Procedure For Student Observers
Research interns and nursing students will receive a 60-minute training session from a member of the research team in observing the behaviour of the resident during the experimental and control conditions, using the INTERACT . The INTERACT scale has 22 items with 5 answer options ranging from Not at all to Nearly all the time, and is used to rate the mood, speech, relation to another person or to the environment, need for prompting, and stimulation level of a person with dementia during a therapy session , as well as any negative interactions like reluctance, complaining or aggression . The students will also rehearse how they can give constructive feedback to the formal carers carrying out the intervention regarding communication styles and techniques when communicating with the resident.
How To Choose The Most Appropriate Activities For A Loved One With Dementia
Selecting activities for a loved one with dementia is a very personal choice and should be based on your care recipients interests and abilities. With so many excellent ideas in this post and other sources, most caregivers will find a few activities that are meaningful and enjoyable for their loved one. When selecting your activities, here are a few things to keep in mind.
- Choose the Right Time for Each Activity. When starting an activity with a loved one, make sure that they are not particularly anxious or preoccupied with other things. If the time is not right for an activity, its usually best to postpone it and switch gears to a less-stressful activity. When the time is right, choose a clutter-free area to avoid distractions. It may also be helpful to plan activities based on the time of day. For example, you can choose gentle and relaxing activities like listening to music in the evening hours before bed.
- Adapt Activities to Match Abilities. Its a good idea to check with your loved ones healthcare providers to ensure that a new activity or exercise is safe for your loved one. Also, start small and give the person time to make progress, which will make the effort more rewarding. Activities that involve creativity like art are especially useful, as you will have something to display and enjoy after finishing.
How Social Interaction Can Help With Dementia Care
At Eastleigh care homes, we are firm believers in the power of tailored social interaction for all of our residents. Hence we focus so much on activities for elderly with dementia.
We see the benefits this brings, particularly for individuals in the grip of dementia. Dementia can make it so that people surrounding the patient step back from true engagement and offer an individualised approach this is detrimental.
Earlier this year, results of a fascinating study were released which goes to demonstrate the importance of social interaction that is personalised to those with dementia.
The study conducted by the National Institute of Health Research was published in PLOS Medicine. It involved looking at dementia care patients across 69 UK care homes and dividing them into two groups.
One group continued care and treatment as is normally offered within UK care homes. The other group received a programme of Wellbeing and Health for People with Dementia .
WHELD is a staff training programme which focuses on person-centred care with a core focus on person-centred activities and interactions, as well as the most appropriate use of psychotropic medication.
To understand the results of the study we first need to recognise the complex and unique effects of dementia on an individual.
Dementia is typically thought of as a form of confusion due to cognitive decline. Whilst this is true, it is often just one of many symptoms which can affect different individuals to different degrees.
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Understanding And Supporting A Person With Dementia
This page can help you understand what a person with dementia is going through in order to give them the help and support they need to live well.
Understanding and supporting someone with dementia
Living with dementia can have a big emotional, social, psychological and practical impact on a person. Many people with dementia describe these impacts as a series of losses and adjusting to them is challenging.
This page aims to give people – and carers in particular – a better understanding of what it is like to have dementia. It looks at ways to support someone to live well with the condition, based on that understanding. It also looks at how supporting someone with dementia can affect carers.
Press the orange play button to hear an audio version of this page:
Where To Begin When Planning Dementia
The one thing we do know is that being active and engaged is one way to slow the onset of dementia. So, where is a good place to begin? A good first rule for any caregiver: Meet your loved one where they are.
It is common for someone with a diagnosis of dementia to withdraw from social activities and events that are too stimulating. They try to hide symptoms and compensate with strategies that make sense to them. It is important to figure out ways to engage and interact with someone with dementia as it is unfolding. Here are some guidelines:
These basic guidelines will help you create a strong foundation that will help you determine activities that are engaging and nurturing for your loved one.
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Socializing Improves The Overall Quality Of Life
Dementia can significantly impact your seniors quality of life, causing him/her to feel isolated, agitated, frustrated, depressed, and embarrassed. Your seniors inability to perform daily tasks and remember simple things can affect his/her emotional wellbeing as well.
Patients with dementia often land up in hospitals mainly due to fractures, urinary tract or chest infections, or strokes. These patients have twice as many hospital stays every year compared to other seniors, contributing to a total annual healthcare cost of $259 billion.
According to a research paper presented at the Annual Alzheimers Association International Conference, social interaction can significantly improve the quality of life of patients with dementia, ease their agitation, and reduce overall healthcare costs. Support from family, friends, and relatives can go a long way in building the confidence of elderly patients.
Talking With Friends May Boost Your Brain Function As Well As Your Mood
Exercising your brain through healthy social interactions with other humans is very important. Similar to adequate sleep, a good diet, and regular exercise, social interaction has a wide scope of positive benefits that you may not have previously considered.
Research shows that people who regularly engage in meaningful social interaction maintain their brain health better at all ages. One study conducted by the National Institutes of Health determined that just 10 minutes of daily social interaction increases performance on cognitive assessments and can give an important cognitive edge as we age.
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Allow An Emotional Outlet
For many people, music or contact with babies, children or animals provides positive feelings. Excellent memories of past events are often kept and looking through old photos, memorabilia and books enables the recall of earlier times. The opportunity to relive treasured moments can be deeply satisfying. If reading skills have deteriorated make individual audiotapes. Locate picture books and magazines in the persons areas of interest.
Involving Family And Friends In Activities In Care Homes
Many activity organisers in care homes have discovered the benefits of involving carers in activities in the home, whether it is escorting residents on a trip out or helping to serve food and drinks at a special event. Involving families and friends may actually make your job easier and create more of a community spirit in your service.
Involving relatives and friends does need some forethought and planning. For example, are you asking the carer to help with looking after their own relative or friend for a specific activity or could they be a more general volunteer or helper?
Many family members and friends are keen to help where they can, especially when they see the benefits of activities for their own relative or friend. However, you need to check whether they feel they have the time and commitment to get involved and how often they might be able to offer this.
Some visitors might not be able to give their time but could have other things to offer, for example collections of music or DVDs to lend, fabrics, wool or hats for activity groups or contacts with community groups such a local church or golf club.
As with all volunteering, you are more likely to keep families and friends involved if you remember the following:
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Limitations And Future Directions
Perhaps the main criticism that may be levelled at this study is the appropriateness of having a single individual acting as the sole interaction partner to all participants. As such, one might question the potential generalisation of the results in situations where other communication partners are involved. A single communication partner was used for three main reasons. First of all, ME is well versed in facilitative communication strategies and is aware of and sensitive to the communicative needs of people with dementia. Secondly, this design provides a means of exerting a modest amount of control over the findings. In short, all participants engaged with one individual thereby ruling out the impact of differing knowledge bases and approaches that may have been used by other interaction partners. Thirdly, training other interaction partners to engage with people with dementia using Adaptive Interaction was out with the scope of this study. However, as previously mentioned this is something that we aim to explore in our future research.
Planning For The Future: Tips For Caregivers
Making health care decisions for someone who is no longer able to do so can be overwhelming. Thats why it is important to plan health care directives in advance. To help plan for the future, you can:
- Start discussions early with your loved one so they can be involved in the decision-making process.
- Get permission in advance to talk to the doctor or lawyer of the person youre caring for, as needed. There may be questions about care, a bill, or a health insurance claim. Without consent, you may not be able to get needed information.
- Consider legal and financial matters, options for in-home care, long-term care, and funeral and burial arrangements.
Learning about your loved ones disease will help you know what to expect as the dementia progresses and what you can do.
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Social Engagement Before And After Dementia Diagnosis In The English Longitudinal Study Of Ageing
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Affiliation Department of Behavioural Science and Health, University College London, London, United Kingdom
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Affiliation Department of Behavioural Science and Health, University College London, London, United Kingdom
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Roles Conceptualization, Methodology, Writing original draft, Writing review & editing
Affiliation Department of Behavioural Science and Health, University College London, London, United Kingdom
Outcome Measures And Products
For Phase I of the study , data will be collected in writing from user feedback meeting rounds and user testing of prototypes. Feedback, comments, and insights from the user groups formal carers, PWD and researchers) will be collected per meeting and reported anonymously. At the end of the development phase, the System Usability Scale , a short 10-item questionnaire that assesses perceived usability , will be given to the formal carers- who were involved in the app development to evaluate its usefulness and user-friendliness. Observations of the persons with dementia themselves during the user tests will be conducted by trained student observers with the INTERACT observation scale .
Data from Phase II will be partly quantitative and partly qualitative. Data on background characteristics based on The Older Persons and Informal Caregivers Survey Minimum Data Set or TOPICS-MDS -such as age, gender, ethnicity, civil/marital status, education level, children, hours of paid or volunteer work, work function will be collected from the PWD and their formal carers. In addition, the following primary and secondary outcomes will also be collected:
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Social Connections & Health
Aside from mental exercise, social interactions facilitate the development and maintenance of our support system and network. As the Harvard Womens Health Watch reported, Dozens of studies have shown that people who have satisfying relationships with family, friends, and their community are happier, have fewer health problems, and live longer.
Those with large social networks are 26% less likely to develop dementia than those with small networks. Resilience to stress is greater among those with well-established social support networks.
As we age, maintaining meaningful interactions become especially important for reducing the risk of cognitive decline. A study conducted by Dr. Lisa Berkman of Harvard University found that individuals who were socially active experienced less decline in memory. In fact, those with the highest sociability reported half as much memory loss compared to those least social. Despite factoring in other demographics like age, gender, race, and health, the statistics remained unchanged.
Study Setting And Participants
The study will be conducted in 14 nursing home wards that are part of 2 large care organizations in the Netherlands . PWD in these participating nursing home wards who meet the inclusion and exclusion criteria , along with their legal guardians, will receive a written invitation from the nursing home with a consent form for participation and information about the study.
Based on the pilot study with the Photo-Activity, in which large positive effect sizes were found for social interaction and reduced negative behaviour using the INTERACT scale during the intervention , a power-analysis and expected 10% dropout in 6 weeks, for this explorative study 45 people with dementia are needed per group to find statistically significant large effects. The researchers will promote the project in the care organizations and work with the research coordinators, ward managers and team leaders in order to meet the required recruitment target.
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Deal With Personal Hygiene And Incontinence
Urinary tract infections, incontinence, constipation these are just some issues the elderly have to deal with. Add to that the tendency to forget the need to go to the toilet or even where the toilet actually is, and a person with dementia has even more trouble. Prominently signpost the toilet with a board of some kind, keep the door open for easy access, and ensure the person with dementia has clothes that are quickly removed using a zipper instead of buttons helps. When it comes to personal hygiene, the fear of falling or becoming disoriented might keep someone from washing regularly. Some patients may allow a caregiver to help with this or be present when they are bathing.14
Ethics Approval And Consent To Participate
VUmc Medical Ethics Committee has approved the research protocol and declared that the study was not subject to the Medical research Involving Human Subjects Act. All participants will receive written and oral information about the study and will be asked for their written, informed consent before participation in the study. Participants are also informed that participation is voluntary and they can decide at any time to withdraw from the study, without needing to give a reason for doing so. The study is registered via the Dutch Trial Register: NL9219.
Potential Harms
The researchers foresee no risks or potential harms for the residents with dementia participating in either the Photo-Activity or the General Conversation Activity. There is a possibility that the resident may feel bored or disinterested at the least, or upset at most, during the 30 minute intervention/control session. The researchers will make sure to cover these possible scenarios during the training sessions given to the formal carers and the student observers, so they are adequately prepared to identify when this is the case and how to respond. It is also emphasized to the formal carers that if they observe the resident to be too tired, or no longer engaged with the activity, they can end the session at any time. Residents can also be withdrawn from the study if the professional carers deems that the resident is no longer physically fit to participate.
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The Importance Of Individualised Person
The study demonstrates that it is absolutely vital that we take an individualised person-centred approach to care of those with dementia.
In real terms, WHELD requires care homes to increase the time dementia residents spend in personalised socially interactive activities to 60 minutes each week.
At Eastleigh we go beyond this. All of our carers are trained to communicate, talk and listen with our residents in a way that focuses on the individuals interests, and enables them to have input into their own care.
Social Interaction Preserves Cognitive Function
Research has found a strong connection between loneliness and impaired cognitive function. Patients with dementia are often pessimistic about their future and tend to feel lonely owing to social isolation. This happens mainly due to retirement, the death of a spouse and/or close friends, and the lack of mobility.
Numerous studies confirm that seniors with dementia who have a strong social network experience delayed cognitive impairment. Larger social circles have a protective influence on the comprehension and reasoning ability of seniors battling dementia. Seniors who have a considerable amount of support from their families are at a lower risk of developing memory-loss symptoms.
When seniors interact with other family members, relatives, and friends, they have to think of ways to converse and respond. Scientists believe that this basic exchange is a form of exercise that stimulates the brain cells and the formation of brain synapses, thus fueling the creation of new nerve cells.
Encourage and help your senior to build a social network by participating in voluntary and social service activities and cognitive rehabilitation programs. These activities can be a valuable source of social connection for your elder, making him/her feel valued.
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