Medicine and Health Sciences Commons^™

The Relationships Between Licensed Vocational Nurses' Care, Documentation, And Perceptions Of Dementia-Compromised Behaviors In The Nursing Home, Jennifer J. Yeager

Nursing Theses and Dissertations

Behavioral and psychological symptoms of dementia increase as Alzheimer's disease and related dementias progress; these symptoms occur in as many as 80% of persons with dementia living in nursing homes. Behavioral and psychological symptoms of dementia, also known as dementia-compromised behaviors, are a source of stress for nursing home staff, family members, and other residents and adversely affect the quality of life and safety of residents. Ethnonursing, a qualitative research method, was used to examine the relationship between licensed vocational nurses' responses to dementia-compromised behaviors, documentation, and perceptions of dementia care. Data analysis resulted in three overarching themes related to …

Re-Cognizing Power In The Culture Of Dementia Care Knowledge, Ryan T. Deforge

Electronic Thesis and Dissertation Repository

In light of increasing system demands, system regulations, and constrained resources, those living and working with dementia in the long-term care sector are vulnerable to oppressive care practices. This is true so long as our understanding of how social power affects the ways in which dementia care knowledge is created, shared, and enacted remains limited. Based on prolonged field observations and on informal and formal interviews with care recipients, family members, and staff, the aim of this critical qualitative research was to examine the culture of dementia care knowledge in two sites: a specialized dementia care unit in a long-term …

Association Of Cardiovascular Factors And Alzhemer's Disease Plasma Amyloid-Beta Protein In Subjective Memory Complainers, Kristyn Bates, Hamid Sohrabi, Mark Rodrigues, John Beilby, Satvinda Dhaliwal, Kevin Taddei, Arthur Criddle, Megan Wraith, Matthew Howard, Georgia Martins, Athena Paton, Pankaj Mehta, Jonathan Foster, Ian Martins, Nicola Launtenschlager, Frank Mastaglia, Simon Laws, Sam Gandy, Ralph Martins

Simon Laws

A strong link is indicated between cardiovascular disease (CVD) and risk for developing Alzheimer's disease (AD), which may be exacerbated by the major AD genetic risk factor apolipoprotein Eε4 (APOEε4). Since subjective memory complaint (SMC) may potentially be an early indicator for cognitive decline, we examined CVD risk factors in a cohort of SMC. As amyloid-ε (Aβ) is considered to play a central role in AD, we hypothesized that the CVD risk profile (increased LDL, reduced HDL, and increased body fat) would be associated with plasma Aβ levels. We explored this in 198 individuals with and without SMC (average age …

Hippocampal Sclerosis Of Aging, A Prevalent And High-Morbidity Brain Disease, Peter T. Nelson, Charles D. Smith, Erin L. Abner, Bernard J. Wilfred, Wang-Xia Wang, Janna H. Neltner, Michael Baker, David W. Fardo, Richard J. Kryscio, Stephen W. Scheff, Gregory A. Jicha, Kurt A. Jellinger, Linda J. Van Eldik, Frederick A. Schmitt

Sanders-Brown Center on Aging Faculty Publications

Hippocampal sclerosis of aging (HS-Aging) is a causative factor in a large proportion of elderly dementia cases. The current definition of HS-Aging rests on pathologic criteria: neuronal loss and gliosis in the hippocampal formation that is out of proportion to AD-type pathology. HS-Aging is also strongly associated with TDP-43 pathology. HS-Aging pathology appears to be most prevalent in the oldest-old: autopsy series indicate that 5-30 % of nonagenarians have HS-Aging pathology. Among prior studies, differences in study design have contributed to the study-to-study variability in reported disease prevalence. The presence of HS-Aging pathology correlates with significant cognitive impairment which is …

Exploring The Iranian-Canadian Family Experience Of Dementia Caregiving: A Phenomenological Study, Sevil Deljavan

Electronic Thesis and Dissertation Repository

Presently in Canada, there are approximately 500,000 individuals living with dementia, which is expected to increase to over one million by 2038. With Canada’s minority elderly population growing, the number of Iranian-Canadian older adults living with dementia is expected to rise as well. Family caregivers are a significant source of help among Iranian-Canadians and the provision of informal care by adult children for parents with dementia in the Iranian culture is an expression of love and dedication.

This study explored the meaning of the experience of Iranian adult children in Canada caring for a parent with Alzheimer’s disease, the values …

The Social Experiences Of Spouses Of Persons With Young-Onset Dementia (Yod): Social Change, Support And Resiliency, Stacey A. Hawkins Ma, Carrie Mcainey Phd, Margaret Denton Phd, Jenny Ploeg Phd

Stacey A. Hawkins

No abstract provided.

Use Of Day Centers For Respite By Help-Seeking Caregivers Of Individuals With Dementia, Lyn Phillipson, Sandra C. Jones

Sandra Jones

Addressing the under utilisation of respite services in caregivers of people with dementia is an important task to improve social support amongst this vulnerable group. This paper utilises theory to conceptualise the behavioural, normative and control beliefs that caregivers of people with dementia associate with the use of out of home day centers for respite. Interviews and focus groups with 36 caregivers were undertaken to explore the beliefs of both users and non-users of services. Whilst service users held positive beliefs, non - users perceived negative outcomes for the care recipient with dementia, or faced barriers associated with their behavioural …

Why Caregivers Of People With Dementia Don't Utilise Out-Of-Home Respite Services, L Phillipson, S C. Jones, C Magee

Sandra Jones

Carers of people with dementia consistently report an unmet need for respite. Despite this, the overall proportion of carers who utilise available day centre, in-home and residential respite programs tends to be low and, even then, use is often delayed and only at very low intensities. In order to support carers in appropriate and supportive use of respite services, program planners and service providers need a good understanding of the factors influencing use and non-use of respite services. With this in mind, a community based survey of 152 help-seeking caregivers of people with dementia (NSW, Australia) was undertaken to establish …

Dementia, Stigma And Intentions To Help-Seek: A Pilot Study Of Australian Adults 40 To 65 Years, Lyn Phillipson, C Magee, Sandra C. Jones, S Reis, E Skladzien

Sandra Jones

Stigma (prejudice or negative stereotypes associated with personal attributes such the presence of ill health or disease) is an important concept as it has the potential to adversely impact on social exclusion, help seeking behaviours and the utilisation of health and social services. Whilst limited international research suggests that there may be stigma associated with dementia, this paper presents results from the first comprehensive study to explore stigma towards dementia in Australia. Results from an online survey of Australian adults (45-60 years) outline the nature and presence of negative attitudes or stereotypes towards dementia and people living with dementia, and …

Genetic Approaches To Studying Complex Human Disease, Joseph B. Dube

Electronic Thesis and Dissertation Repository

Common, complex diseases such as cardiovascular disease (CVD) represent an intricate interaction between environmental and genetic factors and now account for the leading causes of mortality in western society. By investigating the genetic component of complex disease etiology, we have gained a better understanding of the biological pathways underlying complex disease and the heterogeneity of complex disease risk. However, the development of high throughput genomic technologies and large well-phenotyped multi-ethnic cohorts has opened the door towards more in-depth and trans-disciplinary approaches to studying the genetics of complex disease pathogenesis. Accordingly, we sought to investigate select complex traits and diseases using …

Potentially Inappropriate Use Of Antipsychotics In Community-Dwelling Adults With Dementia More Common In Those With Low Income, Jennifer Tjia

Jennifer Tjia

Comment on: The essential and potentially inappropriate use of antipsychotics across income groups: an analysis of linked administrative data. [Can J Psychiatry. 2012]

Effect Of Lavender Aromatherapy On Agitation In Patients With Dementia At Dementia Clinic, King Chulalongkorn Memorial Hospital: Pilot Study, K Srirojnoppakun, S. Tangwongchai

Chulalongkorn Medical Journal

Objective : To assess the efficacy of aromatherapy as an intervention for agitated behaviors in patients with dementia at the Dementia Clinic, King Chulalongkorn Memorial Hospital. Method : This was a randomized controlled trial which recruited 24 patients with dementia at the Dementia Clinic, King Chulalongkorn Memorial Hospital. The intervention was undertaken at the patient's home by major caregivers. The sample was randomly divided into two groups: the experimental group, 12 patients with a mean age of 80.83 years (SD: 5.31), received aromatherapy with lavender oil for 1 hour every day for 2 weeks: and the control group, 12 patients …

The Impact Of Medicare Prescription Drug Coverage On The Use Of Antidementia Drugs, Nicole R. Fowler, Yi-Fan Chen, Christiana A. Thurton, Aiju Men, Eric G. Rodriguez, Julie M. Donohue

Publications and Research

Background Cholinesterase inhibitors and memantine are prescribed to slow the progression dementia. Although the efficacy of these drugs has been demonstrated, their effectiveness, from the perspective of patients and caregivers, has been questioned. Little is known about whether the demand for cholinesterase inhibitors and memantine are sensitive to out-of-pocket cost. Using the 2006 implementation of Medicare Part D as a natural experiment, this study examines the impact of changes in drug coverage on use of cholinesterase inhibitors and memantine by comparing use before and after Medicare Part D implementation among older adults who did and did not experience a change …

How Do Older People Describe Others With Cognitive Impairment? A Multiethnic Study In The United States, Sarah B. Laditka, James N. Laditka, Rui Liu, Anna E. Price

All PTHMS Faculty Publications

We studied how older people describe others with cognitive impairment. Forty-two focus groups represented African Americans, American Indians, Chinese Americans, Latinos, Vietnamese Americans, and Whites other than Latinos (Whites) (N = 396, ages 50+), in nine locations in the United States of America. Axial coding connected categories and identified themes. The constant comparison method compared themes across ethnic groups. African Americans, American Indians and Whites emphasised memory loss. African Americans, American Indians, Latinos and Whites stressed withdrawal, isolation and repetitive speech. African Americans, American Indians, Vietnamese Americans and Whites emphasised ‘slow thinking’. Only Whites described mood swings and personality changes. …

Evidence-Based Guideline: Wandering, May Futrell, Karen Melillo, Ruth Remington

Ruth Remington

No abstract provided.

A Vitamin/Nutriceutical Formulation Improves Memory And Cognitive Performance In Community-Dwelling Adults Without Dementia, A Chan, Ruth Remington, E Kotlya, A Lepore, J Zemianek, Thomas Shea

Ruth Remington

Adults of both genders without dementia consumed a nutriceutical formulation ("NF," consisting of folic acid, B12, Vitamin E, S-adenosylmethionine, N-acetyl cysteine and Acetyl-L-carnitine), previously shown to improve cognitive performance in Alzheimer's disease, or placebo. Participants receiving NF but not placebo improved statistically and clinically in the California Verbal Learning Test II and the Trail-Making Test. Both groups improved further during a 3-month open-label extension. Additional individuals displayed identical improvement during a separate 6-month open-label trial. Performance declined to baseline following withdrawal of NF, and statistically improved when participants resumed taking NF. Additional participants receiving NF but not placebo demonstrated improvement …

Dementia And Risk Of Adverse Warfarin-Related Events In The Nursing Home Setting, Jennifer Tjia, Terry Field, Kathleen Mazor, Jennifer Donovan, Abir Kanaan, George Reed, Peter Doherty, Leslie Harrold, Jerry Gurwitz

Jennifer Tjia

BACKGROUND: Little attention has been focused on the safety of medications administered to treat non illnesses in nursing home residents with dementia. It is unclear whether this population is at increased risk of adverse drug events. OBJECTIVES: To test the hypotheses that in nursing home residents with dementia prescribed warfarin have less time in therapeutic range and a higher incidence of nonpreventable and preventable adverse warfarin events compared to nursing home residents without dementia after controlling for facility and patient characteristics. METHODS: A prospective cohort embedded in a clinical trial of nursing home residents prescribed warfarin in 26 nursing homes …

Understanding Resource Needs Of Persons With Dementia And Their Caregivers, Rosanne Dizazzo-Miller, Fredrick D. Pociask, Preethy Samuel

Department of Health Care Sciences

The purpose of this study was to understand the lived experiences of family caregivers of persons with dementia in accessing resources as the disease progresses, using four focus groups. Findings indicate differences in caregiver needs by stage of dementia of the care recipient. Service professionals noted family-level dynamics as possibly hindering care and voiced concern with limited mental health services. The need to educate caregivers on the scope of available services and applicable information was clear.

Timeslips: Creativity For People With Dementia, Anne Davis Basting

Case Studies from Age in Action

Educational Objectives

1. Recognize the value of creative storytelling for people with dementia, with its shift in emphasis from memory to imagination.

2. Understand the impact of creative storytelling upon facilitators, storytellers, audiences, and readers.

3. Explore the potential mechanisms at work in creative storytelling.

Is Horticultural Therapy A Safe And Effective Treatment In Reducing Agitation For Dementia Patients In Nursing Homes?, Renee J. Chiodo

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not horticultural therapy is a safe and effective treatment in reducing agitation for dementia patients in nursing homes.

STUDY DESIGN: Review of three English language primary studies published between 2008 and 2010.

DATA SOURCES: Two randomized control trials and a case series, which compare horticultural therapy to the use of traditional therapy methods.

OUTCOMES MEASURED: The primary outcome measured in all three studies focus on the level of agitation in dementia patients. Secondary outcomes also included efficacy of sleep as well as level of cognition. …

Developing A Decision Aid For Drivers Living With Dementia: Supporting Consumers And Carers In The Process Of Making Decisions About Driving Retirement, Catherine L. Andrew, John Carmody, Kate L. Lewis, Victoria Traynor, Don Iverson

Faculty of Science, Medicine and Health - Papers: part A

Abstract of paper that presented at the Occupational Therapy Australia, 25th National Conference and Exhibition, 24-26 July 2013, Adelaide Convention Centre.

Developing A Medication Management Information Guide For Ethnic Minority Family Caregivers Of People Living With Dementia, Judy Mullan, Robyn Gillespie, Lindsey Harrison

Faculty of Science, Medicine and Health - Papers: part A

No abstract provided.

What Factors Delay Driving Retirement By Individuals With Dementia?: The Doctors' Perspectives, J Carmody, J Granger, Kate L. Lewis, V Traynor, D Iverson

Faculty of Science, Medicine and Health - Papers: part A

Introduction: An increasing number of individuals with dementia drive. Many argue that those with mild dementia are safe to do so. This study explored the attitudes, knowledge and behaviour of hospital-based doctors towards drivers with dementia. Methods: 20 doctors in a regional hospital in NSW were surveyed using a 20-item questionnaire. Descriptive statistics were applied to the data collected. Results: Half were unaware of the Austroads national guidelines; 60% incorrectly believed that they were legally obliged to report all unsafe drivers in NSW. Most felt that drivers with dementia delay driving retirement for a wide range of reasons. All participants …

Multistate Markov Chains And Their Application To The Biologically Resilient Adults In Neurological Studies Cohort, Erin L. Abner

Theses and Dissertations--Epidemiology and Biostatistics

Dementia is increasingly recognized as a major and growing threat to public health worldwide, and there is a critical need for prevention and treatment strategies. However, it is necessary that appropriate methodologies are used in the identification of risk factors. The purpose of this dissertation research was to develop further the body of literature featuring Markov chains as an analytic tool for data derived from longitudinal studies of aging and dementia.

Data drawn from 649 participants in the University of Kentucky’s Alzheimer’s Disease Center’s (UK ADC) Biologically Resilient Adults in Neurological Studies (BRAiNS) cohort, which was established in 1989 and …

Stanley, Sharon Interview For The Miami Valley College Of Nursing And Health Oral History Project, Donna M. Curry, Sharon Stanley

Wright State University - Miami Valley College of Nursing and Health Oral History Project

Donna Miles Curry interviewed Sharon Stanley about Wright State University College of Nursing and Health.

Discovery Of New Biomarkers Of Mild Cognitive Impairment And Alzheimer's Disease Risk In Buccal Cells Using Laser Scanning Cytometry, Maxime Francois

Theses: Doctorates and Masters

Previous studies have shown that mild cognitive impairment (MCI) may reflect the early stages of more pronounced neurodegenerative disorders such as Alzheimer’s disease (AD). In clinical practice, patients with AD are not usually identified until the disease has progressed to a stage when primary prevention is no longer possible. Therefore there is a need for a minimally invasive and inexpensive diagnostic to identify those who exhibit cellular pathology indicative of MCI and AD risk so that they can be prioritised for primary prevention. Human buccal cells are accessible in a minimally invasive manner, and exhibit cytological and nuclear morphologies that …

Supporting Speech-Language Pathologist Evidence-Based Practice Use: A Mixed-Methods Study In Skilled Nursing Facilities Within The Promoting Action On Research Implementation In Health Services Framework, Natalie Franko Douglas

USF Tampa Graduate Theses and Dissertations

As the management of dementia is a significant public health concern, efforts to increase access to effective treatments to a greater number of residents with dementia in skilled nursing facilities (SNFs) are warranted. The treatment addressed in this study, non-electronic external memory aids, is an evidence-based practice that has been found to increase positive communicative interactions and decrease negative behavioral problems of residents with dementia in SNFs.

Although use of memory aids is recommended, there are significant barriers such as lack of time and resources that inhibit the use of effective treatments in typical clinical settings. To address such barriers …