Amie Martin, Director of Quality CareEvidence based practices, ideas for treatment, "best practices" for more effective treatments.
Group activities improve mental function in mild to moderate dementia, study findsFriday, February 17th, 2012
February 16, 2012
Structured group activities designed to stimulate cognition has shown to be effective in stimulating cognition in people with mild or moderate stage dementia, according to a study recently published in the Cochrane Database of Systemic Reviews.
British researchers reviewd data from 15 separate studies with 718 people in which groups of patients with dementia participated in structured group activities such as baking, games, art and show-and-tell. Activities took place up to 5 times per week and lasted 30 to 90 minutes. Following the study, participants took tests evaluating cognitive performance.
Those who participated in cognitive activity groups scored one or two points higher than non-cognitive activity participants.
“This is showing the people who work in memory care communities and nursing homes and assisted living facilities that they can improve cognitive function, and they need to be providing these kinds of interventions,” neuroscientist Robert Winningham, Ph.D., told Reuters.
Click here to read the full study.
Webinar: Dining with Friends: An Innovative approach to dining for people with dementiaThursday, February 16th, 2012
Check out this free webinar on person centered approaches to dining for residents with dementia:
Webinar: Dining with Friends: An innovative approach to dining for people with dementia
The “Dining with Friends” program, developed by the Alzheimer’s Resource Center of Connecticut, used person-centered care to offer the opportunity for conversation, socialization, fun, hydration and nutrition.
| Webinar: Dining with Friends™”Dining with Friends” is an approach that focuses on dignified dining for residents with dementia. The “Dining with Friends” program, developed by the Alzheimer’s Resource Center of Connecticut, used person-centered care to offer the opportunity for conversation, socialization, fun, hydration and nutrition. This Webinar will describe specific dining needs and the challenges of meeting those needs, for the person with Alzheimer’s disease. Details about food choices, place settings, dignity, appealing food choices and the overall dining environment will be shared. |
Study Calls for Early Treatment Intervention in Stroke Patients with Spatial NeglectTuesday, January 10th, 2012
The following article was recently published in Rehab Today summarizing research published in the Archives of Physical Medicine and Rehabilitation supporting early therapy involvement for spatial neglect deficits.
Results from a study conducted by the Kessler Foundation, headquartered in West Orange, NJ, and South Orange, NJ-based Seton Hall University, spotlight the need for early diagnosis of acute spatial neglect following a stroke. Researchers say the complication is associated with accidents, falls, safety problems, and functional disability that slows patient recovery.
Anna Barrett, MD, director of stroke rehabilitation research at Kessler Foundation, reports that the study’s focus on the acute phase and early detection of spatial neglect after stroke “could enable cognitive interventions to improve function, and might even prevent chronic disability.”
Researchers say during the study they observed 51 consecutive inpatients with right brain stroke and left neglect for 22 days following stroke. According to the study, the Behavioral Inattention Test (BIT)-conventional and the Catherine Bergego scale (CBS) were used along with laboratory measures of perceptual-attentional and motor-intentional deficits. The study’s results suggested that these pyschometric assessments might potentially be used to pinpoint specific motor-exploratory deficits in spatial neglect. Obtaining CBS-ME scores routinely, researchers report, may also improve early detection and allow clinicians to implement care and safety interventions. Researchers explain that without specific cognitive rehabilitation, spatial-action deficits may persist and facilitate chronic disability in patients.
Barrett adds that a great deal of effort is funneled into hi-tech approaches, yet the study’s results “show that clinical tools can be optimized for the bedside, to identify patients who need targeted management and therapy.”
The study was published in the Archives of Physical Medicine & Rehabilitation.
[Source: Kessler Foundation]
Senate Panel Examines Overuse of Antipsychotics in Nursing HomesMonday, December 5th, 2011
How Mild Cognitive Impairment Affects Day-to-Day LivingWednesday, August 10th, 2011
This article was published in the Alzheimer’s Association Newsletter this month and offers a summary of recent research on mild cognitive impairment and progression of cognitive decline. Completing a thorough cognitive assessment as part of the rehab course, helps us to address daily living skills and discharge transitions effectively and may assist physicians in identifying early cognitive changes to promote symptom management. Check out the full article below:
How Mild Cognitive Impairment Affects Day-to-Day Living
People with Alzheimer’s disease often have trouble remembering things like important dates or whether they took their medications, a problem that can disrupt day-to-day activities and planning. The same problems are also common in those with mild cognitive impairment, or MCI, which often precedes Alzheimer’s disease, even though problems with daily tasks, work or social activities are not generally part of the definition of the condition, according to a new report. The findings appeared in the Archives of General Psychiatry, a journal from the American Medical Association.
For the study, researchers from the New York State Psychiatric Institute surveyed nearly 400 men and women with mild cognitive impairment, and nearly 200 with early Alzheimer’s disease. Another 229 people served as healthy controls.
They asked participants about two main areas of daily concern that are difficult for someone with Alzheimer’s disease. The first involved remembering appointments, family occasions like birthdays and anniversaries, holidays and taking medications. The other set of questions centered around gathering paperwork like assembling tax records or other business records.
Almost three fourths of patients with mild cognitive impairment had problems with these areas of daily functioning. Those who had the most problems were most likely to progress to full-blown Alzheimer’s disease; almost all of those with Alzheimer’s have problems with these activities. In comparison, fewer than 10 percent of the healthy controls had problems with remembering appointments or handling paperwork.
Mild cognitive impairment causes a range of problems, often but not exclusively related to memory. But according to criteria to diagnose the condition, it does not involve “substantial interference with work, usual social activities, or other activities of daily living.” But as this study makes clear, many people with MCI do have problems with day-to-day tasks.
Understanding the level of impairment a patient has is important, note the authors: “Identifying the extent and severity of functional deficits that typically occur in each disorder can aid in early diagnosis, help in estimating prognosis, and improve treatment strategies.”
The results, the researchers note, may help physicians better recognize whether patients with MCI are likely to advance to dementia. “These findings show that even mild disruptions in daily functioning may be an important clinical indicator of disease and represent the latter phases of disease progression within the MCI classification system for cognitive impairment.” They note that additional research is needed to understand when and how trouble with functioning occurs, and what might be done to treat it.
Not all people with mild cognitive impairment go on to develop Alzheimer’s disease. But finding a way to recognize who will progress to Alzheimer’s could be important. Doctors increasingly recognize that treatment for the disease may be more effective in the very earliest stages, when symptoms are minimal and damage to the brain has not become extensive.
Current Alzheimer’s medications are not effective against the downward progression of disease, though they may ease symptoms for a time. As research continues and new treatments are developed, though, it will be important to assess conditions like mild cognitive impairment at its earliest stages, to determine who might benefit from new treatments.
By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.
Source: Patrick J. Brown; D. P. Devanand; Xinhua Liu; Elise Caccappolo; for the Alzheimer’s Disease Neuroimaging Initiative: “Functional Impairment in Elderly Patients With Mild Cognitive Impairment and Mild Alzheimer Disease.” Archives of General Psychiatry. Vol. 68(6), June 2011, pages 617-626.
The Benefits of Stretching in Older AdultsTuesday, August 9th, 2011
Stretching has many benefits. In general, stretching helps with relaxation, and much flexibility can be gained from stretching on a regular basis. Usually, stretching is done before and after exercises to warm up and soothe muscles. However, stretching for seniors is a whole other story.
As we age, our muscles become shorter and lose their elasticity. Senior citizens begin slowing down their movements and even give up their regular routines to avoid injury and falls as their bodies get weaker. In some cases, seniors become unable to walk due to disease or loss of strength. Stretching is an important part of senior’s flexibility and will help offset the effects of normal decline in the flexibility of your joints, and help you remain active and independent. It is extremely important to keep muscles strong, even when one cannot walk or move for long periods of time. This is where stretching for seniors carries the most benefits.
When the body doesn’t move, it only gets weaker. Muscles get smaller and basic movements become impossible, as well as, joint pain that some seniors suffer on a daily basis. But when stretching is added to your life, you’ll feel better and joint problems will improve. Stretching can also improve blood circulation, reduce symptoms of disease and give you an overall feeling of wellbeing. Stretching especially can benefit those suffering from Arthritis, Parkinson’s, and Multiple Sclerosis.
Stretching exercises may seem simple or not worth the time, but even with a little movement stretching for seniors can help. To learn more about a stretching program fit specifically for you, speak with a Physical Therapist. The goal of physical therapy is to restore physical ability so that you can function as independently as possible. Physical therapists understand how the body moves, and thus work with you to help improve movement. Not only do they try to strengthen weakened muscles through exercise and appropriate stretches, they teach some people how to move better by using canes and walkers. A physical therapist also may need to assess how well you are able to perform daily activities in your home. Remember, before you start a new exercise or stretching program, always consult with your physician first.
Staying In Control with IncontinenceTuesday, August 9th, 2011
Urinary incontinence in any form is the most undiagnosed condition mainly because it is not talked about by over 30 million adults.
Incontinence is defined as the involuntary loss of bladder control-or as we call them, ”accidents”. This condition displayed through urinary frequency or loss of control while sneezing or coughing affects men and women, young and old and makes us feel uncomfortable and humiliated. However, it’s nothing to be embarrassed about. Millions of people (30 million to be exact) deal with some type of urinary incontinence.
There are many treatment opportunities for incontinence through therapy available at your disposal. Don’t depend on your sanitation napkin or brief to get you through. Treat and manage the problem of incontinence from the inside out through therapy and medication.
Along with leakage of urine includes:
Urgency: A strong desire to urinate, even when the bladder is not full. This is sometimes accompanied by pelvic discomfort or pain.
Frequency: Urinating more than six to eight times a day or more than once every two hours (with normal fluid intake).
Nocturia: Awakening from sleep because of the urge to urinate. This can vary with age and is not necessarily abnormal unless it occurs regularly more than two or more times a night.
Urinary Incontinence is NOT a normal part of the aging process. There are many factors that can lead to urinary incontinence.
- Bladder Infection
- Weak Pelvic Floor Muscles
- Medications
- Cigarette Smoking
- Chronic Illness/Cough
- Caffeine Intake
- Obesity
- Constipation
- Hormonal Changes
- Pregnancy & Childbirth
- Neuromuscular Disorders
- Improper Lifting
The Right Treatment for You
Knowing that you don’t have to live with incontinence is half the battle. Discussing your problem with a health care professional that is knowledgeable in evaluating and treating incontinence is the next step. It may not have to be a urologist, you may be able to have treatment prescribed by your family physician.
Then you’ll be ready for your therapy team to customize an individualized treatment program that works best for your type of incontinence.
How Can Therapy Help?
- Education about the bladder, pelvic floor muscles and normal emptying technique
- Pelvic Exercises
- Kegels
- Specialized Programs to fit your needs
If you battle the effects of urinary incontinence, call our therapy department today so we can help you get back into control.
Technology for fall prevention: Smart SlippersWednesday, July 13th, 2011
According to AT&T, their team of scientists have been developing prototype connected health products, with the goal of making everyday household items “part of the network cloud.” Bob Miller of AT&T labs and his team want to connect thermometers, scales, blood pressure cuffs and other “old technology” along with wireless radios to leverage WiFi networks and Bluetooth interoperability for connected medical devices. That includes slippers. Called “smart slippers,” they have pressure sensors embedded in their soles to transmit foot movement data over AT&T’s network. If something is amiss in an elderly patient’s gait or there is a fall, the device will alert a doctor via e-mail or text message. The slippers are undergoing clinical trials and may be available as early as next year.
adapted from a newsletter article and info at ATT.com
CDC publishes results of study related to injuries occuring in the bathroom resulting in emergency department (ED) visitsWednesday, July 6th, 2011
The CDC recently published the results of a study related to injuries occuring in the bathroom resulting in emergency department (ED) visits. An excerpt from the article is provided below. View the complete article at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6022a1.htm?s_cid=mm6022a1_e&source=govdelivery#Tab2&emc=lm&m=652713&l=14&v=2709957
PT and OT can reduce injury risk through specific analysis of bathroom mobility, environmental modifications including but not limited to non-slip surfaces, grab bars, tub seats, modified toilet seats and the use of visual contrast. Transfers onto and off of the toilet should be a particular focus of treatment for at risk clients. Addressing shower/tub safety as part of the safe transition plan is also important. Check out the staff resources available in the ADL and falls prevention folders under clinical tools tab of the portal to help with your efforts to promote bathroom safety.
Nonfatal Bathroom Injuries Among Persons Aged ≥15 Years — US, 2008
June 10, 2011 / 60(22);729-733
In 2008, an estimated 234,094 nonfatal bathroom injuries among persons aged ≥15 years were treated in U.S. EDs, for an injury rate of 96.4 per 100,000 population. The rate for women was 121.2 per 100,000 and was 72% higher than the rate for men (70.4 per 100,000) (Table 1). Although approximately the same number of cases occurred in each 10-year age group, injury rates increased with age. Falls were the most common primary cause of injury (81.1%), and the most frequent diagnosis was contusions or abrasions (29.3%). The head or neck was the most common primary part of the body injured (31.2%). Most patients (84.9%) were treated and released from the ED; 13.7% were treated in the ED and subsequently hospitalized.
The highest rates were for injuries that occurred in or around the tub or shower (65.8 per 100,000) and injuries that happened on or near the toilet (22.5 per 100,000) (Table 2). The precipitating events in 37.3% of injuries were bathing (excluding slipping while bathing), showering, or getting out of the tub or shower; only 2.2% occurred while getting into the tub or shower. The precipitating event for 17.3% of injuries was slipping, which included slipping while bathing; 14.1% occurred when standing up from, sitting down on, or using the toilet; and 5.5% were attributed to an antecedent loss of consciousness.
Injury rates increased with age, especially those that occurred on or near the toilet, which increased from 4.1 per 100,000 among persons aged 15–24 years to 266.6 among persons aged ≥85 years. Injuries occurring in or around the tub or shower also increased markedly, from 49.7 per 100,000 among persons aged 15–24 years to 200.2 among persons aged ≥85 years. Within each 10-year age category, the relative proportion of injuries differed by location within the bathroom. The proportion of injuries in or around the tub or shower was highest among persons aged 15–24 years (84.5%) and lowest among persons aged ≥85 years (38.9%), whereas the proportion of injuries that happened on or near the toilet was lowest among persons aged 15–24 years (7.0%) and highest among persons aged ≥85 years (51.7%).
Within age categories, the relative proportion of injuries also differed by precipitating event (or activity). Among persons aged 15–24 years, the percentage of injuries that occurred while bathing or showering was 34.3% (rate 20.2 per 100,000), whereas among persons aged ≥85 years, the percentage of injuries occurring while bathing or showering was 15.5% (rate 79.9). In contrast, the proportion of injuries that occurred when getting on, off, or using the toilet was lowest among persons aged 15–24 years (2.0%) and increased with age, reaching 19.3% among persons aged 65–74 years, 26.9% among persons aged 75–84 years, and 36.9% among persons aged ≥85 years. Injury rates were 1.2, 21.6, 64.8, and 190.1 per 100,000 for age groups 15–24, 65–74, 75–84, and ≥85 years, respectively.
The injury rate associated with syncope or loss of consciousness was low. For most age groups, it accounted for fewer than 7.0% of injuries and ranged from 3.6% among persons aged 25–34 years to 9.4% among persons aged 15–24 years.
The leading injury diagnoses were contusions or abrasions (29.3%), strain or sprain (19.6%), and fracture (17.4%). The age-specific rate for contusions or abrasions increased from 13.5 per 100,000 (aged 15–24 years) to 157.9 (aged ≥85 years), whereas rates for strains and sprains increased only slightly with age. In contrast, the fracture rate increased markedly, from 5.8 per 100,000 (aged 25–34 years) to 165.6 (aged ≥85 years). Hospitalization rates, which could be calculated only for persons aged ≥55 years, followed a similar pattern (lowest among persons aged 55–64 years [11.9 per 100,000] and highest among persons aged ≥85 years [197.4]).
Reported by
Judy A. Stevens, PhD, Elizabeth N. Haas, Div of Unintentional Injury Prevention; Tadesse Haileyesus, MS, Office of Program and Statistics, National Center for Injury Prevention and Control, CDC. Corresponding contributor: Judy A. Stevens, CDC, jas2@cdc.gov, 770-488-4649.
Assistive Technology at Our Fingertips…Wednesday, July 6th, 2011
Smart phone apps may be a useful tool as part of the individualized safe transition plan from rehab. Sample applications include voice4u–a collection of voice and picture prompts to assist clients with speech difficulties– that also allows you to download your own photos and voice prompts. Check out the full OT practice article that includes 2 case studies and a list of applications to consider in treatment plans to address communication impairments, cognitive deficits, and ADL obstacles, including medication management.
http://www.nxtbook.com/nxtbooks/aota/otpractice_vol16issue11/index.php#/12
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