PURPOSE: This study was conducted to investigate effects of welfare center's cognitive improvement program on the community elderly provided by nursing student volunteers and social welfare.METHODS: A quasi-experimental with non-equivalent control group pretest-posttest design was implemented. The participants were the community elderly with or without mild cognitive impairments (experimental group: 17, control group: 15). The experimental group participated in the cognitive improvement program for four months based on the demonstration program of the special grade of dementia in long-term care insurance for the elderly.RESULTS: After the intervention, the satisfaction with perceived social support (F=9.30, p=.005) was improved statistically between the experimental group and the control group, but there was no significant difference in MMSE-K, IADL, depression, EQ-VAS, and EQ-5D variables.CONCLUSION: These results indicated that a multidisciplinary approach or a variety of manpower is needed, in order to prevent the dementia of the elderly. However, in order to provide a systematic cognitive-based intervention, it was once again recognized that the training of relevant experts and the quality planning on them were very important.
Aged ; Cognitive Therapy ; Dementia ; Depression ; Humans ; Insurance, Long-Term Care ; Mild Cognitive Impairment ; Nursing ; Social Welfare ; Students, Nursing ; Volunteers

BACKGROUND: Dementia is a condition in which a person who has been living a normal life suffers from various cognitive impairments in memory, words, and judgment that considerably disrupt daily life. The oral care ability and subjective oral status of elderly individuals with dementia are lower than those of a healthy person. The oral health care of individuals admitted to nursing homes inevitably falls to nursing assistants and nursing care staff. This study aimed to investigate the need for oral health management items of and to provide basic direction for the future of the Dementia National Responsibility System. METHODS: Elders aged 65 years and over were selected from a comprehensive welfare center. A total of 155 questionnaires were analyzed. The questionnaire consisted of 15 items about general status, 9 items about recognition of the Dementia National Responsibility System, 5 items of the subjective recognition of oral health, and 6 items of the correlation between oral health and dementia. RESULTS: Among our subjects, 71.0% answered that they did not know about the Dementia National Responsibility System, 78.7% answered that they think they need the system, and 81.9% think that they should add dental health items to the Dementia National Responsibility System. The response to the need for dementia national responsibility, oral health items in the Dementia National Responsibility System, and oral specialists all showed scores of >4 points. The need for the Dementia National Responsibility System, oral health items, and specialists were found. CONCLUSION: It is necessary to include oral health care items in the Dementia National Responsibility System so that elderly individuals with dementia can receive the needed oral health care.
Accidental Falls ; Aged ; Cognition Disorders ; Dementia ; Dental Care ; Humans ; Judgment ; Memory ; Nursing ; Nursing Care ; Nursing Homes ; Oral Health ; Specialization

PURPOSE: In Korea, the prevalence of dementia patients has increased, which makes the care burden of nurses important. The purpose of this study is to identify factors affecting the care burden of nurses caring elderly patients with dementia. METHODS: A cross-sectional design was conducted using a convenience sample of 127 nurses from two hospitals and a nursing home in Korea. Participants completed questionnaires on knowledge of and attitudes toward dementia, social support, self-esteem, dementia problematic behavior (DPB), and professional caregiver burden index. The data were analyzed by using the t-test, ANOVA, Pearson correlation, and multiple regression with the SPSS/windows version 21.0 program. RESULTS: The influencing factors for nurse burden include day shift, DPB, self-esteem, social support, which explain 28.0% of care burden of nurses. CONCLUSION: To reduce the burden of the nurses, there needs to be an administrative system that focuses on enhancing their self-esteem and social support. Active institutional support may be necessary for the nurses taking care of elderly patients with dementia.
Aged ; Caregivers ; Dementia ; Humans ; Korea ; Nursing Homes ; Prevalence

PURPOSE: There has been a growing recognition that person-centered care enhances the quality of life of nursing home residents with dementia. This study was conducted to develop a person-centered dementia care online education program for direct care staff in long-term care facilities. METHODS: Delphi method with expert group was used to validate contents. We developed 61 draft items based on literature review. Twenty experts participated in consecutive three round surveys including 5-point Likert scale questions and open-ended questions. Based on experts' opinions, the content validity ratio for content validity and the coefficient of variation for stability were calculated. RESULTS: Three-round Delphi surveys and additional feedback from the expert panel established a consensus of core contents: 1) dementia (7 categories), 2) person-centered care (6 categories), 3) communication (8 categories), and 4) behavioral and psychological symptoms of dementia (6 categories). Specific sub-categories in each category were differentiated according to the job qualifications (65 sub-categories for registered nurses, 64 sub-categories for nursing aids, and 41 sub-categories for personal care workers). CONCLUSION: This delphi study identified person-centered dementia education curricula, in which the person-centered approach should be a key policy priority in Korean long-term care system. Now it is urgently needed to develop education programs utilizing online platforms that enable efficient and continuous learning for long-term care staff, which can contribute to behavior changes in the person-centered dementia care approach and improvement of care quality in long-term care facilities.
Caregivers ; Consensus ; Curriculum ; Delphi Technique ; Dementia ; Education ; Humans ; Learning ; Long-Term Care ; Methods ; Nurses ; Nursing ; Nursing Homes ; Quality of Life

PURPOSE: The purpose of this study was to evaluate the effects of reminiscence therapy on depressive symptoms in older adults with dementia using a systematic review and meta-analysis. METHODS: Randomized controlled trials (RCTs) published from January 2000 to January 2018 were searched through Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), Korean Medical Database (KMbase), KoreaMed, PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Ovid MEDLINE. Two researchers independently performed the search, selection, and coding. Comprehensive Meta-Analysis 3.0 was used for meta-analysis, and Review Manager program 5.3 was used for quality assessment. RESULTS: Out of the 1,250 retrieved articles, 22 RCTs were selected for analysis. The overall effect size of reminiscence therapy for mitigating depressive symptoms in older adults with dementia was −0.62 (95% Cl: −0.92 to −0.31). The effect size was greater in older adults under 80, those with less disease severity, and those for whom the therapy session lasted less than 40 minutes. CONCLUSION: Reminiscence therapy is an effective non-pharmacological therapy to improve depressive symptoms in older adults with dementia. Because its effectiveness is also influenced by age, disease severity, and application method, it is necessary to consider treatment designs based on individual characteristics as well as methodological approaches.
Adult ; Clinical Coding ; Dementia ; Depression ; Humans ; Information Dissemination ; Information Services ; Mental Recall ; Methods ; Nursing

OBJECTIVE: It investigated the tendency of the increase of elderly patients in a psychiatric hospital. In this regard, it examined whether the number of patients with outpatient consultant, discharge, medical diseases, and neurocognitive disorder increased or not. METHODS: It retrospectively reviewed inpatient medical records for the years 2008, 2011, 2014, 2017. To investigate the changes of elderly patients admitted to psychiatry, it examined the changes of patients who are older than 50 or 60 years in addition to the people who are older than 65 years. It analyzed diagnosis, discharge, medical diseases, and outpatient consultant of the three groups respectively. RESULTS: It confirmed that the number of elderly patients who are older than 50, 60, and 65 years has increased in mental hospital for 10 years. There was a significant increase in the number of neurocognitive disorder patients, the ratio of consultant outpatient, and the mean number of outpatient consultant. Diabetes increased in all three groups. Especially it has significantly increased for patients who are older than 50 and 60 years. In the case of patients discharged due to transfer, the number of patients increased in all three groups but it was statistically significant for the patients who are older than 50 years. CONCLUSION: The study shows that the number of elderly patients increased with the trend of aging society. In relation to this, the rate of outpatient consultant and discharge, including diabetic and dementia patients, also increased. Therefore, if the mental health department provides a system to manage the elderly ward or nursing ward to respond to the increase of elderly patients, or to manage the accompanying chronic diseases such as diabetes and its complications, it could solve the inconvenience of patients due to the consultation outside a hospital or discharge.
Aged* ; Aging ; Chronic Disease ; Consultants ; Dementia ; Diagnosis ; Hospitals, Psychiatric* ; Humans ; Inpatients ; Medical Records ; Mental Health ; Neurocognitive Disorders ; Nursing ; Outpatients ; Retrospective Studies

PURPOSE: The purpose of this study was to identify factors predicting behavioral and psychological symptoms of dementia (BPSD) in persons with dementia. Factors including the patient, caregiver, and environment based on the multi-dimensional behavioral model were tested. METHODS: The subjects of the study were 139 pairs of persons with dementia and their caregivers selected from four geriatric long-term care facilities located in S city, G province, Korea. Data analysis included descriptive statistics, inverse normal transformations, Pearson correlation coefficients, Spearman's correlation coefficients and hierarchical multiple regression with the SPSS Statistics 22.0 for Windows program. RESULTS: Mean score for BPSD was 40.16. Depression (β=.42, p<.001), exposure to noise in the evening noise (β=−.20, p=.014), and gender (β=.17, p=.042) were factors predicting BPSD in long-term care facilities, which explained 25.2% of the variance in the model. CONCLUSION: To decrease BPSD in persons with dementia, integrated nursing interventions should consider factors of the patient, caregiver, and environment.
Behavioral Symptoms ; Caregivers ; Dementia* ; Depression ; Humans ; Korea ; Long-Term Care ; Noise ; Nursing ; Residential Facilities ; Statistics as Topic

BACKGROUND: Physical activity (PA) is critical for maintaining the health and well-being of older people in community and also institutional settings. The purpose of this study was to examine the current status of PA and related individual and organizational factors among older nursing home residents with and without dementia. METHODS: This is a secondary data analysis study of a nationwide survey of 92 long-term care facilities in Korea, and the study sample includes older residents with dementia (n=753) and without dementia (n=480). The level of PA was measured by PA time and whether or not residents had an outdoor activity over the past 3 days. Multi-variate, multi-level analyses were conducted. RESULTS: More than half of the sample in both groups had no or less than 1 hour of PA. About one out of four older people in our sample had no outdoor activity over the past 3 days regardless of whether or not they had dementia. Among the people without dementia, several individual-level factors were associated with PA, including dependency for activities of daily living, social activity participation, and caregivers' belief in the functional improvement of residents. Unlike the non-dementia group, individual- and organizationallevel factors including staffing level and having the relevant equipment for PA were associated with PA among those with dementia. CONCLUSION: Study findings provide evidence on the lack of PA among older nursing home residents, and the importance of institutional capacity with regard to human resources and physical equipment for promoting PA among people with dementia, in particular. Policies and supports are needed to promote the implementation of healthy aging programs including PA for older nursing home residents. Such programs should be person-centered with consideration to the physical and cognitive status of individual residents.
Activities of Daily Living ; Aging ; Dementia ; Humans ; Korea ; Long-Term Care ; Motor Activity ; Nursing Homes ; Nursing ; Statistics as Topic

Singapore has an ageing population with a projected 53,000 people aged ≥ 60 years living with dementia by 2020. Primary care doctors have the opportunity to initiate early work-up for reversible causes of cognitive dysfunction, allowing identification of comorbidities and discussion of medical therapy options. Early diagnosis confers the sick role on the patient, which allays frustration and explains events and behaviour that may have strained relationships with family and friends. The patient can be encouraged to plan for future health and personal care options with a Lasting Power of Attorney and/or Advance Care Planning. Objective cognitive tests (e.g. abbreviated mental test and Mini-Mental State Examination) and brain imaging are adjuncts that help in formulating the diagnosis. Referral to a hospital memory clinic activates a multidisciplinary team approach to dementia, including clinical consultation, dementia counselling, physiotherapy sessions on gait/fall prevention, occupational therapy sessions on cognitive stimulation and caregiver training.
Advance Care Planning ; Aged ; Aged, 80 and over ; Brain ; physiopathology ; Caregivers ; Cognition ; Cognitive Dysfunction ; diagnosis ; epidemiology ; therapy ; Cognitive Therapy ; Dementia ; diagnosis ; epidemiology ; therapy ; Geriatrics ; methods ; Home Nursing ; Humans ; Interdisciplinary Communication ; Memory ; Middle Aged ; Neuropsychological Tests ; Referral and Consultation ; Singapore

PURPOSE: This study aims to investigate the effects of intervention using the therapeutic robot, PARO, on the cognition, emotion, problem behavior, and social interaction of elderly people with dementia. METHODS: A nonequivalent control group pretest-posttest design was used. A total of 33 elderly people with dementia living in a nursing home facility participated in the study, with 17 in the experimental group and 16 in the control group. The intervention program with PARO was administered twice a week for 6 weeks, for a total of 12 sessions. Data were collected before and after intervention, using a questionnaire, direct observation, and video recording. RESULTS: There were statistically significant differences in positive emotions and problem behaviors between the groups. The experimental group demonstrated a significant improvement in social interaction. CONCLUSION: PARO intervention can be utilized as an effective nursing intervention to increase positive emotions and social interaction, as well as decrease problem behaviors, in elderly people with dementia living in nursing home facilities.
Aged ; Cognition ; Dementia ; Humans ; Interpersonal Relations ; Nursing ; Nursing Homes ; Problem Behavior ; Robotics ; Social Behavior ; Video Recording