Family Caregivers Providing Complex Chronic Care to People with Cognitive and Behavioral Health Conditions

From the AARP Public Policy Institute, Insight on the Issues series, this paper reports on results from a national survey showing that caregivers of family members with challenging behaviors were more likely to perform more than one medical/nursing task, such as managing medications, and often do so with resistance from the person they are trying to help.

This analysis offers recommendations for assisting family caregivers who play this dual role.

http://bit.ly/1rE7SaV

Meeting needs and reducing distress

The Meeting Needs and Reducing Distress Website was created in partnership with the NHS, with the aim of ensuring that health care professionals can safely prevent and manage responsive behaviours in health care settings, including long-term care facilities.  This website hosts comprehensive information for staff, students and managers in long-term care and hospitals.  It is the result of an ongoing project managed by NHS and members of an Expert Group, and includes the resources, strategies and good practice gathered and/or created by these leaders in the field.  The website hosts a variety of resources including:

·         Best Practice Guidelines for staff, managers, security personnel and residents/caregivers, including information on managing risk, organizational responsibilities and using physical interventions.

·         Case Studies that are taken from real-life events and demonstrate the application of practical solutions, including one on dementia

·         Training Videos for health care staff on managing risks and care strategies

The website emphasizes good communication skills and the importance of compassionate care, staff training and creating a supportive care environment.  For more information and to explore the website, please visit http://bit.ly/SNq9T0. 

For the latest resources on behaviours in long-term term, don’t forget to check out our Current Perspectives on the topic.

New Tool from the Canadian Coalition on Senior's Mental Health

Tool on Pharmacological Treatment of Behavioural Symptoms of Dementia in Long Term Care Facilities for Older Adults.  For the a front and back PDF of the tool, go to: [pdf front | back]

Behavioural Education and Training Supports Inventory (BETSI)

Behavioural Supports Ontario (BSO) has published the Behavioural Education and Training Supports Inventory (BETSI), a comprehensive decision making framework and program inventory that will strengthen the capacity of planners to choose the most appropriate of education programs and effectively support the application of new knowledge into practice.

BETSI compliments BSOs Capacity Building Roadmap; assisting providers, agencies and facilities to build knowledgeable care teams who will provide the best care possible, in safe and supportive workplaces, for older adults with or at risk of responsive behaviours due to mental health, dementia, addictions or other neurological disorders; and their caregivers.

BETSI allows planners and organizations to define local education needs and decide on appropriate behavioural, health and safety education and training programs, thereby ensuring efficient use of their training resources, while notably enabling their teams to provide clients with the right care, at the right time and in the right place.

The BETSI Framework should be used by those who need to make decisions about what education is required to manage and better serve older adults with responsive behaviours. Across service sectors this could include Directors of Care, Psychogeriatric Resource Consultants, Educators, Capacity Building Leads, Joint Health & Safety Committees etc.

http://akeresourcecentre.org/betsi

Supporting People with Intellectual Disabilities Who Challenge or are Ageing: A Rapid Review of the Evidence

A significant care need for service commissioners and providers of services for people with intellectual disabilities (ID) is presented by people with behaviours that challenge and/or have mental health problems, and ageing people with an ID. In addition family caregivers of both these populations can face many obstacles in their caring roles if adequate supports are not in place to help them.

This rapid review was undertaken using a framework adapted from the NHS Centre for Reviews and Dissemination (CRD, 2009) and the Rapid Review Methodology (NHS, Wales 2006).

The aims of the review are as follows.

• Aims and review questions – behaviours that challenge
• In relation to people who challenge the aim was to search for, evaluate and prioritise studies or other robust literature that have focussed on the following main review question.
• What services and support do people with ID who display behaviours that challenge and their caregivers require to meet their needs?

Citation: Slevin, E. Taggart, L. McConkey, R. Cousins, W. Truesdale-Kennedy, M. Dowling, L. (2011) A rapid review of literature relating to support for people with intellectual disabilities and their family carers when the person has: behaviours that challenge and/or mental health problems; or they are advancing in age, Belfast, Northern Ireland: University of Ulster.

http://www.publichealth.hscni.net/sites/default/files/Intellectual%20Disability.pdf

Non-pharmacological Interventions for Behavioral Symptoms of Dementia

In 2004, the U.S. Office of the Assistant Deputy Under Secretary for Health for Policy and Planning estimated that the total number of Veterans with dementia would be as high as 563,758 in FY 2010. The VHA Office of Geriatrics and Extended Care (OGEC) in Patient Care Services has primary responsibility for coordination and direction of VHA dementia initiatives. OGEC convened an interdisciplinary Dementia Steering Committee (DSC) in December 2006, with the goal of making recommendations on comprehensive, coordinated care for Veterans with dementia.

The DSC requested VA HSR&D's Evidence-based Synthesis Program (ESP) to review evidence on selected topics, in order to assist with DSC planning efforts. This evidence review addresses the following questions:

1. How do non-pharmacological treatments of behavioral symptoms compare in effectiveness with each other, with pharmacological approaches, and with no treatment?
2. How do non-pharmacological treatments of behavioral symptoms compare in safety with each other, with pharmacological approaches, and with no treatment?
3. How do non-pharmacological treatments of behavioral symptoms compare in cost with each other, with pharmacological approaches, and with no treatment? 

http://www.hsrd.research.va.gov/publications/esp/dementia_nonpharm.cfm

Geripods

The GeriPod broadcast series is offered for interdisciplinary practicing clinicians, students and others involved in primary care and aging.

These free podcasts are developed by the New Jersey Institute for Successful Aging through its federally-funded New Jersey Geriatric Education Center and are available as a subscription or as individual episodes at no charge from iTunes University.

Topics include:

• Use of antipsychotics
• Depression
• Management of behavior problems

To access the series go to:
http://njisa.umdnj.edu/education/geripods/index2.html

New Resources at the Canadian Coalition for Seniors' Mental Health

• Tool on the Assessment & Treatment of Behavioural Symptoms of Older Adults Living in Long Term Care Facilities (clinician pocket card)
• Delirium: Assessment and Treatment for Older Adults (clinician pocket card)

University of Iowa E-News: Nonpharmalogic Approaches to the Management of Behavior in Demenita.

The June issue of E-News, "Nonpharmacologic Approaches to the Management of Behavior in Dementia," is now available online. This requires Acrobat Reader, a free download from Adobe Systems. If you do not have Acrobat Reader, click on the logo on the right to download it.

In this issue of the E‐NEWS, you will find abstracts for:

• An article that reviews the research on the effectiveness of community-based, nonpharmacologic interventions for older adults with early-stage dementia.
• A study that assesses the effects of bright light therapy on agitation in dementia.
• A study that examines the efficacy of systematic, individualized, nonpharmacologic interventions in reducing agitated behaviors in nursing home residents with dementia.
• An article that describes the use of the Tailored Activity Program to reduce behavioral symptoms in persons with dementia.
• A study that evaluates the use of massage for reducing agitation in cognitively impaired nursing home residents.
• An article that discusses the evaluation and management of neuropsychiatric symptoms of dementia.
• An article that analyzes studies of psychosocial treatments of behavior symptoms in dementia.
• A study that investigates the efficacy of music therapy in the treatment of behavioral and psychiatric symptoms of dementia.

http://www.healthcare.uiowa.edu/igec/publications/e-news/default.asp