The PBAR Protocol: Antipsychotic Medication Reduction in the Nursing Home
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Advanced Dementia: Enjoy It or Avoid It?
Submission Deadline: November 15, 2020 (Open) Submit Now
Ladislav Volicer, MD, PhD
Courtesy Full Professor, School of Aging Studies, College of Arts and Sciences, University of South Florida, Tampa, FL, 33620, USA;
External Professor, 3rd Medical Faculty, Charles University, Prague, Czech Republic
Research Interests: Dementia; Alzheimer's disease; palliative care; medical ethics; behavioral symptoms of dementia
About This Topic
With the skyrocketing prevalence of age-related dementias and lack or curative treatment for Alzheimer’s disease and other progressive degenerative dementias, many persons will live with advanced dementia. In this condition, persons are dependent in all activities of daily living, cannot eat and drink, and ambulate independently and communicate verbally. Despite these disabilities, they can still enjoy life if pain, depression and behavioral symptoms of dementia are effectively treated, and meaningful activities designed for this population are provided. However, some persons are so afraid of living with advanced dementia that they want to avoid it at any cost. Some strategies for decreasing risk of dementia development exist but none of them assure that dementia will be prevented. Similarly, advance directives limiting life-sustaining medical intervention do not always prevent living with advance dementia, because the persons may not require them. Some persons commit suicide when they still can, and others include withdrawal of help with eating and drinking in their advance directives. Advance dementia challenge health care system and all of us to decide how to deal with this condition. Should we support enjoyment of life, avoidance of advance dementia or combination of both?
The PBAR Protocol: Antipsychotic Medication Reduction in the Nursing Home
by Melodee Harris , Priya Mendiratta , Gohar Azhar , Ruofei Du and Jing Jin
Received: 24 November 2020; Published: 15 June 2021; doi: 10.21926/obm.geriatr.2102172
Neuropsychiatric symptoms (NPS) occur in almost all persons living with dementia. Antipsychotic medications are often prescribed inappropriately for persons living with dementia who experience NPS. Adverse side effects of antipsychotic medications include falls, sedation, cognitive dysfunction, prolonged QTc interval, extrapyramida [...]
Promoting Quality of Life in Advanced Dementia Care: Reading Buddies Program as Service-learning
by Scott A. Trudeau and Megan E. Gately
Received: 08 February 2021; Published: 30 April 2021; doi: 10.21926/obm.geriatr.2102169
The Reading Buddies Program was developed as a service-learning component of an Occupational Therapy Practice with Older Adults course as a collaboration between Tufts University and the VA Bedford Health Care System. The purpose of this service-learning program was to challenge graduate students’ implicit biases and improve [...]
Research Recommendations to Address Dementia Workforce Development Needs
by Joan Weiss , Nina Tumosa , Robert Espinoza , Elizabeth Bragg , Jennifer Craft Morgan , Jason Flatt , Eleanor S. McConnell and Grace Whiting
Received: 12 November 2020; Published: 16 March 2021; doi: 10.21926/obm.geriatr.2101162
This policy paper presents workforce development recommendations for research, clinical care and public stakeholders as they plan future research activities to strengthen the workforce to support the healthcare and social needs of persons living with dementia and their families and caregivers. To create these recommendations, the 2020 National [...]
Spousal Dementia Grief: A Research Report from the Two-Track Model of Dementia Grief Project
by Alexander Manevich , Simon Shimshon Rubin , Rachel Ben-Hayun , Judith Aharon-Peretz and Michael Katz
Received: 07 September 2020; Published: 12 March 2021; doi: 10.21926/obm.geriatr.2101160
Caregiving for a loved one suffering from cognitive decline involves coping with many challenges and losses. This experience increases the risk of worsening the physical and mental health of the caregiver and has been the subject of a substantial number of studies focusing on the stress and burden of the primary caretaker. Theory and research [...]
Acute Care Decision-Making for Patients with Advanced Dementia: An Exploratory Study Using Cognitive Task Analysis
Received: 11 November 2020; Published: 01 March 2021; doi: 10.21926/obm.geriatr.2101159
Decision-making by medical and health care staff forms the core of professional practice. Thought processes, including non-clinical considerations, significantly impact how clinical decisions are made. Such considerations become more relevant when addressing end-of-life care decisions for patients with advanced dementia (PAD). Though palliativ [...]
Bridging Biomedical and Person-centered Care Approaches via Namaste Care with Family Participation: An Asian Experience in Advanced Dementia Treatment
by Noorhazlina Ali , Cai Ning Tan , Jasmine Kang , Aik Phon Chew , Caroline Caroline , Mary Lee and Wee Shiong Lim
Received: 27 October 2020; Published: 04 December 2020; doi: 10.21926/obm.geriatr.2004140
A locally-adapted, multisensory, psychosocial intervention called Namaste Care program was developed to improve the daily life of persons with advanced dementia (PwAD) through arranging meaningful activities and physical interactions by healthcare staff (Namaste Carers). Congruent with Asian values, the families of PwAD were invited to partici [...]
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