments, the paper identifies rights to intimacy and sexual expression, and argues that those rights should be recognised in reforms to aged care legislation and policy. The paper considers some of the existing barriers to intimacy and sexual expression, including staff attitudes, and, taking New South Wales as an example, existing criminal legislation which provides a narrow view of consent. Recommendations are made with respect to emphasising the intrinsic benefits of intimacy and sexual expression for all people, regardless of age or cognitive impairment.

Person-centered care and engagement via technology of residents with dementia in aged care facilities.

Touchscreen technology (TT) is a resource that can improve the quality of life of residents with dementia, and care staff, in residential aged care facilities (RACF) through a person-centered care approach. To enable the use of TTs to engage and benefit people with dementia in RACFs, education is needed to explore how these devices may be used, what facilitates use, and how to address barriers. We sought to provide education and explore RACF staff views and barriers on using TT to engage their residents with dementia. An educational session on using TT with residents with dementia was given to staff from three long-term RACFs in Melbourne, Australia. A cross-sectional convenience sample of 17 staff members (personal care attendants, registered nurses, enrolled nurses, allied health clinicians, and domestic staff) who attended were administered questionnaires pre- and post-sessions. As a result of the education seminar, they were significantly more confident in their ability to use TT devices with residents. TT, and education to staff about its use with residents with dementia, is a useful strategy to enhance RACF staff knowledge and confidence, thereby enhancing the use of technology in RACFs in order to improve care standards in people with dementia.

Implementing a psycho-educational intervention for care assistants working with people with dementia in aged-care facilities: facilitators and barriers.

Many intervention studies lack an investigation and description of the factors that are relevant to its success or failure, despite its relevance to inform future interventions. This study aimed to explore the facilitators and barriers to the implementation of a psycho-educational intervention for care assistants caring for people with dementia in aged-care facilities. A process evaluation was carried out alongside a pretest/post-test controlled study conducted in aged-care facilities. Seven focus-group interviews involving 21 care assistants (female; mean age 43.37 ± 10.0) and individual semi-structured interviews with two managers (female; mean age 45.5 ± 10.26) were conducted 2 weeks and 6 months after the intervention, in two aged-care facilities. Interviews were recorded, transcribed and submitted to content analysis by two independent researchers. Results were organised into implementer, participant and organisation level hindered and facilitator factors. Findings enable the interpretation of the experimental results and underscore the importance of collecting the perception of different grades of staff to obtain information relevant to plan effective interventions.

Analgesic use and pain in residents with and without dementia in aged care facilities: A cross-sectional study

To investigate analgesic use and pain in people with and without dementia in Australian residential aged are facilities. A cross-sectional study of 383 residents of six residential aged are facilities was conducted. Nurses assessed self-reported and clinician-observed pain. Analgesic use data were extracted from medication charts. Logistic regression was used to investigate factors associated with analgesic use. Analgesics were administered to 291 (76.0%) residents in the previous 24 hours. The prevalence of analgesic use was similar among residents with and without dementia (79.3% vs 73.4%, P = 0.20). Residents with dementia had a higher prevalence of self-reported pain than those without dementia but similar prevalence of clinician-observed pain. In residents with dementia, high care residence and dementia severity were associated with analgesic use. The prevalence of analgesic use was similar among residents with and without dementia. Both self-reported and clinician-observed measures are needed in regular pain assessments.

Effectiveness of professional oral health care intervention on the oral health of residents with dementia in residential aged care facilities: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE The objective of this review is to critically appraise and synthesize evidence on the effectiveness of professional oral health care intervention on the oral health of aged care residents with dementia. More specifically the objectives are to identify the efficacy of professional oral health care interventions on general oral health, the presence of plaque and the number of decayed or missing teeth. INCLUSION CRITERIA Types of participants This review will consider studies that include residents with a formal diagnosis of dementia currently residing in permanent care in Residential Aged Care Facilities. This review will exclude participants that have not received a formal diagnosis of dementia as well as those who are not living as a permanent admission in Residential Aged Care Facilities. Studies conducted on community dwelling individuals with a formal diagnosis of dementia will be excluded. Types of intervention(s)/phenomena of interest This review will consider studies that evaluate the efficacy of professional oral health care performed by a dental hygienist. These studies involve professional oral health care performed by a dental hygienist using a toothbrush, interdental brushes, floss and hand scalers if necessary to remove plaque and food debris and in some instances hardened calculus or tartar. If there are studies involving the professional oral health care being performed by dentists or a combination of dentists and dental hygienists they will be included in the analysis. This review will exclude interventions involving staff training interventions and interventions performed by nurses/assistant nurses. TRUNCATED AT 250 WORDS

An evaluation of Snoezelen® compared to ‘common best practice’ for allaying the symptoms of wandering and restlessness among residents with dementia in aged care facilities

Snoezelen has become an increasingly popular therapy in residential aged care facilities in Australia and elsewhere, despite no conclusive evidence of its clinical efficacy. This paper reports on an evaluation of the use of Snoezelen compared to ‘common best practice’ for allaying the dementia related behaviors of wandering and restlessness in two residential aged care facilities in Victoria, Australia. Sixteen residents had their behavior and responses to Snoezelen or ‘common best practice’ observed and recorded over three time periods. The Wilcoxon signed-rank test showed there was a significant improvement in behaviors immediately after the intervention and after 60 min. However, no significant differences were found between residents receiving Snoezelen and ‘common best practice’ interventions for the reduction of the dementia related behaviors.

Analgesic use, pain and daytime sedation in people with and without dementia in aged care facilities: a cross-sectional, multisite, epidemiological study protocol

IntroductionPeople living with dementia may experience and express pain in different ways to people without dementia. People with dementia are typically prescribed fewer analgesics than people without dementia indicating a...

The effectiveness and meaningfulness of strategies for assisted bathing of older adults with dementia: A comprehensive systematic review.

Objective The objective of this systematic review is to determine the best available evidence regarding assisting bathing/showering of older adults with dementia in aged care facilities and community settings. Review questions: The quantitative component will aim to answer questions of effectiveness: - What is the most effective bathing/showering method in reducing agitated or aggressive behaviours in older adults with dementia in aged care facilities and community settings? - What are the most effective bathing/showering method and related educational/ supportive interventions in improving confidence and satisfaction level of nurses, care staff or family caregivers in assisting bathing/showering older adults with dementia? The qualitative component will aim to answer questions of meaningfulness, appropriateness and feasibility: - What are the bathing/showering experiences of older adults with dementia? - What are the experiences of nurses, care staff and family caregivers in assisting bathing/showering older adults with dementia? The textual component will aim to provide supplemental evidence to the quantitative and qualitative components. Participants: - Older adults with dementia (assessed using scales such as Mini Mental Scare Examination, Global Deterioration Scale) in aged care and home settings - Nurses and formal care staff - Family caregivers Intervention: phenomena of interest Assisting bathing/showering of older adults with dementia and related educational or supportive interventions for nurses, formal care staff and family caregivers Comparison (quantitative component) - Usual care Outcome measures The quantitative component: - Frequency and severity of aggressive or agitated behaviours measured by scales such as RAGE (Rating Scale for Aggressive Behaviour in Elderly) - Satisfaction rate by residents, family caregivers or nursing/formal care staff - Confidence rate of residents, family caregivers or nursing/formal care staff The qualitative component: - Subjective accounts of nurses/formal care staff or family caregivers in assisting bathing/showering older adults with dementia - Subjective accounts of nurses/formal care staff or family caregivers to have received educational or supportive interventions related to bathing/showering older adults with dementia - Subjective accounts of older adults with dementia in receiving assistance in bathing/showering - Subjective accounts of older adults with dementia in receiving interventions aiming to improve bathing/showering experiences/outcomes TRUNCATED AT 350 WORDS

A Nurse Practitioner initiated model of service delivery in caring for people with dementia

The increasing number of people with dementia in aged care facilities is reported to have a high burden of care among staff. The Nurse Practitioner role can be beneficial in the provision of dementia care particularly when difficult and aggressive behaviour is being displayed. The model of service described in this paper is designed in such a way to make the outreach team contribute to staff sustainability. Such a service is different to other outreach services and focuses on a number of key deliverables. In practice, the service ensures that recommendations made by the team at the initial assessment are implemented. In addition, they work with the staff in managing the resident’s behaviour, train and model suggestions for practice in interventions. Evaluation of the service is a work in progress and will highlight important aspects about the workforce for the improvement of quality of life for residents with dementia.