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Parallel Session P13 - Non-pharmacological approaches to the management of dementia

Detailed Programme and abstracts

Saturday, 2 October – 14.00-15.30 (Red Room)

P13.1. Dance and movement as a tool - education in Summer University of Pohjois-Pohjanmaa.

Memorynurse Anne Happo, anne.happo@karpalokoti.fi, Finnish Dementia Association, MuistiLuotsi at Karpalohome, Finland

Dance and movement as a tool -education is a professional complementary education put into practice by Summer University of Pohjois-Pohjanmaa. It is targeted for adults, who have achieved at least a basic examination.

Training is based on a scientific study conducted in Pyhäjärvi at Karpalokoti, a rehabilitation and study unit of dementia owned by Finnish Dementia Assosiation, 2000-2003. The method has had positive effects in communication; the number of information units in narrative speech grew, also sociality in group multiplied.

Dance and movement as a tool -education is mainly targeted for people working with people with memory disorders and the goal is that participants will be able to use the method as a resource in their own work. The goal for the training is to explore new tools and by that create an opportunity for memory patients to express themselves trough their bodies and thereby to bring joy and content to the everyday lives of the patients.

The education is processive by nature and includes getting acquainted to the body and dance trough different exercises, lectures, group conversations, working in group and written exercises.

The extent of the education is 25 academic credits. One credit is equivalent to 27 hours of work. Studies are formed of three main parts, divided into eight terms. It takes a year to complete the education. Each term includes 16 lessons of theory and exercises executed in two days.

Teachers are dance-, movement- and music therapists, doctors specialised in memory disorders and trained nurses directing dance movement groups.

P13.2. “The past recaptured” - A personal webpages reminiscence programme

N. Karparthiou1, D. Potamianou1, A. Efthymiou1, C. Nikolaou1, P. Sakka1

1 Athens Association of Alzheimer’s Disease and Related Disorders, M. Mousourou 89, Athens, Greece, 11636 kentroalz@ath.forthnet.gr

Background : Reminiscence is a well-established psychosocial intervention which is based on remembering past events. Different types of reminiscence programmes have been used with people with dementia involving a variety of mediums.

The Personal Webpages Programme combines the use of computer technology with the life review intervention. It is a reminiscence programme which leads to the construction of participants’ Personal Webpages. Personal Webpages are handed to people with dementia as a hard copy and in a printed form for use at home, to enhance communication and conversation with relatives, friends and caregivers.

Personal Webpages contain written accounts of participants’ life, photographs, songs, poems and other personal mementos. Information and materials are gathered in collaboration with their families, as well as through the internet.

The purpose of the study was to evaluate the Personal Webpages Programme, a reminiscence programme leading to the construction of participants’ Personal Webpages.

Methods: The programme was delivered in a group setting in a Dementia Day Care Centre over 4 months with a frequency of 2 times a week, alongside with other interventions (physical exercise, cognitive training and recreational activities). In total 28 sessions took place.10 persons with dementia participated in the study, ranging from mild cognitive impairment to mild dementia. The control group (n=10) attended all the Dementia Day Care Centre activities but the Personal Webpages Programme.

Cognitive abilities were evaluated pre and post intervention using the MMSE, MOCA, CDT, verbal & category fluency, BNT-15, digit span, modified trails and Rey’s figure. GDS-15, FAQ and SQLC were used as a measure of depression, functional ability and quality of life respectively. Participants’ questionnaires were collected to evaluate the implementation of the Personal Webpages Programme.

Results: Statistical analysis of the data using a factorial mixed design ANOVA did not reveal any statistically significant differences between the experimental and the control group. However, post-intervention, subjects in the experimental group performed significantly better on the verbal fluency task (p<0.05), whereas subjects in the control group worse on the digit span task (p<0.05). Participants reported high satisfaction rates with the Programme and their Personal Webpages and considered the use of computer technology to be a positive and essential element of the reminiscence programme. All of them stated that they will use their Personal Webpages at home.

Conclusions: The Programme promoted interaction between group members. All participants were highly involved and eager to use their Personal Webpages at home. The use of computer technology seems to motivate people with dementia and their families and can be used as an alternative tool in reminiscence programmes.

P13.3. Doll therapy, non-pharmacological treatments for the managament of BPSF (behavioural and psychological symptoms of dementia) in subjects sufferent from Alzheimer dementia

Ivo Cilesi Italy ivocilesi@virgilio.it , Psycological and Consulent non pharmacologycal therapy, Foundation S. Maria Ausiliatrice ( Bergamo Italy), Collaborator Alzheimer Center in Gothenburg, Sweden

Background: The therapeutic value of the use of the doll with persons with dementia which exhibit important behavior disturbances, assumes symbolic meaning in relation to the regressive potentialities enhanced by the object doll . The doll is an instrument that stimulates the activation of memories by encouraging the motherly care. The applied therapeutic approaches are modulated and proposed after the observation of the behavioral dynamics of persons under test.

The use of the therapeutic doll recalls the relational dynamics typical of infancy and motherhood, especially in people affected by a progressive loss of capabilities and abilities, and with important behavioral problems, such as in advanced dementia. The doll becomes a symbolic instrument which contains the paternal and maternal background and encourages memories and emotions of past life. The doll is the child to care, to nurse, to caress, to look at, to embrace. This way, archaic emotions are stimulated. Persons recognize as real the inanimate object and the care of the doll alleviates the behavior disturbances.

Methodology: 20 institutionalized persons suffering from severe degree of Dementia and severe behavior disturbances - such as wandering, agitation and aggressiveness - were selected for the experiment. Dolls produced in Sweden and built with the purpose to encourage the relational contact were adopted. The doll weight, open position of legs, building material, and lateral glance itself, encourages the approach and child-like care.

The study envisaged an observation period, objectified by observation forms filled by the team operators that evaluated the persons, all day long. Afterwards an observation form for the initial evaluation of the relational dynamics persons/doll was activated. The related items explored the relational interactions: she accepts her, she searches her, she speaks to her, she hugs her, she rocks her, she attends her(she rearranges the suits and dresses again her),she smiles when she looks the doll. She smiles toward others, she sings, she plays with her, she seeks the consent, she abandons her ,the contact is continuous or fleeing, she caresses her hair, she holds her without moving her. If the evaluation was positive, patients were admitted to a one-year experimentation. The doll was proposed to the persons both during the acute phase of the behavior disturbance and in other moments, in order to facilitate the therapeutic continuity. The pursued objectives were to investigate both whether the non-pharmacological technique alleviate the behavior disturbance or turned it into a less severe disturbance, f.i. from wandering to bustling around.

Conclusions:

The study highlighted interesting potentialities of the therapeutic dolls in the treatment of the BPSD resulting in their reduction or lower incidence. This implied:

  1. a reduction in the pharmacological load, especially for Neuroleptic patients
  2. a better handling of patients from the assistive personnel
  3. a higher degree of satisfaction from relatives
  4. a less disturbing and slower clinical course of the disease

Therefore, it can be inferred that these methodologies dramatically improve the quality of life of the elderly suffering from dementia, while the results in assistive terms are very interesting.

It was indeed experienced that all the members of the tem were more involved and participative in the assistive process, with a resulting motivation that induced a reduction in the absences due to illnesses and a dramatic reduction of the burn out phenomenon.

P13.4. Cognitive training as a non–pharmacological approach in comprehensive care and treatment of patients with Alzheimer´s Disease.

Katarína Karolová1, Mária Čunderlíková2, Mária Wirth3.

1 MEMORY Center, Bratislava, Slovakia, centrummemory@nextra.sk

2 MEMORY Center, Bratislava, Slovakia, centrummemory@nextra.sk

3 Slovak Alzheimer´s Society, Bratislava, Slovakia, spolocnost@alzheimer.sk

The MEMORY Center is a non profit organization. It is the first preventive, diagnostics, specialistic and training environment for people with memory disorders and Alzheimer´s Disease in Slovakia. The care and treatment of patients with Alzheimer´s disease is primarly focused on the non-pharmacological approaches. The Center collaborates closely with the Slovak Alzhemier´s Society.

Since 2007 we have realized a project in cooperation with Slovak Health University, aimed at studying the effects of non-pharmacological approaches in stimulating cognitive functions of individuals with Alzheimer´s Disease. The improvement of cognitive and clinical parameters has been monitored.

Within the project the methods of the group cognitive training and individual cognitive training has been verified.

The cognitive training includes activities for maintaing the cognitive functions of patient, to stimulate the locomotor system, keeping up social contact with others, supporting individual´s indenpendence and encouraging the patient to self-activity.

Comprehensive care includes the management and the education of family members. For relatives we have created methodology of intensive educational support program .

P13.5. Home Ergotherapy: Supporting the person with Alzheimer disease and his family

Dufour Anouk, Alzheimer Belgique asbl , Belgique , info@alzheimerbelgique.be

Introduction: Home ergotherapy is a service organised by “Alzheimer Belgique asbl”. It has been created as an answer to the numerous requests collected at our phone monitoring station like: grace requests for the assistant, specialised activities request for the diseased person, information requests on the disease.

Method: Based on his knowledge of the disease and on the psychological, cognitive and physical consequences for the disoriented person, the ergotherapist evaluate and try to find out the capabilities of the person with dementia. The observation and the assessment of the home situation allow the experimentation of new activities or new supporting methods for the diseased person. The means and techniques to implement it in practice can be teached to the near relations.

Objectives: The ergotherapist promote keeping the person at home and improve the quality of life of the diseased person as well as that of the near relations. It allows:

  • To promote the communication between the diseased and its circle;
  • To keep as much as possible the functional and mental autonomy of the disoriented person;
  • To relieve his emotional distress;
  • To promote his integration with his surroundings;
  • To inform the family of the evolution of the disease and of the capabilities of the person.

Results: This ecological approach, that evaluates the impact of the Alzheimer disease on the daily life, and the global support of the patient and his family give this last one support and grace not only during our activities but also during the day-to-day life as the way of behaving toward the sick person can become simpler and his behaviour is less confusing as better understood by the other people after our intervention.

 

 
 

Last Updated: mercredi 03 novembre 2010

 

 
 

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