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| 2. |
- Asplund, Kenneth, et al.
(författare)
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Facial Expressions of Patients With Dementia : A Comparison of Two Methods of Interpretation
- 1995
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Ingår i: International psychogeriatrics. - 1041-6102 .- 1741-203X. ; 7:4, s. 527-534
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Tidskriftsartikel (refereegranskat)abstract
- Two methods of interpreting the videotaped facial expressions of four patients with severe dementia of the Alzheimer type were compared. Interpretations of facial expressions performed by means of unstructured naturalistic judgements revealed episodes when the four patients exhibited anger, disgust, happiness, sadness, and surprise. When these episodes were assessed by use of modified version of the Facial Action Coding System, there was, in total, 48% agreement between the two methods. The highest agreement, 98%, occurred for happiness shown by one patient. It was concluded that more emotions could be judged by means of the unstructured naturalistic method, which is based on an awareness of the total situation that facilitates imputing meaning into the patients' cues. It is a difficult task to find a balance between imputing too much meaning into the severely demented patients' sparse and unclear cues and ignoring the possibility that there is some meaning to be interpreted.
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| 3. |
- Borell, L
(författare)
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Supporting functional behavior in Alzheimer's disease
- 1996
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Ingår i: International psychogeriatrics. - : Cambridge University Press (CUP). - 1041-6102 .- 1741-203X. ; 8 Suppl 1, s. 123-5
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Tidskriftsartikel (refereegranskat)abstract
- Institutionalized persons with Alzheimer's disease (AD) often demonstrate nonfunctional behaviors such as resistance to dressing and washing, disturbed sleep, restlessness, homesickness, and wandering. If behavior is regarded as emanating from the person with impaired cognition interacting with his or her environment, the environment is found to have a very significant impact on retaining functional capacity. For example, studies have demonstrated how behaviors described as wandering and homesickness strongly relate to events and objects in the environment (Zingmark et al., 1993). The context or environment contributes to the success or failure of behavioral strategies. The goal in dementia care must be to have a positive impact on functional behavior. One consequence of this is that functional behavior can be altered, within limits, through environmental strategies.
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| 4. |
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| 5. |
- Ekman, SL
(författare)
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Monolingual and bilingual communication between patients with dementia diseases and their caregivers
- 1996
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Ingår i: International psychogeriatrics. - : Cambridge University Press (CUP). - 1041-6102 .- 1741-203X. ; 8 Suppl 1, s. 127-32
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Tidskriftsartikel (refereegranskat)abstract
- The relationship between a demented patient and his or her caregiver is an important aspect of the patient's environment. The interaction between the parties is the basis of their relationship. It stems from their ability to communicate—a very complex process with many different aspects from perception to practice.
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| 6. |
- Elmståhl, Sölve, et al.
(författare)
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Behavioral disturbances and pharmacological treatment of patients with dementia in family caregiving : A 2-year follow-up
- 1998
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Ingår i: International Psychogeriatrics. - 1041-6102. ; 10:3, s. 239-252
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Tidskriftsartikel (refereegranskat)abstract
- Behavioral disturbances are common in dementia. Polypharmacy due to progression of disease and fluctuation of symptoms among patients might increase risk of overtreatment and/or undertreatment. Drug prescription habits were studied in relationship to symptoms of dementia after relocation of patients to group-living care units (GC). Seventy-six demented patients (mean age 81 years) were assessed before, 12 months after, and 24 months after relocation to GC. Vascular dementia was found in 47%, Alzheimer's dementia in 46%, and other dementias in 7%. Medications, regular or as required, were recorded from medication lists. Repeated observations of symptoms like depressive mood and lack of vitality were made with validated scales. Eighty percent of the patients were prescribed drugs; 40% were given neuroleptics and 9% were given antidepressants. During the 2-year follow-up, polypharmacy increased; patients with five drugs or more increased from 15% to 35%; usage of neuroleptics or sedatives, as required, increased from 8% to 25%, p < .01. Depressive mood was noted in 86% after 2 years and 74% showed aggressiveness and anxiety, but only 12% of the patients with depressive symptoms were on antidepressants. Analgesics were prescribed to 26% of patients. In conclusion, a high proportion of patients with dementia had depressive mood and undertreatment of depressive disorder might be suspected. Polypharmacy increased during the 2-year follow-up; this finding calls for careful monitoring of adverse drug reactions, because of the deteriorating cognitive function of these patients.
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| 7. |
- Elmståhl, Sölve, et al.
(författare)
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Family caregiving in dementia : Prediction of caregiver burden 12 months after relocation to group-living care
- 1998
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Ingår i: International Psychogeriatrics. - 1041-6102. ; 10:2, s. 127-146
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Tidskriftsartikel (refereegranskat)abstract
- The strain of caregiving associated with the care of demented persons living at home often continues after relocation, and group-living-care units (GL), designed for a small number of subjects, have been developed. The aim was to prospectively describe caregiver burden in relationship to symptoms of patients with dementia after relocation to GL. Sixty-four caregivers and 64 demented patients were assessed before, 6 months after, and 12 months after relocation. Thirty-six caregivers were children, 7 were spouses, and 21 were others. Validated scales were used for caregiver burden and dementia symptoms. Total burden of caregivers decreased after 12 months, but the degree of isolation was unchanged and feeling of disappointment increased significantly. The burden was not related to changes of activities of daily life or disorientation. Patients' lack of vitality at relocation independently predicted caregiver's burden 1 year later. Hallucinations and changes of symptoms during the first year were associated with less caregiver burden, probably due to greater detachment of the relationship. The caregiver burden remains 1 year after relocation and any support to the caregiver should consider patients' symptoms, especially lack of vitality.
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| 8. |
- Elmståhl, Sölve, et al.
(författare)
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Precipitating and Predisposing Factors of Acute Confusional State Among Emergency Department Patients
- 1995
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Ingår i: International Psychogeriatrics. - 1041-6102. ; 7:4, s. 519-526
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine predisposing and precipitating factors of acute confusional state (ACS) retrospectively in medical records of patents examined in an acute medical unit (AMU) who had a preliminary diagnosis of confusion/anxiety. The study comprised all 221 patients who were 65 years old and older among the 18,015 patients examined in the AMU during 1 year who, after a preliminary examination in the AMU, received a diagnosis of confusion/anxiety without any other etiologic diagnosis. Fifty-six cases fulfilled the DSM-III-R criteria for ACS. The control group comprised 165 patients, with anxiety, depression, or psychosis the main finding in 135 cases. Among patients further examined in other departments or for whom consultations were made, the medical records showed that the ACS group had on average 2.6 predisposing factors for ACS, with dementia, cerebrovascular disease, and sensory deficits the most common. Three to six predisposing factors were found among 46% of the ACS patients, compared to 4% of the control group. A precipitating factor of ACS was found in 78% of the ACS cases, and the average number of precipitating factors was 1.6. Dementia (32%), metabolic disturbances (30%), and cardiovascular diseases (16%) were the most frequent precipitating factors among the ACS group. The mortality rates 2 years after examination in the AMU were 32% for the ACS group and 20% for the control group (p <.05). The study suggests that the causes of ACS are often multifactorial and that it is important to seek several precipitating factors when treating this potentially reversible condition.
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| 9. |
- Josephsson, S
(författare)
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Supporting everyday activities in dementia
- 1996
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Ingår i: International psychogeriatrics. - : Cambridge University Press (CUP). - 1041-6102 .- 1741-203X. ; 8 Suppl 1, s. 141-4
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Tidskriftsartikel (refereegranskat)abstract
- Dementing disorders such as Alzheimer's disease have an enormous impact on the everyday life of the person affected, on his or her family members, and on the staff involved in providing daily care (Borell, 1992). Cognitive dysfunction resulting from dementing diseases, such as memory problems, interferes greatly with the performance of most activities of daily living. The field of occupational therapy has developed a variety of intervention programs addressing everyday activities for persons with dementia. A review of the relevant literature shows, however, that even if the need for such interventions is acknowledged (Porszt-Miron et al., 1988) and an outline for the intervention is described (Bryant, 1991; Rogers et al., 1987), there are few studies evaluating the efficacy and functional relevance of such interventions. Consequently, one urgent task for research is to identify and evaluate intervention strategies addressing occupational functioning among persons with dementia disorders.
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| 10. |
- Lynöe, Niels, et al.
(författare)
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When others decide : reasons for allowing patients with Alzheimer's disease to participate in nontherapeutic research
- 1998
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Ingår i: International psychogeriatrics. - 1041-6102 .- 1741-203X. ; 10:4, s. 435-436
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Tidskriftsartikel (refereegranskat)abstract
- The quality of information given to family members of patients with Alzheimer's disease was studied. The patients had participated in a pharmacological investigation. The relatives were generally satisfied with the information given, and perceived it as adequate. The reasons given for allowing the patients to participate in the investigation were mainly altruistic.
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