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Healthcare

While pharmacologic treatment of dementia evolves, nonpharmacologic measures are taking center stage because of their ability to reduce risk and nursing home admissions while enhancing the quality of life for patients and family caregivers. 

Recently, “cognitive stimulation therapy” has gained attention for its ability to reduce depressive symptoms while enhancing cognition and quality of life. In fact, as early as 2009, care techniques involving “low-stress, focused sensory experiences” were discovered to “emphasize pleasure, sequencing, and gratification” for the dementia patient.

Now that the beneficial effects of nonpharmacologic care are established, professional home care services are poised to play a vital role in delivering care for dementia patients. This article explores how.

Dementia by the numbers

A 2016 study, “The Management of Dementia in Primary Care” pointed out that the nearly 50 million people around the globe who live with dementia will almost double in 20 years. “At present,” the study reported, the incidence of new dementia cases is “one new case every 3.2 seconds.”

Compounding the challenge of more dementia patients requiring care are two other factors:

  1. Globally, an estimated 66% of dementia remains undetected in primary care environments.
  2. The quality of disease management – assessment, drug treatment including management of side effects, safety, and coordination of care is frequently “suboptimal.” (Ibid).

Nonpharmacologic care delivered by qualified home health professionals in conjunction with family caregivers can help address several related problems. It can support “eyes-on” monitoring, coordinate patient care, enhance patient engagement, and reduce hospitalizations and nursing home admissions, which tend to worsen the quality of life and trigger financial difficulties for both patients and caregivers.

New Dementia Cases

One new case every 3.2 seconds

The Management of Dementia in Primary Care (2016) called attention to two related developments: The rise in dementia cases, and the difficulty in diagnosing dementia in primary care settings.

Cognition stimulation to reduce Behavioral and Psychological Symptoms of Dementia (BPSD)

A 2017 article from the Missouri State Medical Association called for “the development of cognitive stimulation interventions in which caregivers can be trained to deliver programs at home and in the community and for the creation of non-pharmacologic interventions to address issue of BPSD and depression.” 

It reported the following results of cognitive stimulation interventions: “Participants exhibited improvement in cognitive function, quality of life, and well-being immediately when compared to those receiving usual care (anti-dementia medication).” Cognitive Stimulation Therapy, it concluded, “is the newest and potentially most impactful strategy for enhancing cognition, quality of life, and depressive symptoms. “

For the RNs, CNAs, LPNs, LCSWs, and Home Health Aides who provide home care services to dementia patients, these findings are consistent with everyday professional experience. 

The common thread: Constructive patient engagement

The 2017 research referenced above is one report among many that examines the use of specific activities to improve life.

For example, a 2015 literature review, “Nonpharmacological Interventions to Reduce Behavioral and Psychological Symptoms of Dementia” showed that the use of music therapy, light therapy, exercise, touch therapy, and other approaches led to this conclusion: “these interventions have important and significant efficacy improving BPSD such as agitation, psychotic symptoms, and apathy. Undesired side effects of pharmacological treatments, as antipsychotics and benzodiazepines, have promoted a search for alternative treatments for BPSD. Therefore, nonpharmacological interventions programs should be considered as first-option interventions to treat BPSD.”

Other examples of cognitive engagement include singing familiar songs, preparing a meal, arts and crafts, sorting photos, and flower arrangement as a means of elevating and stabilizing mood and significantly reducing the stress on family caregivers. Success is consistently documented.
As one such study summarized: “Purposeful and regular activities at home that tap into previous interests and procedural memory can prevent or reduce agitation and depression.”

The integrated care management model by SeniorBridge

Home care services vary widely in the services they provide. 

SeniorBridge offers an integrated care management practice model that involves two components:
1. Clinical care (under the direction of an RNCM/Registered Nurse Care Manager) supported by a Social Worker and a team of caregivers, based on patient’s needs and
2. A portfolio of home care services and geriatric care management in such areas as nutrition, caregiver education, benefit coordination, transportation, nursing home admission, and coordination with discharge planners, physicians, pharmacy, home health agencies, and care managers.

NOTE: We have full COVID-19 safety protocols in place to keep clients, families and associates safe.

For more information on dementia home care support services, contact SeniorBridge.

Sources consulted:
National Library of Medicine /The Gerontologist (2009)
IntechOpen (2016)
National Library of Medicine /NIH/Missouri Medicine (2017)
National Library of Medicine /NIH/BioMed Research International (2015)
National Library of Medicine /NIH/HHS Public Access (2013)

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