265 research outputs found
INTERDEM network celebrates 20 years
No full textMyrra Vernooij-Dassen, INTERDEM Chair, Esme Moniz-Cook,Co-chair and Rabih Chattat, Board member highlight some ofthe network’s key achievements of the past 20 years
INTERDEM network celebrates 20 years
No full textMyrra Vernooij-Dassen, INTERDEM Chair, Esme Moniz-Cook,Co-chair and Rabih Chattat, Board member highlight some ofthe network’s key achievements of the past 20 years
REMCARE: reminiscence groups for people with dementia and their family caregivers - effectiveness and cost-effectiveness pragmatic multicentre randomised trial
No full textOBJECTIVES:
The aim of the REMiniscence groups for people with dementia and their family CAREgivers (REMCARE) study was to assess the effectiveness and cost-effectiveness of joint reminiscence groups for people with dementia and their family caregivers as compared with usual care.
DESIGN:
A multicentre, pragmatic randomised controlled trial with two parallel arms - an intervention group and a usual-care control group - was carried out. A restricted dynamic method of randomisation was used with an overall allocation ratio of 1 : 1, restricted to ensure intervention groups of a viable size. Assessments, blind to treatment allocation, were carried out at baseline, 3 months and 10 months (primary end point).
SETTING:
Most participants were recruited through NHS Memory Clinics and Community Mental Health Teams for older people. Assessments were usually carried out in the person's home, and treatment groups were held in a variety of community settings.
PARTICIPANTS:
A total of 488 individuals (mean age 77.5 years) with mild to moderate dementia (meeting Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition criteria), who were initially living in the community, and who had a relative or other caregiver maintaining regular contact, who could act as an informant and was willing and able to participate in the intervention, were recruited to the study. Most carers were spouses (71%). A total of 350 dyads completed the study.
INTERVENTIONS:
The intervention consisted of joint reminiscence groups held weekly for 12 consecutive weeks, followed by monthly maintenance sessions for a further 7 months. The sessions followed a treatment manual, and were led by two trained facilitators in each centre, supported by a number of volunteers. Up to 12 dyads were invited to attend each group.
MAIN OUTCOME MEASURES:
The primary outcome measures were self-reported quality of life for the person with dementia and psychological distress for the carer [General Health Questionnaire-28 item version (GHQ-28)]. Secondary outcome measures included autobiographical memory and activities of daily living for the person with dementia, carer stress for the carer and mood, relationship quality and service use and costs for both parties.
RESULTS:
The intention-to-treat analysis identified no differences in outcome between the intervention and control conditions on primary or secondary outcomes [self-reported quality of life in Alzheimer's disease: mean difference 0.07, standard error (SE) 0.65; F = 0.48; p = 0.53]. Carers of people with dementia allocated to the reminiscence intervention reported a significant increase in anxiety on a subscale of the GHQ-28 at the 10-month end point (mean difference 1.25, SE 0.5; F = 8.28; p = 0.04). Compliance analyses suggested some benefits for people with dementia who attended more reminiscence sessions; however, carers attending more groups showed increased caregiving stress. Use of health- and social-care services was modest, with no significant difference in service use between conditions. Owing to negligible difference in quality-adjusted life-year gains (derived from European Quality of Life-5 Dimensions) between the conditions the planned full economic analysis was curtailed.
CONCLUSIONS:
This trial does not provide support for the effectiveness or cost-effectiveness of joint reminiscence groups for people with dementia and their carers. Although there may be some beneficial effects for people with dementia who attend sessions as planned, this must be viewed in the context of raised anxiety and stress in their carers. The reasons for these discrepant outcomes need to be explored further, and may necessitate reappraisal of the movement towards joint interventions.
TRIAL REGISTRATION:
Current Controlled Trials ISRCTN42430123.
FUNDING:
This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 16, No. 48. See the HTA programme website for further project information
‘Behaviour that challenges’ in dementia care: an update of psychological approaches for home and care home settings
No full textOver and above the personal and financial costs associated with dementia, those for ‘behaviour that challenges’ (BtC) are significant (Lowry & Warner, 2009; Hermann et al., 2006). This briefing paper outlines the importance of having a psychological understanding of both the causes and appropriate interventions required for BtC. It highlights the role of clinical psychologists, ideally working within multi-disciplinary teams, in producing biopsychosocial formulations to meet the health and psychosocial needs of a person living with dementia (PwD). The paper also draws on relevant evidence including findings from a recently completed NIHR programme of work on the Management of Challenging Behaviour at home and in care homes (Moniz-Cook et al., 2017) to provide recommendations for action
‘Behaviour that challenges’ in dementia care: an update of psychological approaches for home and care home settings
No full textOver and above the personal and financial costs associated with dementia, those for ‘behaviour that challenges’ (BtC) are significant (Lowry & Warner, 2009; Hermann et al., 2006). This briefing paper outlines the importance of having a psychological understanding of both the causes and appropriate interventions required for BtC. It highlights the role of clinical psychologists, ideally working within multi-disciplinary teams, in producing biopsychosocial formulations to meet the health and psychosocial needs of a person living with dementia (PwD). The paper also draws on relevant evidence including findings from a recently completed NIHR programme of work on the Management of Challenging Behaviour at home and in care homes (Moniz-Cook et al., 2017) to provide recommendations for action
What are meaningful psychosocial interventions for people with dementia and how can they be captured in research? Report of a pan-European consultation
No full textYe
Alzheimer Europe's position on involving people with dementia in research through PPI (patient and public involvement)
No full textThis paper reflects Alzheimer Europe's position on PPI (patient and public involvement) in the context of dementia research and highlights some of the challenges and potential risks and benefits associated with such meaningful involvement. The paper was drafted by Alzheimer Europe in collaboration with members of INTERDEM and the European Working Group of People with Dementia. It has been formally adopted by the Board of Alzheimer Europe and endorsed by the Board of INTERDEM and by the JPND working group ‘Dementia Outcome Measures - Charting New Territory’.Alzheimer Europe is keen to promote the involvement of people with dementia in research, not only as participants but also in the context of PPI, by generating ideas for research, advising researchers, being involved in consultations and being directly involved in research activities. This position paper is in keeping with this objective. Topics covered include, amongst others, planning involvement, establishing roles and responsibilities, training and support, managing information and input from PPI, recognising the contribution of people with dementia involved in research in this way, promoting and protecting the rights and well-being of people with dementia, training and support, and promoting an inclusive approach and the necessary infrastructure for PPI in dementia research
The effect of personality on the adjustment to residential care for those with dementia
No full textIt has been suggested that personality may affect the adjustment to residential care for those with dementia. However, many theorists have stated that personality changes due to dementia. Therefore this study investigates personality modes (namely autonomy and sociotropy) believed to be stable over time, irrespective of dementia. The personality modes are predicted to negatively affect adjusting to residential care. However the measure developed to investigate these modes (Sociotropy-Autonomy Scales) has not been validated with an older adult (dementia) population. The present aims of the study are: 1) Examine the SAS in relation to an older adult (dementia) population 2) To explore the stability of the personality modes 3) to investigate the affect of personality on adjustment to residential care. PARTICIPANTS AND MEASURES - An interview with 63 families of residents and key-workers, was followed by a two-hour direct observation. Measures used include: SAS, CAPE-CASIBRS, BASOLL-mood, Cornell, RAID, CBS and CBOS. RESULTS - The SAS was able to discriminate personality modes in an older adult (dementia) population. The autonomous and sociotropic modes showed stability, irrespective of dementia. There was an association found between personality modes and adjustment (in terms of problematic behaviour and mood problems). CONCLUSION - There are aspects of personality that are unaffected by dementia and that influence the difficulty of adjusting to residential care
An exploration of adolescents' thoughts about their sexually abusive behaviour : a qualitative study
No full textThis study aimed to explore adolescent sex offenders' thoughts about their sexuallyabusive behaviour and to understand their perspective of cognitive distortion using Interpretative Phenomenology qualitative methodology. Five participants convicted of indecent assault, attempted rape or rape were recruited from two sites and consented to participate in the study. A semi-structured interview schedule was used to elicit the adolescents' thoughts and experience with regards to their sexual offending which was analysed using Interpretative Phenomenological Analysis (IPA).Analysis indicated that a disintegrated/dissociated 'sense of self resulting from abandonment, neglect and the absence of good enough parenting partially underpinned adolescents' sexual offending behaviour. Cognition had a specific role in the process of sexual offending that was related to own victimisation. The results indicate a role of social-learning mechanisms in the process of sexual offending by adolescents and highlight the likely differences that may be evident between this population and models of understanding adult sex offenders. Regret and Guiltalongside attempts to understand the abusing aspects of self are relevant for treatment interventions.Clinical implications of the findings and directions for future research are discussed
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