Tijdschrift voor Gerontologie en Geriatrie最新文献

A condition for good quality care for people with dementia is that nurses and carers have sufficient knowledge of dementia. To test this knowledge, to measure the effects of psychosocial interventions and to develop educational programs, knowledge tests for dementia have been developed. This review examined which knowledge tests are available for nurses and care workers. These are assessed by their method of development and their psychometric qualities. Eight measuring instruments were traced: KIDE, DKAT1, DKAT2, DKAS, ADKS, UJA Alzheimer's Care Scale, KASA and KDC-SAT. The DKAS had the best psychometric qualities: the instrument discriminates expectedly between groups with more versus less knowledge, education and experience with dementia, it is sensitive to change after education, it has a solid internal consistency and good reliability. It includes domains of the biomedical model as well as domains of the biopsychosocial model. The cross-cultural validity of the DKAS needs attention. For Dutch practice, the cross-cultural validity of the DKAS should be investigated in an applied study.

The study examined changes in giving and receiving care by community-dwelling older adults during the COVID-19 pandemic in 2020 compared to a period about two years before. Using data collected in two waves by the Longitudinal Aging Study Amsterdam (N = 1013), we study how many and which older adults report a change in care use and provision and how these changes impact on psychological well-being. The results show that only for a small part of the sample changes occurred. The large majority provides no care (73%) or uses no care (62%) in both waves. 7% stayed a care provider during the pandemic, where 15% quitted care provision and 5% started care provision. 17% remained a care user, where 15% did not receive care anymore and 6% started to use care. The informal carers mainly consisted of women and younger elderly in good health and the care recipients were mainly women and older elderly in poorer health. Using care had a negative impact on psychological well-being, but providing care was not related to wellbeing during the pandemic. The results imply that the pandemic and the measures taken affected the care situation of only a small part of the older adults.

We describe a case of a geriatric patient with repeated hepatotoxicity after (re)start of atorvastatin. We also noticed an increased effect, a fast decline of LDL-cholesterol, after intake of atorvastatin. The intake of rosuvastatin or low dose lovastatin was not associated with hepatotoxicity. Multiple hypotheses were investigated and applied on the case. Genetic testing of statin transporters and CYP-enzymes and medication interactions could not explain the hepatotoxicity.

Relatively little is known about loneliness in nursing homes. The aim of this study is to gain insight in the prevalence of social, emotional and existential loneliness among nursing home residents and in the relationship between loneliness and participation in activities and having contacts. Data is collected among nursing home residents in the province of Zeeland in the Netherlands (N = 101; age range = 42 to 103 years; median = 83 years; 71% female). Social, emotional and existential loneliness, personal characteristics and participation in activities and having contacts are measured. Prevalence of loneliness is calculated. Regression analyses are performed to study the relationship between loneliness and personal characteristics, participation in activities and having contacts. The majority of respondents experiences social, emotional and/or existential loneliness. A longer duration of stay in the nursing home and participating in exercise activities are related to a lower extent of social loneliness but not emotional or existential loneliness. Organised activities typically aim at social loneliness, but not emotional and existential loneliness, even though these forms of loneliness occur often in nursing homes.

Care recipients are becoming increasingly involved in the decision-making process for suitable treatments. Advance Care Planning (ACP) enables care recipients and healthcare professionals to timely think and discuss wishes and preferences for treatments, before a care recipient becomes limited by disease, cognitive problems or age. The Treatment Passport is developed by geriatric specialist Esther Bertholet and contains supportive questions to think about treatment wishes. This study aimed to evaluate the experiences of civilians and healthcare professionals with the usage of the Treatment Passport during ACP. Involved care organisations distributed the Treatment Passports to healthcare professionals, for example dementia casemanagers. Healthcare professionals then handed the Treatment passports to civilians, for example older persons. Thereafter, healthcare professionals (N=30) and civilians (N=80) filled out a questionnaire about the experiences with usage of the Treatment Passport. 65% of the civilians had a disease and a mean age 75.3 years. The Treatment Passport was considered a helpful tool to think and talk about treatment wishes. 57% of the healthcare professionals wants to keep using the Treatment Passport and 78% of the civilians would recommend it to others. Participants who found the passport of limited added value mostly had their own methods of discussing their treatment wishes.

The measures taken in Dutch nursing homes during the first wave of the COVID-19 pandemic resulted in both an increase and a decrease of challenging behavior in nursing home residents. Staff undertook various initiatives to reduce the negative effects. For example, video calling between residents and their relatives was facilitated. In addition, initiatives in digital care (telehealth) were deployed. The aim of this study was to explore nursing home practitioners' experiences with online communication between residents and relatives, working remotely in general and the remote treatment of challenging behavior in particular. One hundred and seventy-five nursing home professionals (psychologists, elderly care specialists, nursing specialists, daytime activities coordinators) completed an online questionnaire at the end of 2020/start of 2021. Open and closed questions showed that face-to-face contacts are preferred over online communication. Online communication was mainly seen as a (meaningful) addition. Although professionals wanted to continue some of their work remotely, and found this efficient and workload-reducing, they felt that this could impair their job satisfaction and the quality of care. For remote work and remote treatment, each task needs to be evaluated on whether it can be performed properly and whether that results in good care. More research into online communication, remote working and digital care in nursing homes is needed.