Social and Behavioral Sciences Commons^™

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 …

Improving Occupational Therapy Student Utilization Through A Community Engagement Program For Individuals With Dementia, Andrew Stevenson

UNLV Theses, Dissertations, Professional Papers, and Capstones

The contents of this doctoral project include an introduction to some of the difficulties people with dementia face in regard to engaging in the community, and how that may impact their health. It goes on to support how occupational therapists (OTs) have the skills to provide treatment addressing this issue but have faced difficulty entering settings such as memory care. A literature review demonstrates some of the positive benefits that can result from providing people with dementia opportunities for community engagement and reveals some of the difficulties associated with providing quality dementia care. This helps to explain the purpose of …

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 …

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 Physiological Factors Of Diabetes And Their Effect On The Cognitive And Emotional Functioning In Older Populations: A Secondary Data Analysis, Celeste Anahi Alvidrez

Open Access Theses & Dissertations

Background: The rates of Type 2 Diabetes (T2D) have increased over the past 20 years in all age groups. The physiological factors that underlie T2D could have impact on specific brain pathways that support cognitive and emotional functioning. Aims and Objective: The goal of this study was to examine whether older Mexican American individuals with a history of T2D were more likely to develop later cognitive impairment and/or depression. Hypotheses: It was predicted that elderly participants (mean age at time of interview = 87.87 years) with a history of T2D onset prior to age 65, are more likely to have …

Social Support Of Caregiver Sons Of Parents With Dementia, Ralph Callanta Pascual

Walden Dissertations and Doctoral Studies

Despite the growing number of male caregivers, few researchers have examined social supports for caregiver sons of parents with dementia. The purpose of this qualitative interpretative phenomenological study was to contribute to the empirical literature on the social support of caregiver sons of aging parents with dementia. The research question centered on the lived experience of social support of caregiver sons of parents with dementia. The theoretical framework was the social role theory. The sample consisted of eight caregiver sons of parents with dementia. Participants were interviewed using semi-structured, researcher-developed questions. The results were generated from coding and thematizing processes, …

Optimizing The Use Of Normative Data In Dementia Diagnostic Evaluations, Laurie Holler

Walden Dissertations and Doctoral Studies

Cognitive tests are typically scored and interpreted using an appropriate normative reference group, often similar age individuals with similar levels of education. Psychometric testing theory presupposes that demographic correction is always beneficial, supporting the ubiquitous use of age and education correction in clinical practice. In the context of dementia, however, there is some evidence suggesting that demographic correction (specifically age correction) may reduce the sensitivity of cognitive tests to age-related cognitive decline. It was hypothesized that age correction would reduce the utility of cognitive tests for detecting cognitive change in individuals with mild cognitive impairment and mild dementia due to …

Probate Attorneys’ Understanding Of The Inclusion Of The Lucid Interval In Testamentary Capacity Proceedings, Jeremy Cassius

Walden Dissertations and Doctoral Studies

This study focused on the experience of probate attorneys with the lucid interval in contested will cases. There is a gap in the research for understanding the lucid interval for people who live with dementia. Dementia can affect the testamentary capacity (TC) of a testator who is signing a will because the testator may not understand all the property that is in their possession. This causes difficulties and conflict for families when a loved one dies. It can also cause the testator to be susceptible to undue influence. The present study analyzed data from interviews with 6 probate attorneys about …

Staff Perceptions Of Quality Interactions In Dementia Care, Rebecka A. Schultz

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

The national aging trend suggests that population of those aged 65 and older will reach 83.7 million by the year 2050. With increasing age comes the growing possibility of one getting some form of dementia. The Alzheimer’s Association expects the number of American’s with dementia to triple from the reported 5 million cases in 2014 by 2050. With a rise in this cognitively impaired population there is reason to look closely at the needs of persons with dementia living in residential facilities and whether or not they are being met. The main focus of residential facilities is to provide aid …

Staff Education Intervention To Enhance Care Planning For Older Adults, Mozhgan Peiravi

Walden Dissertations and Doctoral Studies

The increased prevalence of cognitive deterioration has increased the challenges of caring for older adults. This study's project site offers a psychiatric program for older adults with customized care for complex geriatric mental health patients. Clinical assessment and care management are often overlooked in geriatric mental health patients diagnosed with behavioral and psychological symptoms of dementia (BPSD). The purpose of this project was to deliver an education program developed from the Staff Training in Assisted Living Residences-Veterans Administration, P.I.E.C.E.S model and the Castle framework to 42 nursing and allied health staff of the project site. The project question explored whether …

Unmet Support Needs Of Informal Caregivers Of Older Adults, Julie Ann Smith Hinders

Walden Dissertations and Doctoral Studies

Due to projected growth of the 65-and-older population and concerns of an impending care gap, reliance on informal caregivers is expected to increase. Improving support for informal caregivers is viewed as a national priority, yet research related to the unmet support needs of informal caregivers is limited. The purpose of this cross-sectional correlational study was to examine predictive relationships between contextual factors (caregiving relationship and type of illness) and environmental factors (rurality) and the unmet support needs (classes, service access, support groups, counseling, and respite) of informal caregivers of older adults. The theoretical framework was Bronfenbrenner's ecological systems theory. Archival …

Reducing Antipsychotic Medication Use In Long-Term Care Settings, Martha Ofeibea Agbeli

Walden Dissertations and Doctoral Studies

The prescription rate of antipsychotics in patients with dementia varies between 20% and 50% for the common and troubling neuropsychiatric symptoms experienced by patients with dementia. The use of these antipsychotic medications has been linked with increased risk of morbidity and mortality due to associated Parkinsonism, over sedation, gait disturbances, cognitive decline, and cardiovascular adverse events. The purpose of this project was to assess whether development of an evidence-based clinical practice guideline (CPG) for a long-term care facility would increase awareness about issues that govern the safe use of antipsychotic medications. The conceptual framework for the project was Watson's model …

Informing Care: Mapping The Social Organization Of Families’ Information Work In An Aging In Place Climate, Nicole K. Dalmer

Electronic Thesis and Dissertation Repository

Within an institutional ethnography method of inquiry, this dissertation makes visible the information work that permeates the care work of families of people living with dementia who are also aging at home. An institutional ethnography privileges people’s everyday work and acknowledges that local contexts are influenced by translocal, ruling relations. To map out the social organization of family caregivers’ information work, this dissertation details four separate, yet interrelated studies. The first study comprises two sets of interviews: one with 13 family caregivers of older adults to understand their experiences of the information work they do and a second with five …

The Impact Of Depakote On Agitation And Short-Term Memory In Nursing Home Dementia Residents, Kristin E. Fazzolari-Pleace

Walden Dissertations and Doctoral Studies

Researchers have linked dementia to common psychiatric symptoms such as agitation and aggression, known as behavioral and psychological symptoms of dementia (BPSD). To treat residents manifesting BPSD, nursing homes (NHs) use psychoactive medications. However, research is limited and inconsistent regarding the impact of Depakote treatment on agitation and short-term memory (STM) in NH residents who have dementia. The purpose of this nonexperimental quantitative study was to evaluate for 1 year the impact of Depakote treatment on agitation and STM in NH residents as measured by each resident's Minimum Data Set (MDS). Moncrieff and Cohen's drug-centered theory served as the theoretical …

Transitional Care For Older Adults With Dementia: Variation Across Patients And Providers, Patricia Prusaczyk

Arts & Sciences Electronic Theses and Dissertations

Older adults with dementia are particularly vulnerable to negative outcomes and adverse events when they transition between healthcare settings such as being discharged from the hospital. However, little is known about how healthcare providers help patients prepare for a care transition – known as transitional care – among older adults with dementia. Therefore, this study sought to understand the transitional care currently delivered by hospital healthcare providers to older adults with dementia, how it compared to that received by older adults without dementia, and how it varied across different patient and provider characteristics. Guided by key provider/informant interviews and theory, …

Activities And Quality Of Life For Persons With Dementia, Cassidy Rose

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

This study was conducted to better understand how activities may impact quality of life on dementia care units. Researchers observed dementia care units, and looked into how different activity types impacted emotional affect in the person with dementia, and how they elicited different levels of positive staff interaction. Results indicated that there were significantly higher levels of positive affect from participants on certain activity types, compared to no activity. Activities that had high levels of staff to client interactions had more positive affective outcomes. Researchers concluded that quality activities should consider the environment, staff ratio, staff communication and interaction, engagement …

Facilitating Environmental Enrichment In Senior Care Activities With Professional Development, Celia Mary Ross

Walden Dissertations and Doctoral Studies

There is little known about the current state of professional development and continuing education practices for empowering activity professionals to better enhance environmental enrichment in long term care. The purpose of this qualitative study was to explore the activity professional's perceived role and best strategies for professional development to enrich the long-term care environment. The study used social cognitive theory as its theoretical framework to develop research questions focused on the views of activity professionals concerning professional development and continuing education to support care for long-term care residents. Using a narrative approach, 9 activity professionals were recruited through networking at …

Using Music Intervention To Reduce Anxiety And Agitation For Dementia Residents In Long Term Setting, Sonia Brown

Walden Dissertations and Doctoral Studies

Abstract

Dementia is one of the degenerative conditions that present in old age with a decline in cognitive function resulting in changes in personality and the ability to carry out activities of daily living and social functions. Dementia is usually associated with behavioral disturbances that include anxiety and agitation that pose a challenge for family members or caregivers in an alternate home or care-related facility. The purpose of this project was to design and implement a quality improvement program to evaluate music therapy intervention for residents in a long-term care who have dementia. The aim was to evaluate if music …

Cost-Effectiveness Of Psychotherapy And Dementia: A Comparison By Treatment Modality And Healthcare Provider, Megan Ruth Story

Theses and Dissertations

Dementia is a chronic disorder that affects approximately 40 million individuals throughout the globe. This study provides a preliminary description of psychotherapeutic treatment for the management of dementia. This study compares treatment outcomes by both modality (individual, family, and mixed) and provider type. Results found that therapy is a low-cost treatment, however, it is not being often used for people with dementia, or their family members. Participants (n=327) include individuals with ages ranging from 46-95(M=70.52, SD=12.16). Females made up 57.5% (n=188), while males made up 42.5% (n=139) of the sample. Descriptive statistics found that the number of sessions ranged from …

Improving The Experiences Of Informal And Formal Alzheimer's Disease And Dementias Caregivers, Roxroy Anthony Reid

Walden Dissertations and Doctoral Studies

Informal and formal caregivers of persons with Alzheimer's disease and related dementias (ADRD) encounter a more difficult and unique set of challenges than do caregivers of individuals with general disabilities. If adequate caregiver supports are not provided, caregivers may experience increased strain as the disease progresses, increasing the likelihood of unnecessary institutionalization of their care recipients and increasing the cost to the public. Using rational choice theory and political systems theory, the purpose of this study was to differentiate between the phenomenological experiences of formal and informal caregivers of ADRD patients. The overall research was a qualitative design that used …

Relationship Between Occupational Complexity And Dementia Risk In Late-Life: A Population Study, Daylee Rose Greene

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

According to cognitive reserve theory, challenging and/or stimulating cognitive activities can build a theoretical reserve, which may lead to a delay in the clinical expression of dementia and/or Alzheimer's disease. These cognitively stimulating activities are thought to build cognitive strategies and neural pathways that are more efficient, enabling the individual to live symptom-free for a longer period of time. One mechanism through which cognitive reserve can be built is by participating in an occupation high in cognitive complexity. When individuals hold an occupation that is high in complexity, they may build their cognitive reserve in such a manner as to …