Tijdschrift voor Gerontologie en Geriatrie最新文献

Delirium is a common serious complication in dementia that is associated with poor prognosis and a high burden on caregivers and healthcare professionals. Appropriate care is therefore important at an early stage for patients with delirium superimposed on dementiaTo gain insight into the care of six patients with delirium superimposed on dementia, 19 semi-structured interviews were conducted focused on the experiences of caregivers and professionals. The interviews revealed four themes that appeared to play a role: 1. experiences with and views on behavioral problems of these patients, 2. recognition and diagnosis of delirium in dementia, 3. views on good care and 4. organizational aspects. Knowledge gaps about delirium in dementia, as well as ethical considerations, play an important role in organizing timely and adequate care for patients with delirium superimposed on dementia.

Background: Integrated disease management with self-management for Chronic Obstructive Pulmonary Disease (COPD) is effective to improve clinical outcomes. eHealth can improve patients' involvement to be able to accept and maintain a healthier lifestyle. Eventhough there is mixed evidence of the impact of eHealth on quality of life (QoL) in different settings.

Aim: The primary aim of the e-Vita-COPD-study was to investigate the effect of use of eHealth patient platforms on disease specific QoL of COPD patients.

Methods: We evaluated the impact of an eHealth platform on disease specific QoL measured with the clinical COPD questionnaire (CCQ), including subscales of symptoms, functional state and mental state. Interrupted time series (ITS) design was used to collect CCQ data at multiple time points. Multilevel linear regression modelling was used to compare trends in CCQ before and after the eHealth intervention.

Results: Of 742 invited COPD patients, 244 signed informed consent. For the analyses, we only included patients who actually used the eHealth platform (n = 123). The decrease of CCQ-symptoms was 0,20% before the intervention and 0,27% after the intervention; this difference was statistically significant (P=0.027). The decrease of CCQ-mental was 0,97% before the intervention and after the intervention there was an increase of 0,017%; this difference was statistically significant (P=0,01). No significant difference was found in the slopes of CCQ (P=0,12) and CCQ-function (P=0,11) before and after the intervention.

Conclusion: The e-Vita eHealth platform had a potential beneficial impact on the CCQ-symptoms of COPD patients, but not on functional state. The CCQ-mental state remained stable after the intervention, but this was a deterioration compared to the improving situation before the start of the eHealth platform. In conclusion, this study shows that after the introduction of the COPD platform, patients experienced fewer symptoms, but their mental state deteriorated slightly at the same time. Therefore, health care providers should be aware that, although symptoms improve, there might be a slight increase in anxiety and depression after introducing an eHealth intervention to support self-management.

This editorial is based on Towards meaningful mobility: a research agenda for movement within and between places in later life.

Inspired by theories from the field of social and emotional aging, we studied the use of ICTs by older adults with cognitive impairments. By means of qualitative interviews (N=30) with older adults with cognitive impairments and their relatives, we got a detailed picture of the role of ICTs in their daily lives.First, our data showed that older adults with cognitive impairments used ICTs to enhance their social and emotional wellbeing. This involved social interaction, feelings of belongingness, and engagement in hobbies and regular daily activities. Second, our research provided insight into the strategies applied when ICT use became too difficult, with a considerable role for the social network. When the network offered help upon request or proactively encouraged the older person, this increased the perception of control. This also applied to the indirect use of ICTs, when someone from the social network operated the devices. Denying the older person the use of ICTs undermined the perception of control.The findings provide insight into how the potential of ICT can be exploited for this target group. We end the paper with practical recommendations.

Although technology has the potential to promote aging in place among community-living older adults with dementia, the use remains scarce. In this literature study we provide an overview of perspectives (i.e., needs, wishes, attitudes, possibilities, and difficulties) of different stakeholders on technology use in the care for community-living older adults with dementia. After selection, 46 studies were included. We mainly found perspectives of informal caregivers and, to a lesser extent, of persons with dementia and formal caregivers. Shared perspectives were, among other things, ease of use, stability and flexibility of technology, importance of privacy, and confidentiality. Among older adults, fun and pleasure, in addition to enhancing freedom and independence, facilitates technology use. Informal caregivers' peace of mind and relief of burden also appeared to be important in using technologies. Formal caregivers value the potential of technologies to improve monitoring and communication. Insight in perspectives of stakeholders are essential to enhance the use of technology in the care for community-living older adults with dementia.

Background Providing person centered care for elderly persons with dementia in residential care settings is challenging. Furthermore, little insight exists into how employees apply person centered care.Goal Map the provision of person centered care for elderly persons with dementia by employees in nursing homes in the Dutch speaking part of Belgium.Methods Eight interviews and two focus groups were conducted with 25 employees of six residential care settings. A descriptive research approach was applied in four phases.Results Three themes emerged from the data concerning employee experiences with person centered care: (1) organizational support; (2) team support and (3) employee mindset. As person centered actions within the current practice, two themes were identified: (4) care at the pace of the resident and (5) contact adapted to the residents' needs.Conclusion Five themes regarding person centered care were found. However, specific examples of how this care was provided in practice could not be provided or were mostly examples of basic care. Employees are often obstructed by task oriented care. Setting the wishes and needs of the residents as reference point, providing organizational support, and investing in training might facilitate person centered care in residential care settings.