Background: Behavioural and psychological symptoms of dementia (BPSD) are common and disturbing and can deter or disrupt the care process. Bathing is associated with the highest frequency of BPSD, triggering a fear response in dementia patients. As part of a larger feasibility/pilot study, this investigation explored whether exposure to MindfulGarden (MG), a digital screen-based calming device, can minimize BPSD during bathing -an activity well-documented to be problematic for both residents and staff. Objective: To determine outcome trends of exposure to MG on number and type of BPSD exhibited by residents with dementia during bathing and on staff time to undress, shower and re-dress them. Method: 8 long-term care home residents (5F, 3M) mean age 86.00±8.16, diagnosed with dementia and reported by care staff as exhibiting BPSD were observed while being showered in their en-suite bathroom. On Days 1 and 2 staff followed the usual bathing procedure; on Day 3 exposure to MG was added. A 26-item checklist developed in a previous study, based on the Cohen-Mansfield Agitation Inventory and the work of Gutman, Mac-Fadgen and Killam, was used to record type and frequency of BPSD, time of staff entry and exit from the resident's room was recorded, and on Day 3 staff rated MG exposure as having a positive, neutral or negative effect. Results: Days 1 -2 yielded highly similar results -an average of 4 BPSD per resident and an average bathing time of 13-14 minutes, with the most common BPSD on both days being physical resistance, verbal resistance, screaming, complaining, and strange noises. Subsequent to exposure to MG (Day 3) trends were observed towards reduction in number of BPSD and bathing duration. Conclusion: MG shows some promise in calming residents, reducing resistance to care, and allowing bathing to proceed more quickly.

Background: Behavioral and psychological symptoms of dementia (BPSD) exhibited by persons with dementia (PwD) in nursing home communal areas are generally managed by segregation and/or pharmacological interventions. Objective: This study trialed MindfulGarden (MG), a novel digital calming device, in a Canadian nursing home. Methods: Participants were 15 PwD (mean age = 87.67; 5m,10f; mean MMSE = 11.64±7.85). Each was observed by a research assistant (RA) for an average of 8–10 hours on two separate days. The RA followed them during time spent in communal areas of the nursing home including their unit’s dining space, lounges, and corridors and spaces shared with other units (e.g., gym and gift shop) and documented any BPSD exhibited. Day-1 provided baseline data; on Day-2, residents were exposed to MG if nursing staff considered their BPSD were sufficiently intense or sustained to warrant intervention. Staff rated the impact as positive, neutral, or negative. Results: On Day-1, 9 participants exhibited both aggressive and non-aggressive behaviors, 4 non-aggressive behaviors only, and 2 no BPSD. On Day-2, 7 exhibiting aggressive behaviors were exposed to MG. Staff reported MG as having distracting/calming effects and gave positive impact ratings to 6/13 exposures; there were no negative ratings. The most common aggressive BPSD on days of observation were pushing/shoving and screaming. Conclusion: MG may have value as a “psychiatric crash cart” in de-escalating agitation and aggression in care home settings.

MindfulGarden (MG) is a digital device resembling a flat screen TV, with touchless sensors that react to voice and motion. In this study 13 long-term care home residents aged 74-100 exhibiting Behavioural and Psychological Symptoms of Dementia (BPSD) were randomized to treatment and control groups. On days 1-3 the treatment group received usual care plus exposure to MG during morning and evening care - events well documented to be problematic for residents and care staff; controls received usual care only. On day 4 both groups were exposed to MG with verbal cueing. A 26-item checklist was used to record frequency and types of disruptive BPSD exhibited; care duration was recorded in minutes. There was a trend toward reduction of BPSD and duration of care during morning care. Findings suggest that verbal cueing may be important for successful implementation of MG in calming residents with dementia during routine care.

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Focus groups were held with family/decision makers of residents in an exclusively Chinese (EC; N=7) and a multi-ethnic (ME; N=8) care home, as well as South Asian (SA; n = 5) and lesbian, gay, bisexual and transgender caregivers (LGBT; n = 5) who had/have a loved one in a care home. Shared themes across groups included the role of the care home in Advance Care Planning (ACP) discussions, the timing of such discussions (i.e., at admission), and the extent to which another person was available and appropriate for such discussions. Issues unique to groups included superstition and the equation of ACP with funeral planning (EC), family history and regrets about not having planned (ME), gender differences and the need for education about ACP (SA) and the absence of traditional family among LGBT older adults. These themes highlight the challenges in ACP among diverse populations and the need for targeted interventions.