| 1. |
- Alafuzoff, I, et al.
(author)
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A comparison of multiplex and simplex families with Alzheimer's disease/senile dementia of Alzheimer type within a well defined population.
- 1994
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In: Journal of neural transmission. Parkinson's disease and dementia section. - 0936-3076. ; 7:1, s. 61-72
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Journal article (peer-reviewed)abstract
- A study was made on 150 clinically demented patients presenting at autopsy at Umeå University Hospital in Sweden. In 90 of the cases dementia was considered to be primary in nature and of these forty six per cent (41 cases), fulfilled both the clinical and histopathological criteria for the diagnosis of Alzheimer's disease/Senile dementia of Alzheimer type (AD/SDAT). The families of these 41 AD/SDAT cases were then studied, and a family history obtained through interviews with multiple family informants and from civil and medical records. Additional diseased family members suffering from progressive dementia (multiplex families) were observed in 12 probands out of 41 (29%). Multiplex families exhibited similar clinical and histopathological characteristics as simplex families containing a single affected individual. The secondary cases in the multiplex families exhibited similar demographic and clinical characteristics as the probands. 39% of the multiplex and 14% of the simplex cases had an early age of onset of the disease, that was under 65 years. The overall prevalence of progressive dementia disorders in the 41 families was 5.9%. The prevalence of a progressive dementia disorder was 11% in the multiplex families (14% for the early onset cases) and 3.5% in the simplex families (2% for the early onset cases). The prevalence of progressive dementia disorder for family members who had passed the mean age of the onset of the disease for their family, was 45% for multiplex and 18% for simplex families. Furthermore the incidence rate for dementia was significantly higher (p < 0.005) in multiplex families (5.5 per 1,000 person years) when compared to simplex families (2.5 per 1,000 person years). No differences could be seen in parental age at birth of the diseased when comparing the two sets of families. However in multiplex families the duration of the disease was significantly (p < 0.025) shorter, in subjects with parental age at birth over 35 years compared to those with a parental age under 35 years. The multiplex families contained significantly (p < 0.025) larger sibships; and showed a significantly lower age of onset for the disease (p < 0.001), and a significantly longer duration of disease (p < 0.05) compared to the simplex families. A significant intra familial correlation of age at disease onset was observed in both sets of the families.
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| 2. |
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| 3. |
- Asplund, Kenneth, et al.
(author)
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Facial expressions in severely demented patients : a stimulus-response study of four patients with dementia of the Alzheimer type
- 1991
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In: International Journal of Geriatric Psychiatry. - : Wiley. - 0885-6230 .- 1099-1166. ; 6:8, s. 599-606
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Journal article (peer-reviewed)abstract
- The ability to exhibit facial expressions was studied in four patients with severe dementia of the Alzheimer type (SDAT), by means of the Facial Action Coding System (FACS) and physiological responses (heart rate, respiration, skin temperature) under pleasant and unpleasant stimulus conditions. Complex facial expressions that could be interpreted as expressions of emotions were not seen. An increase in the number of facial movements and changes in the physiological responses were seen most markedly under the unpleasant stimulus condition. The patients' reactions during the assumed pleasant stimulus conditions indicated comfort. Different reactions were obtained among the patients. The importance of developing further methods to identify and interpret facial movements in nurse-patient relationships is emphasized.
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| 4. |
- Asplund, Kenneth, et al.
(author)
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The Sucking Behaviour of Two Patients in the Final Stage of Dementia of the Alzheimer Type
- 1991
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 5:3, s. 141-147
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Journal article (peer-reviewed)abstract
- Two patients in the final stage of dementia of the Alzheimer type (DAT), who could no longer be given nutrition by assisted feeding, were given fluids by means of the sucking ability they still retained. They sucked more slowly under nutritive than under non-nutritive sucking conditions. The sucking efficiency of one of them improved during training. The status of the patients in the final stage of their dementia differed from one another, which might explain the difference in outcome. It is therefore suggested, that the use of the patients' sucking ability could serve as a complement and/or an alternative feeding technique when assisted spoon-feeding becomes extremely difficult or impossible. It is considered to be more gentle and natural than the present feeding techniques.
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| 5. |
- Athlin, Elsy, et al.
(author)
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Caregivers' perceptions and interpretations of severely demented patients during feeding in a task assignment system.
- 1990
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 4:4, s. 147-155
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Journal article (peer-reviewed)abstract
- Ninety-one focused interviews concerning the feeding of 23 severely demented patients were performed with 62 caregivers who fed the patients in a task assignment system. The aim was to increase the understanding about how caregivers perceive and interpret severely demented patients' behaviour and experiences during feeding. Content analysis showed that the caregivers' commitment or lack of commitment constituted a superior level that determined whether the patient was seen as a subject or as an object. Subcategories that were found were knowledge of the patient's disease and personal history, intuition, identification, empathy, generalisation and routinisation.
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| 6. |
- Hansson, Jan-Håkan
(author)
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Organizing normality : Essays on organizing day activities for people with severe mental disturbances
- 1993
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Doctoral thesis (other academic/artistic)abstract
- This thesis focuses on the organizing of day activities, outside hospital care, for people with severe mental disturbances in Sweden. The purpose of the study is threefold: to describe the material and structural conditions of day activity settings on a national scale; to analyse some of the ideological claims made in the field; and to discuss problems and possibilities arising when more than one organizational sector is involved in the work.The thesis is divided into two parts. Part A presents the empirical material, derived from a national survey, as well as some historical and theoretical points of departure and concludes with a summarizing analysis of results. Part B contains four empirically based papers.The results show a considerable growth in the 1980s of day activity units specifically arranged for this group of people with severe mental disturbances. The average economic resource-input is considerably larger in psychiatry-run units than in units run by the social services. The collaborative efforts between the social services and psychiatry are discussed in the light of the fact that joint venture units develop distinctively different features, when it comes to, for example, recruitment routes of users and collaborative work with other organizations, as compared to units run by the social services or psychiatry alone. Thestructural and discursive power in this new field is largely in the hands of psychiatry. Ideological claims as to the definition of the work adhers to a "therapeutic paradigm".Results from an analysis of self-presentation documents reveals five distinct content categories: the dimension of ambition to change, the dimension of time-structuring, the dimension of profession/expertise, the dimension of intimacy of relation, and the dimension of autonomy. This is discussed in view of tendencies towards professionalization from different occupational groups as well as in view of issues of social control in modem society.Finally some prospects for the development in the future are discussed.
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| 7. |
- Jansson, Lilian, et al.
(author)
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Interpreting Facial Expressions in Patients in the Terminal Stage of the Alzheimer Disease
- 1993
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In: Omega. - 0030-2228 .- 1541-3764. ; 26:4, s. 319-334
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Journal article (peer-reviewed)abstract
- Videotaped interactions between each of two experienced caregivers and each of four patients in the terminal stage of the Alzheimer disease were interpreted. A hermeneutic approach was used to analyze the videotapes. It was possible to see the patients as capable of having experiences and of communicating them to their caregivers. The analysis made it possible to put together the observed communicative cues into a narrative for each patient. The study may contribute to the improvement of the care of severely demented patients by affecting caregivers' preunderstanding of these patients' experiences and communicative abilities.
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| 10. |
- Wimo, Anders, et al.
(author)
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Group living, an alternative for dementia patients : A cost analysis
- 1991
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In: International Journal of Geriatric Psychiatry. - : Wiley. - 0885-6230 .- 1099-1166. ; 6:1, s. 21-29
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Journal article (peer-reviewed)abstract
- The increasing number of patients with dementia requires new forms of care management. Group living (GL) is an alternative, and two units were established in Sundsvall, Sweden, in 1984. The patients in GL used institutional care to a significantly lower extent (nursing homes, emergency hospital care, psychiatric care) after admission to GL (p < 0.001). The costs for the Municipality and the County Council changed from £49 to £42/day (p=0.21) and patient during the first six-month period in GL compared to the six-month period prior to GL. If the costs for GL are compared to the costs for nursing home care (£68/day), GL is significantly cheaper (p < 0.05).
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