Taking ACTION to Manage Dementia Care Caring for a loved one with dementia can oftentimes go hand-in-hand with challenging situations that may lead us to feel stress and uncertainty about how to manage our loved one’s care. It can become overwhelming, especially for one person, but there are steps we can take to minimize the burden and make progress. Action planning gives us guidance and support to meet our caregiving needs and manage our loved one’s care by breaking down larger goals into small, manageable steps towards solutions to potential challenges. Read more
Impact of service dogs on family members’ psychosocial functioning The study evaluated the effects of service dogs on psychosocial health and indicators of wellbeing among individuals with physical disabilities or chronic conditions. Findings suggested that service dogs may have measurable effects on specific aspects of psychosocial health for individuals with physical disabilities or chronic conditions. Read more
The Psychometric Properties of a New Oral Health Illness Perception Measure for Adults aged 62 Years and Older Abstract BACKGROUND: Based on the Common-Sense Model of Self-Regulation (CSM), a new integrated Illness Perception Questionnaire Revised for Dental Use in Older/Elder Adults (IPQ-RDE) was developed for single and multiple dental conditions. This study describes psychometric properties of the IPQ-RDE for adults 62 years and older. METHODS: Participants (n = 198) living in 16 subsidized housing facilities completed the IPQ-RDE and a questionnaire assessing their socio-demographics, frequency of dental visits, perceived condition of teeth/gums, depression, social support, and oral health quality of life (OHQOL). Participants received dental screening for presence/absence of teeth, coronal and root caries, and periodontitis. The 43-item IPQ-RDE was tested for internal (construct, discriminant) and external validity (concurrent, construct, discriminant, predictive) and reliability (internal consistency). RESULTS: Confirmatory factor analysis demonstrated that a ten-factor model in accordance with the CSM framework (identity, consequences, control, timeline, illness coherence, treatment burden, prioritization, causal relationship, activity restriction, emotional representations) had good construct validity based on significant factor loadings and acceptable model fit (RMSEA = 0.065, CFI = 0.902). Edentulous participants had significantly higher mean factor scores (inaccurate perception) for overall IPQ-RDE and four constructs indicating concurrent validity. Discriminant validity was suggested by non-relationship with external measures (education, dental visit frequency). Predictive validity was indicated by the negative correlation of most constructs with OHQOL suggesting that inaccurate perception was related to lower quality of life. Internal consistency of eight IPQ-RDE constructs was excellent (Cronbach's alpha > 0.73). CONCLUSIONS: The IPQ-RDE is a valid and reliable new measure for assessing older adult's perception of dental conditions. It can be an important tool for oral health behavioral research to restructure older adult's perception of dental conditions, and subsequently prevent tooth loss and improve oral health quality of life. Read more
The Effects of Service Dogs on Psychosocial Health and Wellbeing for Individuals With Physical Disabilities or Chronic Conditions Purpose: To evaluate the effects of service dogs on psychosocial health and indicators of wellbeing among individuals with physical disabilities or chronic conditions. Materials and methods: A total of 154 individuals participated in a cross-sectional survey including 97 placed with a mobility or medical service dog and 57 on the waitlist to receive one. Hierarchical regression evaluated the effect of having a service dog on standardized measures of psychosocial health (Pediatric Quality of Life Inventory) as well as anger, companionship, and sleep disturbance (Patient Reported Outcome Measurement Information System). Among those with a service dog, the Monash Dog–Owner Relationship Scale quantified the human–animal bond. Results: Results indicated that compared to those on the waitlist, individuals with a service dog exhibited significantly better psychosocial health including higher social, emotional, and work/school functioning. There was no significant effect of having a service dog on anger, companionship, or sleep disturbance. Among those with a service dog, emotional closeness, dog–owner interaction, and amount of time since the service dog was placed were weak correlates of outcomes. Conclusions: Findings suggest that service dogs may have measurable effects on specific aspects of psychosocial health for individuals with physical disabilities or chronic conditions. Read more
The Impact of a Care Recipient’s Pet on the Instrumental Caregiving Experience Older adults report strong emotional bonds with their pets which often become increasingly important as health declines and dependence upon others increases. Individuals requiring assistance meeting their own needs are likely to need assistance in meeting the needs of their pet. The care recipient’s pet may be an important, though presently overlooked, factor in the caregiving experience. This study measured the amount of care tasks/ activities informal caregivers of older adults devoted to their care recipients’ pet. Caregivers for an individual aged 50 and older who did not consider the care recipient’s pet to be his/her own animal completed an online questionnaire. Descriptive statistics and Pearson correlations were used in analyses. Caregivers (N = 34) performed an average of 14.9 (SD = 5.4) different pet care tasks/activities and an average of 11.21 (SD = 1.33) hours per week in pet care. The total number of tasks/activities performed was significantly and positively correlated with the care recipients’ degree of functional limitation (r = 0.49, p = 0.004). Care recipients’ pets may be a significant factor in shaping the instrumental caregiving experience. Read more
Effectively Selecting Evidence-Based Programs A New Online Resource to Compare Evidence-Based Dementia Caregiving Read more
Turnover Among Community Mental Health Workers in Ohio This study examined turnover of community mental health workers in 42 randomly selected mental health agencies in Ohio. The turnover rate in 2011 was 26%. A regression analysis indicated that agencies with lower turnover offered higher maximum pay and were smaller in size, while those offering career advancement opportunities, such as career ladder programs, had higher turnover. The findings suggest that improving wages for workers is likely to reduce turnover. It is also possible that smaller agencies have lower turnover due to stronger relationships with workers and/or more successful hiring practices. Furthermore, turnover that occurs as a result of career advancement could have positive effects and should be examined separate from other types of turnover in the future. Read more
The Support, Health, Activities, Resources, and Education Program for Early Stage Dementia Results From a Randomized Controlled Trial Purpose: A randomized controlled trial was conducted to test the effectiveness of the Support, Health, Activities, Resources, and Education Program. This six-session psycho-educational program provides dyadic counseling for individuals in the early stages of dementia and their family caregivers. The goal is to prevent common problems in care that emerge during the course of dementia by (1) actively engaging the person with dementia in developing a balanced plan of future care with his/her caregiver, (2) increasing use of available services, (3) enhancing dyadic relationship functioning, (4) improving well-being, and (5) evoking satisfaction with components of the intervention. Design and methods: Persons with early stage dementia (n = 128) and their caregivers (n = 128) were randomly assigned either to Support, Health, Activities, Resources, and Education Program or a control condition. Intervention efficacy was evaluated for completion of a care plan, use of services, dyadic relationship functioning, participant well-being, and program satisfaction. Results: Dyads in the treatment condition were able to construct a balanced care plan and increased their use of services. Dyadic functioning improved for one dimension (decreased emotional disruptions). Compared to the control condition, satisfaction with the intervention was higher for caregivers enrolled in Support, Health, Activities, Resources, and Education Program on four of five dimensions and one dimension for persons with dementia. Implications: Support, Health, Activities, Resources, and Education Program is a promising prevention approach that takes advantage of the early stage of dementia when both members of the dyad can participate fully in making decisions about later care. Read more
Program Components and Outcomes of Individuals With Dementia Results From the Replication of an Evidence-Based Program This study examines whether the delivery of three components, (a) exercise training, (b) behavior management skill building, and (c) dementia-related education, in an evidence-based program are differentially associated with changes in outcomes for individuals with dementia (IWDs) after 3 months. Data come from 508 IWDs participating in the community replication of the evidence-based “Reducing Disability in Alzheimer’s Disease” program. Regression results indicate that after 3 months, more exercise sessions are associated with improvements in physical functioning, mobility, minutes exercising, and symptoms of depression; more dementia education sessions are related to fewer restricted activity days; and more behavior management sessions are related to more symptoms of depression. As resource-strapped agencies look to best serve participants, further analysis and consideration is needed to determine the ideal balance of program efficacy, feasibility, and resources, as well as program benefits for IWDs and caregivers. Read more
Engagement of Veterans With Dementia in Partners in Dementia Care An Evidence-Based Care Coordination Program This study describes engagement of veterans with dementia in an evidence-based care coordination intervention called Partners in Dementia Care (PDC). PDC uses a person-centered approach that encourages participation by individuals with dementia (IWDs), despite their cognitive impairment. PDC also targets primary family or friend caregivers, who often are the main user of the program. Of the total 316 IWDs, 202 passed a mental status screening and were considered to have engagement potential. The study of actual engagement was based on data from IWDs’ PDC records, combined with data from structured research interviews. Approximately 80% of IWDs with engagement potential had a minimum level of actual engagement in PDC. A smaller subsample was more actively engaged, as indicated by assigned and/or accomplished action steps. Younger IWDs and those self-reporting more memory difficulties had higher levels of engagement. Results describe one example of the extent and limits of IWD engagement in psychosocial interventions. Read more
