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PL3. Dementia as a care priority

Detailed programme, abstracts and presentations

PL3.1. Assistive technologies in dementia: Findings of the INDUCT (Interdisciplinary Network for Dementia Using Current Technology) consortium

LIBERT Sébastien, HIGGS Paul, CHARLESWORTH Georgina

University College London, United Kingdom

This short presentation will be an opportunity to review some of the current challenges that surround the development of assistive technologies for dementia, and present different researches attached to solving them. These challenges are of different kind, both technical, but also social and cultural. Firstly, I will propose an overview of ongoing researches on assistive technologies for dementia by early-stage researchers within INDUCT, the Interdisciplinary Network for Dementia Using Current Technology. This European project aims to study the potential of technological innovations to support people with dementia today, and in the future. I will then introduce my own PhD project as part of INDUCT, exploring how our cultural understanding of ageing influences technological developments for dementia, including assistive technologies. Specifically, current understandings of the ageing process within Western cultures bring new challenges associated with the widespread anxiety that identifies dementia as an interruption of active ageing. Complex and multifaceted notions such as independence and autonomy are key articulations of these challenges a found in the development of assistive technologies. Overall, by considering these challenges, I wish to propose a reflexion on the relation between anxiety, novel responsibilities associated with ‘ageing well’ today, current trends toward austerity in social care across Europe, and the position of assistive technologies within these shifting economic, political, and social landscapes.

PL3.2. Redefining and measuring meaningful outcomes for people with dementia

MOUNTAIN Gail

University of Bradford, Bradford, United Kingdom

The presentation will consider whether the outcome measures commonly used in dementia studies are fit for purpose within the context of;

The relatively recently acknowledged value of adopting positive rather than deficit model of dementia

The need for methods of measurement that do not require recall

The importance of working with people living with dementia to develop new tools for research and for practice which are relevant to them

Gail will draw upon the empirical work on outcome measures for dementia research and practice that she has engaged with, and in particular the work conducted with members of the pan European Interdem group of researchers (www.interdem.org).  She will also use her experiences of leading large scale psychosocial intervention studies to propose the changes she considers are required to the science and methods of taking outcome measures to be taken and why.

PL3.3. Partner in balance: an example of tailored post-diagnostic support

De VUGT Marjolein

Maastricht University, Maastricht, Netherlands

E-health technology offers opportunities to tailor interventions in an accessible manner. Existing e-health interventions for caregivers of people with dementia are mainly aimed at dealing with dementia-related problems. They may not fit the needs of informal caregivers of persons in an early stage of the disease process. The program Partner in Balance is a blended care intervention that is developed specifically with and for informal caregivers of people with dementia in its early stages. The program offers tailored online support with personal guidance of a professional coach. The aim of the program is to identify areas of change and to work on personal goals in a step-wise approach. The development, usability, effectiveness and implementation of 'Partner in Balance' will be presented. A randomized controlled trial showed positive effects of 'Partner in Balance' on self-efficacy, experienced control and quality of life in comparison to usual care. The program is currently implemented in the Netherlands and the Euroregion Meuse-Rhine.

PL3.4. Reducing the use of antipsychotics in residential and nursing homes

CARRASCO Manuel Martin

Spain

Antipsychotic medications are commonly used to manage the behavioral and neuropsychiatric symptoms of dementia, but several robust studies have demonstrated an association between treatment with antipsychotics and increased morbidity and mortality in this group population. Despite these risks, antipsychotics may be deemed necessary when symptoms are dangerous or severely distressful and other treatments have failed. However, wide variability in antipsychotic use among nursing homes not explainable by resident characteristics, suggests overuse in this population.

Current guidelines and policy regulations emphasize the relevance of reducing inappropriate prescribing of antipsychotics to the elderly with dementia in residential care. To address this issue, several intervention programs with different approaches have been designed, including educational interventions, outreach information, monitoring antipsychotic prescription (i.e. through pharmacy services), tutorial meetings with accompanying decision aids, etc.

Meta-analysis studies to assess the effectiveness of these interventions have been conducted. Overall, interventions are effective on the short-term, but doubts about sustainability remain.  For prescribing levels to be reduced in the long term, the culture and nature of care settings and the availability and feasibility of nondrug alternatives need to be addressed.

In this presentation, special attention to the situation in Spain will be paid, including implementation of the recently developed culturally adapted CHROME criteria for reducing chemical restrain in nursing homes and residential care.

PL3.5. Fostering and sustaining relationships with people with dementia

ROES Martina, PURWINS Daniel, SERBSER Jonathan, DREYER Jan, VOELZ Silke

DZNE, Witten, Germany

Relationships are among the key factors, from the point of view of people with dementia, which constitute and influence quality of life. Therefore, relationships constitute a fundamental component in person-centered care. Through person-centered care interaction and communication provide the opportunity to build a relationship with people with dementia and their caregivers. Hence, person-centeredness is required as a base for relationship care (Roes et al., 2018).

To capture the quality of care for people with dementia, our project aimed at completing the literature study, meeting the requirements of the German Network for Quality Development in Nursing (method paper). To define the relevant outcome, the global construct quality of life was used. In 2015 O'Rourke et al. published a meta-synthesis on quality of life from the perspective of people living with dementia. In this synthesis the authors discovered four dimensions, which constitute and influence quality of life: “Agency in Life Today”, “Relationship”, “Sense of Place” and “Wellness Perspective”(O'Rourke et al., 2015). The dimension “Relationship” was used to define successful relationships as the overall topic for the expert standard: “Fostering and sustaining relationships with people with dementia”.

The expert standard was presented to professionals in the field of nursing at a consensus conference in October 2017 and published in the beginning of 2018. Finally, in July 2018 the pilot implementation was finished.

O'Rourke, H. M., Duggleby, W., Fraser, K. D., & Jerke, L. (2015). Factors that affect quality of life from the perspective of people with dementia: a metasynthesis. Journal of the American Geriatrics Society, 36(1), 24-38.

Roes, M., Bieber, A., Burbaum, J., Dichter, M. N., Fröhlich, B., Gille, G., Haberstroh, J., Halek, M., Hasenbein, B., Jansen, S., Johannes, S., Kessler, M., Kuckert-Wöstheinrich, A., Lotzen, R., Müller-Hergl, C., & Purwins, D. (2018). Der Expertenstandard „Beziehungsgestaltung in der Pflege von Menschen mit Demenz. In D. N. f. Q. i. d. Pflege (Ed.), Expertenstandard Beziehungsgestaltung in der Pflege von Menschen mit Demenz. Sonderdruck (pp. (im Druck)). Osnabrück: Deutsches Netzwerk für Qualitätsentwicklung in der Pflege.

 

 
 

Last Updated: Wednesday 14 November 2018

 

 
 

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