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ABOUT CARE WEEKLY
Care Weekly 2017;1:2Show summaryHide summary
A.S. Khachaturian (2017): About Care Weekly. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/cw.2017.1
“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;2:25-31Show summaryHide summary
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.
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
ON LIVING ALONE WITH ALZHEIMER’S DISEASE
Care Weekly 2018;2:50-53Show summaryHide summary
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.
E. Portacolone (2018): On Living Alone with Alzheimer’s Disease. Care Weekly. http://dx.doi.org/10.14283/cw.2018.3
ORAL HEALTH AND THE FRAIL ELDERLY
L. Rapp, S. Sourdet, B. Vellas, M.H. Lacoste-Ferré
Care Weekly 2017;1:14-20Show summaryHide summary
Introduction: The relationships between oral health conditions and frailty have rarely been explored. A systematic review of frailty components and oral health concluded that differences in study population endpoint criteria and study design cannot establish a relationship between frailty and oral health.
Objective: This study aims to describe the distribution of the OHAT (Oral Health Assessment Tool) score in a population of frail subjects and to assess associated parameters (age, socio-economic status, living conditions, education level, nutritional habits, cognitive functioning, autonomy).
Design: Cross-sectional observational study among patients referred to the Geriatric Frailty Clinic.
Measurements: 1314 patients participated in different standardized tests to evaluate their health status, cognitive and affective functioning, adaptation to usual daily activities, nutritional status, and oral health status.
Results: The risk of oral health deterioration was higher with the appearance of frailty: the OHAT increased significantly with the Fried Frailty Score (p<0.001). Physical performance and oral health were correlated (p<0.001). The OHAT score and the MNA (Mini Nutritional Assessment) score were significantly correlated: oral status seemed better for malnourished subjects (p<0.001). Dementia significantly increased the risk of an unhealthy oral status (p<0.001). There was no significant correlation between oral status and depression, just a trend.
Conclusion: This pilot study establishes a relationship between the OHAT and Fried Frailty Criteria in a population of frail elderly. It must be expanded to follow the distribution of the different items composing the OHAT score (items assessing lips; tongue; gums and tissues; saliva; natural teeth; dentures; oral cleanliness; and dental pain) with different parameters (age, socio-economic status, living conditions, educational level, medical history, drug treatment, nutritional habits, cognitive functioning, disabilities and handicaps).
L. RAPP ; S. SOURDET ; B. VELLAS ; M.-H. LACOSTE-FERRE (2017): Oral Health and the Frail Elderly. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/cw.2017.5