[Bedside-teaching on dementia and delirium: Development, implementation, and evaluation in an acute care hospital]. / Bedside-Teaching zum Thema Demenz und Delir.

Bedside-teaching on dementia and delirium: Development, implementation, and evaluation in an acute care hospital Abstract: Background: Demographic change and the accompanying increase in people with dementia and delirium in acute care hospitals pose growing challenges for nurses in acute care wards. Objective: Pilot implementation and evaluation of knowledge gain and implementation of previously defined critical behaviors. Method: Implementation of the training by APNs. Parallel evaluation of the training along the New World Kirkpatrick model using questionnaires and non-participant observation. Analysis of the data using descriptive statistics. Results: The training itself was well evaluated by the participants. It showed an increase in knowledge of the participants in the main topic categories. The targeted critical behaviors were implemented for the most part. There are deficiencies in the mapping of interventions in the nursing care process. Conclusion: The training concept is suitable to give nurses confidence in dealing with people with dementia and delirium. Continuous support in practice is needed to maintain the interventions in the long term and sustainably in everyday life.

[Support needs of caregivers of people with dementia: An integrative literature review]. / Unterstützungsbedürfnisse pflegender Angehöriger von Menschen mit Demenz.

Support needs of caregivers of people with dementia: An integrative literature review Abstract: Background: Family caregivers are of great importance in the home care for people with dementia. The care and related stress can have a negative impact on their health. The CSNAT (German: KOMMA) is an approach to support family caregivers in palliative home care that could be used for this group of people. Aim: The aim was to identify support needs for caregivers of people with dementia in the literature and compare these with those that formed the basis for the development of the KOMMA approach. Method: We performed an integrative review. Literature research was conducted in February and March 2021 in the MEDLINE, CINAHL and PsycInfo databases. Relevant studies were identified and assessed using inclusion and exclusion criteria. Using MAXQDA, the data were assigned to categories with a content analytic procedure. Results: 23 studies were included that had been published with peer review procedure. Compared to the KOMMA approach, family caregivers show divergent support needs in the areas of (in)formal assistance, access to knowledge, managing physical and mental health conditions, maintaining the relationship, (temporarily) relinquishing the caregiving role and social integration. Conclusion: The KOMMA tool for identifying support needs cannot be directly adopted for this group of caregivers in its present form. However, given the richness of identified support needs, the development of a person-centered and needs-oriented assessment seems important.

Specifics of and training needs in the inter-professional home care ofpeople with dementia.

Introduction: Successful home care for people living with dementia (PLwD) allows them to live in their own home environment for as long as possible. Current findings indicate a need for further development of medical and nursing knowledge and skills in evidence-based collaborative care for these patients. Aim: To identify specifics of inter-professional care for PLwD and training needs of home care nurses and general practitioners involved in care. Method: A multi-perspective qualitative study was conducted, comprising focus groups as well as individual interviews. Focus groups and interviews followed a semi-structured topic guide. Interview data was digitally recorded and transcribed verbatim, followed by a thematic framework analysis. Results: The sample consisted of nine nurses, one medical assistant, three general practitioners and nine family caregivers of PLwD. Five themes related to inter-professional home care were inductively developed: challenges in outpatient dementia care, challenges in collaboration, insufficient healthcare infrastructure, competencies needed in dementia care, and training requirements. Challenges were a lacking flow of information as well as continuity and organization of care. Home care nurses and family caregivers complained about missing communication skills in health professionals involved in the care of PLwD. Conclusions: The interviews revealed heterogeneous training needs of home care nursing staff and general practitioners that can be addressed by an inter-professional training course.

[Prevalence of neuropsychiatric symptoms of people with dementia in long-term care units: A secondary analysis]. / Prävalenz von neuropsychiatrischen Symptomen bei Menschen mit Demenz in der stationären Langzeitpflege.

Prevalence of neuropsychiatric symptoms of people with dementia in long-term care units: A secondary analysis Abstract: Background: In a progress of dementia, most people develop neuropsychiatric symptoms. However, there is little knowledge about the prevalence of these symptoms and their specific characteristics in long-term care. Aims: A differentiated investigation of the prevalence and characteristics of neuropsychiatric symptoms in people with dementia in a long-term care setting. Methods: The prevalence of neuropsychiatric symptoms of people with dementia in a long-term care setting was examined using a secondary analysis of cross-sectional data from the research projects LebenQD I and II and FallDem. The data were collected using the neuropsychiatric inventory - nursing home version. The analysis included data from 699 people with dementia from a total of 21 long-term care facilities in North Rhine-Westphalia. Results: The symptoms agitation/aggression (36%), depression/dysphoria (33%), apathy/indifference (33%), irritability/lability (30%) and aberrant motor behaviour show the highest prevalence. The symptoms hallucinations (9%) and euphoria/elation (6%) have the lowest prevalence. Conclusions: The high prevalence of specific neuropsychiatric symptoms and their characteristics in people with dementia illustrates the need for care-related or psychosocial interventions to counteract the reasons for the occurrence of the symptoms.

[Care for family carers of people with dementia in municipal communities during the pandemic: A Qualitative Study]. / Versorgung pflegender Angehöriger von Menschen mit Demenz in der Kommune während der Pandemie.

Care for family carers of people with dementia in municipal communities during the pandemic: A Qualitative Study Abstract: Background: The availability of support services for family carers of persons with dementia in the municipal community shows deficits due to the Corona pandemic and thus entails a change in the support of carers. Research question: The questions arise, what changes in the care of family carers of people with dementia do those affected perceive, how do actors from the municipal community experience the care situation during the pandemic and to what extent do the perceptions of the groups coincide or differ. Method: The database consists of town hall talks and focus groups from 13 municipal communities in Germany. Participants were family carers and actors from the municipal community. For data analysis, a qualitative content analysis was carried out. Result: Negative changes in the care of caregivers can be seen, for example, in the omission of care services or groups of relatives. Above all, actors perceived positive changes, such as advancing digitalization or increased neighborly help. The perception of changes in the care situation differs in several subcategories between carers and actors. Conclusion: Although large gaps in care have been created by the pandemic, emerging challenges also create new ways for support such as digital groups for family carers. In the future, opportunities need to be created to implement already developed interventions in such a way that the target group can make use of them.

[Task sharing in outpatient dementia care - Focus groups with GPs and nurses]. / Aufgabenteilung in der ambulanten Versorgung von Menschen mit Demenz.

Task sharing in outpatient dementia care - Focus groups with GPs and nurses Abstract. Background: Caring for people with dementia (PWD) is challenging for the health system and family carers and can only be managed through interprofessional medical and nursing care. AIM: The AHeaD study investigated attitudes of general practitioners (GPs) and nurses towards the transfer of activities previously performed by GPs to advanced nurses in the outpatient care of PWDs. METHODS: In four focus group discussions with 10 GPs and 13 nurses, qualitative content analysis was used to investigate attitudes towards the transfer of certain tasks and to identify opportunities and barriers to their introduction. RESULTS: GPs primarily preferred the transfer of nursing activities such as blood sampling, assessments, their monitoring or follow-up prescriptions for nursing aids. "Classical" medical tasks (e. g. diagnosis of diseases, initial prescription of medication) are still seen in the hands of GPs. Nurses demanded more appreciation and recognition for the relationship between GPs and nurse and criticised the lack of trust and insufficient communication. Both sides pointed to tight time budgets that were hardly oriented towards the actual needs of the PWD. CONCLUSIONS: The implementation of a redistribution of tasks requires the creation of legal and financial framework conditions, time resources, concrete task descriptions as well as a stronger cooperation between the professional groups involved. Innovative concepts could contribute to the sensible use of the resources GP and nurses and strengthen the care of PWDs.

[Information needs of family caregivers regarding new technologies for dementia care at home: A qualitative study]. / Informationsbedürfnisse pflegender Angehöriger zu neuen Technologien der häuslichen Versorgung bei Demenz.

Information needs of family caregivers regarding new technologies for dementia care at home: A qualitative study Abstract. Background: New technologies can support family caregivers in the home care of people with dementia but are unknown to many. To reduce the information deficit, the information needed by caregivers must be determined. Aim: The aim of this study is to investigate the information needs of family caregivers regarding new technologies for dementia care at home, taking into account experiences in past research and future information needs. Methods: Episodic interviews were conducted with eight family caregivers of people with dementia and analyzed according to thematic coding. Results: Caregivers used both media-based and interpersonal channels for technology-related research and made heterogeneous experiences. The researched information content and causes of research varied across respondents. The amount of available online information was a barrier in some cases. With regard to future information needs, the diversity of information channels and the quality of information are of high importance. Conclusions: The individual situation-specific needs of family caregivers must be taken into account in the development of new information and counseling services so that information deficits can be eliminated, and the potential of new technologies can be exploited in the home care of people with dementia. Further research is needed on the information needs of people with dementia.

[Dementia Care Nurse - Feasibility study of outreach assistance for people with dementia and their family carers]. / Dementia Care Nurse.

Dementia Care Nurse - Feasibility study of outreach assistance for people with dementia and their family carers Abstract. Background: Case management for dementia is stipulated in the German national dementia strategy. The effectiveness of case management has been investigated many times, yet the results are heterogeneous. On the contrary, the implementation processes of case management concepts have to date rarely been described or evaluated in detail. Aim: The aim of the project was to analyze the implementation of an outreaching assistance for people with dementia and to explore the changes in care, acceptance, and also facilitators and barriers to the implementation. Methods: Between 08 / 2018 and 07 / 2019, outreaching assistance for people with dementia and their family carers was implemented. Quantitative and qualitative data were prospectively collected using semi-standardised interviews in the context of outreach assistance. Results: A total of 113 people with dementia were included in the study, and for the most part family carers could be involved. On average, eight contacts took place over a period of 74 days. The areas of need and support were diverse. The use of support services increased by 19 % after the end of the intervention. Conclusions: The implementation of continuous and processual support for people with dementia and their carers is possible, whereby the structure and procedure should be transparent. A comprehensive orientation and networking is beneficial. The effectiveness of the intervention remains to be investigated in a controlled study.

[Tracking systems in people with dementia in long-term care - Update of an integrative review]. / Tracking-Systeme bei Menschen mit Demenz in der stationären Langzeitpflege.

Tracking systems in people with dementia in long-term care - Update of an integrative review Abstract. Background: This article is an update of the article by Hülsken-Giesler et al. (2019) and describes the latest findings on tracking systems in inpatient long-term care. RESEARCH QUESTION: The research question also follows on from the underlying article and again deals with the application of tracking systems and their consequences for residents and nursing staff. METHODS: A systematic literature search in the databases MEDLINE via PubMed and CINAHL as well as a hand search for the period starting in August 2017 was performed. The included literature was evaluated by two independent persons regarding content and methodology. RESULTS: In addition to deductive categories from the underlying work, further inductive categories could be formed and thus ethical and implementation aspects could be included. CONCLUSION: Since the first analysis, the focus in nursing science studies on the use of tracking systems in inpatient long-term care has shifted to ethical aspects. Also, the successful and long-term integration into care practice is now relevant.

[Challenges in dementia care at home - The situation at home of a married couple]. / Herausforderungen bei Demenz in den eigenen vier Wänden.

Challenges in dementia care at home - The situation at home of a married couple Abstract. Background: People with dementia and their relatives are faced with major challenges due to complex dementia symptoms. Families need information and counselling in order to find adequate dementia care services tailored to their needs. AIM: This case report's objective is to exemplify the domestic situation of a married couple who is faced with significant challenges within the family and the care system due to the husband's dementia and Parkinson's disease. METHODS: The Dementia Care Nurse project included case monitoring; by means of different assessments relevant information was recorded and the family's situation described. RESULTS: The family's problems and their need for support were multifaceted and entailed reimbursement of costs, application for care services as well as management of challenging behaviours and reduction of the caregiver's psychosocial burden. CONCLUSIONS: The family, particularly the spouse caregiver, was effectively supported in meeting the challenges of dementia, e. g. by drawing on professional services and sorting out entitlement to benefits. From the perspective of the experience in the project, independent counselling structures such as a case management approach are indispenable in order to stabilise the domestic situation.

Die Lebenssituation von Menschen mit Demenz und pflegenden Angehörigen während der Coronavirus-Pandemie Eine qualitative Studie.

The life situation of people with dementia and family carers during the coronavirus pandemic - A qualitative study Abstract. Background: The measures initiated as a result of the coronavirus pandemic have far-reaching consequences for the everyday life of people with dementia and their family carers. Both are usually among those who are the most vulnerable and thus are subject to rigorous restrictions. Their everyday life is made more difficult because care and respite services are currently suspended. In addition, people with dementia have difficulty understanding and implementing the restrictions and hygiene rules. AIMS: This study aims to describe the current life situation of family carers and people with dementia. METHODS: For this purpose, 21 telephone interviews with both family carers and people with dementia have been conducted twice during the spring of 2020 and were subsequently evaluated by a content analysis. RESULTS: The interviewees experienced the situation differently. Especially the social isolation, the higher amount of care, the uncertainty of the situation and the increase in psychological symptoms are described as being stressful. With regard to coping with the situation, discussions are taking place about the support from the social environment, alternative ways of communication, experiences with comparable crises, the stability of formal care and the handling of information. CONCLUSIONS: Family carers and people with dementia feel stressed due to the coronavirus pandemic, but many of them have coping strategies for this special situation. Informal support is a particularly important support mechanism.

[The Healthcare Teams' Perspective on Caring for People with Dementia in Acute Hospitals: A Qualitative Study]. / Die Betreuung von Menschen mit Demenz im Akutkrankenhaus aus Sicht des Behandlungs- und Betreuungsteams.

The Healthcare Teams' Perspective on Caring for People with Dementia in Acute Hospitals: A Qualitative Study Abstract. Introduction: To deal with the complexity of the situation of people with dementia in acute hospitals, it is necessary to develop tailored interventions. In doing so, it is important to consider the perspectives of all relevant persons, including health care teams. AIM: The aim of this study was to explore the situation of people with dementia in three Swiss acute hospitals from the perspective of health care teams. METHODS: We conducted three focus group interviews with health care teams consisting of medical doctors, nurses and therapists. Data were analysed by means of summarising content analysis according to Mayring. RESULTS: A total of 20 health professionals took part. Three main categories were identified: "People with dementia confront the hospital system", "The hospital system fails to meet the needs of people with dementia" and "Necessary changes take place in the hospital system". The results show a lack of intention in the hospital system to address the specific needs of people with dementia. Health care teams feel forced to intensify their teamwork. This occurs unsystematically and with little organisational support. CONCLUSION: It seems of paramount importance to systematically support the teams' initiatives for enhanced teamwork in caring for people with dementia. Teamwork should be considered as a key aspect when developing interventions.

Unmittelbare Reaktionen von Menschen mit Demenz auf individualisierte Musik - Analyse von Verhaltensbeobachtungen im Pflegeheim .

Immediate reactions of people with dementia to individualized music - Analysis of behavioral observations in a nursing home Abstract. Background: Due to the increasing prevalence of dementia, there is an urgent need for effective non-pharmacological interventions to improve the quality of life of people with dementia (PwD) and to relieve their carers. Studies show evidence for the benefits of individualized music. However, the immediate reactions to individualized music have not yet been adequately investigated. AIM: The research objective of the study was the investigation of the immediate effects of an individualized music intervention in a nursing home using a newly developed systematic behavioral observation rating scale. METHODS: In 153 behavioral observations of 20 PwD, 32 different experiences and behaviors pertaining to 11 categories such as emotional and motor changes which indicate immediate reactions to listening to music were rated. RESULTS: Participants showed significantly more positive reactions (e. g. joy or relaxation) and less negative reactions immediately after listening to the music compared to before. Moreover, in the course of listening to music, participants showed significantly more positive reactions, most often smiles, movements to music, attentive listening, relaxation and general vigilance / interest / social contact. CONCLUSIONS: The systematic behavioral observation rating scale proved to be a suitable method for rating the experiences and behaviors of people with dementia. Listening to individualized music seems to be a helpful intervention for PwD in institutional care settings.

Prioritäten der Pflegeforschung für das Themenfeld "Dementia Care" im deutschsprachigen Raum - Eine Delphi-Studie.

Priorities of nursing research in dementia care in German-speaking countries - A Delphi study Abstract. Background and objective: To meet the central needs of people with dementia, their relatives and their caregivers in complex living conditions and care situations, a substantive examination of research priorities is required. The aim of this work was the identification and prioritisation of nursing research topics concerning dementia care in German-speaking countries. METHODS: To identify existing research agendas in dementia care, we conducted a systematic literature research. As part of a Delphi process, systematically identified dementia care experts from German-speaking countries supplemented research priorities extracted from existing research agendas and assessed their importance. Subsequently, they prioritized topics of particular importance for nursing research. RESULTS: Fifteen experts supplemented 61 topics previously identified in existing research agendas. They assessed 107 topics in terms of their importance and prioritized 79 topics. CONCLUSIONS: The research priorities developed are a potential framework for nursing science, health policy and research funding in order to structure research activities. To ensure currency, priorities should be regularly updated and re-opened for discussion.

Needs of people with dementia and their informal caregivers concerning assistive technologies.

Background and objective: Assistive technologies might be a suitable option for supporting people with dementia and their informal caregivers. To avoid "one-fits-all"-solutions and to design useful technologies, it is essential to consider the end-users' needs. The objective of this review was to examine the needs of people with dementia and their informal caregivers with regard to assistive technologies. Methods: We conducted a scoping review based on a comprehensive literature search in databases, handsearching, and free web searching. Additionally, we performed citation tracking of included studies. We included all types of study designs. Two researchers independently selected the studies. The results were thematically categorised by two researchers. Results: The search yielded 7160 references. 18 of 24 included studies were qualitative. The studies had been conducted in 13 different countries, mostly in Europe. The sample size ranged between two and 270 participants. Most of the studies involved people with dementia as well as informal caregivers. The analysis resulted in eleven themes. The themes could be assigned to three domains: "needed technologies", "characteristics of needed technologies", and "information about technologies". Conclusions: The results might guide future usage, development and research addressing end users' needs with regard to assistive technologies.

[Tracking systems in people with dementia in long-term care - an integrative review]. / Tracking-Systeme bei Menschen mit Demenz in der stationären Langzeitpflege.

Tracking systems in people with dementia in long-term care - an integrative review Abstract. Schlüsselwörter: Tracking-Systeme, Überwachungssysteme, Personenortung, Demenz, stationäre Langzeitpflege Tracking systems in people with dementia in long-term care - an integrative review Background: Tracking systems are used increasingly in long-term care settings. However, their use is controversial. AIM: This paper examines how tracking systems are used to monitor people with dementia in long-term care facilities and what the consequences are for both residents and staff. METHODS: A systematic literature review was conducted in the PubMed, CINAHL, Livivo, ScienceDirect data bases and a hand search also took place. Included were studies, reviews and research reports in German and English from 2013 onwards. RESULTS: A total of eight references were included in the analysis. The results point to an ambivalent use of tracking systems in nursing. Nursing professionals face challenges in the areas of trust and distrust as well as autonomy and security. For residents, this means new opportunities for mobility and self-determination, but also more pressure due to continuous monitoring. CONCLUSIONS: The results show that the current debate on the use of tracking systems for people with dementia in long-term care settings concentrates mostly on the economic aspects, whereas aspects of person-centered care, ethical conflicts or the experience of those affected are given less attention. A core finding is that the use of technology changes the work processes and roles of professional carers.

Interne Konsistenz und Konstruktvalidität des demenzspezifischen Lebensqualitätsinstruments QUALIDEM - Eine Sekundärdatenanalyse einer Querschnittserhebung.

Internal consistency and construct validity of the Quality of Life measurement in dementia QUALIDEM - a secondary data analysis of cross-sectional data Abstract. Background: Maintaining and improving the Quality of Life (QoL) of people with dementia is the principal aim of nursing and medical care. The QUALIDEM is a theory-based, dementia-specific QoL instrument in the German language. Until now, however, there are hardly any findings on the construct validity. OBJECTIVE: Evaluation of the item difficulty, internal consistency, discriminant and convergent validity of the German QUALIDEM. METHOD: The evaluation of the construct validity is based on a Multi-Trait-One-Method approach, using a sample of 167 people with mild to severe dementia and 71 people with very severe dementia. RESULTS: The correlation between the QUALIDEM subscales and the comparative constructs agitation, depression, anxiety, aberrant motoric behavior, apathy, pain and QoL, measured with the Alzheimer's Disease Related Quality of Life instrument, was confirmed in the expected direction in 82 % of the predefined hypotheses. The correlation coefficients range between 0.04 and -0.60 (discriminant validity) and -0.21 and 0.71 (convergent validity). For the majority of QUALIDEM subscales a good internal consistency could be demonstrated. CONCLUSION: The results indicate first indications for the construct validity of the QUALIDEM subscales and for the further development of the instrument. In future studies, the validity of the German QUALIDEM should be further investigated.

[Providing knowledge and support for caring relatives with the smartphone - the MoCaB project]. / Über das Smartphone Wissen und Unterstützung für pflegende Angehörige bereitstellen.

Providing knowledge and support for caring relatives with the smartphone - the MoCaB project Abstract. Background: Caring relatives often have a lack of knowledge of illness and care options. Surveys, as part of the MoCaB (Mobile Care Backup) project, showed that this is often experienced as a burden. Aim: The aim is to support caring relatives by increasing their knowledge. Therefore care-relevant knowledge and instructions for self-care should be provided according to their needs. Methods: The core element of the mobile application, personalized knowledge transfer in dialogue form, will be developed in a participative process with potential users. The relevant evidence-based nursing knowledge was reviewed by experts and written down for the target group. Results: So far, 86 relevant topics have been identified and formulated. First usability tests showed that the content itself, the used expressions and the presentation via the MoCaB app are well received. Outlook: In a next step, the app will be tested in the home setting with caring relatives and, in order to identify any further need and areas for improvement.

[Counselling approaches to assistive technologies in nursing care for people with dementia - A focus group study with informal carers]. / Beratungsansätze zu assistiven Technologien in der Pflege von Menschen mit Demenz.

Counselling approaches to assistive technologies in nursing care for people with dementia - A focus group study with informal carers Abstract. Background: Assistive technologies may support caregiving relatives of people with dementia. Presently, counselling and training courses are lacking as well as concrete considerations for didactic and methodical implementation. AIM: To convey the perspectives of caring relatives on the development of knowledge and competences in assistive technologies. METHODS: Six interview-guided focus groups with 46 caring relatives of people with dementia were conducted. For analysis the documentary method was applied. RESULTS: Assistive technologies currently do not seem to play a role in care-relevant information and counselling structures. The early development of competences as part of a guided support process is explicitly requested by caregiving relatives. The respondents favoured to try out assistive technologies, e. g. by moderated test possibilities. CONCLUSION: The interviewed caregiving relatives consider the existing approaches to get access to assistive technologies as inadequate. Access to knowledge and competence development of caregiving relatives must be more clearly integrated into the design of the care process. Counselling formats focusing on experience, reflection and usage of assistive technologies might be the didactic basis of structured competence achievement for sustainable integration of useful technologies in daily nursing care.

[Nursing home placement of people with dementia: a secondary analysis of qualitative data and literature review on perspectives of informal caregivers and healthcare professionals]. / Umzug von Menschen mit Demenz in ein Pflegeheim.

Background: Nursing home placement of people with dementia can become necessary when informal care is no longer sufficient. Informal carers experience the transition period as an additional burden. Aim: Experiences and views of informal carers and healthcare professionals regarding the transition from people with dementia to a nursing home are investigated to improve the support for informal carers. Method: This secondary analysis included data from all five focus groups with n = 30 informal carers and healthcare professionals conducted as part of the "RightTimePlaceCare" project. To supplement the material which resulted from a single interview question, a literature analysis with the same focus was conducted. Results: The merged results indicated that informal carers needed professional support early on at home until after the nursing home placement. Concerns regarding nursing homes, financial aspects and family related issues were important aspects in the decision making. Healthcare professionals recommended provision of early guidance regarding those matters and making own experiences with nursing homes. Healthcare professionals should serve as mediators during the transition process and improve the collaboration between service providers. Conclusions: Empowering families to make informed choices could be facilitated by offering advice at home about their options for formal support services, financial support, and housing solutions. Healthcare professionals should support caregivers to make a decision, coordinate the placement and to cope with the new situation.