Risk Factors of High Burden Caregivers of Dementia Patients Institutionalized at Day-Care Centres.
We examined which variables are associated with day care centres utilization among caregivers of dementia patients. A cross-sectional analysis of socio-demographic variables, relationship with caring and psychological aspects was conducted in 58 informal caregivers with intense burden. 58.6 % used day care assistance and 41.4 % did not. The results showed the importance of the commitment between the caregiver and their family and friends. The use of day care services is independent of the age, gender, educational level, marital status, occupation and relationship with the patient. However, in the multivariate analysis the provision of help by families and friends predicted the use of day care assistance. The bivariate analysis showed a significant relationship between depressive symptoms and self-rated health with day care attendance. Screening the help provision from families and friends in caregivers of dementia patients with intense burden would be relevant to design interventions which delay their institutionalization and reduce costs. PMID: 25535044 [PubMed - as supplied by publisher]
“Get out! Get out!” My wife, Joan, having just woken up, was screaming, and hitting out wildly at the stranger in her bed. She was in a panic, her body shaking with fright. “Get away from here. Get out!” The man she perceived as a stranger was me, her husband of more than forty years. Joan was eight years into the destructive course of atypical early-onset Alzheimer’s disease, a horrific disorder that ravaged her, leaving her blind and with serious dementia. At that moment, she was experiencing something called Capgras Syndrome, in which patients become deluded that those close to them and the...
There are so many new updates to The Right to Die: The Law of End-of-Life Decisionmaking (Wolters Kluwer 2020). Here are some of them:Idaho’s first reported judicial decision on end-of-life decision making, finding the Idaho advance directive statute constitutional as it applies to pregnant women. An appellate ruling in California upholding most of the interdisciplinary team approach to medical decision making for unbefriended patients in long-term care facilities. Promulgation of federal regulations that expand and protect statutory conscience rights in health care, including with respect to advance direc...
This study aimed to investigate the significant socio-demographic, lifestyle-related and disease-related correlates of depressive symptoms among this cohort. Cross-sectional data were obtained from a sample of 154 Chinese community-dwelling older adults with MCI. MCI subjects were screened by the Montreal Cognitive Assessment. Depressive symptoms were measured by the Geriatric Depression Scale. Possible correlates of depressive symptoms in individuals with MCI were explored by multiple linear regressions. The prevalence of depressive symptoms among Chinese older adults with MCI was 31.8%. In multiple regression analysis, p...
CONCLUSIONS: The combination of memantine with escitalopram was well tolerated and as effective as escitalopram and placebo in improving depression using HAM-D. Combination memantine and escitalopram was significantly more effective than escitalopram and placebo in improving cognitive outcomes at 12 months. Future reports will address the role of biomarkers of aging in treatment response. PMID: 31519517 [PubMed - as supplied by publisher]
ConclusionFew evidence-based best-practice models or guidelines for the diagnosis of YOD exist internationally. Increased awareness of the signs and symptoms of YOD among all healthcare professionals is necessary. There is a need for improved linkages to be developed between Geriatric Medicine, Neurology, Psychiatry, and Primary Care services and in certain instances for suspected cases of YOD to be referred to neurology-led memory clinics.
ConclusionWhilst some areas of Comprehensive Geriatric Assessment are achieved adequately, others are not. Our electronic assessment did not include a Geriatric Depression Score. Although pain was frequently assessed, again a score was not always used. Other areas for improvement include visual acuity, fractures and osteoporosis and advanced care planningThe results of this audit have been presented to the team, adjustments have been made to our electronic assessments so that we can record and capture this data better. There will be a reaudit in 6 month’s to evaluate improvement.
ConclusionSignificant improvements are noted since 2016 with the overall prevalence of antipsychotic prescribing decreasing from 35% to 16%, with the majority of these prescriptions having a clear indication. It is reassuring that residents are not receiving prn medications frequently. We await the national clinical guidance on “Appropriate Prescribing of Psychotropic Medication in People with Dementia” to further guide our practice.
ConclusionDyadic interventions (and psychoeducational programmes in particular) have the potential to benefit both people with dementia and their care partners by decreasing depression and anxiety, increasing knowledge and coping skills and helping improve cognitive function. (Moon and Betts Adams, 2012) The practical guidance document developed from this review provides HSCPs with useful advice and information to facilitate the setting up and running of post-diagnostic psychoeducational support programmes.
A recent study concludes that wearing hearing aids is associated with later onset of dementia and a reduced risk of anxiety, depression, and falls.
DISCUSSIONWhereas some AD biomarkers showed to be associated with affective symptoms in AD, most evidence was inconsistent. This is likely due to differences in study design or heterogeneity in affective symptoms. Directions for future research are given.