Medicine and Health Sciences Commons^™

Audiological Evaluation Of Persons With Dementia: A Systematic Review, Yehudis Hoch

Dissertations, Theses, and Capstone Projects

Background: Dementia and hearing loss are both prevalent, age-related conditions and recent research has established a correlation between the two. Audiological evaluations of persons with dementia are important due to a likely comorbidity of dementia and hearing loss, the detrimental effect that hearing loss has on cognition and cognitive tests, and because the similar presentation of the two conditions can cause hearing loss to be overlooked. Hearing loss intervention is critical for this population due to the positive effects that amplification has on cognition, social engagement, and listening effort. Despite the importance of hearing assessment and intervention, audiological evaluation of …

The Association Between Cognitive Dysfunctions And Cardiovascular Disease Of Minority And Lgbtq+ Communities In The United States, Nathan G. De Shields

Walden Dissertations and Doctoral Studies

Dementia, the loss of cognitive acuity is an umbrella term of neuro-degenerative symptoms that impact an estimated 6.5 million Americans, and amid heart disease, cancers, and emerging viruses, such as COVID-19, has reportedly increased in prevalence. A cross-sectional study of secondary data from the National Health and Nutrition Examination Survey (NHANES) was conducted to analyze minority and non-heterosexual experiences of health risks found higher in prior studies of distress rates in LGBTQ+ adults. The socio-ecological framework was used to interpret the competing ecologies of social health determinants in natural and social settings. Literature reviews on cognitive dysfunction and other vascular …

Art Of Aging – A Portraiture Study, Alaina Mann

Theses/Capstones/Creative Projects

The process of aging can be viewed through different lenses within our society. In the past, scientists and medical professionals performed various studies to better understand and analyze different facets of aging, medicine, and health in general. Historically the arts have reflected multiple aspects of medicine and treatments while more recently, the arts have been used in a research capacity to provide different ways to represent illness, suffering, and care. This study used art-based research methods and portraiture to gather qualitative observations on the older populations within our community. Data collected included drawings, a field journal, and interviews. This study …

Gender Differences In Episodic Memory In Later Life: The Mediating Role Of Education, Sara Robinson

USF Tampa Graduate Theses and Dissertations

In the United States (U.S.), 14 million individuals aged 65+ are expected to be diagnosed with dementia by 2060, and women are nearly twice as likely to be diagnosed. Low education is a well-established risk factor for dementia and is hypothesized to partly explain the gender differences in late-life cognition. However, few studies have investigated education as a mediator of these gender differences. This study aims to investigate education as a mediator of gender differences in episodic memory using longitudinal data from the U.S. Health and Retirement Study (HRS). I used a sample of 35,721 respondents (20,190 women and 15,531 …

A Multi-Modal Imaging Analysis Of Inter-Community Hub Nodes In Subjective Cognitive Decline Linking Longitudinal Hub Function Disruption To White Matter Integrity Kurtosis, Duncan Nowling

MUSC Theses and Dissertations

Subjective Cognitive Decline (SCD) has garnered much interest as a potential identifiable preclinical stage and indicator of risk for cognitive decline in Alzheimer’s Disease and related dementias (ADRD). Identification of individuals in this stage though is difficult, as they present with objectively normal cognitive evaluation scores, relying instead upon self-report of concern about decline in cognitive abilities. The use of non-invasive in-vivo imaging methods like BOLD functional imaging and diffusion tensor have allowed for complex mapping of both the functional and structural network features unique to this condition. This study furthers this network biomarker map of SCD by investigating the …

Geriatric Interest Plan For Individuals With Dementia: Improved Quality Of Life, Alexis T. Francois

Department of Occupational Therapy Entry-Level Capstone Projects

The purpose of this Capstone experience was to identify the specific needs to improve the quality of life for individuals with Dementia and Alzheimer’s. According to the Alzheimer’s Association (2022a), 1 in 9 people aged 65 and older have dementia. It is imperative for people living with this disease to be actively involved in meaningful activities that can reduce their negative symptoms. People with dementia constitute 40% of patients with significant depression (Alzheimer’s Association, 2022a). The common risk factors that increase the likelihood of depression in these adults include social isolation and loneliness, lack of exercise, and functional limitations that …

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. …

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 …

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, …

Training Program For Occupational Therapists Working With Skilled Caregivers In Skilled Nursing Facilities, Lovegifty Dudero, Mai Huynh, Ridhee Patel

Occupational Therapy | Graduate Capstone Projects

Dementia impairs one’s ability to live independently and participate in everyday activities (CDC, 2019). Individuals with dementia (IwD) are often referred to skilled nursing facilities (SNFs) for around-the-clock care to receive support for their everyday challenges brought on by dementia symptoms. Although certified nursing assistants (CNAs) help IwD with everyday self-care tasks, they frequently lack specialized dementia care training. Consequently, CNAs experience low self-efficacy when providing care and managing challenging behaviors IwD may have. OTs have expertise and understanding regarding the stages of dementia and how the symptoms of dementia impact participation in daily occupations. OTs working in SNFs are …

Mental Confidence In Alzheimer's Disease, Harrison Adams

Electronic Theses and Dissertations

A simple symptom like forgetfulness can lead to a gradual, subtle decline in the individual’s sense of identity. In dementia, self-efficacy is the foundation that allow individual to prolong their capacity of independence and identity. Alzheimer’s disease (AD) is the most prominent form of dementia with tens of millions in the world currently living with Alzheimer’s disease. AD is most often associated with impaired memory, confusion, language impairment, and unpredictable, agitated, aggressive, and paranoid behavior. While there are many studies examining the quality of life in individuals with AD, there are fewer investigating the psychological effects of AD on the …

Promoting Early Detection In Primary Care: Program Evaluation Of The Dementia Care Aware Program In Orange County, Ennah Cabading

UNLV Theses, Dissertations, Professional Papers, and Capstones

The aging population is growing quickly, raising concerns about the increasing numbers of those with Alzheimer's disease and related dementias, as age is the common risk factor for acquiring the disease. The increase in the elderly population may influence higher healthcare costs and the need for more healthcare professionals like primary care professionals. However, primary care professionals face challenges meeting this population's demands due to the lack of training, confidence, and understanding of dementia care. A new California initiative called Dementia Care Aware aims to support primary care professionals by offering training, tools, and resources to increase early detection and …

Treating Cognition Through Occupational Performance In Individuals With Neurological Disorders In Home Health, Alcina J. Park

Occupational Therapy Capstone Presentations

Neurological Disorders (ND) like Alzheimer’s Disease, is one of the leading chronic diseases in older adults (National Council on Aging, 2023). One of the most common symptoms of ND is cognitive dysfunction, which prevent individuals with NDs from pursuing their daily occupations (Liu et al., 2019). This makes the exploration of treatment that delays functional decline in NDs imperative. Occupational therapy is valued and recognized in literature, but limited research is specific to cognition in occupational performance in home health. This capstone project used cognitive therapy approaches Cognitive Stimulation Therapy, Cognitive Rehabilitation Therapy, and Cognitive Training, to combat cognitive decline …

“For The Future, For Him, And For Our Life Together”: The Relationship Goals And Well-Being Of Persons Living With Dementia And Their Spousal Care Partners, Claire Leigh Szapary

Public Health Theses

Background. Identities and dynamics in relationships can change when one spouse develops dementia. This study aimed to understand the various types of goals both spousal care partners and persons living with dementia (PLWD) have for their relationship, and to explore whether approach or avoidance goals were associated with individual wellbeing and relational support – as well as their partners’ wellbeing and support.

Methods. A secondary analysis of data from sixty-two spousal dyads where one partner has dementia was conducted. Thematic goal-type categories were determined through a card-sort content analysis methodology using participants’ brief qualitative responses to a question asking about …

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 …

Exploring Barriers To Accessing Funding For Individuals With Dementia Who Reside In Long-Term Care Facilities, Gwendolyn Cox Smith

Walden Dissertations and Doctoral Studies

AbstractMedicare and Medicaid are the most used funding sources for long term care (LTC); however, they are insufficient to pay for all social activities needed by individuals with dementia who reside in LTC facilities in the United States. Barriers in accessing funding to provide social activities for these individuals were explored though the theoretical lens of a logic model related to funding. A qualitative exploratory case study design was used to find not only the barriers of accessing funding but also the type of available funding and the eligibility criteria for receiving funds for social activities for those with dementia …

Occupational Therapists’ Perspectives On Using The Physical Environment In Skilled Nursing Facilities, Jennie L. Digrado

Walden Dissertations and Doctoral Studies

Occupational therapists (OTs) are among the health care professionals who assist individuals with neurocognitive disorders (NCDs) to engage in self-care and leisure skills in a skilled nursing facility (SNF) environment. Although the SNF environment has been researched, a gap exists regarding how OTs use the built environment to help clients with a NCD engage in self-care and leisure-related activities. The purpose of this qualitative case study was to understand how OTs use the physical environment in a SNF to help individuals with a NCD engage in self-care and leisure related activities. The conceptual framework that guided this study was the …

The Motivations And Work-Life Balance Of Paid Home-Based Caregivers Of Clients Experiencing Dementia, Cheraire Lyons

Walden Dissertations and Doctoral Studies

With an expected increase in demand for professional caregivers for the growing older adult and aging population, caregivers need balance in their lives so they can provide quality patient care. The purpose of this qualitative multiple case study was to explore what motivates paid, professional home-based caregivers of clients with dementia to maintain their work–life balance. The caregiver ambition framework was the guide for exploring home-based caregivers’ work life issues along with caregivers’ motivations for work–life enrichment. Interview data were collected from five interviews that were analyzed first manually by exploring the transcribed interviews for commonly seen words and phrases. …

How Do Informal Caregivers Of A Person With Dementia Experience Stress And Which Supports Help Mitigate The Effect Of These Stressors?, Kwandra Andrews Brinson

Occupational Therapy Doctorate Capstone Projects

Background: Alzheimer's disease or related dementias (ADRD) are one of the most rapidly growing epidemics that the world is facing. Caring for a person with ADRD is challenging and often causes informal caregivers stress, loneliness, and social isolation.

Purpose: The aim of this qualitative instrumental case study was to obtain a better understanding of how informal caregivers of persons with ADRD experience stress and which supports helped mitigate the effect of these stressors in their role as a caregiver.

Theoretical Framework: The Model of Human Occupation focuses on therapy helping persons to engage in occupational behaviors that maintain, restore, reorganize, …

Dementia And Socioeconomic Status: A Proposal On The Effects Of Occupation Level On Cognitive Decline, Kristian Krslovic

Senior Projects Spring 2023

Dementia is a term used to describe brain diseases that affect an individual's cognitive functioning (memory, language, problem solving, judgment, etc.). Specifically, dementia can cause losses in cognitive and emotional abilities that affect daily functioning as well as someone’s quality of life. Not only is treatment for dementia and cognitive related diseases paramount, but discovering the cause and external factors that can affect the development or severity of these diseases is equally as important. This, in turn, can help to determine what factors of life can cause a worse prognosis for someone with dementia. This proposal aims to explore how …

Rapid Scoping Review Of The Epidemiological Evidence For Mercury Exposure And Prevalence Of Alzheimer’S Disease, Rebecca Mattingly

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This rapid scoping review examines the current body of epidemiologic research evaluating the potential linkage between environmental exposure to mercury and Alzheimer's disease (AD). Alzheimer’s disease accounts for 60-80% of all neurodegenerative disease in the United States and was the seventh leading cause of death in Kentucky in 2020. The exact etiology of AD needs further investigation; however, environmental factors such as pesticides, arsenic, cadmium, lead, and mercury have been correlated with development of AD lesions, cognitive decline, and AD. Mercury is a toxic metal that can be found in air, water, and soil, both from natural and human-made sources. …

Dementia And The Fragility Of Self: Navigating Ethical Considerations In Medical Decision-Making, Grace Sauers

Scripps Senior Theses

As the global population ages, the incidence of degenerative memory disorders such as Alzheimer's and dementia is expected to rise. The frequency of complex medical decision-making challenges for these patients will subsequently increase. It is now common practice for patients to provide advance directives outlining the care they wish to receive; in the case they are deemed incompetent to perform adequate decision making. However, patients with dementia occasionally express wishes contrary to those stated in their advance directives. This divergence creates ambiguity about which wishes should be honored and for who those wishes are being honored for. I aim to …

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 …

Exploring Barriers To Accessing Funding For Individuals With Dementia Who Reside In Long-Term Care Facilities, Gwendolyn Cox Smith

Walden Dissertations and Doctoral Studies

AbstractMedicare and Medicaid are the most used funding sources for long term care (LTC); however, they are insufficient to pay for all social activities needed by individuals with dementia who reside in LTC facilities in the United States. Barriers in accessing funding to provide social activities for these individuals were explored though the theoretical lens of a logic model related to funding. A qualitative exploratory case study design was used to find not only the barriers of accessing funding but also the type of available funding and the eligibility criteria for receiving funds for social activities for those with dementia …

Occupational Therapists’ Perspectives On Using The Physical Environment In Skilled Nursing Facilities, Jennie L. Digrado

Walden Dissertations and Doctoral Studies

Occupational therapists (OTs) are among the health care professionals who assist individuals with neurocognitive disorders (NCDs) to engage in self-care and leisure skills in a skilled nursing facility (SNF) environment. Although the SNF environment has been researched, a gap exists regarding how OTs use the built environment to help clients with a NCD engage in self-care and leisure-related activities. The purpose of this qualitative case study was to understand how OTs use the physical environment in a SNF to help individuals with a NCD engage in self-care and leisure related activities. The conceptual framework that guided this study was the …

Home-Based Primary Care In Patients With Dementia: Impact On Cost, Medication Use, And Patient Satisfaction, Megan O'Leary

Theses and Graduate Projects

Background: Individuals living with dementia deserve affordable, accessible, and effective healthcare. These patients often face barriers that make it difficult to consistently access traditional in office primary care. Home-based primary care (HBPC) holds the opportunity to bridge the gap between individuals with dementia and preventative healthcare resources.

Purpose: Dementia rates are increasing as the population ages, and additional research is needed to determine the optimal treatment model for individuals with dementia. This literature review evaluates if patients with dementia receive improved care with HBPC vs in office primary care through examining cost, medication use and compliance, and patient satisfaction.

Methods: …

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 …

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 …

Understanding The Experiences Of African American Caregivers Of Loved Ones With Dementia, Paula R. Madison

Seton Hall University Dissertations and Theses (ETDs)

Background: Dementia is a public health problem that is estimated to triple by 2050.Globally, dementia is the seventh leading cause of death among all diseases and one of the major causes of disability and dependency among older people. The direct medical costs and indirect social and economic costs of dementia are burdensome to society, and by 2030 it is projected to cost more than $2.8 TRILLION dollars worldwide. African Americans are two to four times more likely to be diagnosed with dementia than White Americans; and more likely to rely on informal care from family and friends. African …

The Impact Of Alzheimer Disease On Semantic Knowledge, Maileen G. Ulep

UNLV Theses, Dissertations, Professional Papers, and Capstones

The research furthers the understanding of the impact of Alzheimer disease (AD) on cognition and the organization of semantic knowledge in the brain, which might contribute to the development of diagnostic and staging tools, and interventions to palliate cognitive deficits. The disruption of semantic knowledge in AD is well documented in the literature. Much of the existing research focuses on the general impact AD has on semantic knowledge. This study explores the impact of AD on specific domains of knowledge, chiefly, living kinds and artifacts, critical to ordinary functioning. The content, organization and structure of the investigated domains of knowledge …