January 12, 2017

Journal of Dementia Care Vol 25 No. 1 Jan / Feb 2017

Journal of Dementia Care  vol 25 No. 1  Jan / Feb 2017
Full text articles and books are available to members of Alzheimer’s Australia NSW by emailing NSW.Library@alzheimers.org.au

In an environment where many hospitals are struggling to cope with the rise in demand and inadequate resources, what are the challenges and opportunities in acute care for people with dementia …includes letting staff know  who has dementia, training staff, address the under recognition of pain and delirium …p 10-11

What is dementia and how big is the problem?

Authors argue that social support and dementia prevention may be a more sensible approach to investment rather than seeking cures… looks at the limits of medicine, scale of the problem, brain  protection… p 16-17

Engaging mealtimes a chef’s perspective

…how do you awaken the appetite in someone who is losing interest in food – here are some tips … article explores smell, taste, sound, touch, sight…tips on presentation.. painting balance and colour…shapes and textures and flavours and portion size and temperature all matter. And this article gives you tips on how to do all of these things! P 18-19
*related books include:
It's all about the food not the fork!
Everyone enjoys the fun and convenience of snacks and other easy to eat food.
But for some people these meals in a mouthful are a life-changer—especially if they can be eaten with your hands and are good for you as well. That’s where new cookbook It’s all about the food not the fork! 107 easy to eat meals in a mouthful comes in—no cutlery required!
Don't give me eggs that bounce : 118 cracking recipes for people with Alzheimer's
It's all about how to make mealtimes a pleasurable, social and safe experience in the context of dementia, ageing, swallowing difficulties and texture-modified diets.
Carers are especially supported with time saving techniques, easy options and a special chapter on caring for the carer, along with lists of support organisations and resources.       


“Soul journey” to feelings of renewal and fulfilment

This is a film and exhibition project that aims to shatter the common stereotypes and celebrate the creativity of people affected by dementia. Rather than relying on reminiscence and memory based activities they have weaved together songs and poems and movement and dance around particular themes generating safe stimulating conversation, connection and creative expression…p. 20- 21

see the film here https://vimeo.com/105216846

Creating community across generations

Project of bringing adults with dementia and pre-school children together in creative fun activities …involves a 5 week project – observable benefits include:

  • Feel good factor

  • Co-participation in activities

  • Sense of accomplishment

  • Sense of self, expression, self-worth …. P22-23

Imagine …a creative partnership with equal arts

What does it take to be an outstanding care home? Innovative arts initiative wins praise …equal arts program makes people with dementia use their imaginations in the belief that these activities they will be able to enjoy a sense of enjoyment in acheimvements.ie meaningful activities increase well-being …p24-25

Life story work that brought wide benefits

Both facilitated reminiscence and had much wider benefits in supporting people to live well...writing a life story – highly individualised using different methods such as voice recorder …. Included personal photographs, non-personal photographs , internet based resources, conversations with close friends , life events charts ….p26-28
*related books include:
It started with a sea-shell : life story work and people with dementia
Dementia Services Development Centre (University of Stirling)
Establishes the importance of life story work for people with dementia; argues that everyone can get involved and offers practical ideas and a charter of good practice.
Contents: 1. Life story: a view from the literature -- 2. The experience of doing life story work -- 3. Good practice in doing life story work and compiling life story books -- 4. Getting life story work to happen.

Digital technology and dementia: changing lives

Learning how to use digital technology can help people with dementia live more positive lives with memory loss. Tom French discusses key findings from a study showing how new “tech” can maintain mental activity and communication with family and friends..

Key findings – touchscreen technology and the use of stripped back simple interfaces are very successful in helping people with dementia to use technology…by including personalised icons…using multisensory approaches helped with using email and skype with people with dementia … the most popular activities included games and puzzles which the people with dementia could other-wise not do anymore in the physical form – this improved their confidence and sense of accomplishment… project found that community support was necessary as well as internet connection…article includes tips such as training staff adequately , making it personal ; engaging family members ; embedding technology in care plans…p28-31

Dementia: there are so many apps for that…

Digital technology is changing the world, but is it doing the same for people with dementia? Phil Joddrell and Arlene Astell argue that it can, so long as tablet computer “apps” are adapted so that everyone can enjoy using them. In 2012, a survey of Alzheimer’s Society members found that there was a huge unmet need for activities among people with dementia. Activities can make people happy and more alert or tackle boredom and  reduce distress. Caregivers get stressed when the individuals they care forare bored or restless, but they often feel they do not have time to organise activities. So activities that someone with dementia can do on their own can be genuinely beneficial if chosen carefully (NICE-SCIE 2007).

More and more carers, both in care homes and living at home, are buying touchscreen tablet computers such as iPads. Out of the box, these computers have little to offer beyond basic tasks such as internet surfing and emails as so much of their use relies on apps. The degree to Therefore, the AcTo Dementia project focuses on apps that are currently available, with four key aims:

• identifying features of current touchscreen apps that increase their accessibility for people living with dementia

• creating an evidence-based, publicly available app selection framework to support people to find touchscreen apps that can be considered “dementia friendly”

working with app developers to improve the accessibility of existing apps for people living with dementia

• making a website where we can share dementia-friendly apps with the public, as well as offering support guides and a community forum for use by people with dementia or people delivering formal or informal dementia care.
* we also have a reading list that we can send you of useful apps.

January 11, 2017

DVD review by one of our carers

*these are available for loan to members of AANSW - if you would like to reserve them please email the Library on nsw.library@alzheimers.org.au

The Caring Spirit Approach to Eldercare - a Training Guide for Professionals and Families.


This is a very good resource and could be useful in several forums, as the title indicates; it's certainly not preachy and doesn't focus on one source of spirituality; However, it also doesn't go into "new age" thinking either, which is an important point for me in this type of resource. 


It would be great material, for example, for the young onset dementia carers monthly support group that I attend - to take one of the topics, like Spiritual Approaches to Coping with Stress, or Helping a Family Member Finish Well. I would thoroughly recommend its use in this setting, with appropriate support staff in attendance, of course.


Some quotes: 

"Caring is an act of loving kindness that places two people in a sacred space together" (p.5)

"There is more to life than merely increasing its speed." Mahatma Ghandi, (p15)

"... each of us may have left far more behind us than we may ever know." Rachel Naomi Remen from My Grandfather's Blessings. (p.73)

"... Leadership needs to create a meaningful role and place in our society for our elders. They believe that role is one of sage." (p.75)

"The death of an old person is like the burning of a library." Alex Haley (p194)


Teepa Snow

I've also watched the first of the 2 DVD's: 2-1/2 hours!

It's quite enthralling; once you get used to her "out there" style of presentation (which can be quite irritating if you get hung up on it) it's one of the most beautiful and clear and insightful demonstrations I've ever encountered in revealing the impact of dementia on one's personhood. It's loosely set in the "church community" and "church community functionality" but that doesn't preclude its relevance to any setting in society. It's absolutely beautiful and moving in parts, very funny in others. I'm looking forward to watching the 2nd DVD, which is the same length.


I believe this is a most powerful tool that any teaching scenario could use in educating care workers, carers, family members to walk the journey more compassionately with their loved one or their client/patient living with dementia.

  Teepa Snow DVD - a must see for any community
Spirituality in Dementia Care

with Teepa Snow and Rev. Linn Possell
  1. Have you struggled to meet the spiritual needs of a family member living with dementia?
  2. Do you run a faith-based organization and would like to know how to best help a person living with dementia and their families stay connected to their community of faith?
  3. Learn with dementia expert Teepa Snow and Reverend Linn Possell about basic spiritual needs throughout life, what may or may not change when someone is living with dementia and how to best meet those needs.
Watch this program and learn
◾How to meet the spiritual needs that remain when a person is in the midst of brain change
◾How to connect with the spirit of someone living with dementia to create a “soul to soul” relationship
◾How to help family members better manage feelings of guilt, sadness and grief
◾How to offer the highest quality of life by focusing on what the person living with dementia is still able to

Facilitating spiritual reminiscence for people with dementia

Elizabeth MacKinlay and Corinne Trevitt,                           

The authors begin by positioning themselves firmly in the positive dementia care camp, putting the person before the dementia, and operating groups which are inclusive and respectful, emphasising remaining strengths, promoting engagement and facilitating communication. They clearly have an understanding of the value of reminiscence and cite the usual sources to indicate how it is a natural part of the ageing process and a ‘positive activity with educational, recreational, social and therapeutic benefits’ . They also attempt to explain their concept of spirituality as addressing the
core or ultimate meaning of life, covering relationships, creation/environment, religion, and the Arts. This definition of spirituality, even with accompanying diagrams, is far from clear and appears to accommodate almost every kind of reflection whether as retrospective or as experienced in the present. My understanding is that they see the four aspects of spirituality as different routes to spiritual experience and addressing the big questions in life concerning hope, fear, sorrow, religious faith and the meaning of human existence....
To be diagnosed with dementia is "like being blindfolded and let loose in a maze". There is no clear treatment to follow, because each case is unique. But once thickets of misunderstanding and misinformation are brushed aside, there are pathways to hope. "Secular models of support don't adequately reflect Christian values of compassion, love and service," explains Louise Morse. "Neither do they describe the power of spiritual support. This is key to the wellbeing of the caregiver, as well as the person with dementia." This book is packed with examples of what works, as well as practical advice and accessible medical information. Louise Morse is a cognitive behavioural therapist and works with a national charity whose clients include people with dementia. Her MA dissertation, based on hundreds of interviews, examined the effects on families of caring for a loved one with dementia.

new issue of Austrailan Journal of Dementia Care DECEMBER/JANUARY 2016-17

Full text articles and books are available to members of Alzheimer’s Australia NSW by emailing NSW.Library@alzheimers.org.au
Projects updates and viewpoints
Love, personhood and dementia
Australia’s 1st symposium on dementia and love aims to help service providers and community members understand how small acts of love can enrich people’s lives… in a survey conducted by Alzheimer’s Australia people living with dementia said they want support to continue to live well and continue to be involved in things they used to enjoy and that a time when people need the most support often many walk away….
The story of Anne Basting
John Killick continues his  series of articles exploring the history of dementia through the stories of individuals … looks at the amazing ‘timeslips program –which leads to increase in the quality of interactions between staff and residents and between residents themselves
·         Improves the attitudes of staff to people with dementia
·         Reduces the need for medications
·         Decreases distress
·         Reduces stigma

Connecting in the land of dementia: creative activities to explore together by Deborah Shouse
 This practical book offers caregivers hands-on ideas for meaningful, creative activities they can do with their patients, family members, or friends who have dementia.
 This book offers care partners practical, hands-on ideas for meaningful, creative activities they can do with their patients, family members, or friends who have dementia. It also includes creative tips for busy care partners, offering quick and easy forms of renewal and respite.
Too often, people living with dementia are entertained instead of engaged.
 Research shows that artistic and imaginative activities reduce the need for psychotropic medications. Doing activities together also increases social interactions, builds positive energy, and adds a sense of discovery to the day...  features the innovative ideas of about seventy thought leaders in the field of dementia and creativity. Both family and professional care partners can use these activities, in areas such as music, movement, cooking, nature, storytelling, poetry, movies, technology, and more, to engage and connect with people who are living with dementia.
book review
“Deborah has created an assuring, light of heart and deep in wisdom weaving of the great thinkers and practitioners in the field of dementia care. Here you will find bite-sized, inspirational approaches to being in company with someone with memory loss. From music to food, from painting to storytelling, she invites family members to move past resistance (and understandable grieving) to open themselves to a world of connection through creativity.”--Anne Basting
Professor of Theatre, University of Wisconsin-Milwaukee & President, TimeSlips Creative Storytelling - 
Forget memory : creating better lives for people with dementia
Memory loss can be one of the most terrifying aspects of a diagnosis of dementia. Yet the fear and dread of losing our memory make the experience of the disease worse than it needs to be, according to cultural critic and playwright Anne Davis Basting. She says, Forget memory. Basting emphasizes the importance of activities that focus on the present to improve the lives of persons with Alzheimer's disease and other dementias.
Based on ten years of practice and research in the field, Basting's study includes specific examples of innovative programs that stimulate growth, humour, and emotional connection; translates into accessible language a wide range of provocative academic works on memory; and addresses how advances in medical research and clinical practice are already pushing radical changes in care for persons with dementia.
Bold, optimistic, and innovative, Basting's cultural critique of dementia care offers a vision for how we can change the way we think about and care for people with memory loss...
The Penelope Project An Arts-Based Odyssey to Change Elder
We must transform long-term care into an experience we and our loved ones can face without dread. It can be done. The Penelope Project shows how by taking readers on an ambitious journey to create a long-term care community that engages its residents in challenging, meaningful art-making.
At Milwaukee’s Luther Manor, a team of artists from the University of Wisconsin’s theatre department and Sojourn Theatre Company, university students, staff, residents, and volunteers traded their bingo cards for copies of The Odyssey. They embarked on a two-year project to examine this ancient story from the perspective of the hero who never left home: Penelope, wife of Odysseus. Together, the team staged a play that engaged everyone and transcended the limits not just of old age and disability but also youth, institutional regulations, and disciplinary boundaries.
Inviting readers to see through the eyes of residents, students, artists, staff, family members, and experts in the fields of education, long-term care, and civically engaged arts practice, this book underscores the essential role of the arts and humanities in living richly. Waiting, as Penelope waited, need not be a time of loss and neglect. The Penelope Project boldly dreams of how to make late life a time of growth and learning. If you dream of improving people’s lives through creative endeavors, this book provides practical advice. 
Turning tears into laughter
Medical student Gabrielle Cher’s National dementia essay recounts her family’s  personal journey with Alzheimer’s disease and the impact it’s had on her approach to caring for people with dementia
P 11
Creating culturally appropriate care for people with dementia
Colin McDonnell explains how to create residential care environments that support the needs of older people with dementia from culturally and linguistically diverse (CALD) backgrounds
This includes an Italian style piazza for Scalabrini Village’s new care home in Sydney…
Cultural heritage has been largely forgotten and neglected in the past and many continue to base their care philosophy  on a model that is tasks orientated rather than person centred with bland and culturally neutral physical environments that are particularly foreign…this article includes a table of CALD dementia care resources ; creating a home for CALD residents ; keeping culture in mind ; creating culturally appropriate living environments and designing for CALD people with dementia.
Using sensory stories for individuals with dementia
People with dementia are prone to sensory deprivation , but the symptoms like irritability and confusion may be reduced by using multisensory life stories. Look at 2 successful approaches to sensory life work. Looks at Narrative and sensory interventions and the benefits of these ; sensory stories and group sensory story telling …
Learning from Japan : social projects with business links
The dementia care home can profit from observation of practice abroad …
Training  and support features
How the DTSCs established pathway for dementia training in Australia
P 24
DTA offers new approach to workforce education
P 28
Dementia Essentials  vocational training a first for Australia
For the first time ever in Australia  nationally consistent vocational dementia specialist training will be provided 

Dementia Essentials - NSW

Dementia Essentials is the new Unit of Competency CHCAGE005 Provide support to people living with dementia, which sits within the Certificate III Individualised Support/Ageing and Certificate IV Aged Care.
Alzheimer's Australia NSW has expanded the Dementia Essentials course to genuinely focus on true person-centred practice when supporting a person living with dementia.  We are able to offer this education FREE to organisations and individuals working in the Health, Community Care and Aged Care sectors throughout NSW who provide support to people living with dementia.
All our educators are vocational education and training (VET) qualified with extensive industry experience in the health, residential aged care and community care sectors.  Our team is fully committed to supporting participants reach competency, maximising the transfer of knowledge to practice.
Our delivery options are:
  • In a venue within the community for individual professionals within the community, or
  • “In-house” within a residential aged care facility for their staff. For delivery within a facility we would require a specific training room to accommodate approximately 15-22 participants.
Dementia Essentials – CHCAGE005 Provide support to people living with dementia
The Dementia Essentials training program comprises of 6 modules delivered over 3 days.
The modules are as follows:
Module 1 – The nature of dementia
                  Changed Behaviour
Module 2 – The impact of dementia
                  Elder abuse and restraint
Module 3 – The environment of care
                  Person centred care
Module 4 – Communication
Module 5 – Purposeful and meaningful engagement
Module 6 – Application to care practice
As Dementia Essentials is an accredited course, participants are required to attend all 3 days and complete assessment work to reach competency. Assessment comprises an “open book” in-class written assessment followed by a workplace supervisor observation checklist. The observation checklist provides evidence towards the participant demonstrating their learning in their practice, supporting  2 people living with dementia. Workplace observation sign off will be the responsibility of the participant’s supervisor.
Participants who complete the course and reach competency will receive a certified Statement of Attainment.
To see the community workshops please click on https://www.eventbrite.com.au/ (link is external) to go to Eventbrite.  In the search events Enter “Dementia” “NSW” Äll dates”.    All the sessions for Dementia Essentials will come up.  Select the location and date you would like to attend and select register to commence your enrolment process.
P 28
Optimising medication management
Dementia Training Australia – looks at dementia –friendly pharmacy toolkit ; medication management consultancy ; online resources for pharmacists and new expertise and insight – in the need to continue training …
P 29
Designing for people with dementia finds a new home-
Looks at the growing knowledge base and tailored training packages…
P 30

Behaviour consultation program supports change
P 31
New online dementia courses in the pipeline for DTA
P 32
Fellowships to help care teams put knowledge into practise
P 33
Dementia support Australia the new gateway to DBMAS, SBRT
  • Includes DSA : a quick reference guide
  • Key national partners
  • Clinical and consultancy appointments
  • Nationally consistent and local presence
  • Building capacity and knowledge
  • Changing the thinking and language
  • On the ground local experts
Special features: A new approach to dementia training and support
On 1 October 2016, Dementia Training Australia (DTA) and Dementia Support Australia (DSA) became the new Government-appointed providers of dementia care training, education, support and services throughout Australia. This issue of AJDC looks at what they are offering health professionals and carers, as well as reflecting on the dementia training legacy created by the DTSCs.

January 04, 2017

the latest American Journal of Alzheimer's Disease & Other Dementias

Full text articles and books are available to members of Alzheimer’s Australia NSW by emailing NSW.Library@alzheimers.org.au

American Journal of Alzheimer's Disease & Other Dementias

 Current Issue : Volume 31, Issue 8, December 2016

Table of Contents

Errorless learning (EL) is an instructional procedure involving error reduction during learning. Errorless learning is mostly examined by counting correctly executed task steps or by rating them using a Task Performance Scale (TPS).
Here, we explore the validity and reliability of a new assessment procedure, the core elements method (CEM), which rates essential building blocks of activities rather than individual steps.
Task performance was assessed in 35 patients with Alzheimer’s dementia recruited from the Relearning methods on Daily Living task performance of persons with Dementia (REDALI-DEM) study using TPS and CEM independently.
Results showed excellent interrater reliabilities for both measure methods (CEM: intraclass coefficient [ICC] = .85; TPS: ICC = .97). Also, both methods showed a high agreement (CEM: mean of measurement difference [MD] = −3.44, standard deviation [SD] = 14.72; TPS: MD = −0.41, SD = 7.89) and correlated highly (>.75). Based on these results, TPS and CEM are both valid for assessing task performance. However, since TPS is more complicated and time consuming, CEM may be the preferred method for future research projects


We aimed to confirm the effectiveness of brain-activating rehabilitation (BAR) performed in the day care setting at an acute hospital. Brain-activating rehabilitation is based on 5 principles: developing a pleasant atmosphere, promoting communication, praising patients, giving patients a social role, and providing supportive care. A total of 48 patients with dementia or cognitive impairment were selected and randomly divided into the intervention and control groups. The BAR-based intervention was conducted for 1 hour, 3 times a week. The patients’ score of the Multidimensional Observation Scale for Elderly Subjects (MOSES) were used as outcome measures. Repeated-measures analysis of covariance detected a significant interaction between the MOSES disorientation (F = 4.437, P = .041) and the withdrawal (F = 5.052, P = .030) subscales. A BAR-based intervention performed at our acute hospital was effective at maintaining and improving the cognitive and psychosocial functioning of patients with dementia or cognitive impairment.


2016; pp. 618–630
Spatial navigation is one of the cognitive functions known to decline in both normal and pathological aging. In the present study, we aimed to assess the neural correlates of the decline of topographical memory in patients with amnestic mild cognitive impairment (aMCI). Patients with aMCI and age-matched controls were engaged in an intensive learning paradigm, lasting for 5 days, during which they had to encode 1 path from an egocentric perspective and 1 path from an allocentric perspective. After the learning period, they were asked to retrieve each of these paths using an allocentric or egocentric frame of reference while undergoing a functional magnetic resonance imaging scan. We found that patients with aMCI showed a specific deficit in storing new topographical memories from an allocentric perspective and retrieving stored information to perform the egocentric task. Imaging data suggest that this general decline is correlated with hypoactivation of the brain areas generally involved in spatial navigation.


 2016; pp. 631–642
This study tested the effect of written emotional expression on the ability to find meaning in caregiving and the effects of finding meaning on emotional state and psychological burden in 91 dementia family caregivers. In a pretest–posttest design, participants were randomly assigned to either an experimental or a comparison group. Experimental caregivers (n = 57) wrote about their deepest thoughts and feelings about caring for a family member with dementia, whereas those in the comparison group (n = 34) wrote about nonemotional topics. Results showed enhanced meaning-making abilities in experimental participants relative to comparison participants, particularly for those who used more positive emotion words. Improved meaning-making ability was in turn associated with psychological benefits at posttest, but experimental participants did not show significantly more benefit than comparison participants. We explore the mediating roles of the meaning-making process as well as some of the background characteristics of the individual caregivers and their caregiving environments.

2016; pp. 643–649
To determine the predictors of cognitive decline in a rural and remote population with Alzheimer’s disease (AD), we examined the association between cognitive change and sociodemographic, clinical, and functional data at the initial day of diagnosis. Simple linear regression analysis and multiple regression analysis were used to determine the predictors of cognitive decline as measured by the difference in the Mini-Mental State Examination over 1 year. Our sample included 72 patients with AD. Age at the clinic day appointment was 75.3 (standard deviation [SD] = 7.44). History of hypertension and decreased ability to carry out activities of daily living were statistically significant and predicted greater cognitive decline at 1 year. Many previously suggested predictors of cognitive decline were not evidenced in this study. This research helps identify clinically useful predictors of decline in a rural and remote population with AD.

 2016; pp. 650–657
To explore the optimal cutoff score for initial detection of Alzheimer’s Disease (AD) through the Chinese version of Mini-Mental State Examination (CMMSE) in rural areas in China, we conducted a cross-sectional study within the Linxian General Population Nutritional Follow-up study. 16,488 eligible cohort members participated in the survey and 881 completed the CMMSE. Among 881 participants, the median age (Interquartile range) was 69.00 (10.00), 634 (71.92%) were female, 657 (74.57%) were illiterate, 35 (3.97%) had 6 years of education or higher, and 295 (33.48%) were diagnosed with AD. By reducing the CMMSE criteria for illiterate to 16 points, primary school to 19 points, and middle school or higher to 23 points, the efficiency of Chinese version of Mini-Mental State Examination can be significantly improved for initial detection of AD in rural areas in China, especially in those nutrition deficient areas.

2016; pp. 658–663
We sought to investigate whether the Montreal Cognitive Assessment (MoCA) could provide a brief assessment of recall and recognition using Huntington disease (HD) and Alzheimer disease (AD) as disorders characterized by different memory deficits. This study included 80 participants with HD, 64 participants with AD, and 183 community-dwelling control participants. Random-effects hierarchical logistic regressions were performed to assess the relative performance of the normal control (NC), participants with HD, and participants with AD on verbal free recall, cued recall, and multiple-choice recognition on the MoCA. The NC participants performed significantly better than participants with AD at all the 3 levels of assessment. No difference existed between participants with HD and NC for cued recall, but NC participants performed significantly better than participants with HD on free recall and recognition. The participants with HD performed significantly better than participants with AD at all the 3 levels of assessment. The MoCA appears to be a valuable, brief cognitive assessment capable of identifying specific memory deficits consistent with known differences in memory profiles.

Grace Suva Victoria McLelland

 2016; pp. 664–677

Education is needed for enhanced capacity of acute hospitals to provide dementia care. A nonrandomized controlled, repeated-measures design was used to evaluate a dementia education program delivered to an intervention group (IG, n = 468), compared to a wait-listed group (n = 277), representing separate sites of a multisite hospital. Participants completed self-efficacy for dementia and satisfaction measures and provided written descriptions of dementia care collected at baseline, postintervention (IG only), and at 8-week follow-up. Oral narratives were gathered from IG participants 8 weeks postintervention. The IG demonstrated significant improvement in self-efficacy scores from baseline to immediately postintervention (P < .001), sustained at 8 weeks. There were no changes from baseline to 8 weeks postintervention evident in the wait-listed group (P = .21). Intervention group participants described positive impacts including implementation of person-centered care approaches. Implementation of dementia care education programs throughout hospital settings is promising for the enhancement of dementia care.

2016; pp. 678–686
This study evaluated the risk of cognitive decline associated with paroxetine use in elderly nursing home patients with depression.
There was no differential effect of paroxetine on cognition when compared to other SSRIs.

 2016; pp. 687–692
The purpose of the project, Centers for Medicare & Medicaid Services (CMS) Innovation study, was to evaluate the impact on 12 quality measures including 10 Minimum Data Set (MDS) publicly reported measures and 2 nursing home process measures using habilitation therapy techniques and a behavior team to manage dementia-related behaviors. A prospective design was used to assess the changes in the measures. A total of 30 Massachusetts nursing homes participated in the project over a 12-month period. Project participation required the creation of an interdisciplinary behavior team, habilitation therapy training, facility visit by the program coordinator, attendance at bimonthly support and sharing calls, and monthly collection of process measure data. Participating facilities showed improvement in 9 of the 12 reported measures. Findings indicate potential quality improvement in having nursing homes learn habilitation therapy techniques and know how to use the interdisciplinary team to manage problem behaviors


Janet Sansoni  (1Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia)

Cathy Duncan (1Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia)

Pamela Grootemaat (1Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia)
Jacquelin Capell (1Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia)

Peter Samsa (1Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia)
Anita Westera ( 1Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia

 2016; pp. 693–705
This literature review focused on the experience, care, and service requirements of people with younger onset dementia. Systematic searches of 10 relevant bibliographic databases and a rigorous examination of the literature from nonacademic sources were undertaken. Searches identified 304 articles assessed for relevance and level of evidence, of which 74% were academic literature. The review identified the need for (1) more timely and accurate diagnosis and increased support immediately following diagnosis; (2) more individually tailored services addressing life cycle issues; (3) examination of the service needs of those living alone; (4) more systematic evaluation of services and programs; (5) further examination of service utilization, costs of illness, and cost effectiveness; and (6) current Australian clinical surveys to estimate prevalence, incidence, and survival rates. Although previous research has identified important service issues, there is a need for further studies with stronger research designs and consideration of the control of potentially confounding factors.

2016; pp. 706–716
Eating problems and dietary changes have been reported in patients with dementia.
The aim of this article is to explore the generalized problems with nutrition, diet, feeding, and eating reported among patients with dementia.
Medline and Google Scholar searches were conducted for relevant articles, chapters, and books published before 2016. Search terms used included behavioral and psychological symptoms of dementia, dementia, dietary changes, eating behavior. Publications found through this indexed search were reviewed for further relevant references.
Abnormal eating behaviors, eating problems, and dietary changes are present in most people with dementia, especially in the later stages of the condition.
Individuals with dementia frequently develop serious feeding difficulties and changes in eating and dietary habits. The changes may be secondary to cognitive impairment or apraxia, or the result of insufficient caregiving, or the consequence of metabolic or neurochemical abnormalities occurring as part of the dementing process.


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