Dementia in Nursing Homes

244 Pages·2017·3.441 MB·English

by  Sandra Schüssler, Christa Lohrmann (eds.)

Dementia in
Nursing Homes
Sandra Schüssler
Christa Lohrmann
Editors
Dementia in Nursing Homes
Sandra Schüssler • Christa Lohrmann
Editors
Dementia in Nursing
Homes
Editors
Sandra Schüssler Christa Lohrmann
Medical University of Graz Institute Medical University of Graz Institute
of Nursing Science of Nursing Science
Graz Graz
Austria Austria
ISBN 978-3-319-49830-0 ISBN 978-3-319-49832-4 (eBook)
DOI 10.1007/978-3-319-49832-4
Library of Congress Control Number: 2017940194
© Springer International Publishing AG 2017
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microfilms or in any other physical way, and transmission or information
storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, express or implied, with respect to the material contained herein or for any errors
or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims
in published maps and institutional affiliations.
Printed on acid-free paper
This Springer imprint is published by Springer Nature
The registered company is Springer International Publishing AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Sandra Schüssler and Christa Lohrmann
2 Meaningful Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Jennifer Wenborn
3 Patient-/Person-Centered Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Kathryn A. Weigel
4 Psychosocial Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Evelyn Finnema, Cora van der Kooij, Rose-Marie Dröes,
and Linda Wolter
5 Challenging Behavior in Nursing Home Residents
with Dementia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Martin Smalbrugge, Sandra A. Zwijsen, Raymond C.T.M. Koopmans,
and Debby L. Gerritsen
6 Inclusion and Support of Family Members in Nursing Homes . . . . . 67
Hilde Verbeek
7 P ain in Dementia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Sandra M.G. Zwakhalen
8 S taff Training and Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Eira I. Klich-Heartt
9 C ommunication in Dementia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Paul Watts and Stephen J. O’Connor
10 P olypharmacy in Nursing Home Residents with Dementia . . . . . . . . 123
Rob J. van Marum
11 Quality of Life of People with Dementia in Nursing Homes . . . . . . . . 139
Martin N. Dichter and Gabriele Meyer
12 End-of-Life Care and Advance Care Planning in Dementia . . . . . . . 159
Stephen J. O’Connor
v
vi Contents
13 Depression in Nursing Home Residents with Dementia . . . . . . . . . . . 179
Debby L. Gerritsen, Roeslan Leontjevas, Sandra A. Zwijsen,
Raymond T.C.M. Koopmans, and Martin Smalbrugge
14 Delirium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
John P. Gilmore and Kathryn A. Weigel
15 Dementia Care in Nursing Homes Requires a Multidisciplinary
Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
Jos Schols and Tinie Kardol
16 The Prevention and Reduction of Physical Restraint Use
in Long-Term Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
Jan Hamers
17 Care Dependency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
Ate Dijkstra
Introduction 1
Sandra Schüssler and Christa Lohrmann
Abstract
This chapter provides background information about dementia. In addition, the
methodology and the results of both the systematic literature search in interna-
tional databases and the ensuing online survey with international experts in
dementia, upon which the topics of this book were selected, are presented.
Worldwide, dementia is a great strain on health-care systems, because it is increas-
ing at a rapid rate. Globally, there are now more than 46 million people with demen-
tia, and this number will increase to more than 100 million by 2050 (Prince et al.
2015). The worldwide costs of dementia are also increasing. In 2015, approximately
818 billion US dollars were spent on the treatment and care of dementia patients,
and this will rise to one trillion US dollars in 2018 (Prince et al. 2015). These costs
are higher than for other chronic diseases, like heart disease, stroke, or cancer
(Prince et al. 2013). Currently we have no treatment to cure dementia (WHO 2012;
Prince et al. 2015); therefore, nursing care is a very important aspect of its manage-
ment (Alzheimer’s Society 2014).
Internationally, most people with dementia receive (nursing) care and support
at home (OECD 2015). When dementia progresses, however, increasingly com-
plex care needs arise, making in-home care no longer possible and causing many
people with dementia to move into a nursing home (Braunseis et al. 2012, Morley
et al. 2013; OECD 2015; Prince et al. 2015). In developed countries, often more
than 50% of nursing home residents have dementia (Alzheimer’s Association
S. Schüssler, MSc, BSc (*) • C. Lohrmann
Institute of Nursing Science, Medical University of Graz, Billrothgasse 6, 8010 Graz, Austria
e-mail: [email protected]
© Springer International Publishing AG 2017 1
S. Schüssler, C. Lohrmann (eds.), Dementia in Nursing Homes,
DOI 10.1007/978-3-319-49832-4_1
2 S. Schüssler and C. Lohrmann
2013; Hoffmann et al. 2014; Lohrmann et al. 2015; Matthews et al. 2013). This
shows that dementia is a very important disease for investigation in a nursing
home setting.
Nursing home residents with dementia have a high prevalence of care depen-
dency (28–83%) and various nursing care problems, like incontinence (urinary,
39–88%; fecal, 43–87%; double, 49–65%) or physical restraints (8–60%)
(Schüssler et al. 2014a, b, 2015). These problems also increase over time
(Schüssler and Lohrmann 2015), possibly leading to such negative consequences
as reduced quality of life, high care and treatment cost, as well as a higher mortal-
ity risk (Gustavsson et al. 2011; Lohrmann et al. 2015; OECD 2013; Reid 2008).
Therefore, in-depth knowledge about dementia is essential for nursing and other
health-care staff in order to support dementia-specific care in nursing homes
(Schüssler 2015).
This book provides information on the most important current topics in the field
of dementia in nursing homes, sourced from a literature search and subsequent
online survey. In March 2015, a database search was performed in PubMed and
CINAHL with the keywords dementia, nursing home, (geriatric) nursing, priori-
ties, problems, and needs. In total, 31 priority topics for dementia in nursing homes
were identified (see Figure 1.1). After the identification of the topics, an online
questionnaire was generated using Google Forms with a five-point Likert scale
ranking for each topic with the purpose of identifying its importance for dementia
residents in nursing homes. After this, experts in dementia were ascertained
through Internet search, as well as scans of dementia organizations and university
websites. The online questionnaires were sent via email to 52 dementia experts in
March 2015 who were given 2 weeks to fill out the questionnaire. A total of 56%
of the experts participated in the survey. The results of the survey can be seen in
Figure 1.1. Based on the results, 16 (half of all topics) of the most important topics
identified by the experts were included in this book and written about by interna-
tional experts on dementia.
The content of the book is dedicated to all (academic) nursing professionals,
nursing scientists, nursing students, and other health-care professionals. It will be a
valuable resource for nursing home practice and nursing home research.
1 Introduction 3
sutille
Experts in dementia (n=29) Not ImportantSlightly importantModerately importantimportantVery important 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%ssaegestnysyaysssnyeshggestnannnerrcemrenmttpirnfoiostnncoittineeaieleaonalrnliniouaiuiiiiiia dttonottigktudbnmmciefmiaceaeiabeontvuoutanntasr miiapnrlmocmzahrerdeeoitrp tmaoat tgtiroyuseimaps yveceggusrlipeetelrl acti cpde vahehaumimraeyanpinn m dddseltrr erdrtrsp atandnlSioaeeol ly Oipa iptaeu er dlyhl dyualanisasartdieo,E mstsetlfnslitaenlQmmen o eittgcnlmioni,mlaaHlnwicra caceyuPi bnahi/ a mlbfe moe n-net ravam aie mclsnon-,mgcDfoiirceifsi ceaa-otcoeD iatcnuninfvhlf,nu ctrop llstoyieriieaineFaecnnannrOres rr Mtsi,Fonh dehiatveilouhn/ are iielinptdndo,httNtasierDyacnoBi/aitipecc l- vc uPo apd tyfpirdEn,snfdc iisneautcngyeee nPart,ssanhdiaSRset i iPdansndcdmntrPe onroneeeapiaiatvtsdgcen irns etegdiha eorf,i tin Mkreilissplwirar euoeat pcilswDcgc at, nemne,rgIttera anaydreicrtivsaTs iee ln ncryiro ilfupiioat sa ,donec hocfionn is, ueesumneflicliim ttnfnivoIooi tCdccnnaIE ,noitcnuf lacisyhP Most important topics for dementia in nursing home
1
1.
g.
Fi
4 S. Schüssler and C. Lohrmann
References
Alzheimer’s Association (2013) 2013 Alzheimer’s disease facts and figures. Alzheimers Dement
9:208–245
Alzheimer’s S (2014) Formal care of people with dementia. Alzheimer's Society, London
Braunseis F, Deutsch T, Frese T, Sandholzer H (2012) The risk for nursing home admission (NHA)
did not change in ten years – a prospective cohort study with five-year follow-up. Arch Gerontol
Geriatr 54(2):e63–e67
Gustavsson A, Brinck P, Bergvall N, Kolasa K, Wimo A, Winblad B, Jönsson L (2011) Predictors
of costs of care in Alzheimer’s disease: a multinational sample of 1222 patients. Alzheimers
Dement 7:318–327
Hoffmann F, Kaduszkiewicz H, Glaeske G, van den Bussche H, Koller D (2014) Prevalence of
dementia in nursing home and community-dwelling older adults in Germany. Aging Clin Exp
Res 26(5):555–559
Lohrmann C, Bauer S, Mandl M (2015) Pflegequalitätserhebung 14 (Quality of care survey 14).
Institute of Nursing Science/Medical University of Graz, Austria
Matthews FE, Arthur A, Barnes LE, Bond J, Jagger C, Robinson L, Brayne C (2013) A two-decade
comparison of prevalence of dementia in individuals aged 65 years and older from three geo-
graphical areas of England: Results of the Cognitive Function and Ageing Study I and II. Lancet
382(9902):1405–1412
Morley JE, Ouslander JG, Tolson D, Vellas B (2013) Nursing home care. USA, McGraw-Hill
Education
OECD (2015) Adressing Dementia - the OECD response. OECD publishing, Paris
OECD (Organisation for economic co-operation and development) (2013) A good life in old age?
Monitoring and improving quality in long-term care. OECD, France
Prince M, Prina M, Guerchet M (2013) World Alzheimer report 2013, Journey of caring – an
analysis of long-term care for dementia. Alzheimer’s Disease International, London
Prince M, Wimo A, Guerchet M, Ali G-C, Wu Y-T, Prina M (2015) World Alzheimer report 2015,
The global impact of dementia – an analysis of prevalence, incidence, cost and trends. London,
Alzheimer’s Disease International
Reid C (2008) Quality of care and mortality among long-term care residents with dementia. Can
Stud Popul 35:49–71
Schüssler S, Dassen T, Lohrmann C (2014a) Prevalence of care dependency and nursing care
problems in nursing home residents with dementia: a literature review. Int J Caring Sci
7:333–337
Schüssler S, Dassen T, Lohrmann C (2014b) Care dependency and nursing care problems in nurs-
ing home residents with and without dementia: a cross-sectional study. Aging Clin Exp Res
28(5):973–982. doi:10.1007/s40520-014-0298-8
Schüssler S, Dassen T, Lohrmann C (2015) Comparison of care dependency and related nursing
care problems between Austrian nursing home residents with and without dementia. Eur
Geriatr Med 6(1):46–52
Schüssler S, Lohrmann C (2015) Change in care dependency and nursing care problems in nursing
home residents with and without dementia: a 2-year panel study. PLoS One 10(10):e0141653.
doi:10.1371/journal.pone.0141653
Schüssler S (2015) Care dependency and nursing care problems in nursing home residents with
and without dementia. Dissertation, Medical University of Graz, Austria.
WHO (World Health Organization) (2012) Dementia a public health priority. WHO, Geneva