Barbara Wharton McCabe

Using a therapy dog to alleviate the agitation and desocialization of people with Alzheimer's disease.

1. Short-term exposure to a therapy dog can reduce the number of agitation behaviors in institutionalized persons with Alzheimers disease (AD), particularly during the period of agitation known as sundown syndrome. 2. The presence of a therapy dog can increase socialization behaviors among a group of persons with AD. 3. A therapy dog can be used as an adjunct to other calming interventions for persons with AD.

Resident Dog in the Alzheimer's Special Care Unit

Behavioral disturbances are a common feature of Alzheimer’s disease (AD). Prior studies have demonstrated a significant reduction in agitation behaviors during short-term exposure to a dog on an Alzheimer’s special care unit (SCU) for persons with AD. The purpose of this study was to determine the effect over time of a resident dog on problem behaviors of persons with AD in an SCU. A within-participants repeated-measures design was used for this study. The Nursing Home Behavior Problem Scale was used to document behaviors (on days and evenings) 1 week before and 4 weeks after placement of the dog. Participants on the dayshift exhibited significantly fewer problem behaviors across the 4 weeks of the study (F[1, 80] = 7.69, p < .05). No significant change in behaviors occurred on the evening shift. The findings support the long-term therapeutic effects of dogs for persons residing in Alzheimer’s SCUs.

How elderly nursing home residents transcend losses of later life.

Losses of later life can prove overwhelming to older adults. Some elderly persons seem to cope with these losses with a spirit of acceptance and serenity. The purpose of this study was to identify qualities in selected nursing home residents that allow them to transcend difficulties and continue living with some degree of contentment and satisfaction. Qualitative data were obtained in taped interviews from 95 functionally impaired residents (mean age 82.16 years). Content analysis resulted in several themes supporting the spiritual perspective of Reeds theory of self-transcendence: generativity, introjectivity, temporal integration, body-transcendence, and relationship with self, others, and a higher being.

Companion Animals and Persons with Dementia of the Alzheimer's Type Therapeutic Possibilities

Companion animals have the potential to create new meaning and bring comfort in the lives of persons who experience the devastating effects of dementia of the Alzheimers type (DAT). Research studies conducted using companion animals with persons diagnosed with DAT provide evidence that the presence of a companion animal can increase socialization and decrease agitation behaviors. In addition, caregivers can benefit from reduced physiological stress by petting a companion animal. Using Reisbergs staging system, a caregiver can plan activities with companion animals that correspond to the functional and cognitive ability of the person with DAT.

In Sickness and in Health: An Exploration of the Perceived Quality of the Marital Relationship, Coping, and Depression in Caregivers of Spouses With Alzheimer's Disease

Caring for a spouse with Alzheimers disease (AD) is a complex task influenced by numerous factors including the quality of the past and present marital relationship. Assessment of both the caregivers perception of the quality of the past marital relationship and how he or she traditionally coped with marital discord is important for planning effective interventions. AD support groups that work with both the caregiver and the afflicted spouse on problem-solving skills may strengthen or help preserve the marital relationship.

The Role Animals Play in Enhancing Quality of Life for the Elderly

Publisher Summary Many institutions for the elderly have resident pets, and many have regular pet visitation programs. While many studies have demonstrated the beneficial effects of contact with pets for a variety of persons, including the elderly, the long-term effects of resident pets and pet visitation programs have not been examined. Nonetheless, the idea of bringing pets into contact with institutionalized elderly has become quite popular in the United States and elsewhere. There is no doubt that the presence of pets in a setting such as a nursing home, where one ordinarily does not expect to see them, provides a source of distraction and novelty. All one has to do is witness the attention a dog gets as it walks into a unit. Residents, staff, and visitors descend on the dog almost like it is a magnet. Yet, the question that remains to be answered is what the long-term effects of contact with a companion animal for the institutionalized elderly are. Distraction from ones ordinary daily life in a nursing home is not without merit. Also, pets provide a source of affectionate physical contact that often is lacking in an institutional setting. Perhaps these effects are enough to justify the cost of maintaining these programs. There are important areas to consider in instituting an animal-assisted therapy program.

Physical activity counseling for older women

Physical inactivity is a major factor in increasing women’s risk for chronic disease, disability, and premature mortality. This study compared the effectiveness of five behavioral counseling (BC) sessions with a comparison group receiving one BC session based on the five A’s (ask, advise, assist, arrange, and agree) to increase moderate-intensity physical activity, muscle strengthening, and stretching activity. The health promotion model provided the framework for the intervention. A pretest/posttest comparison group design was used, with random assignment of 46 women recruited from an urban midwestern community. A significant group interaction was found only for cardiorespiratory fitness (p < .001). Significant time effects were found (p < .001) for both groups in increasing handgrip, leg strength, and flexibility. BC is a promising intervention to achieve physical activity behavior change with older women.

Commentary by McCabe

Dehydration is identified as a silent epidemic in U.S. nursing homes (Burger, Kayser-Jones, & Prince, 2000) and is recognized as a sentinel event in the nursing home industry. Dehydration continues to be both an underexplored and underaddressed phenomena in nursing and health-related literature. This article represents a second study by Mentes, Chang, and Morris [this issue] critically examining the phenomena of dehydration in nursing homes. The operational definition of dehydration in itself is fraught with challenges. Minimum Data Set assessment uses a 5% weight loss in 1 month as one marker of dehydration, and lack of tissue turgor, although this is not a very useful measure when applied to elderly persons, is also used as an indicator of dehydration (Ebersole, Hess, & Luggen, 2004). First-line health care providers often refer to dry lips, dry oral tissue, and changes in color of urine as indicators of dehydration as did the participants in this study. Mentes, Chang, and Morris are to be commended for their efforts to describe and examine issues related to dehydration among nursing home residents from the perspective of first-line care providers. More than 1.5 million people reside in nursing homes (U.S. Department of Health and Human Services, 2003), a number predicted to reach 3 million by 2030 (Sahyoun, Pratt, Lentzner, Dey, & Robinson, 2001). As we prepare to respond to the needs of this aging population, it is essential that we develop a body of knowledge that accurately describes, predicts, and explains factors in the nursing home setting that directly affect the health of the residents and the daily work of care providers. By focusing on dehydration in the nursing home setting, this research team has taken an important step to contribute to this body of literature. Although the results of this study cannot be generalized beyond the study population, the processes and findings are a springboard to consider issues related to dehydration in the nursing home setting from the perspective of frontline care providers and to explore possible interventions. Collecting data primarily from the certified nursing assistants (CNAs) is especially useful not only because they are the frontline caregivers but because it is essential that nurse scientists and leaders know how to influence and expand the world view of the CNA.