Medicine and Health Sciences Commons^™

The Effects Of Music Therapy On Elderly Adults With Dementia, Jeante J. Jackson

Dissertations, Theses, and Capstone Projects

As people age, the brain is more susceptible to changes that diminish cognitive function. In recent years neuroscience has found convergent evidence between music therapy and brain architecture, as it has shown the generation of new connections in the brain or a reorganization and possible strengthening of existing connections already in the brain. However, the literature regarding music training’s effects on executive control, selective attention, and speech processing is lacking particularly when it comes to older populations.

This study investigated Verbal Working Memory, Visuospatial Attention and Task Initiation, and Auditory Selective Attention in a 91-year-old adult (B.P.) diagnosed with dementia. …

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, …

Therapeutic Gardening And Its Effects On Depressive Symptoms In Dementia Care, Shannon E. Norton

Honors Undergraduate Theses

Aim: To present a literature review of the positive effects and overall reduction of depressive symptoms that an intervention such as therapeutic gardening has on individuals living within memory care facilities.

Background: As most humans age, they often lose abilities or skills that they have had for their entire lives (e.g. driving, grooming, toileting, seeing and/or hearing). By implementing programs that involve therapeutic garden therapy, individuals with dementia who are at greater risk for clinical depressive symptoms may find that this alternative approach improves their symptoms.

Methods: A comprehensive, electronic, literature search in the CINAHL database was completed and included …

A Clinical Practice Guideline For Managing Behavioral Problems In Persons With Dementia, Ken J. Brinker

Walden Dissertations and Doctoral Studies

AbstractAs the baby boom generation ages, the demand for effective nursing care for patients diagnosed with dementia has greatly increased. The challenges associated with dementia include a patient’s inability to focus, pay attention, and follow conversations. Patients often become forgetful, angry, frustrated, and aggressive with family members and caregivers. The medical providers and administrators at a long-term care facility needed assistance in developing a clinical practice guideline for managing behaviors demonstrated by patients with dementia. The project question centered on the identification of current evidence supporting a clinical practice guideline for nursing practice for unpredictable behaviors demonstrated by residents diagnosed …

Improving Nursing Staff Knowledge For Management Of Geriatric Patients With Confusion In The Emergency Department, Kareem G. Carter

Master's Projects and Capstones

Problem: Staff knowledge of effective management of confusion in geriatric patients (>65yo) may be limited and inconsistent with the current goal of establishing a geriatric-friendly Emergency Department (ED) Model of Care. Suboptimal management of this patient population can result in prolonged ED stays, which increases the cost to the hospital and the patient (Han & Wilber, 2013).

Context: An Emergency Department at a large Bay Area urban hospital hopes to obtain Geriatric Emergency Department Accreditation (GEDA) through the American College of Emergency Physicians (ACEP).

Interventions: Create a simplified checklist for nursing staff using mnemonic devices to …

Impact Of Montessori-Based Dementia Programming On Engagement And Affect Of Older Adults With Dementia, Meredith S. Sheppard

Master's Projects and Capstones

The COVID-19 pandemic has profoundly impacted the Adult Day Services program and Adult Day programs across the country. As the Adult Day Services program transitions to an in-person format, goals within the organization include developing appropriate programming, increasing group size, and keeping clients entertained. The framework guiding this quality improvement project is Montessori-Based Dementia Programming ® (MBDP). This project aims to increase client engagement, decrease client anxiety, and decrease staff workload. This will be measured by a self-developed staff workload survey, the Menorah-Park Engagement, and the Affect rating scale. Implementation of MBDP at the Adult Day Center did not meet …

The Lived Experience Of Losing Employment After Diagnosis With Dementia: A Phenomenological Analysis, Susan K. Blaine

Doctoral Dissertations

The purpose of this study was describing the experiences of people with dementia (PWD) who lose their employment after diagnosis with dementia, but sooner than originally planned. A phenomenological approach based on tenets of Maurice Merleau-Ponty was used. Six telephone interviews were conducted, with participants sharing their experiences. Transcripts were transcribed verbatim, and subsequently analyzed via a hermeneutical analysis approach. Themes were identified within and between transcripts, considering the contextual grounds of Merleau-Ponty’s phenomenology: body, others, time, and world, and the contextual ground of participants’ experience: the stigma of dementia. An overarching, central theme of “still working” was identified across …

Palliative Care Screening For Persons Living With Dementia In A Nursing Home, Shanika S. Pruitt

Dissertations

Problem: Dementia is rapidly increasing as the people of the world mature and life expectancy increases. As the world ages and the prevalence of dementia increases, nursing home placement will and is the most sought place for care of this population. Dementia is under recognized as a terminal illness and palliative care is underutilized for nursing home residents with advanced symptoms of dementia.

Methods: This quality improvement (QI) initiative utilized a prospective, descriptive design. The Palliative Care Screening for the Elderly tool was administered to a purposive sample of persons living with dementia residing in the nursing home. Qualitative data …

Improving Family Involvement Through Dementia Education Using A Video Sharing Service, Marissa Lynn Bernabe

Doctor of Nursing Practice Scholarly Project

Dementia is a growing issue among healthcare organizations within the United States (U.S.) with approximately 5.7 million individuals diagnosed. These numbers of affected individuals are expected to increase and reach approximately 152 million by 2050 globally. Dementia is a progressive disease of cognitive loss. Establishing goals or items the patient can perform can have a positive impact on patient care by allowing for a collaborative approach and initiating the family as necessary participants in the care of the dementia patient. Video sharing services such as YouTube have made learning easily accessible for a multitude of varied reasons.

A descriptive quality …

Simulation To Improve Dementia-Related Care Of Veterans, Brandy Wardrip

Doctor of Nursing Practice Projects

Millions of Americans, including Veterans, are diagnosed with dementia. Healthcare staff may benefit from dementia-related training. This Doctorate in Nursing Practice (DNP) project evaluated the effectiveness of the Virtual Dementia Tour (VDT) as a learning tool to improve staff’s knowledge of dementia, enhance their empathy and attitudes when interacting with Veterans diagnosed with the disease, and increase awareness that behaviors commonly seen with dementia may be forms of communication. Interprofessional healthcare staff (N=33) at a Veterans hospital participated in the experiential simulation. A pre-and post-test design utilized the Dementia Knowledge Assessment Scale (DKAS) and the Dementia Attitude Scale …

Staff Education For Identifying, Assessing And Managing Pain In Patients With Dementia, Nadia S. Handspike

Walden Dissertations and Doctoral Studies

Pain is a common symptom in healthcare settings, especially among patients with Alzheimer's Disease (AD). AD patients have cognitive and communication impairment making it difficult or impossible for them to communicate their pain to their caregivers or healthcare practitioners. The purpose of this project was to implement a staff education program for healthcare professionals on evidence-based practices for assessing, recognizing, and managing pain in patients with AD. The practice-focused question explored if a staff education program on identification, assessment, and management of pain in patients with AD improves the staff's knowledge, skills, and attitude towards timely and effective pain assessment …

The Psychosocial Experiences Of African American Sexual And Gender Minority Caregivers Of People With Dementia, Lakeva Harris

Doctoral Dissertations

Over 50 million people in the United States provide unpaid care to a family member or friend. One-third of these caregivers (16 million) provide care to someone with Alzheimer’s disease and related dementias (ADRD). Of these caregivers, more than 20% state caregiving has led to a decline in their health. African American caregivers are less likely to report being in very good or better health than their white caregiving peers. Similarly, lesbian, gay, bisexual, transgender, and/or queer (LGBTQ) caregivers are more likely to report fair or poor health than their heterosexual, cisgender peers. The overlap of these minoritized identities may …

Fall Prevention: The First Line Of Defense. Integration Of Innovated Strategies To Decrease Falls For The Hospitalized Patient, Milledge Smalls

Doctor of Nursing Practice Projects

Background: Falling is defined as an accidental encounter with the ground or other surfaces. Individuals with dementia are at a greater risk for falls due to conditions such as neurological impairments in perception or cognition. Presently, 50 million people live with dementia worldwide, which is projected to increase to 152 million by 2050 because of a rise in life expectancy and an aging population. The incidence of falls has rapidly become a major public health problem around the world. Approximately 30% of people older than 65 years of age fall each year, and patients with dementia cost the nation $236 …

Evidence-Based Recommendations For Assistive Technologies For Safety In Dementia Care, Lee A. Diener

Culminating Experience Projects

A Quality Improvement (QI) project in a Midwestern Continuing Care Residential Community (CCRC) was designed to examine the evidence-base of four assistive technology platforms marketed as safety platforms as means to improve outcomes for older adults residing in memory care environments. Using the Evidence-Based Design Model Socio-Technical Systems Theory, survey data and observational data collected from the organization were considered with respect to the evidence-base supporting each technology. Ten organizational priorities derived from collected data were used to develop an Evidence-Based Assistive Technology Fitness score for each of the AT platforms reviewed. This methodology provides a means to evaluate planning …

Improving Cognitive Function In Persons With Dementia Through Music Therapy, Jillian Natividad

Nursing | Senior Theses

People diagnosed with dementia experience cognitive alterations that cause overwhelming challenges and lead to distinctive life changes. Declining cognitive function noticeably experienced in dementia not only inflicts difficulty with achieving independent living but increases feelings of agitation and disturbs quality of life. Advanced medical care is widely available for managing mental conditions but may not always be effective in treating cognitive changes like memory loss and confusion. Because the stages of dementia vary from person to person, medical interventions are often patient centered to effectively focus on an individual’s specific needs. With non-pharmacological methods, flexibility in adjusting to an individual’s …

The Assessment Of Senior-Level Nursing Students’ Knowledge Regarding Informal Caregiver Role Strain And The Presence Of Role Strain In Informal Caregivers Of Dementia Patients, Amanda Diard

Honors Theses

The goal of this study was to assess senior-level nursing students’ knowledge of informal caregivers of dementia patients, their confidence in their ability to work with informal caregivers, and how well they believe their nursing program prepared them to assist informal caregivers. Seventeen (n = 17) Bachelor of Science (BSN) nursing students participated in the study. A twenty-four-question survey was emailed to both junior- and senior-level students in the five-semester BSN program at the University of Southern Mississippi (USM). Responses from students of different levels were collected to determine if an accurate understanding of informal caregivers of dementia patients …

Do Young Adults With Close Family Experiencing Alzheimer's Have Higher Depression Rates, Ali Sullivan

Chancellor’s Honors Program Projects

No abstract provided.

How Providing Care For Individuals With Dementia Affects How A Caregiver Changes Their Lifestyle: A Focus On The Positives, Veronica Joy Vodola

Senior Theses

Background/significance Caregivers of individuals with dementia (e.g. Alzheimer’s Disease) may change their day-to-day life, especially self-care, to meet the needs of the person with dementia, which can be detrimental to their health. Caregivers for individuals with dementia experience both primarily negative and primarily positive effects on physical and mental health through exposure to the effects of dementia. Caregivers often report substandard self-care practices and unpleasant impacts on mental health. Others report notable beneficial influences within different aspects of their life. The positive effects have not been widely researched in literature.

Purpose The objective of this research study is to understand …

Life Satisfaction: Aging Female Informal Caregivers Of Persons With Dementia, Deborah Ann Monson

Dissertations

Purpose/Aims

The purpose of this study was to describe the relationship between aging female informal caregivers of persons with dementia (PWD) and care recipients’ PWD demographic factors, aging female informal caregivers of PWD social support factors, positive and negative feelings, a sense of flourishing, stress, and life satisfaction.

Background/Rationale

Older adults with dementia are living longer and the majority are receiving care by aging female informal caregivers. Dementia incrementally worsens over time impacting informal caregiver life satisfaction. Most studies have focused on negative aspects of informal caregiving. Therefore, this study investigated both positive and negative aspects of caregiving.

Conceptual Basis …

Improving Caregivers’ Perceived Involvement In Care Through Facilitating Communication With Hospital Providers, Heather Manolas

Student Scholarly Projects

Practice Problem: Involvement of family in care-planning for prevention of delirium in acute care settings is crucial, yet remains underutilized in those who are cognitively impaired. Despite the incidence of delirium in acute care worsening during COVID-19, many factors have led to it being placed on the back burner.

PICOT: In caregivers of cognitively impaired individuals, can implementation of an evidence-based, best practice tool that advocates for evidence-based delirium prevention strategies tailored to their loved-one and facilitates family involvement in care planning for these strategies during a healthcare experience as compared to no other intervention improve confidence in, and …

Implementation Of Cognitive Testing Via Video-Telemedicine, Lindsay Mills Holland, Rosemary Dale, Mary Val Palumbo

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Early diagnosis and timely follow-up of cognitive decline are essential to preserve individual function and memory, improve quality of life, and decrease healthcare costs. Many barriers to in-person assessment exist, the most recent one being COVID-19. Video-telemedicine has been studied as a solution with promising results. Most notably, research shows that the Mini Mental State Examination (MMSE) administered via video-telemedicine has comparable results to in-person assessment.

Purpose: The purpose of this project was to implement cognitive testing via video-telemedicine for follow-up management of cognitive impairment and dementia.

Methods: A protocol for conducting the MMSE via Zoom was developed. Next, …

Increasing Staff Knowledge Regarding The Use Of Nonpharmacological Interventions With Long-Term Care Residents Diagnosed With Dementia, Larissa Latrice Anderson

Walden Dissertations and Doctoral Studies

Dementia is an umbrella term that describes a clinical syndrome of progressive cognitive decline. The prevalence of a dementia diagnosis increases with age, making it a common occurrence within the older population. In long-term care facilities, where 5% of the older population reside, antipsychotic medications are the first line of defense and the choice of treatment among patients diagnosed with dementia. Recently, the Center for Medicare and Medicaid Services (CMS) announced a new goal of decreasing antipsychotic medication usage by 15% by the end of 2019. Guided by Watson’s Theory of Caring, this project was conducted to determine if an …

Fall Risk Factors Among Hospitalized Older Adults With Alzheimer’S Disease And Related Dementias, Jean Bettencourtt Sconza

Doctoral Dissertations

Falls are a common and devastating complication of hospital admission for older adults. Falls are especially significant for those with Alzheimer’s Disease and related dementias (ADRD) as they are at high risk to fall and to suffer injuries from falling. Despite the large body of research on falls in hospitals, less is known about fall risk factors among patients with ADRD. The purpose of this retrospective case-control study was to determine which risk factors are predictors of falls among hospitalized older adults with Alzheimer’s disease and related dementias (ADRD) by comparing those who fell with those who did not fall. …

What's My Age Again? Dementia And The Impact On An Aging Population, Joanna Vest

Nursing Student Class Projects (Formerly MSN)

A literature review of the Cumulative Index of Nursing and Allied Health Literature (CINAHL) database was performed to investigate the risk factors and pathophysiology of dementia in adults. Results were screened for English language and date of publication, with inclusion criteria of years 2015-2020. The search revealed several sub-types of dementia, as well as research into modifiable risk factors. Dementia arises mainly from accumulation of proteins in neurons, dysfunction of the blood brain barrier, vascular degeneration and hypoperfusion of tissues in the brain, and atrophy of brain tissue. Risk factors associated with cognitive decline include hypertension, obesity, insulin resistance, high …

Screening For Delirium In The Emergency Department, Melissa Minks

Dissertations

Abstract

Delirium is a problem for many older adults who are acutely ill. Delirium often comes on suddenly, can be severe, and is often difficult to diagnose, especially in the presence of dementia. Missed delirium has a mortality rate of 30.8% and costs millions. What is the purpose of this study?

Methods The 4A’s Test screening instrument was implemented and evaluated in the Emergency Department of a rural Midwestern hospital from May 1, 2019 through August 31, 2019.

Results There were 122 participants in the study with 61 in each cohort. In 2018, three (5%) were diagnosed with delirium without …

Alzheimer’S Disease, Brandi Herman

Nursing Student Class Projects (Formerly MSN)

Alzheimer’s disease is a cause of dementia that affects older adults worldwide. There is a greater understanding of the disease but the cause remains unknown. Alzheimer’s disease affects the brain ultimately leading to cognitive decline. Although there are modifiable risk factors that could potentially decrease the risk of Alzheimer’s there is no definitive treatment. As numbers increase of Alzheimer’s patients in the United States, updated research and clinical trials are needed to find a cure. Education on managing Alzheimer’s patients along with treating their symptoms is essential.

Barriers To Patient-Centered Care For Dementia Clients In The Long-Term Living Setting, Shaina Gaba

Nursing | Senior Theses

When caring for people with severe dementia, the concept of the person being central is increasingly advocated in clinical practice. Person-centered care acknowledges autonomy in all facets of care. Recent studies examine behavioral changes in individuals with dementia and how health care teams address these alterations. Health care providers are vital for effective holistic management. Therefore, this review focuses on the current knowledge regarding care goals, practices, and perceptions of the client battling with cognitive decline. A literature review ascertains that clients with dementia respond to interventions and have decreased negative health outcomes, when providers ensure values and needs are …

Dementia: Types, What They Are And How They Differ, Jessica N. Schnetzer

Honors Thesis

Dementia: types, what they are and how they differ centers on the known and unknown complexities of dementia. Dementia is a very complex cognitive disease that consumes the brain, an organ of which we know very little about. Even so, this common disorder is actively being researched and is the topic of special interest of this thesis research. Described are Alzheimer’s disease, Creutzfeldt-Jakob disease, Frontotemporal dementia, Huntington’s disease, Korsakoff’s syndrome, Lewy body dementia, Parkinson’s dementia, and Vascular dementia, focusing on what they are, their specific risks, diagnosis, treatment, and their differing progressions. Guidance of this study provided by thesis director …

Non-Pharmacological Interventions For Residents With Dementia, Jared Bielanski

Walden Dissertations and Doctoral Studies

The use of antipsychotic medications in persons with dementia has been shown to increase mortality in long-term care (LTC) patients. National guidelines recommend the use of nonpharmacological interventions when possible for LTC residents with dementia. Nurses who work in a local LTC facility are not regularly trained in effective nonpharmacological interventions and lack the knowledge to provide care for patients with dementia. To provide safe and effective alternative interventions to antipsychotic medication use, nurses and direct care staff must have current, evidence-based education available to them about alternative practices. The purpose of this staff education project, guided by Calista Roy’s …

Engaging Patients With Dementia In The Acute Care Setting: A Quality Improvement Initiative For Staff, Andrea Lee

DNP Scholarly Projects

Caring for dementia patients in the acute care setting can be challenging. Staff is trained to manage the acute illness and the symptoms of dementia can impact that care. Training for the care and management of the patient with dementia is not routinely provided for the acute care setting. According to the Alzheimer’s Association (2018), 5.7 million people are living with Alzheimer’s Dementia with the numbers projected to continue to rise. Training in the management of symptoms can alleviate stress and complications for not only the patient but staff members as well. The goal of this project is to educate …