No description available.

Most demented individuals are now cared for at home by family members. The present study examined the coping strategies employed by family caregivers, their perception of burden, and the internal dialogues employed by caregivers to stressful events. Sixteen (13 females, 3 males) participants with an average age of 67.4 years were interviewed. Results indicate that caregivers who spend less hours per week caring for their care receiver perceived less overall burden and caregivers who subjectively felt that they were coping with their role tended to use more coping strategies. Caregivers' internal dialogues and comments concerning problems coping with Alzheimer's patients are included.

There is an absence of nursing studies that explore interventions to enhance psychological well-being for advanced Alzheimer patients. While sensory stimulation has been identified as a nursing intervention for dementia patients. Few studies reporting the effects of such interventions for patients with late stage dementia are available. The purpose of this study was to examine the effects of sensory stimulation activities on the psychological wellbeing of advanced Alzheimer patients. The conceptual model of “the good life” developed by Lawton (1983) provided the framework for this study. A descriptive design with a single group and pre-test post-test repeated measures analysis of variance was used for this study.A convenience sample of 15 patients from three Midwest long-term care facilities was observed for the effects of music. Touch and smell on psychological well-being as measured by the Discomfort Scale for Dementias of the Alzheimer Type (DS-DAT) (Hurley, Volicer, Hanrahan, Houde & Volicer, 1992). The rights of patients were protected at all times, with legal guardians receiving a written explanation of the study. Actual stimulation activities were conducted by Activity Directors or assistants from each facility.Paired t-test analysis of data revealed that DS-DAT scores for all three stimulation activities were significantly lower at <.05 level of significance than baseline DS-DAT scores. Lower DS-DAT scores included more positive affect behaviors and fewer negative affect behavior. A conclusion was drawn that the three sensory stimulation activities increased psychological well-being in the advanced Alzheimer patient sample. This study was significant because findings will support rationale for education of nursing staff in sensory stimulation procedures and provide information on evaluation of intervention outcomes for advanced Alzheimer patients. / School of Nursing

The purpose of this study was to determine if distinct subgroups of patients with Senile Dementia of the Alzheimer Type (SDAT) could be identified using seven scales of the Cognitive Behavior Rating Scale (CBRS). Ward's method of cluster analysis was used to group 104 patients with a probable diagnosis of SDAT into subtypes.The following three clusters were identified: (a) Moderately Impaired, (b) Severely Impaired, and (c) Emotionally Intact which displayed differences in symptom severity. Clusters could be partially defined by the amount of time they had been diagnosed with the disease. Differences in the cluster's configuration of scores had little/no descriptive utility. Subsequent discrimination analyses indicated that patient demographics were not as useful as the CBRS in classification of patients.This study provided evidence for the CBRS's ability to differentially portray SDAT patients' profiles. Results provide partial support for a stage model of SDAT. Implications of existing subgroups in SDAT are discussed as they pertain to patient management issues. / Department of Counseling Psychology and Guidance Services

Access to abstract permanently restricted to Ball State community only / Access to thesis permanently restricted to Ball State community only / Department of Educational Psychology

When family members no longer have the capacity to meet Alzheimer's Disease (AD) caregiving demands at home, a move to a nursing home or other formal care facility becomes the only solution. Recognizing this as a time of transition, three research questions were identified: (1) What do family caregivers to AD individuals experience as they shift their caregiving from home to formal care settings? (2) How does caregiving in formal care differ from caregiving at home? and (3) How do family caregivers perceive the relationships that develop between families and formal care staff? Specific attention was paid to the experiences of spouses and adult children. Using a qualitative approach, two specific bodies of data were investigated. First, transcripts of a series of 30 focus groups with 179 caregivers, and second, ten follow-up interviews were analyzed. Both spouses and adult children overwhelmingly identified physical exhaustion and often emotional exhaustion as the pervasive common experience. After reaching this state, caregivers identified the pivotal nature of events in contributing to placement. These kinds of events turn out to be more like turning points than crises. Caregivers in this study identified five themes that were influential in their decision-making process. In order of their importance to the caregivers, they were: events, the health care system, caregiver-care receiver relationship, support, and options and availability. A male spouse caregiver was likely to cite a turning point event centered on an incontinence problem, while for a female spouse caregiver, it was an AD safety issue. The health care system was usually a negative influence and served to delay the placement decision. Immediately, after placement, family caregivers noted shifts in control, involvement and personal reorganization. Family caregivers frequently noted the development of a caregiving relationship with staff. The individuals whom the family caregivers mentioned most often were the aides. Their bottom line was that staff deliver quality care, which they equated with caring about the resident rather than only taking care of them. The findings from this study have implications for theory development, family caregivers, formal care staff, and health care policy.

Introduction: Dementia is an age-associated neurodegenerative disorder characterized by a progressive loss of neuro-cognitive function and the emergence of a wide variety of behavioral symptoms. Alzheimer's disease (AD) is the most common types of dementia. Sleep disturbances in patients with Alzheimer's disease is common and previous studies from North America, Europe and Japan reported light therapy could improve the sleep circadian rhythm ( rest-activity) disturbances in AD. However, there was no previous Chinese study on light exposure and sleep quality nor the circadian rhythm in Chinese Alzheimer's disease patients. Objective : The objective of the present study was to investigate the association of light exposure intensity with the quality of sleep and behavioural symptoms in Chinese Alzheimer’s disease (AD) patients Method: This was a cross-sectional observational study. 203 Chinese elderly patients with Alzheimer's disease were recruited from the Memory Clinic in Queen Mary Hospital, the University of Hong Kong, from July 2014 to December 2014. Socio-demographic data and comorbid diseases information were collected from all subjects. Their sleep qualities, quantities and conditions of light exposure were recorded with a sleep logbook and light meter. Their cognitive function, disturbing behaviour, depressive mood and quality of life scales were assessed by a semi-structured questionnaire. Light exposure intensity measured by Light meter (Model SDL 400). Measure for cognitive function were the Abbreviated Mental Test (AMT), Behavioral symptoms measured by the Neuropsychiatric Inventory (NPI) and mood by Geriatric Depression Scale. (GDS-15) The association of outdoor or indoor light exposure with sleep quality and quantities were analyzed by descriptive, bivariate and multivariate analyses. Main outcome measures: The main outcome measure was the sleep quality and quantities of patient, measured by Pittsburgh Sleep Quality Index. (PSQI) Results: 203 subjects (60 males and 143 females) were recruited. 70.4 % of the studied subjects were females. Male to female ratio is 1:2.38. Mean age of them was 81.6 years. The mean (SD) scores of the recruited were: AMT = 4.5 (2.9); PSQI = 6.9 (3.4); NPI =14.4 (17.2); GDS-15= 4.3 (2.8); QOL-AD (patients) = 30.7 (4.9); QOL-AD (caregivers) = 29.5 (4.7) respectively. In bivariate analysis, the Global PSQI score was significantly associated with the morning and afternoon outdoor light exposure. (r = -0.634 and -0.466, respectively) For the total light exposure and mean light exposure, both of them showed strong significant negative correlation with Global PSQI score. (r = -0.769 and -0.769 respectively). Mean (SD) light exposure per day for morning and afternoon outdoor setting were 2372.9 lux (2564.7) and 1090.8 lux (1894.6) respectively. Mean(SD) light exposure per day was 1196.7 lux (866.1) Gender identity showed significant correlation with Global PSQI score (r = 0.034). Global PSQI score was significantly associated with the NPI total score (r = 0.261, p<0.001), the GDS-15 score (r = 0.336, p<0.001), the QOL-AD for patients (r = -0.257, p<0.001), and the QOL-AD for caregivers. (-0.313, p<0.001) In multivariate analyses, using general linear models, the Global PSQI score was highly independent associated with the total light exposure (p=0.000), and significantly associated with the NPI score and Gender (p = 0.011 and 0.021), after adjusting for potential confounders in bivariate analysis. (i.e. gender, activity of daily living status, hypertension and Chronic obstructive airway disease). Confounding factors were NPI and gender. Conclusion: In the present study, We found the intensity of natural light exposure was related to good sleep quality in older Chinese Alzheimer’s disease patients with age 65 years and above in Hong Kong as well as lesser episode of behavioural symptoms. Hence, daily outdoor light exposure is highly recommended for persons with Alzheimer’s disease. / published_or_final_version / Medicine / Master / Master of Medical Sciences

Several tasks examined implicit and explicit memory in matched samples of Alzheimer's (AD) and Parkinson's disease (PD) patients, and healthy elderly subjects. Lexical priming, pursuit-rotor tracking, and a fragmented pictures test, followed by explicit memory tests, were given. AD patients were impaired on all explicit tests and on lexical priming, but were intact on pursuit-rotor tracking and the procedural learning (PL) component of the fragmented pictures test. PD patients were significantly better than AD patients on all explicit memory tests, but were selectively impaired on the PL component of the fragmented pictures test. Finally, a mirror reading test was given to the PD patients and matched control subjects, with no significant differences in performance between the two groups demonstrated. Results are discussed in terms of hypothetical cognitive processes and brain circuits underlying different explicit and implicit memory domains.

Kate Zeller is nearly thirteen, with hair like a rat’s nest and the temperament of a dog chained up against its will: moody and likely to bite you. She lives in the small town of Brookford with her twenty-two year old brother Teddy and her grandfather, Tony, an acclaimed graphic novelist. As summer turns to autumn, two things barrel uninvited into Kate’s life: one is Raleigh, a strange new girl with a head full of Shakespeare and a secret knowledge of ghosts. The other is the Alzheimer’s that sneaks itself into her grandfather’s head and begins to steal it away, piece by piece. The history and tragedy of the Zeller family begins to unwind as reality blurs with fantasy, creator with creations, all being watched by a man who lives deep in the forest that connects Kate’s house to Raleigh’s. A man with eyes that tick. / Includes bibliography. / Thesis (M.F.A.)--Florida Atlantic University, 2015. / FAU Electronic Theses and Dissertations Collection

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences