American Journal of Alzheimer's Disease and Other Dementias - November 2011, Vol 26, No 7

Full text articles are available to fee paying members of Alzheimer’s Australia NSW by emailing lis@alznsw.asn.au


Review of issue
Vitamin D and Alzheimer's: Is There a Relationship?
p. 510

The Beneficial Role of Vitamin D in Alzheimer’s Disease
Patients with AD have a high prevalence of vitamin D deficiency, which is also associated with low mood and impaired cognitive performance in older people. Genetic studies have provided the opportunity to determine which proteins link vitamin D to AD pathology (ie, the major histocompatibility complex class II molecules, vitamin D receptor, renin–angiotensin system, apolipoprotein E, liver X receptor, Sp1 promoter gene, and the poly(ADP-ribose) polymerase-1gene). Vitamin D also exerts its effect on AD through nongenomic factors, that is, L-type voltage-sensitive calcium channels, nerve growth factor, the prostaglandins, cyclooxygenase 2, reactive oxygen species, and nitric oxide synthase. In conclusion, vitamin D clearly has a beneficial role in AD and improves cognitive function in some patients with AD. Calcitriol, 1αα,25-dihydroxyvitamin D3, is best used for AD because of its active form of vitamin D3 metabolite and its receptor in the central nervous system.
p. 511-520

Job Satisfaction and Career Commitment Among Alzheimer’s Care Providers: Addressing Turnover and Improving Staff Empowerment
This study investigated the relation between job satisfaction and career commitment among 262 Alzheimer’s care staff working in long-term and community-based care settings. It was anticipated that the results would suggest whether career commitment could be enhanced to positively influence job satisfaction, and conversely, if improvements in job satisfaction might contribute to a deepened sense of vocational empowerment. Participants attended dementia-specific training and completed 2 short work-related questionnaires that measured job satisfaction and career commitment. The results of stepwise regression revealed interrelations between the 2 constructs. Congruence appeared to be reciprocal with respect to the overall scale scores and the intrinsic job satisfaction measure. Unexpected relations appeared in analyses of the extrinsic job satisfaction measure and the career planning subscale. Results are indicative of the fundamental distinction between job satisfaction and career commitment. Implications for efforts to reduce turnover and improve staff empowerment are also considered.
p. 521-527

Comparison of Informant Reports and Neuropsychological Assessment in Mild Cognitive Impairment
The aim of this retrospective study was to investigate the accuracy of informant reports on cognitive status in mild cognitive impairment (MCI) by comparing the subjective evaluation made by patients’ relatives with the objective results of neuropsychological assessment. We enrolled 119 MCI outpatients and their relatives. Cognitive impairment was assessed by a battery of standardized neuropsychological tests. Informant reports on cognitive functioning were obtained by means of a structured interview. Subjective and objective evaluations of cognitive status were rated according to the same scoring system in order to enable comparison. All but one relative reported cognitive dysfunctions at the interview, but the kind of cognitive profile emerging from their reports was quite different from the one highlighted by neuropsychological assessment. A subjective evaluation of cognitive status based on informant reports could therefore be useful to identify patients with MCI but is unable to define MCI subtypes.
p. 528-534

Storytelling as a Model of Conversation for People With Dementia and Caregivers
Storytelling is an important method of communication at all stages of life. Sharing narratives about lived events and experiences provides topics of conversation and opportunities for connecting with other people. In this article, we apply a conventional model of storytelling to the verbal reminiscences of older people with a dementia diagnosis. Their stories retain the conventional structure, suggesting that storytelling, which is an enjoyable and engaging social activity, can provide a conversation model for people with dementia.
p. 535-541

Cognitive Reserve and Lifestyle in Spanish Individuals With Sporadic Alzheimer’s Disease
Background: Some authors suggest that besides the fundamental components, cognitive reserve (CR) also reflects the influence of a combination of factors that improve mental health. Method: After obtaining the sociodemographic profile of each participant and evaluating their neurologic and neuropsychologic abilities, first, homogeneity analysis was used as a technique to select variables and reduce the number of categories with similar behavior; then CR construct was identified through a latent class analysis model. It was then possible to categorize participants according to their level in this construct and compare the neuropsychological performance of the subgroups that emerged, using a t test of differences of means for independent samples. Results: Participants with Alzheimer’s disease with low CR scores exhibited significantly greater deficits in measures of memory, attention, and language than patients with high CR. Conclusions: Our results ratify the effect of higher education, higher professional performance, and ludic activities on CR.
p. 542-554

Use of the Telephone-Administered Minnesota Cognitive Acuity Screen to Detect Mild Cognitive Impairment
This study determined the sensitivity and specificity of the telephone-administered Minnesota Cognitive Acuity Screen (MCAS) to distinguish mild cognitive impairment (MCI) from healthy controls (HCs) and from Alzheimer’s disease (AD). A total of 100 individuals with MCI, 50 individuals with possible/probable AD, and 50 HCs were screened to exclude medical and psychiatric conditions affecting cognition. In-office evaluation included neuropsychological testing, neurologic examination, and neurodiagnostic work-up. Participants with AD obtained significantly lower MCAS total scores than participants with MCI, who in turn performed worse than the HC group. Sensitivity was 86% and specificity was 78% for distinguishing between MCI and HC. Sensitivity was 86% and specificity was 77% for discriminating between MCI and AD. Sensitivity was 91% and specificity was 78% for discriminating between impaired groups (MCI and AD) and HCs. Results suggest that the MCAS successfully discriminates MCI from HC and AD and has potential as an effective telephone-administered screening tool for memory disorders.
p. 555-562

Intonational Patterns of Nonverbal Vocalizations in People With Dementia
Nonverbal vocalizations in dementia are important clinically since they generally have been regarded as disruptive behavior that is disturbing. The aim of the present study is to describe the interactional pattern, including the prosodic package, of nonverbal vocalizations in a participant in a late stage of dementia. The acoustic analysis shows that the vocalizations do not differ significantly from the verbal utterances regarding mean fundamental frequency or pitch range. The mean fundamental frequency, F0, of the utterances from Anna was significantly higher than the mean F0 from the other elderly participants. The analysis demonstrates that there is a singing-like type of vocalizations that does not resemble the previously described patterns of nonverbal vocalizations. This pattern of the nonverbal vocalization does not resemble the intonation of Anna’s verbal utterances. The other participants perceive Anna’s vocalizations as potentially meaningful turns. Nonverbal vocalizations in clinical settings should be taken as communicative contributions.
p. 563-572

News Briefsp. 573-577

Single traumatic brain injury may prompt long-term neurodegeneration
Years after a single traumatic brain injury (TBI), survivors still show changes in their brains. In a new study, researchers from the Perelman School of Medicine at the University of Pennsylvania suggest that Alzheimer’s diseaselike neurodegeneration may be initiated or accelerated following
a single traumatic brain injury, even in young adults.

Inherited Alzheimer’s detectable 20 years before dementia
Inherited forms of Alzheimer’s disease may be detectable as many as 20 years before problems with memory and thinking develop, scientists will report July 20, 2011, at the Alzheimer’s Association International Conference on Alzheimer’s Disease in Paris.

Aerobic exercise may reduce the risk of dementia, Mayo Clinic researchers say
Any exercise that gets the heart pumping may reduce the risk of dementia and slow the condition’s progression once it starts, reported a Mayo Clinic study published this month in Mayo Clinic Proceedings. Researchers
examined the role of aerobic exercise in preserving cognitive abilities and concluded that it should not be overlooked as an important therapy against dementia.

Alzheimer’s vaccine triggers brain inflammation when brain amyloid burden is high
Patients with Alzheimer’s disease who are in the early stages of their illness will likely benefit most from vaccine therapies now being tested in a number of
human clinical trials, say researchers from Georgetown University Medical Center (GUMC).

Nutritional intervention helps in mild Alzheimer’s disease
A second clinical trial of the medical food Souvenaid confirmed that daily intake of the nutritional intervention improves memory in people with mild Alzheimer’s disease (AD).

Mood, cognition and sleep patterns improve in Alzheimer’s patients after cataract surgery
Researchers at Tenon Hospital, Paris, France, found that patients with mild
Alzheimer’s disease whose vision improved after cataract surgery also showed improvement in cognitive ability, mood, sleep patterns and other behaviors.

Many Alzheimer’s patients get drugs with opposing effects
You wouldn’t brake your car while stepping on the gas—or wash down a sleeping pill with espresso. Yet many people taking common Alzheimer’s disease medications— cholinesterase inhibitors—are given medications with
anticholinergic properties, which oppose their effects.

“Getting on” lessons in caring ...

Great training resource

Set in Ward B4 of King Edward VIIIth hospital, a run-of-the-mill female aged care medical ward in an NHS outpost, Getting On finds its humour in the daily grind faced by the staff - return-to-practice nurse Kim Wilde, the ward dogs body she is a return-to-work nurse who must adapt to the difficulties the modern NHS throws at her, with C. diff, form-filling, and political correctness.* She is the staff member most empathetic to the concerns of patients and their families, which often brings her into conflict her colleagues, who are more concerned with sticking to the rules. The black comedy flows thick and fast as Kim Den and Pippa wade through the bureaucracy, bickering and daily battles with life and death on this health care backwater.

Dr Pippa Moore, is the "tough but fair" Care of The Elderly Consultant. She is uptight, self-centered, and lacking in "people skills", often being discourteous to her colleagues, her medical students, and even the patients. She, however, remains oblivious to the offence she causes, believing that people are impressed by her professionalism.

"… for wry amusement, the series serves a useful role in drawing to the attention of the general public issues that are glossed over by mendacious bureaucrats –"

The library has season 1 and 2 and to borrow them email lis@alznsw.asn.au

If you are interested in person centered care, communication or care plan mapping see our new library resources

Resources for the healthcare professional                  

Dementia care mapping : experience and insights into practice
If you need to learn more about Dementia care mapping or brush up on it- this is a great book to start with.
Dementia Care Mapping (DCM) is a system of careful observation to assess the impact of care from the perspective of the person with dementia.  Over the years DCM has made a major contribution to improving quality of care for people with dementia.  This book brings together important insights and experience.

Tom Kitwood on dementia : a reader and critical commentary
How does Kitwood’s work contribute to our understanding of ‘the dementing process’ and the essentials of quality care? How was Kitwood’s thinking about dementia influenced by the wider context of his work in theology, psychology and biochemistry? What is the relevance today of key themes and issues in Kitwood’s work? Tom Kitwood was one of the most influential writers on dementia of the last 20 years. Key concepts and approaches from his work on person-centred care and well-being in dementia have gained international recognition and shaped much current thinking about practice development. The complexities of Kitwood’s work and the development of his thinking over time have, however, received less attention. This Reader brings together twenty original publications by Kitwood which span the entire period of his writing on dementia, and the different audiences for whom he wrote.


Almost ten years after Kitwood’s death, it is now timely to review his contribution to the field of dementia studies in the light of more recent developments and from a critical and interdisciplinary perspective. The introduction to this Reader summarises and problematises some of the key characteristics of Kitwood’s writing. Each of the four themed sections begins with a commentary offering a balanced consideration of the strengths of Kitwood’s work, but also of its limitations and oversights. The Reader also includes a biography and annotated bibliography.

Communication and the care of people with dementia
This book argues that communication is at the heart of all approaches to dementia care, and is an in-depth exploration of ways of establishing and developing communication with people with dementia. It examines both the nature of dementia as a condition and the subjective experience of those affected. The authors consider in detail how communication between people with dementia and those who care for them changes, and how it can be maintained and enhanced. They include a significant amount of material quoted from people with dementia, and suggest ways of interpreting their words and actions. We learn about what it might be like to have dementia, and what sort of help is needed by people in this situation. Throughout the book the authors address the ethical issues and the implications for practice.


Communication and the Care of People with Dementia is a key resource for students and professionals in health and social care work, including those in such fields as social work, nursing, occupational therapy, speech therapy, physiotherapy, clinical psychology, geriatric medicine, and the management of services.

Communication and dementia new perspectives, new approaches
Dementia is a much-feared, much-misunderstood condition. It has also been very much under-studied. This is despite the fact that dementia is likely to affect more-or-less all of us directly or indirectly, presenting enormous and increasing challenges both to individuals and to societies. This book is the product of recent and uniquely wide-ranging research carried out by the authors. The research brought together what is known about effective communication involving people living with dementia. It explains how good communication can make a real difference to the quality of life of everyone touched by the condition. It describes best current theory - from the fields of gerontology, social psychology and communication studies - and the best practice of skilled and experienced dementia care workers and other health professionals. It is also strongly and directly influenced by the thoughts and experiences of people living with dementia and their loved ones. Cutting edge theory and best current practice are combined to inform a new, person-centred approach to effective communication, detailed here in an academically rigorous, but user-friendly way. This book will interest and help people living with dementia and their loved ones, as well any professionals with an interest in good communicative practice. The research detailed in this book won the International Association of Language and Social Psychology's 2010 James J. Bradac Prize for the most outstanding contribution to the field.

Creativity and communication in persons with dementia : a practical guide
Providing people with dementia with opportunities to engage in creative activity can play a crucial role in maintaining and enhancing communication, and in reinforcing personhood and identity. This thoughtful book describes how people with dementia, and the people who work with and care for them, can foster and develop a creative approach, and provides rich and varied ideas for creative activities. The authors explore the concept of creativity - what exactly it is,its particular relevance for people with dementia and how to get into the creative 'flow'. They introduce a range of creative art forms, including poetry and story-telling, collage, drama, music making, photography, textiles and working with wood and metal, and suggest possibilities for employing them in a range of settings, and with people of all abilities. consideration is given to the practicalities of facilitating such creative work,including how to organise and run sessions, how to involvepeople with dementia and their carers, and how to reflect upon the experience. Practice examples are included throughout the book, as well as the comments and observations of people with dementia, and many examples of the artwork and poetry the authors have created with people with dementia over the years.

Books to help the carer take care of themselves

These books have been selected by our team of counsellors

The Happiness Handbook

'There's no doubt that happiness is something you choose -- and this new model will help you make more decisions that will lead to more happiness'.

Happiness is nothing more than a few simple disciplines practised every day... while misery is simply a few errors of judgement and bad habits repeated every day.'

In the revised edition of this engaging book, he shows that happiness is nothing more than a way of thinking and doing; that beliefs lead to actions, which in turn lead to happiness. His strategies are practical and simple and, in his experience with clients, effective.This model presents six key strategies to happiness including clarity and optimism, building positive relationships and utilising your inner strengths.

Bouncing back : how to overcome setbacks, become resilient, and create a happier life

In this practical book, Brian Babington, a professional counsellor specialising in grief and loss, outlines some approaches to cope with the initial trauma of loss and failure - and to find ways to recover. His approaches are of use to people who have experienced severe loss - such as a death in the family - or other traumatic events such as the breakdown of a relationship or the loss of a job. Brian Babington guides the reader through ways of coping with anxiety and despair, releasing loss, re-energising themselves and realigning their attitudes. He includes over 50 techniques for readers to choose from in creating their own path to recovery.

Bouncing Back provides a simple six-step Resilience Plan to build emotional strength that includes exercise, nutrition, rest, breathing well, creating peace and calm, learning to solve problems and determining new directions. It offers hope and solutions to people experiencing tough times and seeking greater fulfilment. 'We can all overcome adversity by reducing excessive despair,' says Brian Babington, 'and find our own answers by listening compassionately to our inner self. And in the process, the insights we gain from adversity can change us for the better, make us more resilient and lead us to a clearer sense of our life's purpose.'

The happiness handbook : strategies for a happy life

What if almost everything you believed about finding happiness turned out to be inaccurate and misleading? What if those very beliefs were in fact making you miserable? Too many of us are caught in the happiness trap: we think that we should be happy all or most of the time, and we believe that we can control the circumstances of our lives in order to avoid unpleasant experiences.

In reality, every life is touched by disappointment and difficulty. Ironically, it is our fear of negative experiences that keeps us trapped in cycles of unhappiness. Based on the insights and techniques of a new form of psychotherapy called Acceptance and Commitment Therapy (ACT), Harris offers key principles and techniques for escaping the “happiness trap” to create a full, rich, and meaningful life.

Harris shows how mindfulness and acceptance can help us to overcome common emotional problems. He presents the six key techniques of ACT that have been proven effective in helping individuals to: handle painful feelings more effectively, rise above fears, doubts, and insecurities create a richer and more meaningful life

Counting our losses : reflecting on change, loss, and transition in everyday life

This text is a valuable resource for  dealing with non-death, nonfinite, and ambiguous losses in their lives. It explores adjustment to change, transition, and loss from the perspective of the latest thinking in bereavement theory and research. The specific and unique aspects of different types of loss are discussed, such as infertility, aging, chronic illnesses and degenerative conditions, divorce and separation, immigration, adoption, loss of beliefs, and loss of employment. Harris and the contributing authors consider these from an experiential perspective, rather than a developmental one, in order to focus on the key elements of each loss as it may be experienced at any point in the lifespan. Concepts related to adaptation and coping with loss, such as resilience, hardiness, meaning making and the assumptive world, transcendence, and post traumatic growth are considered as part of the integration of loss into everyday life experience

Ten thousand joys & ten thousand sorrows : a couple's journey through Alzheimer's

- advice offered by the author to someone who is caring for a partner with Alzheimer’s?

• Accept that this is one of the most difficult challenges you’ll ever face.
• When you realize that you’re their lifeline in a dissolving world, every supportive and loving gesture is a gift to them.
• For me, when one of my spiritual teachers suggested that caregiving was an opportunity for me to practice the positive qualities of compassion, patience, generosity, and kindness, it helped give meaning to the humblest of tasks.
• Have compassion for yourself when you feel frustrated, impatient, or angry, because caring for an Alzheimer’s patient is a Herculean task.
• Ask friends and family for help! People want to help out, and there’s a real risk in becoming isolated.
• Know what gives the patient comfort or reassurance. For us, it was always touch, physical closeness, music and beauty.

There are many more answers to this question in the Reflections, Suggestions, and Seed Thoughts at the end of each chapter.
"How did Buddhism and meditation help you and Hob to deal with his illness?" More than anything else, our Buddhist practice and understanding made a profound difference to both of us in handling his decline. Through meditation one learns to find an inner refuge – a place of stillness – in the midst of all the changes and challenges. When we accept how much we can’t control, that everything is impermanent, we can begin to step out of our struggle with life. Meditation helps one develop equanimity and acceptance of whatever comes up, and that is a great help in dealing with the losses and heartbreak of Alzheimer’s. To be realistic, meditation is not a panacea, but it is a tremendous support for which both of us were very grateful.

In this profound and courageous memoir, Olivia Ames Hoblitzelle describes how her husband's Alzheimer's diagnosis at the age of seventy-two challenged them to live the spiritual teachings they had embraced during the course of their life together. Following a midlife career shift, Harrison Hobliztelle, or Hob as he was called, a former professor of comparative literature at Barnard, Columbia, and Brandeis University, became a family therapist and was ordained a Dharmacharya (senior teacher) by Thich Nhat Hanh. Hob comes to life in these pages as an incredibly funny and brilliant man who never stopped enjoying a good philosophical conversation-even as his mind, quite literally, slipped away from him. And yet when they first heard the diagnosis, Olivia and Hob's initial reaction was to cling desperately to the life they had had. But everything had changed, and they knew that the only answer was to greet this last phase of Hob's life consciously and lovingly.

*to borrow from Alzheimer's Australia NSW library members should email lis@alznsw.asn.au

On the brain - books and DVDs

Secrets of the grown-up brain : the surprising talents of the middle-aged mind

"Question: So what kinds of things does a middle-aged brain do better than a younger brain?
Answer: Inductive reasoning and problem solving — the logical use of your brain and actually getting to solutions. We get the gist of an argument better. We’re better at sizing up a situation and reaching a creative solution. They found social expertise peaks in middle age. That’s basically sorting out the world: are you a good guy or a bad guy? Harvard has studied how people make financial judgments. It peaks, and we get the best at it in middle age. "

Pulitzer Prize-winning science writer Barbara Strauch explores the latest findings that demonstrate how the middle-aged brain is more flexible and capable than previously thought. In fact, new research from neuroscientists and psychologists suggests that the brain reorganizes, improves in important functions, and even helps us adopt a more optimistic outlook in middle age. We recognize patterns faster, make better judgments, and find unique solutions to problems. Part scientific survey, part how-to guide, The Secret Life of the Grown- up Brain is a fascinating glimpse at our surprisingly talented middle-aged minds.



The brain that changes itself

A new science called neuroplasticity is overthrowing the old notion that the human brain is immutable. Psychoanalyst Doidge traveled the country to meet both the brilliant scientists championing neuroplasticity and the people whose lives they've transformed--people whose mental limitations or brain damage were seen as unalterable. We see a woman born with half a brain that rewired itself to work as a whole, blind people who learn to see, learning disorders cured, IQs raised, aging brains rejuvenated, stroke patients learning to speak, children with cerebral palsy learning to move with more grace, depression and anxiety disorders successfully treated, and lifelong character traits changed. Using these stories to probe mysteries of the body, emotion, love, sex, culture, and education, Dr. Doidge has written an inspiring book that will permanently alter the way we look at our brains, human nature, and human potential.

Haven't got time to read the book "The brain that changes itself" watch the DVD, and catch the sequel "Changing your mind"

Brain that Changes Itself The, & Changing Your Mind

Dr Norman Doidge examines the vast expanse of our brain’s potential in these two fascinating documentaries.

The Brain that Changes Itself
The brain can change its own structure and function through thought and activity. This sentence is the most important shift in our view of the brain since we first sketched out its basic anatomy.
In The Brain That Changes Itself, bestselling author, psychiatrist and researcher Dr Norman Doidge explores the profound implications of the changing brain in a way that will permanently alter the way we look at human possibility and human nature.
Showing the brain as fluid rather than hardwired, Dr Doidge introduces us to both the brilliant scientists championing this frontier science and the astonishing progress of people whose lives have been saved and transformed because of it.
The documentary examines a blind man who sinks a basketball; a woman with half a brain who leads a normal life; learning disorders, strokes and brain traumas that are improved and cured; and chronic pain that is alleviated. The vast expanse of the brain’s possibility is still unrealised.

Changing Your Mind
In Changing Your Mind, the sequel to the eye-opening The Brain That Changes Itself, we explore the latest research that is offering hope to those suffering from obsessive compulsive disorder, post-traumatic stress disorder and even schizophrenia.
Special Features: ◦Includes English subtitles for the hard of hearing

to borrow email lis@alznsw.asn.au

new resources for carers

Alzheimer's with love by Beth Shirley Brough
Can the dreaded spectre of Alzheimer’s disease offer anything positive and enlightening? The author shares a very personal journey where she learns to see beyond the wastage and confusion of her long term friend, to travel with him through his unconventional, new world. She is rewarded with a deeper understanding of human relationships – and ultimately, herself – as old certainties are disrupted, and her belief in the pwer of dreams is reinforced.


University lecturer Beth Shirley Borough forsakes academic language to present her experiences with ‘Reggie’ in a simple, readable style while incorporating Jungian concepts that provide valuable insights fro healthcare workers and families of those with dementia.

No time to read - try a book on CD

Still Alice Alice Howland is proud of the life she worked so hard to build. A Harvard professor, she has a successful husband and three grown children. When she begins to grow forgetful, she dismisses it for as long as she can, but when she gets lost in her own neighbourhood she knows that something has gone terribly wrong. She finds herself in the rapidly downward spiral of Alzheimer's Disease. She is fifty years old. Suddenly she has no classes to teach, no new research to conduct, no invited lectures to give. Ever again. Unable to work, read and, increasingly, take care of herself, Alice struggles to find meaning and purpose in her everyday life as her concept of self gradually slips away. But Alice is a remarkable woman, and her family, yoked by history and DNA and love, discover more about her and about each other, in their quest to keep the Alice they know for as long as possible. Losing her yesterdays, her short-term memory hanging on by a couple of frayed threads, she is living in the moment, living for each day. But she is still Alice.


to borrow these email lis@alznsw.asn.au

Activities Directors' Quarterly volume 12 number 4, 2011

Full text articles are available to fee paying members of Alzheimer’s Australia NSW by emailing lis@alznsw.asn.au

ADQ Inservice
Notes from nursing: Sensory changes and communication with older adults
Sensory losses can have a big impact on the older adult’s quality of life. This article describes common sensory loss issues for activities professionals
p. 7-17

ADQ Proven Activities
Reliving the Eureka Moment
p. 18

Music and memory: Alzheimer’s disease and the ‘Well-Tuned’ iPod – adding a personal playlist to the quest for ‘person-centered care’
p. 19-23

ADQ Seasonal Planner – Calendar of Activities
p. 24-25

ADQ Featured Lesson Plan
Memory Books
p. 26-27

Disaster or emergency: Tabletop drills – What are they?
The third in a series of articles dealing with provision of healthcare to long-term facility residents with dementia in times of disaster.
p. 29 – 36

Anything but recreation! Universal problems associated with the provision of meaningful recreation in long-term care facilities, Part 1: Activities as babysitting – when residents should not be brought to a specific activity
p. 37 – 42

Contest honorable mentions from submissions to ADQ annual Therapeutic Activity Contest for innovative and successful programs
• Smell and tell, touch and feel p. 28
• Five senses bread p. 45
• Mystery auction p. 46

Activities for people with dementia

The new crafty therapist : new achievable arts and crafts for older people in aged care
by Lauretta Kaldor
This book has been written specifically for diversional therapists, recreation officers, occupational therapists, rehabilitation staff and teachers who work with people in aged residential and community centres. All techniques suggested here are based on what artists/craftspeople do and have done in the past. Materials are those that artists/craftspeople have used. For people who do have an arts and crafts background, this book will give ideas on how to adapt activities to the needs of the clients. The activities are easy to do , with simple step-by-step procedures.There are ideas on how to plan, prepare and present the activities as well as ideas on displaying the finished products. All templates can be photocopied to use within one facility.
(About Lauretra  Lauretta has been writing manuals for leisure staff working in aged care for the last sixteen years her manuals contain ideas on craft, reminiscing programs and games. Her books also provide a practical guide to planning and documenting suitable leisure activities for clients in residential and day care facilities. Lauretta works as an in-house consultant and trainer to recreation staff in aged care and have had more than twenty years of work experience with older people.Lauretta is also currently involved in providing activities for clients with early memory loss through Alzheimer’s Australia NSW.)
*we have many other books written by Lauretta

Ming shi art corridor - cherish and celebrate
“Ming Shi Art Corridor – Cherish and Celebrate” is proof that when we step forward and work together, the impact of the difficulties in dealing with dementia can be less challenging. The book is designed to help deliver activities that increase understanding of dementia in the community, to help overcome the stigma of dementia, to encourage social participation by people with dementia and provide support for grassroots dementia services. Readers praise the great effort and commitment that ACCA has put into the project - the project has built bridges for understandings between people living with dementia and the general society, also understandings between the CALD and the mainstream communities.


Doctor Tam, Senior Consultant Physician and Specialist Geriatrician, who is a well known and respected doctor in the Chinese community. He praises that the collective work published in this book is magical and legendary, and should inspire and humble the readers about how to better celebrate life by demonstrating that people with dementia can remember and excel in creativities.
 

 










Better care for people with Alzheimer's: a practice manual for day care centres
The depth of practical and valuable information in this manual has been gathered from extensive quantitative and qualitative surveys of all HACC funded day care centres in Queensland and Victoria. Interviews and observations have been refined to highlight the awareness of the rights and responsibilities of carers and staff.

The Pool Activity Level (PAL) Instrument for occupational profiling : a practical resource for carers of people with cognitive impairment
The Pool Activity Level (PAL) Instrument has become generally used as the framework for activity-based care systems in a variety of health and social care settings for people with cognitive impairments. The Instrument is recommended for daily living skills training and activity planning in the National Institute for Health and Clinical Excellence Clinical Guideline for Dementia (NICE, 2006). The PAL checklist has also been proved valid and reliable by a recent research study.

This third edition includes valuable new material together with the Instrument itself and the photocopiable activity checklists and plans that help to match users' abilities with activities. A new section provides a selection of potential activities together with information on obtaining the necessary resources. The author includes guidance for carrying out these activities with individuals of different ability levels as revealed by the PAL Instrument Checklist.
An essential resource for any practitioner or carer wanting to provide fulfilling occupation for clients with cognitive impairments.


*to borrow any of these email lis@alznsw.asn.au
or ring 02 9888 4218

Journal of Gerontological Nursing - Vol. 38 No. 1 January 2012

Full text articles are available to fee paying members of Alzheimer’s Australia NSW by emailing lis@alznsw.asn.au

Editorial
The Season for New Beginnings
p. 3

Geropharmacology
Crushing or Splitting Medications: Unrecognized Hazards
Given the high use and the cost of medications in the current economy, one way older adults may save money on prescription costs is to split some of their medications in half. However, not all oral medications can be split. Splitting inappropriate medications such as extended-release tablets can be harmful and in some instances very dangerous. In addition to splitting medications, older adults who have difficulty swallowing pills may resort to crushing the medication for ease of administration. This option is also problematic and potentially harmful if the medication is not intended to be crushed. Clinicians managing the care of older adults need to discuss medication administration, clarify the dosing schedule, and clearly indicate the route of administration. Patients should be cautioned not to split or crush a medication without checking with the health care provider or pharmacist.
p. 8-12

Technology Innovations
A Pilot Study Testing a Fall Prevention Intervention for Older Adults: Determining the Feasibility of a Five-Sensor Motion Detection System
Interventions to prevent hospital-based falls in older adults are critically important to reduce morbidity, mortality, and health care costs. The purpose of this pilot study was to test the accuracy and acceptability of a wireless five-sensor motion detection system (5S-MDS) for detecting falls. Wearable motion sensors, which measure and integrate movement in space, may identify human movement patterns that immediately precede falls, thus allowing prevention. However, sensors must be accurate, and older adults must find wearable sensors acceptable. This descriptive feasibility study recruited 5 healthy older adults (mean age = 69.6) who wore the 5S-MDS while performing 35 movement scenarios. All participants agreed the sensors were acceptable, and skin integrity was maintained for all. The 5S-MDS accurately reflected the patients’ movements and was found acceptable to the older adults; thus, the 5S-MDS has potential as an early warning system for falls.
p. 13-16

Spotlight
The 2010 Doris Schwartz Gerontological Nursing Research Award: Kathleen Coen Buckwalter PhD, RN, FAAN
p. 17-21

CNE article
Are Gerontological Nurses Apathetic About Apathy in Older Adults?
Despite its serious health consequences, apathy in older adults is often underrecognized by gerontological nurses and other health care professionals. Within this article, we discuss what apathy is and present a review of the literature and research. Two frameworks emerging from the literature search—one regarding rehabilitation and the other illness—are introduced as ways in which apathy may be conceptualized and addressed. Using these frameworks, implications for gerontological nurses are outlined.
p. 22-28

Feature article
Delirium Superimposed on Dementia: Accuracy of Nurse Documentation
Delirium is an acute, fluctuating confusional state that results in poor outcomes for older adults. Dementia causes a more convoluted course when coexisting with delirium. This study examined 128 days of documentation to describe what nurses document when caring for patients with dementia who experience delirium. Nurses did not document that they recognized delirium. Common descriptive terms included words and phrases indicating fluctuating mental status, lethargy, confusion, negative behavior, delusions, and restlessness. Delirium is a medical emergency. Nurses are in need of education coupled with clinical and decisional support to facilitate recognition and treatment of underlying causes of delirium in individuals with dementia.
p. 32-42

Long-Term Care Nurse Role Models in Clinical Nursing Education: The ECLEPs Experience
This article describes the partnership formed between long-term care (LTC) staff nurses and clinical nursing faculty to provide students with excellent clinical experiences in nursing homes and assisted living facilities. The nurses, called Clinical Education Liaisons, contributed to faculty understanding about LTC and served as resources for students. Faculty provided ongoing mentorship about current trends in clinical education. An in-person interactive training program prepared the nurses and faculty for their new partnership roles. Evaluation results indicate the Enriching Clinical Learning Environments through Partnerships program was successful, with all LTC nurses indicating they would participate in the program again. They also reported that the students had contributed to their organizations and were being well prepared for future practice.
p. 43-51

Carer stories by health care professionals with ideas on dealing with difficult behaviours

These books contain short concise anecdotes of issues and how they were overcome often by using humour and  lateral thinking

Love laughter & mayhem : caregiver survival manual for living with a person with dementia by Cindy Keith, R.N., BS, Certified Dementia Practitioner

A collection of stories about people with dementia the author has known, loved, and worked with. Every story teaches family caregivers how to better care for, and interact with, their loved one with any type of dementia such asAlzheimer's.

The stories shared here will not only teach you a better way to interact with any person with dementia, they will make you laugh, cry and wish you had known all of this long ago. These stories, taken from real life situations, will take you by the hand and lead you through the chaotic journey of caregiving. You will find new ways to interact with your loved one within their current reality. You will see the importance of attending to your own needs, so your lfe, and theirs, will contain more happiness, good health, safety and dignity as you learn from the experiences contained herein. You will capture the love and laughter, as well as manage the mayhem you might encounter with your loved one with dementia.

 
And still the music plays : stories of people with dementia  by Graham  Stokes
 

Using 22 stories, the author draws on his memories of people with dementia he has met to bring the reader a greater understanding of the condition and why some people behave in the way they do. The central theme is that everyone with dementia is unique, with a distinctive personality and experiences, and it is only by thinking deeply about each person individually that we can respond to their unique needs and give the best care possible. It reads quickly and is broken up into bite-size bits which is good because the topics can be demending but there is a resolution to each of the stories told. This book will open up new ways of interpreting some of the unexplainable things going on around you and that may be quite uplifting.
 
A funny thing happened on the way to the nursing home: a different handbook for carers of dementia patients by Jim Connor
 
 

This short, funny and sad book is a series of snapshots rather than a handbook as such. It describes, with a mixture of humour and pathos, some of the experiences of caring for a spouse with dementia, and in so doing imparts practical and useful advice. It is one person's view of how to manage an increasingly common problem, and explains why a sense of humour, and indeed a sense of the ridiculous, are very necessary attributes for surviving the caring process.


The author was able to devote himself to caring for his wife at home until her death, so the nursing home in the title was never reached. This is far from the common experience, but was made possible by his own determination and capabilities, and the amazing support he received from family, the Alzheimers Association support group, and community services. The author's methods of managing his wife's difficult behaviour are excellent examples of lateral quick thinking. Dealing with an imagined visit from a duchess at 2 am, or the urgent need to plant a tree in the middle of the dining room floor, requires a good imagination and fast footwork.

For general practitioners with a number of older patients, this is a good little book to read and then have on the bookshelf in your surgery for lending to carers. For geriatricians it contains some useful ideas for dealing with some of the more difficult behaviours associated with the dementing process. Although aimed primarily at the lay reader, it contains a lot of useful, and at times entertaining, material for the medical profession.

The selfish pig's guide to caring by Marriott, Hugh

Six million people in the UK, often unnoticed by the rest of us, provide unpaid care for disabled or elderly relatives, friends or neighbours. Their job is long, lonely and hard, yet there is limited support and no formal training. As a result, carers suffer frequent damage to physical and mental health.


Oddly, though carers by definition are anything but selfish pigs, they are liable to feelings of guilt, probably brought on by fatigue and isolation. So Hugh Marriott has written this book for them - and also for the rest of us who don’t know what being a carer is all about. His aim is bring into the open everything he wishes he'd been told when he first became a carer. And he does. The book airs such topics as sex, thoughts of murder, and dealing with the responses of friends and officials who fail to understand.
 
to borrow any of these items email lis@alznsw.asn.au