Y. Kuin

Green Care Farms Promote Activity Among Elderly People With Dementia

In the Netherlands, an increasing number of green care farms are providing day care to community-dwelling elderly people with dementia. Currently, it is unknown whether activities, activity participation, and facility use of elderly people with dementia at green care farms differ from those at regular day care facilities. The authors performed group and individual observations at 11 green care farms and 12 regular day care facilities. Activities of elderly people at green care farms were more frequent, occurred outdoors more often, were of a higher physical intensity, and more often were aimed at individuals than activities at regular day care facilities. Therefore, the green care farms’ environment may be more beneficial for elderly people with dementia than the regular day care facility environment.

Need fulfillment in caring relationships: Its relation with well-being of residents in somatic nursing homes

Objectives: Quality of life and well-being in nursing homes are becoming more important in research and practice. Based on self-determination theory, the objective of this study is to examine the contribution of need fulfillment in the caring relationship to residents’ subjective well-being. It was expected that the relation of need fulfillment in the caring relationship with well-being is mediated by need fulfillment in general. Method: During interviews with 88 residents of somatic nursing homes (age 50–97, mean age 78.6), perceptions of need fulfillment in the caring relationship, need fulfillment in general, and two components of subjective well-being, i.e., depressive feelings and life satisfaction, were measured. The hypotheses were tested using hierarchical multiple regression analyses and mediational analysis. Results: As expected, the results indicated that need fulfillment in the caring relationship was related to lower levels of depressive feelings and more life satisfaction. Need fulfillment in general mediated the relation of need fulfillment in the caring relationship with depressive feelings. Conclusion: As suggested by the results, it can be concluded that high-quality caring relationships contribute to the need fulfillment of residents and their well-being. The quality of caring relationships is thus an important topic for further research. The field may especially benefit from longitudinal studies and studies that use observations of the caring relationship in addition to self-reports.

CAMDEX, can it be more efficient? Observational study on the contribution of four screening measures to the diagnosis of dementia by a memory clinic team

To evaluate the efficiency of the CAMDEX by exploring the contribution of its four main screening measures to the diagnosis of dementia at a memory clinic.

Dementia in the movies: The clinical picture

Objectives: Visual media influence the general publics perceptions and attitudes regarding people with mental conditions. This qualitative study investigates the depiction accuracy of dementias clinical features in motion pictures.Method: Using the search terms ‘dementia’, ‘Alzheimers disease’ and ‘senility’ movies with release dates between January 2000 and March 2012 were sought on the Internet Movie Database. Based on four selection criteria 23 movies were included. Independently, three researchers watched all movies, scored symptoms, capacities, and behaviors. Scores were discussed and refined during consensus meetings, resulting in a taxonomy of clinical features.Results: Various features are found, most often cognitive symptoms. Behavioral features are also shown – retiring behavior more than agitation – and various emotions, but physical symptoms are rarely depicted. Capacities are infrequently presented and are unrealistic in several of the movies.Conclusion: The clinical picture of dementia portrayed in fictional movies is mild and may be misleading.

Need fulfillment, need importance, and depressive symptoms of residents over the first eight months of living in a nursing home

BACKGROUND Based on self-determination theory and adaptation theories, the study aim was to investigate the relationship between need fulfillment (of autonomy, relatedness, and competence), need importance, and depressive symptoms during the first months of living in a nursing home. METHODS Eight-month longitudinal questionnaire study in which 75 persons newly admitted to units for physically frail residents participated at baseline. Twenty-three longitudinal participants were remaining at the third and final measurement wave. RESULTS The results show a main effect of need fulfillment and an interaction effect of need fulfillment and need importance on depressive symptoms over time. A prototypical plot shows that residents with low need fulfillment had higher initial levels of depressive symptoms that decreased modestly over time, regardless of their need importance. Residents with high need fulfillment had lower initial levels of depressive symptoms, but their trajectories differed for participants with low and high need importance. Residents with low need importance started with lower levels of depressive symptoms but remained stable over time, whereas residents with high need importance had more depressive symptoms at T1 that decreased slightly over time. CONCLUSIONS In general, depressive symptoms do not change over time. However, individual trajectories of depressive symptoms seem to depend on individual need fulfillment and need importance. The residents that consider need fulfillment to be highly important but experience low need fulfillment had higher initial levels of depressive symptoms that decreased modestly over time, although the level of depressive symptoms remained higher as compared to the other residents.

Personal experience of aging in the children of a parent with dementia

We investigated whether adults with a parent with dementia experience their personal aging differently than adults whose parents do not have dementia. Semi-structured interviews were conducted with 25 adults who had a parent with dementia and 25 controls. We found that, although in a general sense the two groups were quite similar in their personal experiences of aging, there were specific differences. The children of parents with dementia had a health-concept in which there was substantial emphasis on mental health. Moreover, they linked the dementia of their parent to their own aging and worried about developing a dementia syndrome themselves. They also held different attitudes with regard to end-of-life decisions. Finally, participants having a parent with dementia gave more extensive answers to simple questions. This overall response suggests more involvement with growing older and finitude in the children of parents with dementia.

[Premorbid personality and aggressive behavior: a study with residents of psychogeriatric nursing homes].

SamenvattingExperimenteel onderzoek toont aan dat persoonlijkheid een rol speelt in het optreden van agressief gedrag bij volwassenen. Onderzoek naar de invloed van premorbide persoonlijkheid op agressie bij dementie laat echter tegenstrijdige resultaten zien. Voor 166 psychogeriatrische verpleeghuisbewoners vulden verzorgenden de Nederlandstalige versie in van de Cohen-Mansfield Agitation Inventory (CMAI-D), terwijl familieleden de Hetero-Anamnestische Persoonlijkheidsvragenlijst (HAP) invulden. Agressie bleek goed te scheiden van andere vormen van agitatie op de CMAI-D. Vier HAP-schalen correleerden significant met agressie zoals gemeten met de CMAI-D: Moeilijk in de omgang, Grillig en impulsief gedrag, Rigide gedrag en Kwetsbaar in de omgang. De invloed van persoonlijkheid nam af met cognitieve achteruitgang, maar bleef bestaan tot in dementiestadium 6 van de Global Deterioration Scale. Analyse van de items van de HAP leverde een eerste profiel op van de agressiegeneigde persoonlijkheid.

De zaak Alzheimer: het klinische beeld van dementie in bioscoopfilms

SamenvattingVisuele media beïnvloeden de perceptie en attitude van het grote publiek over mensen met psychische aandoeningen. Deze kwalitatieve studie onderzocht de kwaliteit van de weergave van klinische kenmerken van dementie in bioscoopfilms. Aan de hand van de zoektermen ‘dementie’, ‘Alzheimer’ en ‘ouderen’ werden films gezocht op de Internet Movie Database, uitgebracht tussen januari 2000 en maart 2012. Er werden 23 films geselecteerd op basis van vier selectiecriteria. Drie onderzoekers bekeken de films en scoorden symptomen, capaciteiten en gedrag onafhankelijk van elkaar. Scores werden bediscussieerd en verfijnd tijdens consensusbesprekingen, wat resulteerde in een taxonomie van klinische kenmerken. Er zijn met name cognitieve symptomen gevonden. Gedragskenmerken werden door de films ook in beeld gebracht – teruggetrokken gedrag meer dan agitatie –, evenals verschillende emoties, maar fysieke symptomen werden zelden afgebeeld. Capaciteiten werden zelden getoond en waren onrealistisch in verschillende films. Het klinische beeld van dementie in bioscoopfilms is mild en kan misleidend zijn.

Richtlijnen en protocollen

Bij de toepassing van psychologische interventies bij ouderen zijn specifieke aandachtspunten aan de orde. Deze zijn verbonden met het ouder worden van clienten zelf, met veranderingen in hun omgeving en met hun levensgeschiedenis. Maar ook vormen verschillende aspecten van de werkrelatie tussen therapeut en oudere client een aandachtspunt. Hieronder vatten we de veranderingen samen. Daarna volgt grotendeels op basis van praktijkervaring, op welke wijze daarmee rekening kan worden gehouden.

Feit en fictie

SamenvattingSpeelfilms hebben invloed op hoe wij de wereld zien. En dus ook op ons beeld van dementie. Hoe brengen populaire speelfilms mensen met dementie in beeld?