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P22. Care services: Day care and respite care

Detailed programme, abstracts and presentations

P22.1. Green care farms for people with dementia: first results of a new care approach in Germany

WOLF-OSTERMANN Karin, SCHMIDT Annika

University of Bremen, Bremen, Germany

Background: According to demographic developments in most European countries the number of people with dementia (PwD) is rising. Besides other small-scale care facilities green care farms developed in several European countries featuring different stages of development. While in the Netherlands already green care farms exist that provide not only day care but also 24-hour nursing home care for PwD the concept of green care farms in Germany has just started. This study was conducted to – for the first time – characterize barriers and motivating factors for green care farms in northern Germany.

Methods: In an explorative mixed-methods study we conducted in depth interviews with green care farmers (n=4) and political and administrative responsibles (n=6) are as well as a standardized survey of home care services (n=16), nursing homes (n=26) and potential users (n=7). Qualitative data were analysed using content analysis methods according to Mayring, quantitative data using descriptive and inferential statistics.

Results: The findings show first of all, that there currently is a massive lack of individual, person tailored services for care and support of PwD in rural areas besides classical residential care or home care services. Second, there is a great interest of potential users in this special form of care services but third, also many structural barriers like financing these services or even such basic things like organising transportation to green care farms in regions with poor public transportation.

Discussion: The findings point out opportunities and difficulties in implementing Green Care Farms into daily practice in Germany. The results will be useful for rural communities, healthcare and service providers, and academics researching the condition to broaden the range of person-centred care for PwD in Germany.

P22.2. The Alzheimer Café: A dyadic psychosocial support model

TEAHAN Áine, FITZGERALD Christine, O'SHEA Eamon

NUI Galway, Galway, Ireland

Introduction: Research has demonstrated benefits of Alzheimer Cafés from a dyadic perspective; indicating increased quality of life, enhanced social connections and personal identity for people with dementia (PWD) (Phinney et al., 2016), as well as providing long-term support in service-planning to carers and PWD (Kelly & Innes, 2016).

Aim: To examine the effectiveness of the Alzheimer Café model in addressing the psychosocial needs of PWD and carers in Ireland.

Methods: This research adopted a responsive methodological approach to capture the dyadic experience of this innovative care service model. Utilising four interrelated research phases, the methods comprised: focus groups with PWD and family carers currently attending Alzheimer Cafés; experiential interviews with PWD; semi-structured interviews with family carers; and semi-structured interviews with key stakeholders and staff.

Preliminary results: From the dyadic perspective, carers found the Café to be a useful avenue for signposting information on available services and creating supportive interactive networks with other families. PWD also valued the Café's information role in relation to supports and services, both formally and from a peer-support perspective. PWD also enjoyed the social activities aspect of the service and highlighted the importance of having an informal, safe space where they could socialize with their families and other attendees. Governance and organizational factors had an influence on the effectiveness of the Café service provided to PWD and carers.

Conclusion: The Alzheimer Café presents as a multi-functional dyadic psychosocial service, recognising and addressing the needs of both PWD and family carers while facilitating relationship building in a relaxed and safe environment. This research will inform the development of transferable frameworks to other psychosocial supports, benefiting PWD, carers and staff, by ensuring that supports are selected, developed and individualised to the needs of all stakeholders.

P22.3. “Farm-based day care for people with dementia in Norway” a description of the farm context and the service

IBSEN Tanja Louise1, ERIKSEN Siren1, PATIL Grete Grindal2

1Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway, 2Norwegian University of Life Sciences, Ås, Norway

Background: A variation in types of day care services for people with dementia to better facilitate for individual needs is required. Farm-based day care services use farm resources like the agricultural landscape and farming activities to promote health. There is limited knowledge on the service offered. In the present study, we describe farm-based day care for people with dementia in Norway and the participants’ care environment.

Method: We mapped the existing farms offering day care in Norway by the spring 2017 (N= 33) and collected information from service providers at the farms through two cross sectional surveys (N=32). We further compared our findings with data on Norwegian regular day care services.

Results: The services covered day care for 227 people with dementia, and had group sizes from one to ten participants. Young people with dementia (≤ 65) and those in an early stage were primary target group in more than half of the services. About eighty percent of the farms had health care personnel available and most farms had staff with agricultural competence.

The participants spent time outdoor every day at the yard or in a garden, and they used the farm buildings and adjacent outdoor areas. Almost all services had animals. Time of the year influenced on the activities selected. The providers highlighted the opportunity to choose activities individually tailored to each participant, as the diversity of resources on the farm made it possible to adapt activities.

Conclusion: Farm-based day care represents a complementary service to regular day care. It has similarities in organization, daily structure and comparative number of health educated personnel. However, it differs in type of care environment, and the farm offered a wide range of activities with the farm buildings, gardens, animals, and outdoor areas as a part of the context.

P22.4. Impact of dance on balance, gait and confidence of people with dementia

MABIRE Jean-Bernard, CHARRAS Kevin, AQUINO Jean-Pierre

Fondation Médéric Alzheimer, Paris, France

Introduction: Dance interventions are often implemented in dementia care for their pleasantness and their social characteristics. Dance is a multimodal activity with empirical benefits on balance, gait, risk of fall, physical activities, cognition, quality of life, social interactions and behavioral and psychological symptoms. The aims of this study were to test the feasibility of a dance intervention in a day care center and to evaluate its impact on balance, confidence, quality of life and well-being of people with dementia. 

Methods: A 12 weeks dance intervention was proposed for 23 people with dementia. Interventions were led by a skilled dance teacher with a nursing background and with the help of two care staff. The study used a crossover experimental design with two groups that followed the sessions for a period of 12 weeks consecutively.  Thus, each group was an intervention group and a control group.

Three assessments were undertaken: before the intervention, after the first session and after the second session. Assessments were “Get up and Go test”, “Stop walking when talking test” “Unipodal station test”, “Activities-specific Balance Confidence Scale” (ABC-S) and “Quality of Life in Alzheimer’s Disease” (Qol-AD). Well-being was measured before and after each 45 minutes’ dance session with a verbal analogue scale.  

Results: Sample characteristics and comparisons between the sessions were analyzed using an ANOVA. Results concern balance, balance confidence, quality of life and well-being. We also observed a maintenance of results over time. Information about attendance and participants’ feedback will be presented.

Discussion:Dance interventions will be discussed in terms of benefits, implementation procedures and treatment indications according to the results of our study and scientific literature on this topic.

P22.5. The impact of attending a day care centre designed for people with dementia on nursing home admission

ROKSTAD Anne Marie Mork1, SELBÆK Geir2, KIRKEVOLD Øyvind3, BENTH Jūratė Å altytė4, ENGEDAL Knut5

1Vestfold Hospital Trust, Molde, Norway; Molde University College, Molde, Norway, 2Vestfold Hospital Trust; Innlandet Hospital Trust; University of Oslo, Lillehammer, Norway, 3Vestfold Hospital Trust; Norwegian University of Science and Technology; Innlandet Hospit, Hamar, Norway, 4University of Oslo and Innlandet Hospital Trust, Norway, Oslo, Norway, 5Vestfold Hospital Trust, Oslo, Norway

Background: Day care services offer meaningful activities and is a safe environment for the attendees, and a respite for family caregivers.

Aim: The objective of the study was to explore if a day centre program designed for people with dementia could delay nursing home admission (NHA).

Method: A quasi-experimental trial explored the proportion of patients permanently admitted to nursing homes after 24 months as the main outcome by comparing a group of day care attendees (DG) and a comparison group of participants without day care (CG). In all, 257 participants were included (181 in DG and 76 in CG). A logistic regression model was built with NHA as outcome. Group belonging (DG or CG) was the main predictor, baseline patient and family caregiver characteristics and interactions were used as covariates in a model.

Results: Mean age was 81.5 (SD 6.4), 65% were women and 53% lived alone. Mean MMSE score was 20.4 (SD 3.5). In all, 63 participants (25%) completed the follow-up assessment at 24 months, 128 (50%) of the participants were admitted to nursing home and drop-out was due to death (8%) and other reasons (18%). In the logistic unadjusted regression model for NHA after 24 months, group-belonging (DG or CG) was not found to be a significant predictor for NHA. In the adjusted AIC-reduced model, being in the DG gave significantly higher chance for NHA at follow-up as compared to no day care. Group belonging was found to be significantly associated with NHA in interaction with age, living alone, affective symptoms, sleep disturbance and lower function in activities of daily living.

Conclusion: There is a complex interplay between use of day care and patient characteristics in the prediction of NHA.

P22.6. An individual dementia-specific counseling program as part of a dementia-specific respite care concept

CAVAZZINI Christoph, HEINRICH Steffen, HOLLE Bernhard

German Center for Neurodegenerative Diseases (DZNE), Witten, Germany

Objectives: Dementia-specific home care arrangements are complex and multi-layered. Individually tailored special dementia-specific counseling services for family caregivers can support them in reflecting and organizing the caring situation and are contributing to the care planning process. A respite care stay of the PwD opens up the possibility for counseling the family caregivers regarding their care situation. Today there is no tailored dementia–specific counseling program within the respite care setting.

Methods: To address this, a counseling program was developed and modified on the basis of a comprehensive literature research, 6 expert interviews with experienced consultants, 3 visits to existing counseling services and 3 expert workshops with scientists and practitioners. The interviews were analyzed inspired by the qualitative content analysis. This approach was necessary to obtain a comprehensive overview.

Results: Based on the results of analysis it became clear, that the counseling program has to be tailored and the counseling themes should be focused on the individual situation of the PwD and their relatives. Thereforewe designed a program which is based on different assessments and instruments which offer the consultants a more comprehensive picture about the whole care arrangement. Beside others, one of these assessments is focusing on the knowledge which family caregivers have regarding dementia and the burden of the family caregivers. The results of these assessments form the basis for an individual tailored counseling process.

Conclusion: Nowadays the counseling program is being tested in a dementia-specific respite care facility. First results show that family caregivers perceive the counseling program. It has likewise become clear that consultants needs to be well trained in using the developed assessments and the implementation of the counseling program in order to integrate the whole program in their caring routine.

 

 
 

Last Updated: Tuesday 13 November 2018

 

 
  • Acknowledgements

    The 28th AE Conference in Barcelona received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe, CEAFA and Fundación Alzheimer España gratefully acknowledge the support of all conference sponsors.
  • European Union
  • Roche
 
 

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