Needs of People With Dementia in Long-Term Care

With the aging of the population and the projected increase of dementia in the coming years, it is crucial that we understand the needs of people with dementia (PWD) in order to provide appropriate care. The aim of this study is to determine, using the best evidence possible, the care needs of PWD living in long-term care (LTC). A total of 68 studies, published between January 2000 and September 2010, were identified from six databases. From the selected studies, 19 needs of PWD were identified. The existing evidence suggests that psychosocial needs such as the need to engage in daily individualized activities and care must not be ignored in LTC. This review aims to provide a clearer picture of the needs of this growing patient population.

[1]  M. Orrell,et al.  A cluster randomised controlled trial to reduce the unmet needs of people with dementia living in residential care , 2007, International journal of geriatric psychiatry.

[2]  David Ames,et al.  Psychosocial treatments of behavior symptoms in dementia: a systematic review of reports meeting quality standards , 2009, International Psychogeriatrics.

[3]  J. Mintzer,et al.  Time for Change: The Role of Nonpharmacological Interventions in Treating Behavior Problems in Nursing Home Residents With Dementia , 2005, Alzheimer disease and associated disorders.

[4]  Janet B W Williams,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[5]  R. Launois,et al.  [Quality of life]. , 1997, Recherche en soins infirmiers.

[6]  M. Ooms,et al.  The effect of integrated emotion‐oriented care versus usual care on elderly persons with dementia in the nursing home and on nursing assistants: a randomized clinical trial , 2005, International journal of geriatric psychiatry.

[7]  W. Thies,et al.  2008 Alzheimer’s disease facts and figures , 2008, Alzheimer's & Dementia.

[8]  Michelle S. Bourgeois,et al.  Memory aids as an augmentative and alternative communication strategy for nursing home residents with dementia , 2001 .

[9]  E. Bruce,et al.  Moving towards a special kind of care for people with dementia living in care homes , 2002 .

[10]  Jane Marie Cioffi,et al.  The effect of environmental change on residents with dementia , 2007 .

[11]  Mariko Yamamoto,et al.  Impact of the stage of dementia on the time required for bathing-related care: a pilot study in a Japanese nursing home. , 2004, International journal of nursing studies.

[12]  C. Beck,et al.  Effects of Behavioral Interventions on Disruptive Behavior and Affect in Demented Nursing Home Residents , 2002, Nursing research.

[13]  P. Rabins,et al.  Medication use in nursing home residents with advanced dementia , 2008, International journal of geriatric psychiatry.

[14]  W. Dalziel,et al.  Meanings, functions, and experiences of living at home for individuals with dementia at the critical point of relocation. , 2010, Journal of gerontological nursing.

[15]  J. O'brien,et al.  Alzheimer's Disease and Other Dementia in Nursing Homes: Levels of Management and Cost , 2001, International Psychogeriatrics.

[16]  Bethel Ann Powers,et al.  Everyday ethics of dementia care in nursing homes: A definition and taxonomy , 2000 .

[17]  M. Binns,et al.  Meal delivery practices do not meet needs of Alzheimer patients with increased cognitive and behavioral difficulties in a long-term care facility. , 2001, The journals of gerontology. Series A, Biological sciences and medical sciences.

[18]  A. Norberg,et al.  Promoting a good life among people with Alzheimer's disease. , 2002, Journal of advanced nursing.

[19]  E. Souder,et al.  Disruptive behaviors of older adults in an institutional setting. Staff time required to manage disruptions. , 2003, Journal of gerontological nursing.

[20]  J. O'Brien,et al.  Quality of Life for People With Dementia Living in Residential and Nursing Home Care: The Impact of Performance on Activities of Daily Living, Behavioral and Psychological Symptoms, Language Skills, and Psychotropic Drugs , 2001, International Psychogeriatrics.

[21]  Paul T. Costa,et al.  Capturing interests: therapeutic recreation activities for persons with dementia. , 2001 .

[22]  P. Reed,et al.  Dementia care practice recommendations for nursing homes and assisted living, phase 1: Dementia care fundamentals, food and fluid consumption, pain management, and social engagement , 2008 .

[23]  A. Bossen,et al.  Needs of people with early-stage Alzheimer's disease: reviewing the evidence. , 2009, Journal of gerontological nursing.

[24]  J. Cohen-Mansfield,et al.  Self-identity in older persons suffering from dementia: preliminary results. , 2000, Social science & medicine.

[25]  R. Dröes,et al.  The effects of emotion‐oriented approaches in the care for persons suffering from dementia: a review of the literature , 2000, International journal of geriatric psychiatry.

[26]  T. Wells,et al.  Behaviors of nursing home residents with dementia: examining nurse responses. , 2006, Journal of gerontological nursing.

[27]  J. Cohen-Mansfield,et al.  Do Interventions Bringing Current Self-care Practices Into Greater Correspondence With Those Performed Premorbidly Benefit the Person With Dementia? A Pilot Study , 2006, American journal of Alzheimer's disease and other dementias.

[28]  D. O'Connor,et al.  Challenging behaviours in nursing home residents with dementia: a randomized controlled trial of multidisciplinary interventions , 2002, International journal of geriatric psychiatry.

[29]  N. Chappell,et al.  Staff Ratios and Resident Outcomes in Special Care Units: Do Activity Aides Make a Difference? , 2003 .

[30]  C. Lyketsos,et al.  Quality of life in dementia patients in long‐term care , 2000, International journal of geriatric psychiatry.

[31]  J. Chung.  Activity Participation and Well-Being of People with Dementia in Long-Term—Care Settings , 2004 .

[32]  N. Stewart,et al.  Evaluating rural nursing home environments: dementia special care units versus integrated facilities , 2004, Aging & mental health.

[33]  Jiska Cohen-Mansfield,et al.  Use of nonpharmacologic interventions among nursing home residents with dementia. , 2002, Psychiatric services.

[34]  L. Nazarko.  Providing high quality dementia care in nursing homes , 2009 .

[35]  Rose-Marie Dröes,et al.  Subjective needs of people with dementia: a review of the literature , 2007, International Psychogeriatrics.

[36]  Christianna S. Williams,et al.  Dementia care and quality of life in assisted living and nursing homes. , 2005, The Gerontologist.

[37]  M. Litaker,et al.  Efficacy of Theory‐Based Activities for Behavioral Symptoms of Dementia , 2005, Nursing research.

[38]  A. Pearson,et al.  Oral hygiene care for adults with dementia in residential aged care facilities , 2004, JBI library of systematic reviews.

[39]  Rebecca Ory Hernandez,et al.  Effects of Therapeutic Gardens in Special Care Units for People with Dementia , 2007 .

[40]  M. Lawton,et al.  Environmental correlates to behavioral health outcomes in Alzheimer's special care units. , 2003, The Gerontologist.

[41]  Michelle Simpson,et al.  Effects of the Serial Trial Intervention on Discomfort and Behavior of Nursing Home Residents With Dementia , 2006, American journal of Alzheimer's disease and other dementias.

[42]  Jiska Cohen-Mansfield,et al.  Utilization of self-identity roles for designing interventions for persons with dementia. , 2006, The journals of gerontology. Series B, Psychological sciences and social sciences.

[43]  M. Johnson,et al.  Health characteristics of elderly residents in personal care homes. Dementia, possible early dementia, and no dementia. , 2003, Journal of gerontological nursing.

[44]  J. Gardiner,et al.  Music Therapy and Reading as Intervention Strategies for Disruptive Behavior in Dementia , 2000 .

[45]  A. Norberg,et al.  Individualized music played for agitated patients with dementia: analysis of video-recorded sessions. , 2001, International journal of nursing practice.

[46]  Christianna S. Williams,et al.  Characteristics associated with lower activity involvement in long-term care residents with dementia. , 2005, The Gerontologist.

[47]  Rose-Marie Dröes,et al.  Quality of life in dementia in perspective , 2006 .

[48]  L. Buettner,et al.  Mixed behaviors in dementia: the need for a paradigm shift. , 2006, Journal of gerontological nursing.

[49]  M. Orrell,et al.  Quality of life of people with dementia in residential care homes , 2006, British Journal of Psychiatry.

[50]  J. O'Brien,et al.  Language impairment in dementia: impact on symptoms and care needs in residential homes , 2003, International journal of geriatric psychiatry.

[51]  W. Thies,et al.  2013 Alzheimer's disease facts and figures , 2013, Alzheimer's & Dementia.

[52]  C. Camp,et al.  Montessori-based activities for long-term care residents with advanced dementia: effects on engagement and affect. , 2000, The Gerontologist.

[53]  Sandee L. Hicks-Moore,et al.  Favorite music and hand massage , 2008 .

[54]  H. Sung,et al.  The effects of group music with movement intervention on agitated behaviours of institutionalized elders with dementia in Taiwan. , 2006, Complementary therapies in medicine.

[55]  Christianna S. Williams,et al.  Dying with dementia in long-term care. , 2008, The Gerontologist.

[56]  David Moher,et al.  Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews , 2007, BMC medical research methodology.

[57]  W. Dalziel,et al.  Symbolic meaning of relocation to a residential care facility for persons with dementia , 2009, Aging & mental health.

[58]  H. Sung,et al.  A preferred music listening intervention to reduce anxiety in older adults with dementia in nursing homes. , 2010, Journal of clinical nursing.

[59]  Dale A. Lund,et al.  Video Respite® in an Alzheimer's Care Center , 2003 .

[60]  Kristen C. MacDonald.  Family and Staff Perceptions of the Impact of the Long‐term Care Environment on Leisure , 2006 .

[61]  M. Kleban,et al.  The many dimensions of aging , 2000 .

[62]  Seanne Wilkins,et al.  Guidelines for critical review form - Qualitative studies (version 2.0), McMaster University Occupational Therapy Evidence-Based Practice Research Group , 2007 .

[63]  A. Innes,et al.  Measuring the well-being of people with dementia living in formal care settings: The use of Dementia Care Mapping , 2001, Aging & mental health.

[64]  L. Gerdner,et al.  Effects of Individualized Versus Classical “Relaxation” Music on the Frequency of Agitation in Elderly Persons With Alzheimer's Disease and Related Disorders , 2000, International Psychogeriatrics.

[65]  D. Milke,et al.  Meeting the Needs in Continuing Care of Facility-Based Residents Diagnosed With Dementia: Comparison of Ratings by Families, Direct Care Staff, and Other Staff , 2006 .

[66]  N. Watson,et al.  Meaning and Practice of Palliative Care for Nursing Home Residents With Dementia at End of Life , 2008, American journal of Alzheimer's disease and other dementias.

[67]  G. Grossberg,et al.  Unmet visual needs of Alzheimer's disease patients in long-term care facilities. , 2005, Journal of the American Medical Directors Association.

[68]  Laura Bleiler,et al.  Alzheimer's Association Update , 2008, Alzheimer's & Dementia.

[69]  Richard C Zink,et al.  Effect of Person‐Centered Showering and the Towel Bath on Bathing‐Associated Aggression, Agitation, and Discomfort in Nursing Home Residents with Dementia: A Randomized, Controlled Trial , 2004, Journal of the American Geriatrics Society.

[70]  P. Rabins,et al.  Prevalence and treatment of neuropsychiatric symptoms in advanced dementia. , 2008, Journal of gerontological nursing.

[71]  M. Snowden,et al.  Evidence-based interventions for nursing home residents with dementia-related behavioral symptoms. , 2005, Psychiatric Clinics of North America.

[72]  Bob Woods,et al.  The needs of older people with dementia in residential care , 2006, International journal of geriatric psychiatry.

[73]  Ann Kolanowski,et al.  A Randomized Clinical Trial of Theory‐Based Activities for the Behavioral Symptoms of Dementia in Nursing Home Residents , 2011, Journal of the American Geriatrics Society.

[74]  M. Orrell,et al.  The needs of people with dementia in care homes: the perspectives of users, staff and family caregivers , 2008, International Psychogeriatrics.

[75]  Lori A. Mitchell,et al.  Beyond the ‘Iron Lungs of Gerontology’: Using Evidence to Shape the Future of Nursing Homes in Canada* , 2011, Canadian Journal on Aging / La Revue canadienne du vieillissement.

[76]  B. Resnick,et al.  'Knowing what makes them tick': motivating cognitively impaired older adults to participate in restorative care. , 2009, International journal of nursing practice.

[77]  C. Camp,et al.  Montessori-Based Dementia Programming®: Providing tools for engagement , 2007 .