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01/2018 journal articles

Editorials

SPECIAL TOPIC SECTION ON OPTIMIZING CARE COORDINATION. MOVING CARE FORWARD IN ALZHEIMER’S DISEASE: OPPORTUNITIES AND CHALLENGES

Fati Nourhashemi, Ara S. Khachaturian

Care Weekly 2018;2:2-3

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CITATION:
Fati Nourhashemi ; Ara S. Khachaturian (2018): Special Topic Section on Optimizing Care Coordination. Moving Care Forward in Alzheimer’s Disease: Opportunities and Challenges. Care Weekly. http://dx.doi.org/10.14283/cw.2018.5

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Featured Articles

HOW TO PROMOTE PHYSICAL ACTIVITY AND EXERCISE FOR OLDER ADULTS IN THE CLINICAL SETTING ?

Philipe de Souto Barreto

Care Weekly 2018;2:4-8

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Physical activity (PA) and exercise have been found to be associated with a reduced risk of developing major adverse health events during aging without important side effects. However, PA and exercise counselling in routine clinical care is still rare, particularly in the primary care. This opinion paper synthetizes the scientific evidence on the benefits of PA and exercise during aging in order to guide practitioners to advise/prescribe this healthy behavior. Guidance for sitting time is also provided. A specific focus is performed in a population at particular risk for short-, medium and long-term adverse events: middle-aged adults with obesity. In conclusion, all healthy patients (with or without diseases/conditions) may safely increase their PA levels and exercise. Stratifying patients according to the potential benefits they may obtain from PA and exercise counselling may help health practitioners to optimize their care approach by spending the “right time” with the “right person”.

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THERAPEUTIC PATIENT EDUCATION IN ALZHEIMER’S DISEASE: ADDRESSING THE CHALLENGES OF THE DYAD

Hélène Villars, Philippe Girard

Care Weekly 2018;2:9-13

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Psychoeducational approaches such as Therapeutic patient education (TPE) have increased substantially in the field of Alzheimer’s disease. There is evidence to think they can be useful for both patients and caregivers. Such approaches, addressing the patient and the caregiver’s needs, have to be designed in keeping the challenges of the dyad (patient/caregiver) in mind. This article summarize the most important results in the literature, as regards the impact of psychoeducational interventions as TPE on caregivers ’outcomes (stress, well-being, health in general) but also patient’s outcomes (quality of life, behaviour). Person-centered and tailored informations delivered to caregivers by specifically trained professionals using pedagogic methods and innovative tools, could improve the quality of care delivered to AD patients. TPE seems to have a place in an integrated care type of approach for AD patient’s and caregivers.

CITATION:
Hélène Villars ; Philippe Girard (2018): Therapeutic Patient Education in Alzheimer’s Disease: Addressing the Challenges of the Dyad. Care Weekly. http://dx.doi.org/10.14283/cw.2018.7

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ONLINE HEALTH INFORMATION-SEEKING: THE CASE OF DEEP BRAIN STIMULATION IN SOCIAL MEDIA

Julie M. Robillard, Emanuel Cabral, Tanya L. Feng

Care Weekly 2018;2:14-20

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Background: Online health information-seeking is a common behavior among caregivers. Social media increasingly plays a role as a source of health information, including for novel or emerging treatments such as deep-brain stimulation. Objectives: To examine health information-seeking related to deep brain stimulation. Design: Content analysis was applied to questions and answers related to deep brain stimulation posted online. Setting: Content was captured from the website Yahoo! Answers between 2006 and 2015. Participants: No participants were recruited for this study. The analysis was conducted on freely-accessible publicly posted content in online social media. Results: Most discussions involved information-seeking and -sharing about a disease, treatment, or the procedure for deep brain stimulation. Nearly half of the questions featured some emotional valence, most often negative. Only a minority of questions and answers mentioned risks associated with deep brain stimulation. Deep brain stimulation was most discussed in the context of age-associated movement disorders such as Parkinson disease. Evaluations of the benefits and efficacy of deep brain stimulation for movement disorders differed significantly from evaluations of its use for mental health disorders (X2 [6, N = 432] = 28.46, p < 0.01). Conclusions: With the increasing use of deep brain stimulation and its expanding application to a variety of age-associated neurological and psychiatric conditions, it is crucial to understand information-seeking trends related to this emerging neurotechnology to inform the development of knowledge dissemination initiatives for the public, patient and caregivers, and heath care providers.

CITATION:
Julie M. Robillard ; Emanuel Cabral ; Tanya L. Feng (2018): Online Health Information-Seeking: The Case of Deep Brain Stimulation in Social Media. Care Weekly. http://dx.doi.org/10.14283/cw.2018.8

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BRIDGING HEALTH AND SOCIAL CARE WITH THE CITIZENS – THE CASE OF EIT HEALTH PROJECT “HEALIQS4CITIES” AND “PRAÇA VIDA+”, IN PORTUGAL

Bebiana Sá-Moura, Patrícia Couceiro, Luís Catarino, Diana Guardado, Maja de Brito, Bárbara Gomes, Rui Tavares, João Ramalho-Santos, Ana M. Teixeira, Luís Rama, Flávio Reis, Anabela Mota-Pinto, Manuel Veríssimo, Carlos Gonçalves, António Cunha, João O. Malva

Care Weekly 2018;2:21-24

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The global burden of population ageing imposes the need of innovative care models and good practices to ensure the sustainability of health and social care support, as well as optimal quality of life of the citizens. Science and technology-based innovation is required to be cross-fertilized with co-creation strategies, involving different stakeholders and the citizens. Health literacy is a crucial component of this challenge, including instruments focused on better training of formal and informal caregivers and citizen’s empowerment towards healthy lifestyles. In the present paper, we highlight the implementation of two EIT Health projects, Healiqs4cities and CARE Campus, and one event, Praça Vida+, as good examples of the interdisciplinary approach to develop innovative good practices, science outreach and innovative ICT-based training schemes for care providers. Moreover, we identify the European Innovation Partnership on Active and Healthy Ageing Reference Sites and the Reference Site Collaborative Network as quadruple helix-based ecosystems ideally positioned to inspire other European regions and their decision makers for large adoption of innovative practices and change management across Europe.

CITATION:
Bebiana Sá-Moura ; Patrícia Couceiro ; Luís Catarino ; Diana Guardado ; Maja de Brito ; Bárbara Gomes ; Rui Tavares ; João Ramalho-Santos ; Ana M. Teixeira ; Luís Rama ; Flávio Reis ; Anabela Mota-Pinto ; Manuel Veríssimo ; Carlos Gonçalves ; António Cunha ; João O. Malva (2018): Bridging Health and Social Care with the Citizens – The Case of EIT Health Project “Healiqs4cities” and “Praça Vida+”, in Portugal. Care Weekly. http://dx.doi.org/10.14283/cw.2018.9

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“IT TOOK THE STRESS OUT OF GETTING HELP”: THE STAR-CTELEMEDICINE MIXED METHODS PILOT

A. Lindauer, R. Croff, K. Mincks, N. Mattek, S.J. Shofner, N. Bouranis, L. Teri

Care Weekly 2018;2:25-31

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Background: Caring for a family member with Alzheimer’s disease and related dementias can be mentally and physically taxing. Support programs are available to mitigate the strain of care, but caregivers report access challenges (e.g., distance). STAR-C is an evidence-based, effective, one-on-one caregiver educational intervention. However, family caregivers who do not live near a STAR-C consultant (e.g., rural caregivers) cannot participate in the program. The earth-bound mode presents a critical barrier to widely-available caregiver support. Objectives: We assessed the feasibility, preliminary efficacy, and cost of implementing a caregiver support intervention (STAR-C-Telemedicine), using Internet-based videoconferencing. Design: Using a mixed-methods approach, we examined feasibility and pre- and post-intervention changes in caregiver burden. Focus groups provided feedback on program acceptability. Setting: Participants, in their own homes, connected the university-based study staff using videoconferencing technology. Participants: Twenty family caregivers for those with dementia consented to the study. Intervention: The STAR-C-TM intervention included 8 weekly sessions in which the university-based consultant met (via videoconferencing) with caregivers in their homes. The intervention focused on identifying upsetting behaviors and identifying triggers to the behaviors. Measurements: We assessed caregiver burden, depression and desire to institutionalize prior to and after the intervention. Results: Fourteen caregivers (82% of those who started the intervention) completed all study components. We found statistically significant reductions in caregiver burden. Caregivers liked the videoconferencing option. Almost two-thirds reported, given the choice, that they would prefer it over an in-person offering. STAR-C-TM saved, on average, $1150/per caregiver over the traditional program. Qualitative findings supported the quantitative data. Conclusions: Telemedicine-based support for family caregivers is a feasible and cost-effective option. As the prevalence of dementia grows, programs such as STAR-C-TM can fill an important gap in caregiver education and support.

CITATION:
Allison Lindauer ; Raina Croff ; Katherine Mincks ; Nora Mattek ; Sabrina J. Shofner ; Nicole Bouranis ; Linda Teri (2018): It Took the Stress out of Getting Help”: The STAR-C-Telemedicine Mixed Methods Pilot. Care Weekly. http://dx.doi.org/10.14283/cw.2018.10

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BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS OF DEMENTIA: AN OVERVIEW OF THEORETICAL FRAMEWORKS AND ASSOCIATED NONPHARMACOLOGICAL TREATMENTS FOR BPSD

Arlinda Cerga-Pashoja, Asmae Doukani, Parthenia Giannakopoulou

Care Weekly 2018;2:32-42

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Behavioural and Psychological Symptoms of Dementia (BPSD) such as agitation and aggression are core symptoms of dementia and affect almost everyone with the condition. Such symptoms cause distress to the person with dementia and their caregivers and have also been found to predict early institutionalisation as well as death. Historically, BPSD have been managed with medication, typically using anti-psychotic drugs. However, recent data show that anti-psychotic medications increase mortality and the risk of stroke in people with dementia. On the other hand, non-pharmacological interventions such as sensory manipulation, psychological therapies and providing training and psychoeducation for caregivers, present more encouraging results. Consequently, there is a need to explore the potential impact of non-pharmacological interventions on BPSD.

CITATION:
Arlinda Cerga-Pashoja ; Asmae Doukani ; Parthenia Giannakopoulou (2018): Behavioral and Psychological Symptoms of Dementia: An Overview of Theoretical Frameworks and Associated Non-Pharmacological Treatments for BPSD. Care Weekly. http://dx.doi.org/10.14283/cw.2018.11

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CARE CAMPUS. A EUROPEAN CONSORTIUM MODEL TO SUPPORT FORMAL AND INFORMAL CAREGIVING TRAINING

Melek Somai, Anneliese Lilienthal, Arlinda Cerga, Karen Abbott, Helene Villars, Barbara Gomez, João Malva, Lena Alksten, Stephanie Giraud, Laurie Owen, Fabien Lanterri, Sylvia Nissim, Christine Boutet-Rixe, Mario Ottiglio, Mike Hodin, Vincente Traver, Amie N Heap, Caroline Manus, Miia Kivipelto, Susanne Guidetti, Carl Johan Sundberg, Maria Hagströmer, Suzanne Pathkiller, Kristal Morales Pérez, Mark Belan, Alexandra Manson, Gideon Shimshon, Trevor Brocklebank, Elizabeth Muir, George Leeson, Charles Consel, Sarah Harper, Theng Yin Leng, Jan-Olov Hoog, Eric Asaba, Lefkos Middleton

Care Weekly 2018;2:43-49

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Today’s health and social care systems are facing a challenge in how to effectively address caregiving for ageing populations facing cognitive disorders and frailty. Scholars and policy makers are now identifying a rise of “hidden form of care”, e.g. informal caregiving, as a phenomenon in support for ageing populations. Across Europe for instance, the rise in the older old adult population has led to a rapid expansion of the number of carers, both professional (formal) and informal. The latter, representing mostly family members caring for their loved ones, truly represents a “hidden form of care”. This can be a problem if formal and informal caregivers are not fully integrated into the healthcare continuum or are not given a systematic support to carry out caregiving in a relevant and safe way. There is currently no comprehensive European-wide legal framework and support mechanisms, in terms of training and education for this group. CARE Campus, an EIT Health programme within the Educational Campus Pillar, is a new model of collaboration between academic institutions, the private sector, and the public sector whose main aim is to support the development of a comprehensive training for formal and informal caregivers in Europe. The initial phase of the development encompasses nine (09) online training modules with a quality control process to ensure that the curriculum is evidence-based, compliant with the national and local regulations, and addresses the needs of caregivers across Europe. The objective is to support formal, informal, and family caregivers and reduce the burden on health care systems, whilst improving the quality of care for older adults.

CITATION:
Melek Somai ; Anneliese Lilienthal ; Arlinda Cerga ; Karen Abbott ; Helene Villars ; Barbara Gomez ; João Malva ; Lena Alksten ; Stephanie Giraud ; Laurie Owen ; Fabien Lanterri ; Sylvia Nissim ; Christine Boutet-Rixe ; Mario Ottiglio ; Mike Hodin ; Vincente Traver ; Amie N Heap ; Caroline Manus ; Miia Kivipelto ; Susanne Guidetti ; Carl Johan Sundberg ; Maria Hagströmer ; Suzanne Pathkiller ; Kristal Morales Pérez ; Mark Belan ; Alexandra Manson ; Gideon Shimshon ; Trevor Brocklebank ; Elizabeth Muir ; George Leeson ; Charles Consel ; Sarah Harper ; Theng Yin Leng ; Jan-Olov Hoog ; Eric Asaba ; Lefkos Middleton (2018): CARE Campus. A European Consortium Model to Support Formal and Informal Caregiving Training. Care Weekly. http://dx.doi.org/10.14283/cw.2018.12

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Perspective

ON LIVING ALONE WITH ALZHEIMER’S DISEASE

E. Portacolone

Care Weekly 2018;2:50-53

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A sociologist’s encounters with a retired executive living alone with Alzheimer’s disease reveal gaps in the U.S. healthcare system. These gaps emerge during eight ethnographic interviews and participant observation between 2014 and 2017 with Ms. Judith Banks, 79. Ms. Banks’ perspective offers an inside-view of the challenges of living alone with cognitive impairment. Receiving a diagnosis of Alzheimer’s disease was “brutal” for her and the support to continue living in the community almost non-existent. Gaps in the U.S. healthcare system further emerge from the contrast between Ms. Banks’ case study and the examination of the Danish system of care for non-institutionalized persons with dementia. Given that one third of people with dementia live alone in the U.S. and that they are likely to experience poorer health outcomes than counterparts living with others, it is critical to ensure that they receive appropriate health services upon diagnosis of cognitive impairment.

CITATION:
E. Portacolone (2018): On Living Alone with Alzheimer’s Disease. Care Weekly. http://dx.doi.org/10.14283/cw.2018.3

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CARING AND AGEING RE-IMAGINED IN EUROPE (CARE CAMPUS). AN INNOVATIVE APPROACH TO TACKLE THE HEALTHCARE CHALLENGES OF AGEING POPULATION IN EUROPE

Melek Somai, Lefkos Middleton

Care Weekly 2018;2:54-56

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CITATION:
Melek Somai ; Lefkos Middleton (2018): Caring and Ageing Re-imagined in Europe (CARE Campus). An Innovative Approach to Tackle the Healthcare Challenges of Ageing Population in Europe. Care Weekly. http://dx.doi.org/10.14283/cw.2018.13

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Review Articles

OVERVIEW OF GLOBAL HEALTH AND WELLNESS COACHING TRAINING PROGRAMMES

Aravind Sesagiri Raamkumar, John Robert Bautista, Tuo-Yu Chen, Mohamed A. Shaik, Neha Malhotra, Yin-Leng Theng

Care Weekly 2018;2:57-64

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Background: Health and wellness coaching (HWC) has emerged as an important vocation that complements traditional primary care and caregiving services. Although prior studies have reviewed HWC scientific literature, there is an apparent lack of literature on the global HWC training programmes. In this paper, we attempt to address this gap by analysing data pertaining to HWC training programmes offered across the globe. General-purpose search engine Google was used for finding HWC training programmes in June 2018. We identified 224 relevant training programmes and the required data were manually extracted from the corresponding websites. Findings indicate that HWC training is predominant in North America, UK, and Australia, with online learning as the most used delivery mode. Certificate programmes are widely offered by training institutes and academic organisations compared to degree programmes, with only a meagre number of programmes recognized by International Consortium for Health & Wellness Coaching (ICHWC) and International Coach Federation (ICF). HWC programmes seem to be focused on training coaches to help clients primarily with conditions and ailments, such as diabetes, stress, and other chronic diseases. However, there is only a very small number of HWC training programmes on eldercare found.

CITATION:
Aravind Sesagiri Raamkumar ; John Robert Bautista ; Tuo-Yu Chen ; Mohamed A. Shaik ; Neha Malhotra ; Yin-Leng Theng (2018): Overview of Global Health and Wellness Coaching Training Programmes. Care Weekly. http://dx.doi.org/10.14283/cw.2018.14

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Research News

SEASONAL VARIATION IN VITAMIN D STATUS AMONG FRAIL OLDER HOSPITALIZED PATIENTS

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EDUCATING MEDICAL STUDENTS IN COUNSELLING OLDER ADULTS ABOUT EXERCISE: THE IMPACT OF A PHYSICAL ACTIVITY MODULE

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HOW TO MANAGE FRAIL OLDER ADULTS IN THE COMMUNITY? PROPOSAL OF A HEALTH PROMOTION PROGRAM EXPERIENCED IN A CITY OF 16,638 INHABITANTS IN FRANCE

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DIABETES MELLITUS AND COGNITIVE DECLINE – PREVENTION SHOULD NOT BE DELAYED!

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W.H.O ( World Health Organization) PROGRAM ON MAINTAINING INTRINSIC CAPACITIES WITH AGING

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IDENTIFYING BETTER OUTCOME MEASURES TO IMPROVE TREATMENT OF AGITATION IN DEMENTIA: A REPORT FROM THE EU/US/CTAD TASK FORCE

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