Joel G. Anderson

Mechanism of Action for Nonpharmacological Therapies for Individuals With Dementia: Implications for Practice and Research

The current review addresses the need for increased use of evidence-based, nonpharmacological therapies for individuals with dementia. To facilitate understanding of the potential efficacy of nonpharmacological therapies on cognitive functioning for individuals with dementia, the mechanisms of action for selected therapies are described, including the assessment method used to identify the mechanism. The strength of evidence supporting each therapy was evaluated, with some therapies demonstrating strong support and others only moderate support for their effectiveness and mechanism of action. Therapies with the strongest support include (a) cognitive training/stimulation, (b) physical exercise, and (c) music. Therapies with moderate support include (a) biofield, (b) meditation, (c) engagement with a naturally restorative environment, and (d) social engagement. Although the strength of evidence varies, together these therapies offer treatments designed to improve cognitive functioning, have low risks and adverse effects, and have the potential for widespread accessibility, thereby increasing the potential range of therapies for individuals with dementia.

“The Church of Online Support”: Examining the Use of Blogs Among Family Caregivers of Persons With Dementia

Many individuals, including dementia caregivers, use blogs to share their experiences. These blogs contain rich narratives representing an untapped resource for understanding the psychosocial impact of caring for a person with dementia at the family level. The present study used blogs written by caregivers of persons with dementia to explore how these individuals leveraged this medium as part of the caregiving experience. Blogs written by self-identified informal caregivers of persons with dementia were identified using a systematic search method, and data were analyzed using a qualitative thematic analysis. Four themes emerged from the narratives: social support through communication and engagement, information gathering and seeking, reminiscing and legacy building, and altruism. By understanding the ways in which individuals providing care for persons with dementia use social media as part of the caregiving experience, family nurses can develop interventions and services aimed at improving caregiver burden and quality of life.

Mental Health Wellness and Biofield Therapies: An Integrative Review

ABSTRACT Biofield therapies such as Healing Touch and Reiki increase relaxation, decrease anxiety and stress, and improve mood. Understanding the efficacy of these therapies in terms of mental health wellness is important for nurses interested in complementary and integrative care. The goal of the present integrative review was to investigate the state of knowledge regarding biofield therapies and the impact on anxiety, mood, and mental health wellness. Electronic databases were searched for articles available in English and published from 2014 to 2016. Biofield therapies show safety and promise in reducing anxiety, improving mood, and cultivating mental health and wellness.

Characteristics of LGBT caregivers of older adults: Results from the national Caregiving in the U.S. 2015 survey

Using data from the Caregiving in the U.S. 2015 national survey, we compared characteristics of lesbian, gay, bisexual, and transgender (LGBT) and non-LGBT caregivers of older adults and explored predictors of caregiver strain. LGBT caregivers were younger, more racially/ethnically diverse, and less frequently a spouse/partner compared with their heterosexual counterparts. LGBT caregivers more frequently reported helping with medical nursing tasks and reported higher levels of financial strain. While LGBT identity was not an independent predictor of greater strain, characteristics more frequently reported by LGBT caregivers were, for instance, helping with medical nursing tasks. In addition, LGBT individuals who were children of the older adult were more likely to report higher levels of emotional strain than other relationship types.

Identifying people with dementia on Twitter

There is a growing body of research on the use of Twitter by people with health conditions, but it does not include people with dementia. In this brief report, we aim to: (1) determine whether people with dementia are using Twitter; (2) provide an estimate of the number of Twitter account holders who identify as having a diagnosis of dementia; and (3) examine the demographic characteristics of these account holders. Tweetcatcher was used to identify tweets containing the search terms ‘dementia’ or ‘Alzheimer’. These data were systematically searched to locate account holders who identified themselves as having a diagnosis of dementia, and a content analysis was conducted of these account holders’ profiles. Thirty account holders self-identified as having a diagnosis of dementia. The average age of account holders was 59 years and the majority were located in North America or the UK. Although the majority of account holders reported having Alzheimer’s disease or did not specify a type of dementia, some rare forms of dementia were also evident. The sample consisted of relatively young account holders and contained more men, which might suggest that other groups are under-represented on Twitter. The majority of account holders considered themselves a dementia activist or were affiliated with a dementia organisation. The findings suggest that people with dementia, with varying demographic characteristics and a range of diagnoses, are active on Twitter. These account holders are more frequently male, relatively young, and dementia activists.

Mind–Body Therapies in Individuals With Dementia: An Integrative Review

Mind-body therapies frequently derive from Eastern philosophies and are becoming increasingly popular. These therapies, such as meditation, yoga, tai chi, qigong, biofield therapies, and guided imagery, have many reported benefits for improving symptoms and physiological measures associated with various chronic diseases. However, clinical research data concerning the effectiveness of these practices in individuals with dementia have not been evaluated using a synthesis approach. Thus, an integrative review was conducted to evaluate studies examining the efficacy of mind-body therapies as supportive care modalities for management of symptoms experienced by individuals with dementia. Findings from the studies reviewed support the clinical efficacy of mind-body practices in improving behavioral and psychological symptoms exhibited by individuals with dementia. [Res Gerontol Nurs. 2017; 10(6):288-296.].

Nonpharmacological Strategies for Patients With Early-Stage Dementia or Mild Cognitive Impairment: A 10-Year Update.

As the incidence and prevalence of early-stage Alzheimers disease and mild cognitive impairment increases worldwide, gerontological researchers continue to examine the efficacy and effectiveness of strategies to help patients and caregivers live with the disease. Although pharmacological treatments remain the focus of much of the research, nonpharmacological strategies and approaches to care continue to gain ground as effective means of improving the health-related quality of life for this patient population. The current commentary summarizes the state of the science based on a series of integrative and systematic reviews undertaken by the International Dementia Scholars Collaborative as a 10-year update to a previous white paper. Selected topics from this previous white paper (e.g., support groups, nutrition, exercise, cognitive training, falls) as well as new topics (e.g., mind-body, advance care planning, driving safety) are discussed, and recommendations for future research are provided. [Res Gerontol Nurs. 2017; 10(1):5-11.].

Paroxysmal Sympathetic Hyperactivity in Children: An Exploratory Evaluation of Nursing Interventions

Background Paroxysmal sympathetic hyperactivity (PSH) produces symptoms of autonomic instability and muscle over‐activity; however, the majority of nursing interventions used in clinical practice are anecdotal and not evidenced based. Objective The primary objective was to report nursing documentation of PSH events, and to describe the clinical nursing interventions and care provided to children who have suffered a severe brain injury and are exhibiting PSH. The secondary objective was to demonstrate how the Symptom Management Theory (SMT) can serve as a framework for research related to brain injury and PSH. Methodology The study consisted of a retrospective chart review of nursing progress notes using direct content analysis. The nested sample of ten randomly selected charts was chosen from a larger quantitative study of 83 children who had suffered severe brain injuries with and without PSH. Textual analysis of verbatim nursing progress notes was used to describe nursing interventions that were used and documented for this patient population. Results The priority nursing interventions to manage these symptoms included medication administration, facilitation of family presence, and strategies to target auditory, tactile, and visual stimuli. The sample received different individual interventions for PSH. Additionally, individual subjects demonstrated different patterns of interventions. Implications While tactile interventions were documented most frequently, there was not a uniform approach to interventions. The SMT can be useful to provide a framework that organizes and tests clinical care and management of PSH strategies. HighlightsParoxysmal sympathetic hyperactivity (PSH) is fever, hypertension, tachycardia, tachypnea, agitation, diaphoresis, and dystonia.Symptom Management Theory (SMT) can serve as a framework.The priority nursing interventions to manage PSH included medication administration, facilitation of family presence, and strategies to target auditory, tactile, and visual stimuli.

Instrumental Measurements of Water and the Surrounding Space During a Randomized Blinded Controlled Trial of Focused Intention

The main goal of this work was the assessment of measurable interactions induced by focused intention, frequently used in biofield practices such as Healing Touch and Reiki. Water, as the main component of the human body, was chosen as a model. Intention experiments were performed over 4 different days at a scheduled interval, during which 286 trained biofield practitioners from several countries were instructed to meditate with the intention to change the molecular vibrational state of water samples selected by a blinded operator. The experimental protocol was randomized, blinded, and controlled; the measured variables included Raman spectra and the pH and electrical conductance of the water, as well as the magnetic field and UV-VIS (ultraviolet-visible) radiation near the experimental spot. Although a direct causal relationship cannot be established, some measurements of the water samples, as well as the magnetic field and radiation near the experimental spot, were responsive during the experimental period.