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P27. Meaningful day-time activities and respite

Detailed programme, abstracts and poster presentations

P27.1. People with dementia attending farm-based day care in Norway. Individual and farm characteristics associated with the participants’ quality of life

IBSEN Tanja Louise1-2, KIRKEVOLD Øyvind1-3-4, PATIL Grete Grindal5, ERIKSEN Siren1-6

1Norwegian National Advisory Unit on Aging and Health (Aging and Health), Vestfold Hospital Trust, Tønsberg, Norway, ²University of Oslo, Faculty of Medicine, Oslo, Norway, 3Norwegian University of Science and Technology (NTNU) Department of Health Sciences in Gjøvik, Norway, 4Centre of Old Age Psychiatry Research, Innlandet Hospital Trust, Norway, 5Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway, 6VID Specialized University, Faculty of Health Studies, Oslo, Norway

Background: Farm-based day care (FDC) for people with dementia is supposed to contribute to better quality of life for the participants, using activities and resources of the farm environment to promote mental and physical health. The aim of the present study was to describe the group attending FDC in Norway and explore the association between individual and farm characteristics and the quality of life.

Methods: From January 2017 to January 2018, a sample of 94 people with dementia attending FDC was recruited from 25 FDCs across Norway. Interview with the participants and their next of kin was performed using standardized instruments. Information about the farm was retrieved from data material used in a former study. The association between individual characteristics, characteristics of the farm and quality of life, was examined using a linear multilevel regression model.

Results: The attendants had mean age 76 years and consisted of 62% men. 68 percent had an additional education after primary school. Most of them had mild (54.3%) or questionable dementia (18.3%). The use of antipsychotics was 3.7%, tranquilizers 9.9% and painkillers 13.6%, while 30.9% used antidepressants. Quality of life was associated with the experience of having social support, low score on depressive symptoms and spending time outdoors at the FDC. The variation in quality of life between the FDC services, was related to time spent outdoors at the FDC.

Conclusion: Most attendants at FDC had early-stage dementia. The use of antidepressants was high, while the use of other psychotropic drugs was limited. Time spent outdoors at the FDC was an important contribution to quality of life for the participants, together with good social support and low levels of depressive symptoms. When comparing with regular day care, we see that participants at FDC are more often men, younger and with a higher educational level.

P27.2. Farm based day care services for people with dementia – An observational study

ELLINGSEN-DALSKAU Lina Harvold1, PEDERSEN Ingeborg1, DE BOER Bram2

1Norwegian University of Life Sciences, Ås, Norway, 2Maastricht University, Maastricht, Netherlands

Background: Day care services for people with dementia should provide meaningful activities in a safe social community. To ensure a good person-environment fit a variety of day care services should be offered. One alternative to ordinary day care is farm based day care. The two services are organized in similar ways, but farm based day care offer activities related to the resources and surroundings of the farm. In this study we wanted to get a better understanding of what farm based day care comprise by investigating possible differences in aspects of daily lives for people with dementia in ordinary and farm based day care.

Methods: A validated momentary assessment observation tool was used. A total of 42 participant attending farm based day care and 46 participants attending ordinary day care was included. Type of activity, level of physical effort, location, social interaction and mood during the activity was registered 12 times for each participant, during one day while attending their day care service. An Independent-samples t-test was used to compare these aspects of daily life between the groups.

Results: A large proportion of the day was spent on common meals and time to sit and rest in both types of day care services. However, participant in ordinary day care spent more time on quizzes, listening to someone read aloud, music and chair exercise. In farm based day care, more time was spent on promenading, doing domestic chores and taking care of animals. In addition, these participants were statistically significantly more outdoors, had a higher level of physical effort, social interaction and positive mood compared to people in ordinary day care.

Conclusion: Farm based day care may be a good supplementary service, offering activities where people with dementia can spend more time outdoor and be more physically active. 

P27.3. Multiple stakeholders’ perspectives on respite service access for people with dementia and their carers

O'SHEA Emma1, TIMMONS Suzanne2, O'SHEA Eamon3, IRVING Kate1

1Dublin City University, Dublin, Ireland, 2University College Cork, Cork, Ireland, 3National University of Ireland, Galway, Ireland

Introduction: People with dementia and carers do not always access respite services in a timely manner, and in some cases, they do not access respite services at all. While carers’ perspectives on respite access have been explored, other stakeholder perspectives, especially those of people with dementia, are under-represented in the existing literature. The aim of this study was to synthesise multiple stakeholders’ perspectives, including people with dementia, on accessing respite services in the context of dementia.

Methods: Purposive sampling was employed. Semi-structured interviews were conducted with 35 key stakeholders, including people with dementia (N=6), carers (N=9), respite front-line staff (N= 4), respite managers (N=8), primary care professionals (N=3) and policy-makers/academics (N=5). Informed consent was obtained from all stakeholders who could give this. Dewing's 'process consent' method was employed in relation to people with dementia. Data were interpreted inductively using thematic analysis. We aimed to move beyond the semantic level of meaning, and to interpret patterns of meaning in the data. Reflexivity was considered throughout the research process.

Results: Three themes (‘Service Acceptability’; ‘Navigational Knowledge and Skills’; ‘Constructing and Adjudicating Respite Need’) were identified that relate to how access to respite services is negotiated between service providers and dyads.

Discussion: A number of the findings support previous research; however novel findings discussed relating to the access negotiation process include (1) the ambiguous legitimacy of respite needs, in a system configured to deliver a biomedical model of care and which considers non-medical care as a family responsibility, and (2) the constraining effects of disparate conceptualisations of ‘respite’ between carers and providers. Future research should interrogate the appropriate boundaries of public responsibility in relation to respite service planning/delivery for dementia, with particular reference to client preferences for community and in-home provision.

P27.4. Physical activity in day care services for people with dementia

FINNANGER GARSHOL Bjørnar, ELLINGSEN-DALSKAU Lina, PEDERSEN Ingeborg

Norwegian University of Life Sciences, ÅS, Norway

Background: Day care services for people with dementia should give its participants an opportunity to experience social, physical and cultural activities. Despite public focus on the importance of physical activity and findings showing the benefits of such activity, research has shown that people with dementia are less physically active and have more sedentary behaviour than other people in similar age groups. Farm-based services have been highlighted as an innovative and customized day care service, which could facilitate such activity. While organized similarly as ordinary day care, farm-based day care based their activities on the farms resources and natural surroundings. The aim of this study was to explore the differences in levels of physical activity between participants in the two types of services and to investigate if levels of physical activity related to days spent at the farm based service.  

Methods: In this comparative cross-sectional study, we gathered one week of actigraphy data from 107 people attending ordinary day care and 29 people attending farm-based day care. We used linear regression, adjusting for age, gender and physical function, to compare levels of physical activity between the groups. Further, we used mixed model analysis to analyse physical activity between days spent at the farm and at home for people attending farm-based dementia care.

Results:Persons attending farm-based day care spent statistically significant longer time in moderate activity, approximately half an hour each day, compared to persons attending ordinary day care. Further, participants in farm-based day care spent statistically significant less time spent in sedentary activity and more time in light and moderate activity, compared to days not at the farm.  

Conclusion:The findings indicate that farm based day care services have higher levels of physical activity compared to ordinary day care and that it increases levels of physical activity for its attendees.

P27.5. Demonstrated added value of the individualized Meeting Centres Support Programme

DROËS Rose-Marie1, VAN RIJN Annelies2, RUS Eline3, DACIER Seghoslène4, BOSMANS Judith5, MEILAND Franka1

1Department of Psychiatry, Amsterdam UMC, location VUmc, Amsterdam Public Health Research Institute, Amsterdam, Netherlands, 2Department of Psychiatry, Amsterdam UMC, location VUmc, Leiden, Netherlands, 3Dept of Clinical psychology, Faculty of Behavior and Movement Sciences, VU University, Amsterdam, Netherlands, 4Department of Neuropsychology, Faculty of Behavior and Movement Sciences, VU University, Amsterdam, Netherlands, 5Health Economics and Health Technology Assessment, Faculty of Science, VU University, Amsterdam, Netherlands

Objective:There is little support for community-dwelling people with dementia to continue to fulfill their potential in society and still relatively little support for informal carers by e-Health. In this study, we evaluated the effectiveness of the individualized Meeting Centers Support Program (iMCSP), which consists of three innovative interventions: DemenTalent (people with dementia work as volunteers in society based on their talents), Dementelcoach (telephone coaching) and STAR e-learning for carers.

Method:An explorative randomized controlled trial, with pre/post measurements (M0-M6) and 3 groups, was conducted to compare iMCSP with regular MCSP and No day care control group.

Results:A broader group of participants (people with dementia, carers) utilized the centres which offered iMCSP. Both regular MCSP and DemenTalent positively impacted participants’ affect. Regarding behaviour and mood symptoms, DemenTalent had added value (moderately positive effect) and symptoms proved less severe. Carers of DemenTalent participants reported less emotional impact of behaviour and mood symptoms. Also, DemenTalent proved cost-effective. No differences between iMCSP and regular MCSP were demonstrated in carers’ experienced burden, sense of competence or quality of life. Compared to those receiving No respite/support carers using iMCSP (by DemenTalent, Dementelcoach or STAR-e-Learning) proved happier. People with dementia and carers highly valued individualized and regular MCSP.

Conclusion: iMCSP can be effectively applied for people with dementia and carers who prefer individualized activities/support as alternative of, or in addition to, regular MCSP. In people with dementia, DemenTalent decreased behaviour and mood symptoms, in carers emotional burden, and it was cost-effective. All iMCSP interventions resulted in happier carers (compared to No respite/support). To evaluate the impact of iMCSP on other quality of life domains of participants, further research on a larger scale is needed.

This study was funded by ZonMw-Memorabel, Stichting Dioraphte, Stichting RCOAK, Fonds Sluyterman Van Loo, Stichting Hofje Codde & Van Beresteyn, Bavostichting.

P27.6. Are community day care centres for the elderly ready for the provision of support services to persons with cognitive impairment and their family caregivers in Hong Kong?

LAW Gemma KC

HKU SPACE, Hong Kong SAR, China

This year support services to elderly with cognitive Impairment and their family caregivers following the annual speech made by Chief of Executive are launched though the subvented community day centres are mainly to provide day care respite, home care and support services for physically frail elderly in Hong Kong since late 1970s. A registered social worker is employed to be responsible for developing the support services for dementia to own catchment area. There is a lack of protocol or community model of dementia care for setting up dementia support servcies for social worker to adopt. The challenge is to provide a range of support services to persons with cognitive impairment and their family caregivers by a single social worker. The presenter, as advisor of Hong Kong Carers Alliance for Dementia, has initiated collaboration with seven NGOs for organizing the road shows to their local districts in March, May and September 2019. The purpose of the road show is to help with promotion of the dementia services whilst finding out public knowledge to dementia and their needs of servcies. The road show is to reach out to ageing districts of New Territories and Kowloon.

Quantitative data for measuring public knowledge on dementia and their awareness of new dementia service will be collected through face to face interview at the site. Towards the end of the road show, the collaborators will be interviewed to share their plans for offering support servcies to local elderly dewellrs with cognitive impairment and their family caregivers.  The structured questions will be focused on their management support, professional knowledge on dementia care, their service plan and concerns.  Descripitve analysis will be presented on demographic characteristics, knowledge and needs of servcies. Comparision of the knowledge, public awareness and needs of servcies will be done across the three districts.

 

 
 

Last Updated: Thursday 22 August 2019

 

 
  • Acknowledgements

    The 29th AE Conference in The Hague received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe and Alzheimer Nederlands gratefully acknowledge the support of all conference sponsors.
  • European Union
  • Roche
 
 

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