Digital Commons Network^™

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 …

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 …

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 …

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 …

An Exploration Of Volition: Caregiver Perceptions Of Persons With Dementia, Christine Raber, Mikel Stone

The Open Journal of Occupational Therapy

The purpose of this study was to understand what formal caregivers know about the volition of older adults with moderate dementia. A qualitative approach was used at one assisted living facility. Semi-structured interviews were conducted with formal caregivers to gain their perceptions of residents’ volition or motivation for occupation. Volition of resident participants was assessed using the Volitional Questionnaire (VQ). Caregiver interviews and resident VQ’s were analyzed using van Manen’s phenomenological approach to examine their congruence with regard to the volitional abilities of residents. Thematic analysis yielded two broad themes: (a) Caregivers possess varying layers of insight regarding the volitional …

Bringing Comfort To People With Advanced Dementia, Ann Wyatt

Case Studies from Age in Action

Educational Objectives

1. Explain the purpose of looking at palliative care through a dementia lens.

2. Define dementia-capable palliative care.

3. Identify and provide examples of specific care practices that can bring comfort to people with advanced dementia.

4. Describe the process that staff use in identifying what brings comfort to individual residents.

Behavioral Implications Of A Cognitive Training Program For Individuals With Moderate Cognitive Impariment, Joseph L.D. Kennedy

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this study was to evaluate the effectiveness of a cognitive training program on behavioral outcomes for individuals with moderate cognitive impairment. A total of twenty participants were randomized into either a waitlist control or an experimental group. Collateral individuals familiar with each participant completed a series of measures of behavioral and emotional functioning at both pre- and post-intervention. Results demonstrated little effectiveness for the cognitive training program in stabilizing or improving behavioral functioning. Limitations and future directions are then provided to enhance future research in this area.

Is Alzheimer Disease Related To Age-Related Macular Degeneration?, Seden Demi̇rci̇, Ali̇me Güneş, Kadi̇r Demi̇rci̇, Serpi̇l Demi̇rci̇, Levent Tök, Özlem Tök

Turkish Journal of Medical Sciences

Background/aim: To compare the cognitive functions and define the frequency of Alzheimer disease (AD) between participants with and without age-related macular degeneration (AMD). Materials and methods: Fifty-nine patients with late-stage AMD (74.3 ± 7.3 years) and 49 age-, sex-, and education-matched control subjects were compared for the presence of AD according to the guidelines of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA). Detailed neuropsychological tests were performed for all subjects. Results: Neuropsychiatric tests scores were lower in the AMD group than the control group. The frequency of AD …

A Therapeutic Approach For Senile Dementias: Neuroangiogenesis, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Alzheimer's disease (AD) and related senile dementias (SDs) represent a growing medical and economic crisis in this country. Apart from cautioning persons about risk factors, no practical, effective therapy is currently available. Much of the recent research in AD has been based on the amyloid cascade theory. Another approach assumes a vascular basis for SDs. This paper presents evidence from a score of studies that cerebral capillary density (CCD) declines during old age in animals and people as well as in AD. Neuroangiogenic (NAG) factors initiate and maintain capillaries in the brain. Thus a waning level of these factors and …

Interpersonal Communication In The Context Of Dementia: Examining Family Caregivers' Appraisals And Burden, Stacy Lynn Barnes

Dissertations (1934 -)

Purpose and Objectives: The purpose of this study was to explore dementia family caregivers' appraisals of communication behaviors and strategies, and their relationships to caregiver burden. Study objectives were to investigate: 1) the relationship between frequency of dementia-related communication behaviors and caregivers' appraisals of frustration; 2) the relationship between caregivers' use of communication strategies and appraisals of helpfulness; 3) the structural relationships between communication behavior appraisal, communication strategy appraisal, problem behaviors, and caregiver burden; and 4) caregiver education level as a moderating variable of the final structural model. Methods: A written, mailed questionnaire was developed to capture dementia family caregivers' …

Self-Reported Head Injury And Risk Of Late-Life Impairment And Ad Pathology In An Ad Center Cohort, Erin L. Abner, Peter T. Nelson, Frederick A. Schmitt, Steven R. Browning, David W. Fardo, Lijie Wan, Gregory A. Jicha, Gregory E. Cooper, Charles D. Smith, Allison M. Caban-Holt, Linda J. Van Eldik, Richard J. Kryscio

Sanders-Brown Center on Aging Faculty Publications

Aims: To evaluate the relationship between self-reported head injury and cognitive impairment, dementia, mortality, and Alzheimer's disease (AD)-type pathological changes. Methods: Clinical and neuropathological data from participants enrolled in a longitudinal study of aging and cognition (n = 649) were analyzed to assess the chronic effects of self-reported head injury. Results: The effect of self-reported head injury on the clinical state depended on the age at assessment: for a 1-year increase in age, the OR for the transition to clinical mild cognitive impairment (MCI) at the next visit for participants with a history of head injury was 1.21 and 1.34 …

The Social Environment, Apoe-E4, And Dementia: The Social Environment As A Moderating Factor Among Individuals Genetically Predisposed To Develop Dementia, Judith L. Poey

Graduate Doctoral Dissertations

Many studies have shown a relationship between the APOE-e4 allele and dementia, as well as a relationship between the social environment and dementia. However, relatively little investigation into the potential moderating effect of the social environment on the relationship between the APOE-e4 allele and cognitive well-being has been reported. Further, studies that did examine these relationships typically have employed clinical populations, along with regional and non-U.S. samples. This study contributed to the research literature, in part, by using the first U.S. nationally representative sample of older adults that included clinical diagnosis of cognition and dementia (Aging, Demographics, and Memory Study …

Strategies For Sustaining Self Used By Family Caregivers For Older Adults With Dementia, Margaret J. Bull

College of Nursing Faculty Research and Publications

The negative health consequences of caring for an older adult family member with dementia are well documented. However, not all family caregivers experience these negative health consequences. The purposes of this study were to describe strategies family caregivers use to help them continue to provide care for an older family member with dementia despite challenges and describe these family caregivers’ resilience and psychological distress. A mixed methods design was used with a narrative approach dominant and standardized scales for resilience and psychological distress used to enhance the description of the sample. Data were collected through telephone interviews with 18 family …

Results And Lessons Learned From A Nurse Practitioner-Guided Dementia Care Intervention For Primary Care Patients And Their Family Caregivers, Richard H. Fortinsky, Colleen Delaney, Ofer Harel, Karen Pasquale, Elena Schjavland, John Lynch, Alison Kleppinger, Suzanne Crumb

Articles - Patient Care

Older adults with dementia care needs often visit primary care physicians (PCPs), but PCP dementia care limitations are widely documented. This study tested the value of employing a nurse practitioner (NP) with geropsychiatric expertise to augment PCP care for newly and recently diagnosed patients and family caregivers. Twenty-one dyads received the NP intervention; 10 dyads were controls. Outcomes included patient neuropsychiatric symptom and quality of life changes, and caregiver depression, burden, and self-efficacy changes. Intervention acceptability by patients, caregivers, and PCPs was determined. No outcome differences were found; however, the NP intervention was deemed highly satisfactory by all stakeholders. Patients …

The End Of Alzheimer's Disease - From Biochemical Pharmacology To Ecopsychosociology: A Personal Perspective, Peter J. Whitehouse

Faculty Scholarship

The future of the Alzheimer's disease (AD) field involves a more complete understanding not only the state of current scientific approaches, but also the linguistic and cultural context of preclinical and clinical research and policy activities. The challenges surrounding dementia are large and growing but are only part of broader social and health concerns. In this latter context, the current state of research in the AD area is reviewed together with necessary priorities in moving forward. Creating a more optimistic future will depend less on genetic and reductionist approaches and more on environmental and intergenerative approaches that will aid in …

Habilitation Training Curriculum: Is It Useful?, Ryan K. Cole, Christine Wyman

Thinking Matters Symposium Archive

Alzheimer’s disease is the most common form of dementia, affecting approximately five million Americans. Paul Raia, PhD, Vice President, Clinical Services at the Alzheimer’s Association, MA/NH Chapters, developed a training curriculum called Caring for People with Alzheimer’s Disease: A Habilitation Training Curriculum. The Alzheimer’s Association’s Maine Chapter has been implementing this training in care facilities across Maine. The purpose of this project was to evaluate if this training is perceived as useful in direct care settings.A secondary goal of the project was to determine if this training should be adapted for use in other settings in which professionals of varying …

Clinical Trials And Late-Stage Drug Development In Alzheimer’S Disease: An Appraisal From 1984 To 2014, L. S. Schneider, F. Mangialasche, S. Andreasen, H. Feldman, E. Giacobini, R. Jones, V. Mantua, P. Mecocci, L. Pani, B. Winblad, M. Kivipelto

Human Clinical Trials Collection

The modern era of drug development for Alzheimer's disease began with the proposal of the cholinergic hypothesis of memory impairment and the 1984 research criteria for Alzheimer's disease. Since then, despite the evaluation of numerous potential treatments in clinical trials, only four cholinesterase inhibitors and memantine have shown sufficient safety and efficacy to allow marketing approval at an international level. Although this is probably because the other drugs tested were ineffective, inadequate clinical development methods have also been blamed for the failures. Here, we review the development of treatments for Alzheimer's disease during the past 30 years, considering the drugs, …

The Phenomenology Of Husbands Caring For Wives With Dementia, Melanie Mayo

Nursing ETDs

The lived experience of husbands caring for wives with dementia was investigated in order to develop a better understanding of their caregiver burden. The conceptual background for the study originated in the work of philosophical phenomenologists Edmund Husserl and Edith Stein with particular attention to their theories of inter-subjectivity and empathy. Amadeo Giorgis Descriptive Phenomenological Method in Psychology was used for study design and analysis. Results suggest an enduring connectedness of the couples and their bonds throughout the shifting of roles and emotions as the dementia progresses. Implications for nursing include the need to employ interventions respectful of the persistence …

Betsy: A Case Study Of A Client With Down's Syndrome And Dementia, Cheryl D. Schlamb, Christine D. Moriconi

Nursing Faculty Publications

No abstract provided.

Evaluation Of The Jewish Community Housing For The Elderly Memory Support Initiative, Joan Hyde

Gerontology Institute Publications

Jewish Community Housing for the Elderly (JCHE) is a large, multi-campus organization that houses and serves 1,500 residents (80 market rate and 1,420 low income). The average age is 80 years old, with one-third of residents 85 and older. Three quarters of the residents are not native English speakers. Through HUD and other funding, JCHE offers a range of supports to these residents, including translators, interpreters and staff with language and cultural competence, meals, transportation and, through their Service Coordinators, facilitation of resident access to government benefits, home care and other services.

According to the Alzheimer’s Association’s 2012 special report …

Goffman And The Infantilization Of Elderly Persons: A Theory In Development, Stephen M. Marson, Rasby M. Powell

The Journal of Sociology & Social Welfare

Infantilization is a behavioral pattern in which a person of authority interacts with, responds to, or treats an elderly person in a child-like manner. This paper uses Erving Goffman’s theories as a framework from which to analyze the reasons for and the results of infantilization of elderly residents in partial and total institutions (i.e., adult day care centers and nursing homes). First, we review the literature on infantilization. Next, we offer a brief summary of Goffman’s work and delineate his major theoretical assumptions. Then, we analyze the process of infantilization through Goffman’s theories. Finally, we offer suggestions for advancing research …

Dementia In Maine: Characteristics, Care, And Cost Across Settings [Chartbook], Julie T. Fralich Mba, Stuart Bratesman Mpp, Louise Olsen, Catherine Mcguire Bs, Tina Gressani, Karen Mauney, Catherine Gunn, Romaine Turyn

Disability & Aging

This report provides a baseline picture of the current use of services by people with and without dementia in Maine.

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 …

A Review Of Empirical Approaches To Maintenance Of Staff Implementation Of Function-Based Interventions In Nursing Home Settings, Kazu Takeguchi

Research Papers

The use of atypical anti-psychotic medications has been increasing in nursing homes, even though the adverse effects of such medications in patients with dementia have been widely reported. Additionally, the Omnibus Budget Reconciliation Act of 1987 mandates the use of behavioral interventions before any medications are used in order to reduce challenging behaviors in demented patients. It has been empirically demonstrated that function-based behavioral interventions are effective in reducing challenging behaviors in older adults with dementia. Behavioral interventions are safe, noninvasive, and usually positive alternatives for physical or medical restraints. However, local staff's intervention implementation is typically not maintained after …

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. …

Picturing Leisure: Using Photovoice To Understand The Experience Of Leisure And Dementia, Rebecca Genoe, Sherry Dupuis

The Qualitative Report

Interviews and participant observation are commonly used to explore the experience of dementia, yet may not adequately capture perspectives of persons with dementia as communication changes. We used photovoice (i.e., using cameras in qualitative research) along with interviews and participant observation to explore meanings of leisure for persons with dementia. We discuss our photovoice process and the challenges we encountered, including ethical concerns, difficulty using the equipment, forgetting the context of photos, and questioning self. Despite challenges, photovoice aided in cuing memory, planning for the interview, sharing stories, and capturing meaning. We recommend further exploration of photovoice with this population.

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.

Applying Mobile Application Development To Help Dementia And Alzheimer Patients, Jean F. Coppola Phd, Marc A. Kowtko, Christina Yamagata, Shannon Joyce

Wilson Center for Social Entrepreneurship

Caregiver anecdotes attest that music and photographs play an important role for family members diagnosed with Alzheimer’s disease (AD), even those with severe AD. Tablets and iPads, which are prevalent, can be utilized with dementia patients in portraying favorite music and family photographs via apps developed in close partnership with geriatric facilities. This study addresses cognitive functioning and quality of life for people diagnosed with dementia via technology. Research has shown that technology instruments such as iPods, help stimulate those with dementia. This study focuses on innovative devices such as iPads and tablets, which are mainstream and easy to use, …

The Impact Of A Memory Box Activity On Relationships Between Residents Of A Long Term Care Facility And The Staff, Camilla Reynolds

Senior Honors Theses and Projects

When working in a residential facility it is difficult for staff to take the time to really get to know whom they are helping due to time constraints. This study conducted a pre and post test to determine the impact that a Memory Box Activity has on staff attitudes about the residents. The Memory Box is a box put together by residents (with staff help) that includes items that have meaning to them. The presumption was that by participating in this activity with the residents the staff attitudes would be positively impacted. This study was conducted at two local long-term …