Predicting falls from behavioral and psychological symptoms of dementia in older people residing in facilities

Sato, Sei; Kakamu, Takeyasu; Hayakawa, Takehito; Kumagai, Toru; Hidaka, Tomoo; Masuishi, Yusuke; Endo, Shota; Fukushima, Tetsuhito

doi:10.1111/ggi.13528

Cited by 13 publications

(12 citation statements)

References 20 publications

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“…Both music therapy and personalized playlist interventions without the involvement of a trained music therapist are particularly effective in reducing agitation in people with dementia across a range of different situations. 9 This can have a flow-on effect, since agitation is closely linked to high rates of falls, 30 poor nutrition, 31 poor relationships with carers, 32 and low quality of life. 33 Understanding the potential for music to reduce demands on caregivers can increase the incentive of staff at all levels to incorporate personalized music programs into individual care plans.…”

Section: Discussionmentioning

confidence: 99%

Benefits, Challenges and Solutions for Implementing Personalised Music Playlist Programs in Residential Aged Care in Australia

Garrido

Markwell

Andreallo

et al. 2021

JMDH

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Introduction: Residential aged care facilities face the immense challenge of adapting to the increasingly high needs of their residents, while delivering personalised, holistic care. There is considerable evidence that music can provide an affordable, accessible way to reduce changes in behaviour associated with dementia, in order to meet these standards of care. However, a number of barriers exist to the effective implementation of music programs in long-term aged care facilities. Methods: This study involved focus groups with 17 participants including staff in residential aged care facilities and family caregivers to investigate the benefits of music programs, as well as the challenges and possible solutions to them. A general inductive approach was taken to data analysis. Results: A number of benefits of music programs were identified, including improvements to the wellbeing of both residents of aged care facilities and their caregivers. However, an ingrained culture within residential aged care of focusing on physical care rather than thinking holistically about wellbeing was identified as a significant barrier. Discussion: These findings revealed that education is a key component of changing ingrained cultures of task-driven care at both a managerial level and in care staff, so that attention can be given to psychological and emotional needs as well as the physical.

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Section: Discussionmentioning

confidence: 99%

Benefits, Challenges and Solutions for Implementing Personalised Music Playlist Programs in Residential Aged Care in Australia

Garrido

Markwell

Andreallo

et al. 2021

JMDH

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“…However, these medications are often utilized long-term (Helvik et al, 2017;Westbury et al, 2010). The risks associated with neuropsychiatric symptoms are substantial, including lower quality of life (QoL) and increased risk of physical injuries to the residents (Sato et al, 2018;Sylliaas et al, 2012;van de Ven-Vakhteeva et al, 2013), increased distress and turnover of the LTCF staff (van Duinen-van den Ijssel et al, 2018;Zwijsen et al, 2014), and increased costs of care due to greater use of health services (Morris et al, 2015;Murman et al, 2002). It is not surprising then that a significant barrier to the reduction of antipsychotic and/or benzodiazepine use is the belief among LTCF staff and General Practitioners (GPs) that the initial symptoms, such as agitation, anxiety and sleep disturbances, and QoL, may worsen (Azermai et al, 2014;Bourgeois et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Clinical impact of antipsychotic and benzodiazepine reduction: findings from a multicomponent psychotropic reduction program within long-term aged care

Hoyle

Peterson

Bindoff

et al. 2020

Int. Psychogeriatr.

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Objectives: To explore the relationships between dose changes to antipsychotic and/or benzodiazepine medications and resident outcomes, including variations in neuropsychiatric symptoms, quality of life (QoL), and social withdrawal, within a multicomponent, interdisciplinary antipsychotic and benzodiazepine dose reduction program. Design: Prospective, observational, longitudinal study. Intervention: The Reducing Use of Sedatives (RedUSe) project involved 150 Australian Long-Term Care Facilities (LTCFs) incorporating auditing and benchmarking of prescribing, education, and multidisciplinary sedative reviews. Setting: A convenience sample of LTCFs (n = 28) involved in RedUSe between January 2015 and March 2016. Participants: Permanent residents (n = 206) of LTCFs involved in RedUSe taking an antipsychotic and/or benzodiazepine daily. Residents were excluded if they had a severe psychiatric condition where antipsychotic therapy should generally be maintained long-term (e.g., bipolar disorder, schizophrenia) or were considered end-stage palliative. Measurements: Neuropsychiatric symptoms (Neuropsychiatric Inventory, Cohen-Mansfield Agitation Inventory (CMAI)), QoL (Assessment of Quality of Life-4D), and social withdrawal (Multidimensional Observation Scale for Elderly Subjects-withdrawal subscale) were measured at baseline and 4 months where nursing staff completed psychometric tests as proxy raters. Results: There was no evidence that psychometric measures were worsened following dose reductions. In fact, dose reduction was associated with small, albeit non-statistically significant, improvements in behavior, particularly less physically non-aggressive behavior with both drug groups (−0.36 points per 10% reduction in antipsychotic dose, −0.17 per 10% reduction in benzodiazepine dose) and verbally agitated behavior with benzodiazepine reduction (−0.16 per 10% dose reduction), as measured with the CMAI. Furthermore, antipsychotic reduction was associated with non-statistically significant improvements in QoL and social withdrawal. Conclusions: Antipsychotic and benzodiazepine dose reduction in LTCFs was not associated with deterioration in neuropsychiatric symptoms, QoL, or social withdrawal. Trends toward improved agitation with antipsychotic and benzodiazepine dose reduction require further evaluation in larger, prospective, controlled studies.

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“…For instance, the association between elderly with other chronic health conditions such as antidepressants with falls, and other risk of falls factors varies from each individual [7]. Another common chronic health issue among elderly is progression of dementia, more than a quarter of older people will have dementia or related symptoms and they are eightfold higher to be at risk of falling compared to those without dementia [8]. Reducing fall rates for adults in residential care facilities has been a priority among healthcare lawmakers due to associated risks related to prolonged hospitalization.…”

Section: Article Info Abstractmentioning

confidence: 99%

Association Between Falls and Chronic Health Conditions Among Adults in Residential Care Facilities: Analysis of the National Survey of Residential Care Facilities (NSRCF) Data

Alshahrani¹,

Shih²,

Kim

2020

BJSTR

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This study attempts to examine the effects of stroke, heart disease, Alzheimer/dementia, Chronic Obstructive Pulmonary Disease (COPD), age, gender, and Medicaid status on falls for adults in residential care facilities.Methods: Univariate analysis was conducted to examine the distribution of resident demographic characteristics, health conditions, and Medicaid status for the entire sample. Bivariate analyses (Chi-square test of independence) were also conducted to determine if there were any statistically significant associations between independent and dependent variables. Finally, multivariable logistic regression analyses were conducted to determine the effects of stroke, heart disease, Alzheimer/dementia, and COPD, age, gender, and Medicaid status on the likelihood of any falls in the past year among adult residents in residential care facilities.Results: Overall, our model is statistically significant compared to an empty model. The multivariable logistic regression model was statistically significant (χ2 (8) = 116.57, p < 0.001). Of the seven-predictor variables, only five variables were statistically significant: age, gender, heart disease, Alzheimer's /Dementia, and Medicaid status. COPD and stroke were a not-statistically significant predictor of falls. Conclusion:Falls have been associated with several different risk factors. Age or gender are risk factors that cannot be altered. However, many other fall risk factors can be controlled (e.g., muscle strength, number of medications, balance). Appropriate assessments can help to identify those residents who have an increased risk of falls. Assessment should include the underlying causes and plans to reduce the negative impact of falls in older adults.

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Predicting falls from behavioral and psychological symptoms of dementia in older people residing in facilities

Cited by 13 publications

References 20 publications

Benefits, Challenges and Solutions for Implementing Personalised Music Playlist Programs in Residential Aged Care in Australia

Benefits, Challenges and Solutions for Implementing Personalised Music Playlist Programs in Residential Aged Care in Australia

Clinical impact of antipsychotic and benzodiazepine reduction: findings from a multicomponent psychotropic reduction program within long-term aged care

Association Between Falls and Chronic Health Conditions Among Adults in Residential Care Facilities: Analysis of the National Survey of Residential Care Facilities (NSRCF) Data

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