Practitioners' identification of informal caregivers' difficulties with activities of daily living interventions for older people with dementia in Japan.
ADL impairment
ADL interventions
Alzheimer's disease
difficulty
informal caregiver
Journal
Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society
ISSN: 1479-8301
Titre abrégé: Psychogeriatrics
Pays: England
ID NLM: 101230058
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
revised:
07
03
2021
received:
09
10
2020
accepted:
09
03
2021
pubmed:
14
4
2021
medline:
6
7
2021
entrez:
13
4
2021
Statut:
ppublish
Résumé
Older people with dementia who cannot perform daily activities independently due to cognitive impairment need support at home and in the community. This study identified aspects of activities of daily living (ADL) interventions that advanced dementia care practitioners recognise as challenging for informal caregivers to perform. We conducted a self-administered cross-sectional survey on advanced dementia care practitioners, including certified nurses, specialising in gerontological, community health, home care, and visiting nursing, nurses specialising in dementia certified by the Japanese Nursing Association, and dementia care leaders certified by prefectural governors. The participants rated a caregivers' extent of difficulty in aspects of ADL interventions on a four-point Likert scale. Factor analysis was performed to determine ADL intervention aspects that are recognised by advanced dementia care practitioners as challenging for informal caregivers. The highest loaded factors for mild, moderate, and severe cognitive impairment stages were 'right time to draw attention,' 'opportunities to perform ADL,' and 'communicating how to perform ADL without giving up,' respectively. Therefore, it is imperative to educate informal caregivers about the effects of cognitive impairment on ADL performance in people with dementia and enable them to provide concrete ADL interventions and tips to support the persons' autonomy and independence. The Cronbach's alpha values of the highest loaded factors for mild, moderate, and severe cognitive impairment stages were 0.851, 0.925, and 0.946, respectively. Moreover, the cumulative contribution ratios of each stage were 46.04%, 50.52%, and 47.36%, respectively. This study dealt with identifying informal caregivers' difficulties with ADL interventions across the stages of dementia. Informal caregivers should be supported on aspects of ADL interventions that are potentially difficult for them to perform. Useful educational content and approaches in training programs for informal caregivers should be developed to enable them to help people with Alzheimer's disease maintain ADL performance toward 'ageing in place' even as the disease progresses.
Sections du résumé
BACKGROUND
BACKGROUND
Older people with dementia who cannot perform daily activities independently due to cognitive impairment need support at home and in the community. This study identified aspects of activities of daily living (ADL) interventions that advanced dementia care practitioners recognise as challenging for informal caregivers to perform.
METHODS
METHODS
We conducted a self-administered cross-sectional survey on advanced dementia care practitioners, including certified nurses, specialising in gerontological, community health, home care, and visiting nursing, nurses specialising in dementia certified by the Japanese Nursing Association, and dementia care leaders certified by prefectural governors. The participants rated a caregivers' extent of difficulty in aspects of ADL interventions on a four-point Likert scale. Factor analysis was performed to determine ADL intervention aspects that are recognised by advanced dementia care practitioners as challenging for informal caregivers.
RESULTS
RESULTS
The highest loaded factors for mild, moderate, and severe cognitive impairment stages were 'right time to draw attention,' 'opportunities to perform ADL,' and 'communicating how to perform ADL without giving up,' respectively. Therefore, it is imperative to educate informal caregivers about the effects of cognitive impairment on ADL performance in people with dementia and enable them to provide concrete ADL interventions and tips to support the persons' autonomy and independence. The Cronbach's alpha values of the highest loaded factors for mild, moderate, and severe cognitive impairment stages were 0.851, 0.925, and 0.946, respectively. Moreover, the cumulative contribution ratios of each stage were 46.04%, 50.52%, and 47.36%, respectively.
CONCLUSION
CONCLUSIONS
This study dealt with identifying informal caregivers' difficulties with ADL interventions across the stages of dementia. Informal caregivers should be supported on aspects of ADL interventions that are potentially difficult for them to perform. Useful educational content and approaches in training programs for informal caregivers should be developed to enable them to help people with Alzheimer's disease maintain ADL performance toward 'ageing in place' even as the disease progresses.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
466-477Subventions
Organisme : Older Adult Health and Healthcare Advancement Project Division
ID : 1002-2
Informations de copyright
© 2021 Japanese Psychogeriatric Society.
Références
Statistics Bureau of Japan. Older People's Population. [Cited 15 Sep 2019]. Available from URL: https://www.stat.go.jp/data/topics/topi1211.html
Cabinet Office. Annual Report on the Ageing Society. [Cited 20 Dec 2018]. Available from URL: https://www8.cao.go.jp/kourei/whitepaper/w-2016/html/gaiyou/s1_2_3.html
Ministry of Health, Labour and Welfare. Number of Older Persons with Dementia. [Cited 24 Aug 2012]. Available from URL: https://www.mhlw.go.jp/stf/houdou/2r9852000002iau1.html
Ministry of Health, Labour and Welfare. Comprehensive strategy for promoting dementia measures. New Orange Plan. [Cited 20 Dec 2015]. Available from URL: https://www.mhlw.go.jp/file/06-Seisakujouhou-12300000-Roukenkyoku/nop1-2_3.pdf
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edn. Arlington, VA: APA, 2013.
Nakaaki S, Sato J. The assessment and clinical significance of executive function in dementia. Jpn J Geriatr Psychiatry 2015; 26: 248-256.
Ministry of Health, Labour and Welfare. Promotion of Dementia Measures in Japan. [Cited 22 Nov 2017]. Available from URL: https://kouseikyoku.mhlw.go.jp/chugokushikoku/chiikihoukatsusuishin/documents/shiryou1.pdf
Japanese Nursing Association. Nurse Specialist. [Cited 1 Oct 2016]. Available from URL: http://nintei.nurse.or.jp/nursing/qualification/cns2016.9.7
Japanese Nursing Association. Certified Nurse. [Cited 1 Oct 2016]. Available from URL: https://nintei.nurse.or.jp/nursing/wp-content/uploads/2019/01/leaflet_CN2019-3.pdf
Borson S, Scanlan J, Sadak T, Lessig M, Vitaliano P. Dementia services mini-screen: a simple method to identify patients and caregivers in need of enhanced dementia care. Am J Geriatr Psychiatry 2014; 22: 746-755. https://doi.org/10.1016/j.jagp.2013.11.001.
Hepburn K, Lewis M, Tornatore J, Sherman CW, Bremer KL. The savvy caregiver program: the demonstrated effectiveness of a transportable dementia caregiver psychoeducation program. J Gerontol Nurs 2007; 33: 30-36. https://doi.org/10.1016/j.gerinurse.2019.01.005.
Nichols LO, Martindale-Adams J, Burns R, Graney MJ, Zuber J. Translation of a dementia caregiver support program in a health care system-REACH VA. Arch Intern Med 2011; 171: 353-359. https://doi.org/10.1001/archinternmed.2010.548.
Tremont G, Davis JD, Fortinsky RH. Telephone-delivered psychosocial intervention reduces burden in dementia caregivers. Dementia 2008; 7: 503-520. https://doi.org/10.1177/1471301208096632.
Jensen M, Agbata IN, Canavan M, McCarthy G. Effectiveness of educational interventions for informal caregivers of individuals with dementia residing in the community: systematic review and meta-analysis of randomized controlled trials. Int J Geriatr Psychiatry 2015; 30: 130-143. https://doi.org/10.1002/gps.4208.
Jütten LH, Mark RE, Sitskoorn MM. Can the mixed virtual reality simulator into dementia enhance empathy and understanding and decrease burden in informal dementia caregivers? Dement Geriatr Cogn Disord Extra 2018; 8: 453-466. https://doi.org/10.1159/000494660.
Pot AM, Blom MM, Bernadette MW. Acceptability of a guided self-help internet intervention for family caregivers: mastery over dementia. Int Psychogeriatr 2015; 27: 1343-1354. https://doi.org/10.1017/S1041610215000034.
Zimmerman S, Sloane PD, Ward K et al. Helping dementia caregivers manage medical problems: benefits of an educational resource. Am J Alzheimers Dis Other Demen 2018; 33: 176-183. https://doi.org/10.1177/1533317517749466.
McCabe M, You E, Tatangelo G. Hearing their voice: a systematic review of dementia family caregivers' needs. Gerontologist 2016; 56: e70-e88. https://doi.org/10.1093/geront/gnw078.
Spigelmyer PC, Hupcey J, Kitko L. A concept analysis of resistiveness to care. Clin Nurs Res 2018; 30: 50-58. https://doi.org/10.1177/1054773818789862.
Spigelmyer PC, Schreiber JB. A pilot study: resistive behaviour in the context of informal caregiver-assisted activities of daily living. Geriatr Nurs 2019; 40: 399-404. https://doi.org/10.1016/j.gerinurse.2019.01.005.
Teri L, McKenzie GL, LaFazia D et al. Improving dementia care in assisted living residences: addressing staff reactions to training. Geriatr Nurs 2009; 30: 153-163. https://doi.org/10.1016/j.gerinurse.2008.07.002.
Karel MJ, Teri L, McConnell E, Visnic S, Karlin BE. Effectiveness of expanded implementation of STAR-VA for managing dementia-related behaviors among veterans. Gerontologist 2016; 56: 126-134. https://doi.org/10.1093/geront/gnv068.
Dobbs D, Hobday J, Roker R, Kaas MJ, Molinari V. Certified nursing assistants' perspectives of the CARES® activities of daily living dementia care program. Appl Nurs Res 2018; 39: 244-248. https://doi.org/10.1016/j.apnr.2017.11.016.
Coste JK. Learning to Speak Alzheimer's. A Groundbreaking Approach for Everyone Dealing with the Disease. Wilmington, MA: Houghton Mifflin Company, 2003.
Grimsland F, Seim A, Borza T, Helvik AS. Toileting difficulties in older people with and without dementia receiving formal in-home care-a longitudinal study. Nurs Open 2019; 6: 1055-1066. https://doi.org/10.1002/nop2.289.
Ridzuan SA, Darussalam SE, Hisham NH et al. A review of burden of caregivers of patients with Alzheimer's disease. Malang Neurol J 2019; 5: 42-45. https://doi.org/10.21776/ub.mnj.2019.005.01.7.
Quinn C, Nelis SM, Martyr A, Morris RG, Victor C, Clare L. Caregiver influences on ‘living well’ for people with dementia: findings from the IDEAL study. Aging Ment Health 2019; 24: 1-9. https://doi.org/10.1080/13607863.2019.1602590.
Ministry of Health, Labour and Welfare. Grant-in-Aid for Scientific Research: Comprehensive Research Project on Dementia Prevention. Dementia Prevalence in Urban Areas and Response to Functional Disorders in Activities of Daily Living Associated with Dementia. FY2011 to FY2012 Summary Research Report 2013. [Cited 10 Aug 2014]. Available from URL: http://www.tsukuba-psychiatry.com/wp-content/uploads/2013/06/H24Report_Part1.pdf
Japan Visiting Nursing Foundation: FY2013 Ministry of Health, Labour and Welfare Subsidy for Projects promoting geriatric health (Projects promoting geriatric health). Development of guidelines in line with the daily life disability and behavioural and psychological symptoms of dementia for each stage of dementia in people living at home. [Cited 10 Aug 2014]. Available from URL: http://www.jvnf.or.jp/katsudo/kenkyu/26kenkyu/h2603.pdf
Reisberg B, Ferris SH, Anand R et al. Functional staging of dementia of the Alzheimer type. Ann N Y Acad Sci 1984; 435: 481-483. https://doi.org/10.1111/j.1749-6632.1984.tb13859.x.
Suwa S, Yumoto A, Ueno M, Yamabe T, Hoshishiba Y, Sato M. Characteristics of care methods for daily life disabilities in Alzheimer's type dementia that respect autonomy and independence. Nurs Open 2019; 6: 1-12. https://doi.org/10.1002/nop2.283.
Prizer LP, Zimmerman S. Progressive support for activities of daily living for persons living with dementia. Gerontologist 2018; 58: S74-S87. https://doi.org/10.1093/geront/gnx103.
Japan Society of Neurology (Editorial supervision). Dementia Treatment Guidelines Preparation Committee. Dementia Treatment Guidelines. Tokyo: Igaku Shoin, 2017.
Chang-Quan H, Hui W, Chao-Min W et al. The association of antihypertensive medication use with risk of cognitive decline and dementia: a meta-analysis of longitudinal studies. Int J Clin Pract 2011; 65: 1295-1305. https://doi.org/10.1111/j.1742-1241.2011.02810.x.
McGuinness B, Todd S, Passmore P, Bullock R. Systematic review: Blood pressure lowering in patients without prior cerebrovascular disease for prevention of cognitive impairment and dementia. J Neurol Neurosurg Psychiatry 2008; 79(1): 4-5. https://doi.org/10.1136/jnnp.2007.118505.
Ohara T, Doi Y, Ninomiya T et al. Glucose tolerance status and risk of dementia in the community: the Hisayama study. Neurology 2011; 77: 1126-1134. https://doi.org/10.1212/WNL.0b013e31822f0435.
Arai A, Ozaki T, Katsumata Y. Behavioural and psychological symptoms of dementia in older residents in long-term care facilities in Japan: a cross-sectional study. Aging Ment Health 2017; 21: 1099-1105. https://doi.org/10.1080/13607863.2016.1199013.
Asada T. Dementia and stigma. Clin Psychiatry 2013; 55: 1053-1056.
Kawamura Y. The birth of researches from the perspective of people with dementia. Nurs Res 2013; 46: 274-285.
Kolcaba K. Comfort Theory and Practice: A Vision for Holistic Care and Research. New York: Springer Publishing Company, 2002.
Yuasa M, Ogawa T. Development of an index for understanding the effectiveness of care for elderly patients with severe dementia (report 1): example clinical application of an index that considers the concept of ‘comfort.’ J Chiba Assoc of. Nurs Sci 2007; 13: 80-88.
dos Santos SB, Rocha GP, Fernandez LL, de Padua AC, Reppold CT. Association of lower spiritual well-being, social support, self-esteem, subjective well-being, optimism and hope scores with mild cognitive impairment and mild dementia. Front Psychol 2018; 9: 371. https://doi.org/10.3389/fpsyg.2018.00371.
Kobayashi S, Masaki H, Noguchi M. Developmental process: family caregivers of demented Japanese. J Gerontol Nurs 1993; 19: 7-12. https://doi.org/10.3928/0098-9134-19931001-05.
Jütten LH, Mark RE, Sitskoorn MM. Predicting self-esteem in informal caregivers of people with dementia: modifiable and nonmodifiable factors. Aging Ment Health 2018; 24: 1-6. https://doi.org/10.1080/13607863.2018.1531374.
Lawton MP, Kleban MH, Moss M, Rovine M, Glicksman A. Measuring caregiving appraisal. J Gerontol 1989; 44: P61-P71. https://doi.org/10.1093/geronj/44.3.p61.
Lawton MP, Moss M, Kleban MH, Glicksman A, Rovine M. A two-factor model of caregiving appraisal and psychological well-being. J Gerontol 1991; 46: P181-P189. https://doi.org/10.1093/geronj/46.4.p181.
Talkington-Boyer S, Snyder D. Assessing impact on family caregivers to Alzheimer's disease patients. Am J Fam Ther 1994; 22: 57-66. https://doi.org/10.1080/01926189408251297.
Tarlow BJ, Wisniewski SR, Belle SH, Rubert M, Ory MG, Gallagher-Thompson D. Positive aspects of caregiving: contributions of the REACH project to the development of new measures for Alzheimer's caregiving. Res Aging 2002; 26: 429-453. https://doi.org/10.1177/0164027504264493.