Continuum of Care for Alzheimer's Disease: A Nurse Education and Counseling Program

Abstract

This study evaluated a one year long course education and counseling program with 93 family caregivers of elders afflicted with Alzheimer's disease. The elders had received treatment for agitation in an inpatient setting and were subsequently discharged to the caregivers' home. Caregivers were randomly assigned to an experimental group (n = 68) and a control group (n = 25). Baseline assessments (Time 0) were conducted while the elder was an inpatient. Postdischarge interventions and assessments were conducted at 2 weeks, 6 weeks, 12 weeks, and 6 and 12 months (Times 1-5 respectively). There were no significant treatment effects for care recipient agitation, caregiver stress, depression, and physical health, and no significant differences between groups in rates of institutionalization for afflicted elders. Longitudinal data, however, revealed several important trends. Afflicted elders' agitation rose steadily for control group subjects at Times 3 through 5 but declined for experimental group subjects. Caregiver depression increased for control group subjects at Time 5, but declined for experimental group subjects. Caregiver physical health declined for control group subjects at Times 4 and 5 but was maintained for experimental group subjects. A significantly higher number of afflicted elders were still at home among experimental group subjects at the end of the one year study. The difficulties in demonstrating efficacy of interventions with family caregivers of Alzheimer's disease are discussed. Finally, the issue of data collection being perceived as support by control group subjects is evaluated.

Case management for dementia in primary health care: a systematic mixed studies review based on the diffusion of innovation model

“…Of the included studies, eleven were quantitative studies, comprising nine randomized controlled trials,10–12,27–39 one nonrandomized study,40 and one quantitative descriptive study41 (Table 1), and 12 were qualitative studies, comprising eleven qualitative descriptive studies42–53 and one multiple-case study54 (Table 2). Ten studies were conducted in the USA,10,12,27,36,39,40,43,45,48,50 five in the UK,42,46,47,49,51 and four in the Netherlands 32,41,52,54.…”

“…Ten studies were conducted in the USA,10,12,27,36,39,40,43,45,48,50 five in the UK,42,46,47,49,51 and four in the Netherlands 32,41,52,54. The remaining four studies were from Belgium,31 Australia,53 India,34 and People’s Republic of China 35,55.…”

“…Short duration of the intervention seems to be a limiting factor 34,36–39. Dias et al acknowledged that the short follow-up period precluded them from achieving the expected effect 34.…”

Barriers to Implementation of Case Management for Patients With Dementia: A Systematic Mixed Studies Review

“…12,17,22,51,53,56,57,91 In the studies that showed a decrease in institutionalization, 48,64,67 the mean effect size was small (0.21). 48,67 In 2 of 5 studies, hospital admission decreased (mean effect size = 0.66).…”

Strangers, Patients, Monsters, Jailers, or Children: How South African Caregivers View Their Partners with Manganese Poisoning

“…Current literature validates these caregivers' experience of quasi-incarceration, as many care givers have reported experiences of restricted freedom of movement (Chang & Horrocks, 2006;Che et al, 2006;Mokhosi & Grieve, 2004;O 'Brien, 1993 ;Proot et al, 2003 ;Sawatzky & Fowler-Kerry, 2003;Wright et al, 2001), and suggests that there are commonalities between carers of partners with MP and carers of partners with other degenerative conditions. However, the previously documented sense of confinement relates mostly to constant supervision of loved ones rather than fear of emo tional blackmail and concerns for their physical safety that the present research shows.…”