Dementia Patient Suffering and Caregiver Depression.1
Dementia Patient Suffering and Caregiver Depression.
The caregiving situation among caregivers and their spouses with Alzheimer’s disease, the support and services received, the unmet needs, and the caregivers’ satisfaction with the services are examined. The study included a survey of a random sample of 1943 caregivers of persons with Alzheimer’s disease in Finland. Mean age of the caregivers was 78.2 years, and 35% had poor subjective health. Disabilities and behavioral symptoms were common among the spouses with Alzheimer’s disease. The services most often offered were financial support (36%), technical devices (33%), physiotherapy (32%), and respite care in nursing homes (31%). Most often needed services were physiotherapy for the spouse with dementia (56%), financial support (50%), house-cleaning (41%), and home respite (40%). Only 39% of the caregivers were satisfied with the services, and 69% felt they did not have any influence on what services were offered. It was concluded that official services poorly meet the needs of these caregivers.
Decision-Making Involvement Scale for Individuals With Dementia and Family Caregivers
This report describes the development and preliminary psychometric properties of the Decision-Making Involvement Scale for individuals with dementia and family caregivers. Data were collected from 217 individuals with dementia and their respective caregivers. Principal axis factor analysis, Kendall , and Pearson correlations were used to determine the Decision-Making Involvement Scale’s psychometric properties, mean differences of caregiver and individual with dementia, and the relationship between scores of Decision-Making Involvement Scale and measures of well-being. Analyses support a reliable, 1-factor solution of the Decision-Making Involvement Scale for both individuals with dementia and caregivers. Socio-demographic, impairment, and well-being variables are differentially related to the perceptions of how involved the individual with dementia is in decision making. The Decision-Making Involvement Scale provides useful information about daily decision making of an individual with dementia, and it shows promise as a means for understanding the relationship between decision-making involvement and well-being of individuals with dementia and caregivers.
Does a Wander Garden Influence Inappropriate Behaviors in Dementia Residents?
Background: The effect on resident behaviors of adding a wander garden to an existing dementia facility was investigated. Methods: 34 male residents were observed for 12 months before and after opening the garden. Behaviors were assessed using the Cohen-Mansfield Agitation Inventory Short Form (CMAI), incident reports, as needed medications (pro re nata [PRN]), and surveys of staff and residents’ family members as indices of affect. Results: Final CMAI scores and total PRNs employed were lower than baseline values with a trend for residents who used the garden more often to have less agitated behavior. Verbal inappropriate behaviors did not change significantly whereas physical incidents increased. Staff and family members felt that the wander garden decreased inappropriate behaviors and improved mood and quality of life of the dementia residents. Conclusions: Study design characteristics and garden management may have affected behaviors both positively and negatively. Additional studies are needed to explore the benefits of wander gardens for dementia residents.
Serum Albumin Levels Predict Cognitive Impairment in Elderly Hip Fracture Patients
The aim of this study was to investigate the possible interrelation of serum albumin levels and cognitive function of elderly hip fracture patients. The study involved 331 elderly patients with hip fractures, admitted for rehabilitation. Cognition was assessed by Mini-Mental State Examination (MMSE). MMSE scores less than 24 points were considered suggestive of cognitive impairment. Age, serum albumin levels, and previous stroke emerged as the only statistically significant parameters differing between those with MMSE score less than 24 or higher. After adjusting for confounding variables, the middle and lowest tertiles of serum albumin levels were associated with an increased risk of cognitive impairment (odds ratio 1.97, 95% confidence interval 1.15-3.38, P < .01 vs 3.06 and 1.79-5.23, P < .001, respectively). This study shows that lower serum albumin levels are independently associated with lower MMSE scores in hip fractured elderly patients, supporting the possible role of chronic low-grade inflammation in age-related cognitive decline.
Salivary Cortisol Awakening Response in Mild Alzheimer Disease, Caregivers, and Noncaregivers.