ObjectivesTo evaluate the effect of different pathways for developing a life story book (LSB) for people with dementia.MethodPreliminary randomised control trial; 23 people with dementia in care homes (mean age 86) randomly assigned to receive either 12 individual life review sessions and co-creating a LSB or a personal LSB created by their relatives as a ‘gift’ResultsNo difference in quality of life (quality of life–Alzheimer's disease (QOL–AD)) was observed between the two groups, six weeks after having received the LSB (F(1,20) = 0.08, p = 0.77). At this point, QOL–AD had improved for both groups, but there was a significant between-group difference at an intermediate assessment immediately after the life review sessions had been completed, before the LSBs were received (F(1, 20) = 5.11, p = 0.035), in favour of life review. A similar pattern was observed on autobiographical memory (extended autobiographical memory interview), with the life review group improving significantly more than the gift group during the life review sessions, but no difference was observed once all participants had had their LSB for six weeks. After the LSBs were produced – by either pathway – quality of relationship as rated by relatives improved significantly (F(2, 39) = 19.37, p < 0.001) and staff knowledge regarding the resident and attitudes to dementia improved.ConclusionThe creation of LSBs – either through a life review process or by relatives without involving the person with dementia – has benefits for people with dementia, relatives and staff in care homes. However, undertaking a life review requires training and supervision.
This systematic review aims to review the potential psychosocial benefits of individual reminiscence therapy for people with dementia. Five randomized controlled trials were identified. All were carried out in nursing or care homes, and several different approaches were represented. The studies reported some immediate and longer-term psychosocial benefits to people with dementia of individual reminiscence work, where this involved a life review process or personalized, specific reminiscence work. These benefits included mood, well-being and aspects of cognitive function. There was no evidence that the use of general reminiscence materials was associated with psychosocial benefits. The use of life story books and multimedia alternatives, with or without an associated life review process, does appear to be worth pursuing from both clinical and research perspectives.
Background and aimThere is increasing interest in using information and communication technology to help older adults with dementia to engage in reminiscence work. Now, the feasibility of such approaches is beginning to be established. The purpose of this study was to establish an evidence-base for the acceptability and efficacy of using multimedia digital life storybooks with people with dementia in care homes, in comparison with conventional life storybooks, taking into account the perspectives of people with dementia, their relatives, and care staff.MethodsParticipatory design was used to create a life story movie based on a previously completed conventional life storybook with six older adults with dementia (four females; mean age 82 years). Relatives were involved in helping the participant to provide additional information and materials for the digital life storybook. In this multiple case study design, both quantitative and qualitative approaches were used. For quantitative purposes, a set of questionnaires that had been completed three times before and after the conventional life storybook was developed were repeated 4 weeks after the life story movie was completed. Semistructured interview questions were designed to collect feedback from participants, relatives, and care staff.ResultsThe result indicated that five of the six participants showed additional improvement in measures of quality of life and autobiographical memory. All participants showed improvement or stability in depression scores. Thematic analysis showed that, participants, relatives, and care home staff viewed digital life storybooks as a very useful tool triggering memories and (largely) positive emotions. Participants’ case vignettes were presented to document the impact of digital life storybook.
Background The main aim of this study was to determine the association between Behavioral and Psychological Symptoms of Dementia (BPSD) and caregiver burden, and the mediating role of coping strategy and personality style of caregivers to patients with dementia (PWD). Methods This cross-sectional study was conducted among 202 caregivers to PWD in home-based settings. Recruited caregivers were administered questionnaires regarding BPSD which was measured using Neuropsychiatric Inventory-Questionnaire (NPI-Q), caregiver burden using Zarit Burden Interview (ZBI), Brief COPE for coping strategies and Big-Five Inventory which measured personality traits. Results Majority of the caregivers were female (71.3%), aged 50 and above (55%), single (46%), married (43.6%), working full time (45%) while the rest work part time (22.3%), unemployed (7.4%) and retiree (25.2%), and majority were parents (58.9%) and spouse (18.3%). The duration of caregiving was less than a year (33.7%) while the rest are more than a year. Results demonstrated that the most frequent types of BPSD exhibited by PWD was irritability, followed by apathy and agitation. All of the types of BPSD showed to be significantly correlated to caregiver burden except for anxiety, elation and appetite. Of personality traits, only conscientiousness was found to mediate the relationship between BPSD and caregiver burden ( p < .05). Self-distraction, active coping, planning and acceptance were the coping strategies that demonstrated to have mediation effect on the relationship between BPSD and caregiver burden. Conclusion Presentation of BPSD is correlated to caregiver burden which is partially mediated by coping strategies and personality styles.
In this review, we aimed to identify the risk factors that may influence cognitive impairment among stroke survivors, namely, demographic, clinical, psychological, and physical determinants. A search from Medline, Scopus, and ISI Web of Science databases was conducted for papers published from year 2004 to 2015 related to risk factors of cognitive impairment among adult stroke survivors. A total of 1931 articles were retrieved, but only 27 articles met the criteria and were reviewed. In more than half of the articles it was found that demographical variables that include age, education level, and history of stroke were significant risk factors of cognitive impairment among stroke survivors. The review also indicated that diabetes mellitus, hypertension, types of stroke and affected region of brain, and stroke characteristics (e.g., size and location of infarctions) were clinical determinants that affected cognitive status. In addition, the presence of emotional disturbances mainly depressive symptoms showed significant effects on cognition. Independent relationships between cognition and functional impairment were also identified as determinants in a few studies. This review provided information on the possible risk factors of cognitive impairment in stroke survivors. This information may be beneficial in the prevention and management strategy of cognitive impairments among stroke survivors.
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