Digital Commons Network^™

Animal Assisted Interventions For Older Adults Experiencing Cognitive Impairment, Preeti Bachu

Psychology

As individuals age, they often experience gradual declines in cognitive abilities that ultimately affect their quality of life and independence. Severe cognitive decline is not necessarily a natural or universal part of the aging process and tends to be exacerbated by various neurodegenerative diseases, most notably Alzheimer's disease (Colita et al., 2024). There have been promising outcomes of animal assisted interventions in improving the conditions of several populations and spaces, including educational, rehabilitative, and therapeutic settings. Animal assisted therapy specifically is delivered by a qualified or licensed health professional. Previous research has shown a large benefit in long-term memory, verbal …

Dementia Caregiver Support: Offering Spiritual And Emotional Guidance To Loved Ones Filling The Gap, William Reid Bishop

Doctoral Dissertations and Projects

The problem at Tremont Church of God is that members offering caregiver support to their loved ones with dementia are unaware of the coping skills needed for support. The purpose of this DMIN action research project is to provide an 8-week training program to teach caregivers techniques for managing their emotional and spiritual needs. The sample population for this project is church members over the age of 18 who are actively caregiving for a spouse or close relative with dementia. The sample size is between 10 and 15 participants. The training is located at Tremont COG. The training is in …

Lessons Learned From The Implementation Of A Pragmatic Trial Evaluating Non-Pharmacological Approaches To Dementia Care In Us Nursing Homes, Carin Wong, Catherine V. Piersol, Felicia Chew, Cara Lekovitch, Victoria Shier, Mike Morris, Jenny Martínez, Julie Britton, Natalie E. Leland

Department of Occupational Therapy Faculty Papers

RATIONALE: The consistent delivery of effective evidence into nursing home practice has been shown to enhance quality of care and residents' outcomes. Pragmatic trials enable the evaluation of efficacious interventions in a real-world context, including care of residents living with Alzheimer's Disease and Related Dementias (ADRD). Yet, there are limited pragmatic trials conducted in nursing homes and even less evidence on the strategies to successfully conduct such research in this setting.

OBJECTIVE: To identify the lessons learned from a pragmatic trial and provide recommendations for future successful studies in United States (US) nursing homes.

METHODS: Drawing on a case example …

Predicting Mortality And Costs After Emergency Department Visits By People With Dementia: Timing And Location Matter, Jason K Bowman, Christine S Ritchie, Kei Ouchi, Kyler M Godwin, James A Tulsky, Joan M Teno

Faculty, Staff and Students Publications

Background: People with dementia have high rates of emergency department (ED) and hospital utilization, high mortality and costs, and other poor outcomes. To successfully impact the care trajectories of these patients, health care systems must pragmatically identify the correct target population. This study described patterns of ED utilization by people with dementia and explored the accuracy of administrative data models to predict mortality and costs.

Methods: Retrospective cohort study of a 20% random sample of Traditional Medicare (TM) beneficiaries with dementia, age ≥ 66 years, and an index ED visit in 2018. One-year mortality and high costs were described, and …

Self-Efficacy Change Among Diverse Family Caregivers In Dementia Care, Deborah M Oyeyemi, Erich J Greene, Yunshan Xu, David R Lee, Rafael Samper-Ternent, Maya L Lichtenstein, Alan Stevens, Jeff D Williamson, Arun S Karlamangla, Debra Saliba, David B Reuben

Faculty, Staff and Student Publications

Objectives: To determine whether changes in caregiver self-efficacy (beliefs about one's ability to manage dementia-related problems and access help) differed by caregiver race and ethnicity across all participants enrolled in a large pragmatic trial of comprehensive dementia care.

Methods: In the Dementia Care Study (D-CARE), community-dwelling older adults with dementia and their unpaid family caregivers were randomized to receive usual care, community-based, or health system-based comprehensive dementia care. Caregiver self-efficacy was assessed at baseline, 6 months, and 18 months using a 4-item scale (range 4-20, higher scores indicate greater self-efficacy). Among all caregivers, we compared least squares means for overall …

Effect Of Antipsychotic Medication Use And Type On Mortality And Cardiovascular Risks In Nursing Home Patients With Dementia, Hamid R. Okhravi, Fang Fang, Melissa P. Hunter, Brynn E. Sheehan

Glennan Center for Geriatrics and Gerontology Faculty Publications

Introduction

Antipsychotic medication (APM) use in nursing home (NH) patients with dementia is common but carries risks. This study assessed the association between APM use and mortality, stroke, and myocardial infarction (MI) compared to non-use, as well as differences between first- and second-generation APMs.

Methods

A serial cross-sectional study using Medicare data examined outcomes from 2012 to 2015 in a national sample of 328,138 US NH residents aged 50 and older with dementia. Multivariate logistic regressions were used to analyze risk.

Results

APM use was associated with increased mortality in all years (odds ratio [OR] range: 2.39 to 1.23, all …

Alzheimer's Medications And Polypharmacy Management In Advanced Dementia And Hospice Care, Rana Senlik, Robert Martin

Advocate GME

No abstract provided.

Potential Mechanisms Of Influence Between Spiritual Practices And Cognitive Health: A Systematic Review And Conceptual Model, Katherine Carroll Britt, Hayoung Oh, Augustine Cassis Obeng Boateng, Sherry Morgan, Sato Ashida, Corey Nagel, Roland J Thorpe, Harold G Koenig

Staff and Researcher Publications

Background/Objectives: This systematic review summarizes the evidence regarding potential mechanisms underlying the relationship between spiritual practices and cognitive health in adults. The review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist.

Methods: An extensive search of six electronic databases (i.e., PubMed, PsycINFO, Embase, Sociological Abstracts, ATLA, CINAHL) was conducted using keywords related to spiritual practices, religious activities, and cognitive health from 1 January 2000 to December 2025. The quality of the included studies was assessed using the Mixed Methods Appraisal tool aligned with the study design.

Results: A total of …

Implementation Of A Dementia-Specific Advance Care Planning Tool: A Quality Improvement Pilot, Stephanie Nichole Johnson

Biennial Convention (CONV)

Purpose: There are 55 million cases of dementia worldwide and the cost of care for these individuals is estimated to rise to $2 trillion by 2030. Dementia-specific Advance Care Planning (ACP) can help to reduce the burdens of providing care to those diagnosed with dementia. This study sought to determine if the implementation of a dementia-specific ACP tool increases knowledge and decision-maker confidence, as well as decrease inappropriate healthcare utilization rates.

Method: At a Program for All-Inclusive Care for the Elderly (PACE), individuals diagnosed with a cognitive deficit (CD) and their surrogate decision-maker (SDM) were recruited as dyads to participate …

Family Caregivers' Perspectives On Challenges And Support Needs In Hospital-Based Palliative Care For Persons Living With Dementia, Jung Kwak, Anita Chary, Sarah Stayer, Kwaku Duah Oppong, Sumin Yoon, Snehal Patel, Elizabeth A Kvale

Faculty, Staff and Students Publications

Palliative care needs of hospitalized persons living with dementia (PLWD) and their family caregivers remain poorly understood. This mixed-methods study explored caregivers' perspectives on challenges and support needs when hospitalized PLWD received specialist palliative care consultations. Thirty-two caregivers were recruited from two hospitals; 18 completed interviews and surveys, and 14 completed surveys only. Participants were racially and ethnically diverse (19% Black or African American, 34% Latino or Hispanic). Most identified as women (65%) and adult children (56%). Commonly reported challenges included managing health issues (59%), emotional distress (56%), and decision-making (47%). Thematic analysis of interviews revealed three themes: the value …

Reminisce And Relive Joyful Memories Despite Dementia, Candice Cacal Nono

Creating Healthy Work Environments (CHWE)

Background: Dementia is a progressive neurological disease that affects cognition and behavioral and mood impairments, such as depression, that must be addressed. The DNP Project implemented an evidence-based intervention to improve healthcare outcomes involving depression in patients with dementia in a long-term care setting.

Problem: Dementia is a progressive neurological disease affecting mood and conditions that can lead to depression, affecting a patient’s quality of life. A quality improvement project was implemented in a long term care facility in Chicago, Illinois.

Methods: Eight residents with mild to moderate dementia participated in an eight-week Group Reminiscence Therapy program to measure the …

Mayo Normative Studies: Regression-Based Normative Data For Remote Self-Administration Of The Stricker Learning Span, Symbols Test, And Mayo Test Drive Screening Battery Composite And Validation In Individuals With Mild Cognitive Impairment And Dementia, Nikki H Stricker, Jason Hassenstab, Et Al.

2020-Current year OA Pubs

No abstract provided.

Staff Education To Improve Quality Of Life For Patients With Dementia, Vanessa Ann Soda

Walden Dissertations and Doctoral Studies

Dementia is a chronic neurodegenerative disease that is incurable and unpredictable. Patients with dementia experience a decline in functional abilities, communication, and social skills. Fifty-five million people worldwide live with dementia with over 6.9 million people over 65 years of age diagnosed in the United States. The practice problem identified by a 25-bed assisted living facility in the north-central United States was staff’s lack of knowledge of dementia diagnosis, person-centered care approaches, and optimal care strategies supporting a positive quality of life for patients with dementia. The practice-focused question addressed whether an education program consisting of evidence-based practices using the …

Training To Move An Evidence-Based Dementia Caregiver Support Program Into Practice: A Pragmatic, Randomized, Non-Inferiority Trial Protocol, Nancy A. Hodgson, Miranda V. Mcphillips, Karen B. Hirschman, Emily Summerhayes, Catherine Verrier Piersol, Laura N. Gitlin

Department of Occupational Therapy Faculty Papers

Background

Objective

Health System, Community-Based, Or Usual Dementia Care For Persons With Dementia And Caregivers: The D-Care Randomized Clinical Trial, David B Reuben, Thomas M Gill, Alan Stevens, Jeff Williamson, Elena Volpi, Maya Lichtenstein, Lee A Jennings, Rebecca Galloway, Jenny Summapund, Katy Araujo, David Bass, Lisa Weitzman, Zaldy S Tan, Leslie Evertson, Mia Yang, Katherine Currie, Aval-Na'ree S Green, Sybila Godoy, Sitara Abraham, Jordan Reese, Rafael Samper-Ternent, Roxana M Hirst, Pamela Borek, Peter Charpentier, Can Meng, James Dziura, Yunshan Xu, Eleni A Skokos, Zili He, Sherry Aiudi, Peter Peduzzi, Erich J Greene, D-Care Study

Faculty, Staff and Student Publications

Importance: The effectiveness of different approaches to dementia care is unknown.

Objective: To determine the effectiveness of health system-based, community-based dementia care, and usual care for persons with dementia and for caregiver outcomes.

Design, setting, and participants: Randomized clinical trial of community-dwelling persons living with dementia and their caregivers conducted at 4 sites in the US (enrollment June 2019-January 2023; final follow-up, August 2023).

Interventions: Participants were randomized 7:7:1 to health system-based care provided by an advanced practice dementia care specialist (n = 1016); community-based care provided by a social worker, nurse, or licensed therapist care consultant (n = 1016); …

Frontotemporal Dementia And Amyotrophic Lateral Sclerosis: A Case Report And Clinical Insights, Audrey Grigore, Lynne J. Goebel

Internal Medicine

Primary care providers are often the first contact for patients with neurodegenerative illnesses, however, they may not be aware of the relationship of certain diseases that may have an impact on their patients' longevity. This case report reminds clinicians of the association between frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS). Physicians should be aware of the association, because FTD commonly occurs first and may prepare clinicians to be alert to the signs of ALS in these patients, leading to earlier detection of ALS and the prescription of disease-modifying medication that may extend the lifespan of people with these diseases. …

Ethical Considerations Of Percutaneous Endoscopic Gastrostomy Tube Placement In A Patient With Creutzfeldt-Jakob Disease And Advanced Dementia, Toni Habib, Niamh Siobhán Mulrooney, Yisroel Grabie, Mohammad Maruf, Sophia Kasapira

HCA Healthcare Journal of Medicine

Background

Creutzfeldt-Jakob disease (CJD) is a rapidly progressive neurodegenerative condition that is not easily diagnosed and has no curative treatments available, essentially requiring palliative measures, including tube feeding. Nonetheless, data shows that the endoscope used for percutaneous endoscopic gastrostomy (PEG) tube insertion can be a vector for CJD transmission.

Case Presentation

We discuss the case of an elderly patient diagnosed with CJD, requiring tube feeding. Multiple specialists were consulted, and they were unable to reach an agreement on the best approach. Eventually, the hospital ethics committee intervened, and the family agreed to comfort measures only. This case report sheds light …

Online Act For Caregivers: A Longitudinal Mixed Methods Study, Jacob D. Gossner

All Graduate Theses and Dissertations, Fall 2023 to Present

Family caregivers for people with dementia are a resilient population operating under stressful circumstances that can put them at risk of multiple negative outcomes. Existing interventions may be difficult for family caregivers to access due to time and transportation constraints; an alternative is online, self-guided interventions that caregivers can access from their own homes. The purpose of this dissertation is to evaluate the impact of ACT for Caregivers, a six session online, self-guided program based on the principles of Acceptance and Commitment Therapy. Participants had an average age of 61.93 (SD = 13.69), had been caregiving for an average …

Exploring Touch: Art Therapy With Older Adults, Katherine Gilpatrick

Expressive Therapies Capstone Theses

Touch is an incredible tool that allows humans to connect with one another. It is instrumental in art therapy as we work with different populations and materials. Touch can occur in many ways but must be clearly defined in the therapeutic space, especially regarding ethical codes. This paper explored touch within senior living communities across different levels of care, including dementia care. A variety of art materials were used including drawing materials, collage, clay, and digital art. Art experiences were documented and analyzed through journaling and reflective artmaking. Four patterns emerged when examining the results including connection to product, differences …

Increasing Nursing Aide Knowledge On Benefits Of Light For Sundowning Syndrome, Grace Hilfiker, Julie Masters

Honors Program: Senior Projects (Public)

In this study, the knowledge of nursing aides on the benefits of light for sundowning syndrome was investigated. While dementia and sundowning syndrome is discussed during nursing aide training in the state of Nebraska, there is no discourse focused on how light plays beneficial role in lessening the symptoms of sundowning syndrome for those who are afflicted with dementia. This study asked what the current knowledge base surrounding dementia and sundowning syndrome is of nursing aides in the state of Nebraska. The aim was to justify adding a focus on concrete methods to use when caring for patients with dementia …

Exploring The Health Care Professionals' Attitudes And Beliefs Of Patient-Centered Care On The Progression Of Dementia, Brittany L. Holmes

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the attitudes and beliefs of patient-centered care on the progression of dementia for healthcare professionals at a long-term patient-centered care residential site. The theory guiding this study was Ajzen’s theory of planned behavior in 1985 as it will provide the basis for the attitudes and beliefs of various health care professionals. Attitudes and beliefs influence behavior. Therefore, the implementation of patient-centered care is based on the attitudes and beliefs of healthcare professionals and may impact the progression of dementia. Data was collected through in-person and/or virtual meetings to gather consent forms, …

Exploring Racial And Ethnic Disparities In Alzheimer's Disease And Related Dementias: Prevalence, Healthcare Utilization, And Costs, Michael E. Myers Ii

Doctoral Dissertations and Projects

Objective: This study aims to investigate the disparities in prevalence rates, healthcare utilization patterns, and healthcare costs associated with Alzheimer’s Disease and Related Dementias (ADRD) among various racial and ethnic groups over time. Methods: Utilizing data from the medical expenditure panel survey over a five-year period, this study employs factorial logistic regression to analyze ADRD prevalence rates and multivariate analysis of variance to examine healthcare utilization and costs. The analysis focuses on weighted populations to account for the representation of racial and ethnic groups, ensuring the generalizability of the findings. Results: The study identifies statistically significant disparities in ADRD prevalence, …

The Dementia Care Study (D-Care): Recruitment Strategies And Demographic Characteristics Of Participants In A Pragmatic Randomized Trial Of Dementia Care, Mia Yang, Rafael Samper-Ternent, Elena Volpi, Aval-Na'ree Green, Maya Lichtenstein, Katy Araujo, Pamela Borek, Peter Charpentier, James Dziura, Thomas M Gill, Rebecca Galloway, Erich J Greene, Kristin Lenoir, Peter Peduzzi, Can Meng, Jordan Reese, Amy Shelton, Eleni A Skokos, Jenny Summapund, Erin Unger, David B Reuben, Jeff D Williamson, Alan B Stevens

Faculty, Staff and Student Publications

INTRODUCTION: Pragmatic research studies that include diverse dyads of persons living with dementia (PLWD) and their family caregivers are rare.

METHODS: Community-dwelling dyads were recruited for a pragmatic clinical trial evaluating three approaches to dementia care. Four clinical trial sites used shared and site-specific recruitment strategies to enroll health system patients.

RESULTS: Electronic health record (EHR) queries of patients with a diagnosis of dementia and engagement of their clinicians were the main recruitment strategies. A total of 2176 dyads were enrolled, with 80% recruited after the onset of the pandemic. PLWD had a mean age of 80.6 years (SD 8.5), …

End-Of-Life Choice For People Living With Alzheimer’S Disease And Related Dementias: Comparing American And Canadian Approaches, Amy Subach

Lewis & Clark Law Review

This Note argues for an expansion of end-of-life choice for people diagnosed with Alzheimer’s Disease and Related Dementias in the state of Oregon, using both Canadian waiver of final consent and Supported Decision-Making models, with additional proposed safeguards to prevent coercion and missed diagnoses of treatable conditions.

How Marital Stress May Affect The Onset Of Dementia In Older Adults, Khunza Asma

All Graduate Theses, Dissertations, and Other Capstone Projects

Marital stress has been identified as a significant factor influencing the cognitive health of older adults, with emerging evidence suggesting a potential link between marital discord and the risk of developing dementia. This study will review the existing literature on the relationship between chronic stress, depression, marital discord, and the development of cognitive impairment which can increase the risk of developing dementia in older adults. However, the purpose of studying how marital stress affects the onset of dementia is to deepen our understanding of the complex interplay between psychosocial factors and cognitive health in older adults, with the ultimate goal …

Refinement Of An Emergency Department-Based, Advance Care Planning Intervention For Patients With Cognitive Impairment And Their Caregivers, Kei Ouchi, Christopher Joshi, Jenson Kaithamattam, Seth A Gale, Gad A Marshall, Alison Pietras, Wei Wang, Edward W Boyer, James A Tulsky, Susan D Block, Dorene Rentz, Mara A Schonberg

Faculty, Staff and Student Publications

Background and objectives: Advance care planning (ACP) conversations are important to provide goal-concordant care (i.e., the care that matches the patient's previously stated goals) near end of life. While 31% of older adults presenting to the emergency department (ED) have dementia, only 39% have previously had ACP conversations. We refined and piloted an ED-based, motivational interview designed to stimulate ACP conversations (ED GOAL) for patients living with cognitive impairment and their caregivers.

Research design and methods: We systematically refined ED GOAL and then conducted an acceptability study in an urban, academic medical center. We prospectively enrolled adults aged 50+ with …

Home And Community-Based Service Utilization Patterns For Seniors With Alzheimer's Disease And Related Dementias, Margaret E. Saari

Dissertations

Half a million Canadians are living with Alzheimer's disease and related dementias. Approximately half these individuals live in the community, supported by informal caregivers. In this population, utilization of formal services is low and patterns of utilization are not well understood. Previous studies examining predictors of service use have examined services in isolation however, often multiple services are utilized, with little coordination between services.

The purpose of this study was to provide a better understanding of the community-based services utilized concurrently by seniors with dementia and their caregivers.

Exploring The Hinterland: The Development Of A Person-Centered Music Therapy Method For A Hospice Patient With Lewy Body Dementia, Paige Chaplin

Expressive Therapies Capstone Theses

This thesis explores the development and implementation of a music therapy method with an individual diagnosed with dementia with Lewy Bodies (DLB) receiving home hospice services. There is very little known about the effect of music therapy on patients diagnosed with DLB. Informed by Tom Kitwood’s Person-Centered Care (PCC) philosophy for dementia care, Yumiko Sato’s Musical Life Review (MLR) model, and Lisa Kelly and Bill Ahessy’s Reminiscence-Focused Music Therapy (RFMT) model, a clinical method was developed to explore the effects of person-centered music therapy on reminiscence, caregiver connection, and identity. I drew inspiration from music therapy concepts by Tony Wigram …

What Drama Therapy Core Processes Can Be Observed In A Timeslips Session With Residents In Dementia Care Units?, Saverina Scopelleti

Expressive Therapies Capstone Theses

Despite the arrival of the person-centered movement in dementia care, biases continue in caregiving around ageism, cognitive disability, and pharmacological interventions to mitigate behavior issues. This paper underscores the efficacy of drama therapy as a non-pharmacological intervention in dementia care practices, directing focus on drama therapy core processes and how to utilize them to meaningfully engage with persons with dementia. In this phenomenological study, run over a four week period, I facilitated group interventions using TimeSlips with residents from two memory care units at separate assisted living facilities in New England. TimeSlips is an established program, specifically created for persons …

Evaluation Of A Care Management Program On Family Caregivers Of Persons With Dementia, Victoria L. Jackson

Doctoral Projects

Dementia due to Alzheimer’s and other disease is a growing concern for healthcare providers as the number of individuals in the U.S. population ages. Persons with dementia (PWDs) rely on caregivers, primarily family caregivers (FCGs), for basic and instrumental activities of daily living as the disease progresses. There may be negative outcomes, such as depression, strain, and distress for FCGs of PWDs. Routine assessment and intervention by healthcare providers can address needs of FCGs of PWDs. There are multiple interventions that have demonstrated effectiveness in caring for PWDs and FCGs; one such intervention is care management. The University of California, …