336 research outputs found
Sytse U. Zuidema. Neuropsychiatric symptoms in Dutch nursing home patients with dementia
No full textBespreking proefschrift
Sytse U. Zuidema. Neuropsychiatric
symptoms in Dutch nursing home patients
with dementia Proefschrift Radboud Universiteit
Nijmegen, 8 februari 2008, 159 p, ISBN 987 90
9022470 1
Paratonia in dementia: a systematic review
No full textBackground:Paratonia is a dementia-induced motor abnormality. Although paratonia affects virtually all people with dementia, it is not well known among clinicians and researchers.Objective:The aim of this study was to perform a systematic review of the literature on the definition, pathogenesis, diagnosis, and intervention of paratonia as well as to propose a research agenda for paratonia.Methods:In this systematic review, the Embase, PubMed, CINAHL, and Cochrane CENTRAL databases were searched for articles published prior to December 2019. Two independent reviewers performed data extraction and assessed the risk of bias of the studies. The following data were extracted: first author, year of publication, study design, study population, diagnosis, assessment, pathogenesis, therapy and interventions.Results:Thirty-five studies met the inclusion criteria and were included. Most studies included in the review mention clinical criteria for paratonia. Additionally, pathogenesis, method of assessment, diagnosis, and paratonia severity as are interventions to address paratonia are also discussed.Conclusion:This systematic review outlines what is currently known about paratonia, as well as discusses the preliminary research on the underlying mechanisms of paratonia. Although paratonia has obvious devastating impacts on health and quality of life, the amount of research to date has been limited. In the last decade, there appears to have been increased research on paratonia, which hopefully will increase the momentum to further advance the field
Frontal brain functioning and pain: Possible underlying mechanisms of increased pain responses in age- and dementia-related cognitive impairment
No full textIn dit proefschrift heb ik onderzoek gedaan naar pijn bij dementie. Dementie kenmerkt zich door neurodegeneratie, het afsterven van zenuwcellen in de hersenen. Hierdoor kunnen mensen met dementie onder andere niet meer goed aangeven dat zij pijn hebben. Op basis van eerder onderzoek was bovendien het vermoeden dat mensen met dementie gevoeliger worden voor pijn, mogelijk door neurodegeneratie in met name het voorste deel van de hersenen (de frontale cortex). In een experimentele pijnstudie heb ik onderzocht of mensen met dementie anders reageren op pijnprikkels dan cognitief gezonde ouderen. Ik onderzocht specifiek het vermogen om pijn te remmen. Omdat mensen met dementie moeite kunnen hebben met het aangeven van pijn, werd pijn niet alleen gemeten door aan de deelnemers te vragen hoe pijnlijk de pijnprikkels waren, maar ook aan de hand van gezichtsuitdrukkingen. Alle deelnemers ondergingen ook een structurele MRI scan van de hersenen, zodat ik kon onderzoeken of reacties op de pijnprikkels zijn gerelateerd aan de hersenstructuur. Het belangrijkste resultaat van dit proefschrift is dat mensen met dementie verhoogde pijnreacties hadden in vergelijking met cognitief gezonde ouderen. Zo konden mensen met dementie bijvoorbeeld minder goed pijn remmen. De verschil was alleen te zien wanneer pijn werd gemeten aan de hand van gezichtsuitdrukkingen en niet wanneer gevraagd werd hoe pijnlijk de pijnprikkels waren. Het verminderd vermogen om pijn te remmen was, zoals werd vermoed, geassocieerd met neurodegeneratie in de frontale cortex. Dit onderzoek laat hiermee zien dat mensen met dementie door de schade in de hersenen mogelijk gevoeliger zijn voor pijn dan gezonde ouderen
‘More at Home with Dementia’ Effects of psychosocial interventions in the community and in nursing homes
No full textThe first part of the thesis describes a study into the effect of a dementia caregiver training ‘More at Home with Dementia’. During this training caregivers attend 14 workshops on all relevant changes that come with living with someone with dementia. The partners with dementia have their own program. The training lasted five days and took place in a holiday accommodation. Training groups consisted of maximum six dyads of cohabiting caregivers and persons with dementia. Although the training did, on average, not have a positive effect on the quality of life of the caregiver, subgroups of men and people with less education experienced a better quality of life compared to the control group. During follow-up meetings participants reported a variety of positive effects e.g., more acceptance, better coping and improved general knowledge on dementia and facilities. A cost-effectiveness analysis showed that the training probably saves money. The first year after the training the intervention group made use of significantly less day care, home care and nursing home care. This saving more than outweighed the costs of the intervention. because of these positive effects, the training is still offered. Part two describes a describes a review of the literature on the effect of psychosocial interventions aimed at behavioral problems of people with dementia on psychotropic drug use in nursing homes. The results of this study show that these interventions may lead to a significant reduction of antipsychotic drug use, especially in studies reporting on cultural change and involving the prescribing physician
Tailoring care for older adults:understanding older adults' goals and preferences
No full textThe increasing amount of older adults with multi-morbidity and increasing care complexity demands a fundamental change in care delivery. It entails a shift from a disease-oriented approach to a tailored approach for frail older adults. Nowadays, proactive integrated person-centred care is strived for in order to face these aging population challenges and achieve tailored care. Despite all efforts, the effects of these care reforms are unclear and the reasons for their hampered implementation are not fully understood. Therefore, the realist evaluation approach can be of help, which focusses not only on the outcomes of new care initiatives, but also on the mechanisms and context in which these reforms take place. We used this approach to study the role of goal setting within proactive care services for frail older adults. We evaluated three different perspectives in this regard: the extent to which goal setting programs have improved outcomes for older adults, the mechanisms of goal setting within proactive care, and the context of older adult’s preferences inferencing these outcomes and mechanisms. Multiple resources were combined (medical records, audio-taped assessments, older adults’ self-reported preferences and wellbeing status, and semi-structured interviews with older adults and care professionals), which led to the following conclusion: Tailored care for older adults experiencing frailty and multi-morbidity by means of goal setting and involvement adapted to their engagement preferences, supports their need for holistic care, but can only have an impact on individual goals when embedded within a durable contact with professionals who actively align care with each other. Of course, this demands for future research, as well as commitment of policy makers and care professionals
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