Medicine and Health Sciences Commons^™

The Dance Of Here And Now: A Heuristic Journey Uncovering The Role Of Presence While Practicing Dance/Movement Therapy With An Elderly Population Experiencing Dementia, Kaitlynn Sinki

Creative Arts Therapies Theses

The goal of this heuristic research study was to further explore the concept of presence within the dance/movement therapist, and how presence could be accessed within the practice of dance/movement therapy. Specifically, how I the researcher, can efficiently utilize presence within myself as a vehicle for therapeutic change while working with an elderly population experiencing dementia. Guided by heuristic and intuitive inquiry methodologies, my personal experience of presence was observed and analyzed. Data collection took place over a three month period consisting of structured journaling, embodied movement responses, and spontaneous artmaking in relation to dance/movement therapy sessions. Findings suggested that …

Trends In Psychotropic Dispensing Among Older Adults With Dementia Living In Long-Term Care Facilities: 2004-2013., Akshya Vasudev, Salimah Z Shariff, Kuan Liu, Amer M Burhan, Nathan Herrmann, Sean Leonard, Muhammad Mamdani

Psychiatry Publications

OBJECTIVE: Guidelines worldwide have cautioned against the use of antipsychotics as first-line agents to treat neuropsychiatric symptoms of dementia. We aimed to investigate the changes over time in the dispensing of antipsychotics and other psychotropics among older adults with dementia living in long-term care facilities.

METHODS: We used drug claims data from Ontario, Canada, to calculate quarterly rates of prescription dispensing of six psychotropic drug classes among all elderly (≥65 years of age) long-term care residents with dementia from January 1, 2004, to March 31, 2013. Psychotropic drugs were classified into the following categories: atypical and conventional antipsychotics, non-sedative and …

Vascular Cognitive Impairment In First Ever Ischemic Stroke Survivors, Sarfraz Ahmed Mahesar, Raheel Ahmed Channa, Alam Ibrahim Siddiqui

Pakistan Journal of Neurological Sciences (PJNS)

Stroke and transient ischemic attacks (TIA) are highly prevalent in Pakistan. Post stroke dementia (PSD) is one of the main causes of dependency in survivors and includes any dementia after a stroke, irrespective of its cause, which includes vascular, degenerative, or mixed. Many Independent survivors have residual physical or cognitive deficits, or behavioral changes which can affect family life and have professional consequences. Study design: Cross sectional study at Department of Neurology CMC Hospital Larkana from Aug-2014 to Jan-2015 to find out frequency of dementia in first ever ischemic stroke patients, its severity and outcome. Methods: Study approved from ethical …

Eating And Swallowing, Oral Health, And Saliva Production, Rebecca H. Affoo

Electronic Thesis and Dissertation Repository

Eating and maintaining optimal nutrition are essential to health and quality of life. In both health and disease, eating is influenced by multiple factors including swallowing, oral health, and saliva production. Perturbations to any, or all, of these inter-related factors may result in consequences that negatively affect the health and wellness of an individual. Eating and swallowing impairment are common symptoms of neurodegenerative diseases such as dementia, and these symptoms are associated with a host of negative sequelae such as malnutrition, dehydration, aspiration pneumonia, and reduced quality of life. The studies reported in this dissertation explored elements of eating and …

Topical Administration Of Psychotropic Medications In Pluronic Lecithin Organogel To Treat Patients With Dementia: A Retrospective Observational Study, Cornelius W. Thomas, Md, Suzanne Holroyd, Md. Chair, Department Of Psychiatry

Suzanne Holroyd

OBJECTIVE: Treatment of mood and behavioral symptoms in geriatric patients with advanced dementia may be impeded by poor compliance with oral medications. Pluronic lecithin organogel (PLO) is a compounding substrate that can be used for the topical administration of psychotropic medications. METHODS: Charts of patients treated with psychotropic medications compounded with PLO cream were reviewed for treatment outcomes. All patients were treated by a nursing home outreach service. RESULTS: Records from twenty-four patients, mean age 86.8 + 5.9, were reviewed. Common psychiatric symptoms included agitation, aggressive behavior, and depression. Medications most commonly administered as a PLO cream included quetiapine and …

Pancreatic Encephalopathy- A Rare Complication Of Severe Acute Biliary Pancreatitis, Vlad Denis Constantin, Alexandru Carȃp, Bogdan Socea, Simona Bobic

Journal of Mind and Medical Sciences

Background. Pancreatic encephalopathy is a rare complication of severe acute pancreatitis, with high mortality, being difficult to diagnose and treat, thus requiring continuous research regarding its management.

Materials and Methods. Of 20 patients diagnosed with severe acute pancreatitis on admission at Department of Emergency and Admission (DEA), from January 1st 2010 to March 31st 2014, 5 cases complicated by pancreatic encephalopathy were analyzed using a descriptive observational, retrospective, single-centre study.

Results. The study shows different types of diagnostic algorithm and therapeutical approaches, in correlation with morbidity and mortality rates.

Conclusions. Our study highlighted the fact that speed is critical, early …

The Concept Of Missing Incidents In Persons With Dementia, Meredeth Rowe, Amy M. Houston, Victor A. Molinari, Tatjana Bulat, Mary E. Bowen, Heather Spring, Sandra Mutolo, Barbara Mckenzie

Nursing Faculty Publications

Behavioral symptoms of dementia often present the greatest challenge for informal caregivers. One behavior, that is a constant concern for caregivers, is the person with dementia leaving a designated area such that their whereabouts become unknown to the caregiver or a missing incident. Based on an extensive literature review and published findings of their own research, members of the International Consortium on Wandering and Missing Incidents constructed a preliminary missing incidents model. Examining the evidence base, specific factors within each category of the model were further described, reviewed and modified until consensus was reached regarding the final model. The model …

Topical Administration Of Psychotropic Medications In Pluronic Lecithin Organogel To Treat Patients With Dementia: A Retrospective Observational Study, Cornelius W. Thomas, Md, Suzanne Holroyd, Md. Chair, Department Of Psychiatry

Marshall Journal of Medicine

OBJECTIVE: Treatment of mood and behavioral symptoms in geriatric patients with advanced dementia may be impeded by poor compliance with oral medications. Pluronic lecithin organogel (PLO) is a compounding substrate that can be used for the topical administration of psychotropic medications.

METHODS: Charts of patients treated with psychotropic medications compounded with PLO cream were reviewed for treatment outcomes. All patients were treated by a nursing home outreach service.

RESULTS: Records from twenty-four patients, mean age 86.8 + 5.9, were reviewed. Common psychiatric symptoms included agitation, aggressive behavior, and depression. Medications most commonly administered as a PLO cream included quetiapine and …

Evaluation Of A Sleep Knowledge Translation Strategy For Occupational Therapists Working With Persons Who Have Dementia, Laura Laberge, Blaire Sangster, Cary A. Brown

The Open Journal of Occupational Therapy

Introduction: Sleep deficiency is a significant, largely overlooked issue for persons with dementia (PWD), and is associated with physical and mental health problems, increased caregiver burden, and increased likelihood of institutionalization. Despite the high prevalence of sleep deficiency in PWD, most health care professionals lack knowledge of the relationship between sleep problems and dementia. This project aimed to determine the feasibility of an archived online presentation, a knowledge translation (KT) strategy to increase therapists’ understanding of the impact of blue-spectrum light on sleep in PWD.

Method: Therapists who participated in a previous sleep and dementia survey were recruited via email. …

Resourcefulness In African American And Caucasian American Caregivers Of Persons With Dementia: Associations With Perceived Burden, Depression, Anxiety, Positive Cognitions, And Psychological Well-Being, Abir K. Bekhet

College of Nursing Faculty Research and Publications

Purpose

Providing care to persons with dementia can have negative effects on caregivers' physical and psychological well-being. This secondary analysis explored relationships among perceived burden, depression, anxiety, resourcefulness, and psychological well-being in 28 African American (AA) and 45 Caucasian American (CA) caregivers of persons with dementia.

Design and Methods

Descriptive, cross-sectional design was used to examine the hypothesized relationships in a sample of 73 caregivers.

Findings

CAs reported greater burden (t = −3.68, p < .001), more anxiety (t = −2.66, p < .01), depression (t = −2.21, p < .05), and hostility (t = −2.30, p < .05) than AAs. AAs reported higher scores than CAs on resourcefulness, positive cognitions, and psychological well-being.

Practice Implications

The study findings provided directions for the development of resourcefulness interventions …

How Clinicians Feel About Working With Spouses Of The Chronically Ill, Douglas Ingram

NYMC Faculty Publications

Clinicians who provide psychotherapy to spouses or partners of the chronically ill were solicited through listserves of psychodynamic and other organizations. The current report excluded those therapists working with spouses of dementia patients. Interviews were conducted with clinicians who responded. The interviews highlight the challenges commonly encountered by psychotherapeutic work with this cohort of therapy patients. A comparison is drawn that shows both overlap and distinctions between the experiences of those therapists engaging with spouses of chronically ill patients without a dementing process and those working with spouses of chronically ill patients who do suffer from a dementing process.

The Effect Of A Multiple Modality Mind-Motor Exercise Intervention On Single And Dual-Task Gait, Balance, And Executive Function, In Community Dwelling Older Adults With A Subjective Cognitive Complaint: A Randomized Controlled Trial., John P. Bocti

Electronic Thesis and Dissertation Repository

Cognitive decline disorders are becoming increasingly prevalent, with older adults at increased risk. Combined exercise has been recently explored as an intervention to help to prevent the decline, however cognitive activation in combination with physical activity has yet to be explored. Therefore, the purpose of the study is to determine the effects of multiple modality exercise programs in combination with a mind-motor task and their effects on mobility and cognitive variables. A total of (n=89) older adults (55+ yrs), with subjective cognitive complaints participated in a multiple modality exercise class, three days a week over six months, with the intervention …

A Mindfulness And Health Promotion Program To Decrease The Perception Of Stress And Burnout In Psychiatric Mental Health Nurses Who Provide Driect Patient Care To Individuals In Mental Health Units With A Diagnosis Of Alzheimer's Type Dementia, Latarsha Waltronia Bilal Edwards

LaTarsha W Edwards

The principle of this systems-change project is to employ a stress management and health promotion program in Alzheimer’s type units to decrease the perception of stress and burnout in psychiatric-mental health nurses providing direct care in secured units. This systems-change project will implement mindfulness techniques as an effective tool for reducing the perception of stress and burnout. The mindfulness-based stress reduction and burnout prevention program will be implemented into staff development programs for nurses working in locked and psychiatric units in the community. Mindfulness-based stress reduction is an operational tool to aid nurses psychologically and to increase work satisfaction. Behavioral …

Use Of Medications Of Questionable Benefit In Advanced Dementia, Jennifer Tjia, Becky Briesacher, Daniel Peterson, Qin Liu, Susan Andrade, Susan Mitchell

Jennifer Tjia

IMPORTANCE: Advanced dementia is characterized by severe cognitive impairment and complete functional dependence. Patients' goals of care should guide the prescribing of medication during such terminal illness. Medications that do not promote the primary goal of care should be minimized. OBJECTIVES: To estimate the prevalence of medications with questionable benefit used by nursing home residents with advanced dementia, identify resident- and facility-level characteristics associated with such use, and estimate associated medication expenditures. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study of medication use by nursing home residents with advanced dementia using a nationwide long-term care pharmacy database linked to the Minimum Data …

Effect Of Therapeutic Massage On Pain In Patients With Dementia, Yamini Kapoor, Rob Orr

Rob Marc Orr

Introduction

The aim was to investigate whether therapeutic massage was effective in relieving pain in elderly residents with dementia.

Methods

A randomized controlled study was conducted in an aged care facility. Ten participants with dementia or advanced dementia were allocated to an intervention group or a control group. The intervention group received 10?min of massage (effleurage, kneading, and trigger point therapy) four times per week for 4 weeks. The Pain Assessment in Advanced Dementia scale was used as the outcome measure.

Results

No significant changes in mean outcome measure scores were found post intervention (Intervention mean?=?5.0?±?3.49; Control mean?=?5.2?±?3.49: t(8)?=?0.09, p?=?0.93). …

Does Simulation Improve Nursing Student Knowledge, Skills, And Attitudes In Identifying Delirium Superimposed On Dementia?, Sheryl A. Kelly

Theses and Dissertations

This dissertation is comprised of three manuscripts, to be submitted for publication, exploring the use of simulation in geriatric nursing education. The first manuscript is a literature review. Although, a number of articles exist on the use of simulation in nursing education, there is a paucity of research using simulation emphasizing the care of patients with dementia and delirium as a pedagogical strategy or those using a stringent research design.

The second manuscript provides an overview of two conceptual frameworks (National League for Nursing (NLN)/Jeffries Simulation Framework and situated cognition learning framework) and recommends merging them to guide researchers as …

Calcium Channel Blockers, Progression To Dementia, And Effects On Amyloid Beta Peptide Production, Mark A. Lovell, Erin Abner, Richard Kryscio, Liou Xu, Shuling X. Fister, Bert C. Lynn

Sanders-Brown Center on Aging Faculty Publications

Previous epidemiologic studies suggest that antihypertensive drugs may be protective against cognitive decline. To determine if subjects enrolled in the University of Kentucky longitudinal aging study who used antihypertensive drugs showed diminished progression to dementia, we used a 3-parameter logistic regression model to compare the rate of progression to dementia for subjects who used any of the five common categories of antihypertensive drugs to those with similar demographic characteristics but who did not use antihypertensives. Regression modeling showed that subjects who used calcium channel blockers (CCBs) but not the other classes of antihypertensives showed a significant decrease in the rate …

Validation Study Of The Mini-Mental State Examination In Urdu Language For Pakistani Population, Safia Awan, Naila Shahbaz,, Syed Wasim Akhtar, Arsalan Ahmad, Sadaf Iqba, Sellal Ahmed, Haider Naqvi, Mohammad Wasay

Section of Neurology

Validation study of the Mini-Mental State Examination in Urdu language for Pakistani population. Objective: This study was conducted primarily to validate and determine the optimal cutoff score in the diagnosis of dementia among Pakistani’s and study the effects of gender and education on the MMSE performance in our population. Methods: Four hundred participants took part in the study. Patient with dementia recruited from five major hospitals from Pakistan. The MMSE was translated into Urdu. Results: There were 61 men and 39 women in dementia group and 225 men and 75 women in the control group. The mean score of Urdu …

Novel Advances In Alzheimer's Disease, Jacob P. Naumann

The Downtown Review

Alzheimer’s disease, the most common form of dementia in adults, is a progressive degenerative neurological disease that affects memory, cognition, and behavior. Dr. Alois Alzheimer discovered and diagnosed the irreversible disease in 1906 after documenting the famous case of Auguste Deter.¹ Since the discovery of the disease, numerous advances have made it possible to not only better understand the causal factors, but also to improve the medical diagnosis and preventative measures that healthcare providers can implement. For the first time since 1984, the National Institute on Aging (NIAA) and the Alzheimer’s Association (AA) proposed and published new diagnostic guideline …

Dementia In The Context Of Disability, Rosanne Dizazzo-Miller, Fredrick D. Pociask

Department of Health Care Sciences

Patients and caregivers often associate dementia with devastation and a loss of productive contribution to society. People with dementia are often depicted as confused individuals struggling through embarrassing episodes, followed by a loss of independence. The burden and devastation of the diagnosis on the families of people with dementia is exacerbated by their assumption of the role of caregiver with inadequate preparation or training. Disability scholars, in contrast, offer physical and occupational therapists a nontragic view of disability that recognizes the importance of countering the stigma and discrimination that too often accompany dementia. This case example of a woman diagnosed …

Statin Discontinuation In Nursing Home Residents With Advanced Dementia, Jennifer Tjia, Sarah Cutrona, Daniel Peterson, George Reed, Susan Andrade, Susan Mitchell

Jennifer Tjia

OBJECTIVES: To describe patterns of, and factors associated with, statin use and discontinuation in nursing home (NH) residents progressing to advanced dementia and followed for at least 90 days.

DESIGN: Retrospective inception cohort using a dataset linking 2007 to 2008 Minimum Data Set (MDS) to Medicare denominator and Part D files.

SETTING: All NHs in five states (Minnesota, Massachusetts, Pennsylvania, California, Florida).

PARTICIPANTS: NH residents with dementia.

MEASUREMENTS: Residents who developed advanced dementia were observed from baseline (date of progression to very severe cognitive impairment with eating problems) and followed for at least 90 days to statin discontinuation or death. …

Depression And Spiritual Predictors Of Wellness In Family Caregivers Of Individuals With Alzheimer’S Disease, Christine Green

Doctor of Psychology (PsyD)

This study investigated the role of spirituality in family caregivers of individuals with Alzheimer’s disease as a means of lessening the development of depressive symptomology arising through caregiver burden. For this study, there were 41 caregiver participants taking care of a family member with Alzheimer’s disease. The population was obtained through various divisions of the Alzheimer’s Association of the United States of America. Participants completed a basic demographic survey, the General Well-Being Schedule, the Patient Health Questionnaire- 9, and the Spiritual Experience Index. Two groups, religious and non-religious, had their mental health functioning compared. Results from the 41 surveys suggest …

Investigating The Theory Of Ambiguous Loss: The Role Of Ambiguity Tolerance In Pre-Death Grief For Caregivers Of Individuals With Dementia, Megan Kale-Cheever

Graduate Theses and Dissertations

This thesis sought to investigate the relationship between ambiguity tolerance and caregiver grief within the framework of ambiguous loss theory. Thirty-one family caregivers completed a quantitative survey comprising two pre-existing scales and several demographic questions designed to assess level of ambiguity tolerance, level of grief, caregiver age and gender, type of relationship to the care recipient, living situation, length of caregiving career, level of Social support and frequency of difficult behaviors. Quantitative data analysis revealed that while no relationship existed between total ambiguity tolerance and total caregiver grief, a modest, inverse relationship exists between tolerance toward general-type ambiguity and burden, …

Creative Expression And Dementia, Danielle A. Lavee-Dixon

Senior Theses

Art is the expression or application of human creative skills using that individual’s imagination. While most often taught amongst young people, I believe that art is a tool that can be used at all ages to promote reflection, pleasure, and personal passions. As a way to investigate the benefits of artistic expression amongst different groups of people, I have focused on the rewards achieved with art practiced by individuals living with dementia. Highlighting the difficulties a patient with dementia may encounter, and some of the benefits art can have on those patients; I was able to create art workshops that …

Reporting Practices, Knowledge And Opinion Of Policy Regarding Drivers With Dementia Among Arkansas Neurologists And Geriatricians, Erika Martin Gergerich

Graduate Theses and Dissertations

Background: States have various policies regarding a physician's ability or responsibility to report at-risk drivers with dementia to the Department of Motor Vehicles (DMV). Some states have mandatory reporting policies, others have optional reporting policies and some have no policy regarding this issue. Arkansas has no reporting policy regarding drivers with dementia to the DMV. Therefore, physicians in Arkansas face the risk of liability if they report a patient against their will to the DMV in good faith. Neurologists and geriatricians are often in a position to diagnose and treat individuals with dementia. Research Questions: The following three research questions …

The Role Of Medical Comorbidities On The Risk For Severe Dementia, Institutionalization, And Death In Alzheimer's Disease: A Population Study In Cache County, Utah, Mac J. Gilbert

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Alzheimer’s disease is a progressive disease that impairs cognitive and functional abilities. Without a cure, it is estimated there will be 81 million cases of Alzheimer’s disease by 2040. Life for the individual with Alzheimer’s disease, and their family, changes drastically when the affected individual experiences significant problems with memory, thinking, and ability to complete daily tasks. Some become so debilitated that they need to be placed in a nursing home for supportive care. Until a cure is discovered, it will be important to identify what can be done to help those with Alzheimer’s disease minimize time spent experiencing severe …

Connecticut's Elderly Population: An In-Depth Analysis Of Current And Future Trends In Elder Care, With A Focus On Dementia And Cognitive Decline, Emily J. Snodgrass

Honors Scholar Theses

The aging population in Connecticut currently represents ~15% of the state’s population but is anticipated to rapidly increase over the next 20 years. My thesis is an examination of the types of interventions and programs currently available for elderly persons with memory impairment and cognitive decline, as well as the challenges associated with caring for a larger elderly population. Data collected from interviews with CT healthcare and research professionals representative of the diverse specialties of aging together with an analysis of current research literature are used to demonstrate the importance of continued research and expansion of appropriate and accessible services …

Barriers To Music Therapy In The Care Of Those With Alzheimer's/Dementia, Karin E. Kvam

Honors College Theses

This pilot study examines the barriers caregivers encounter when implementing music therapy in the care of those with Alzheimer’s/dementia. An 8-question survey was distributed at two long-term care facilities and an Alzheimer’s support group to understand how often and in what ways music therapy is utilized, as well as what barriers caregivers face when using the therapy. Results indicated that, although the majority of caregivers report using music therapy, it is not implemented as frequently as it could or should be. Caregivers report a knowledge deficit as the main reason for not implementing music therapy. The data suggests that an …

Embedded System Design For Real-Time Monitoring Of Solitary Embedded System Design For Real-Time Monitoring Of Solitary, Robert Philip O'Brien

USF Tampa Graduate Theses and Dissertations

Alzheimer's disease and other forms of dementia cause cognitive disabilities in the afflicted person. As a result, the person with dementia often requires assistance from a primary caregiver. However, while the caregiver is away from the home they are unaware of the person's status and may not be able to find out without returning to the home due to dementia's effects on cognition.

In this thesis work, a system of embedded devices is presented which tracks a solitary dementia patient in the home in real-time. The system is composed of three main hardware components. Multiple passive and active sensors are …

Post Stroke Dementia And Its Putative Risk Factors: A Hospital - Based Study, Iranmanesh F, Sheykholeslami Nz, Rahimdel A, Gadari F, Vazirinajad R, Syedyazdi F

Pakistan Journal of Neurological Sciences (PJNS)

Introduction:
Dementia is common after stroke and has a considerable impact on mortality, rehabilitation and quality of life. There are some published articles regarding post stroke dementia but there are many controversies surrounding this topic. Our aim was to identify the prevalence of post stroke dementia 3 months after stroke and evaluation of some its putative risk factors in Iranian population.

Method:
In this cross-sectional study, 151 patients with acute stroke were evaluated. The diagnosis was confirmed by physical examination and neuroimaging. Three months after the stroke, all patients were visited again. The diagnosis of post stroke dementia was made …