Communication skills in nursing home residents with dementia : Results of a prospective intervention study over 21 months.

BACKGROUND: The dementia syndrome compromises effective communication and may thus lead to social isolation, psychological distress and decreased quality of life. It is therefore of importance to maintain communication capacity in dementia as long as possible. MATERIAL AND METHODS: A total of 24 professional caregivers from 8 nursing homes were assigned to train 254 of their respective colleagues using the train-the-trainer program MultiTANDEMplus. As in the 6 control nursing homes, severity of dementia, depressive symptoms and communication capacity were assessed in a total of 358 residents at baseline and 21 months later. Overall, 189 residents completed the study. RESULTS: Communication capacity declined in control home residents but remained stable in the intervention group although dementia severity increased in both groups. The intervention group exhibited significantly fewer depressive symptoms after the intervention than the control group. CONCLUSION: A standardized training of communication skills for professional caregivers can stabilize communication capacity and reduce depressive symptoms in nursing home residents. These effects are likely sustainable and could be demonstrated 21 months postintervention.

Pharmacological properties of 2,3,3a,4,5,6-hexahydro-8-methyl-1H-pyrazino [3,2,1-j,k]carbazol hydrochloride (pirlindole), a new antidepressant.

The hydrochloride salt of 2,3,3a,4,5,6-hexahydro-8-methyl-1H-pyrazino[3,2,1-j,k]carbazol hydrochloride (pirlindole) exerts pharmacological effects typical of antidepressants. This compound antagonizes the depressant effects of reserpine and tetrabenazine and potentiates the central effects of amphetamine and l-dopa. It also enhances the head-twitch effect of 5-hydroxy-tryptophan, the effects of noradrenaline, adrenaline, serotonin, tyramine on blood pressure as well as the hypertensive and tremor activities of tryptamine. Pirlindole inhibits the neuronal uptake of noradrenaline and exerts reversible, short-lasting anti-MAO activity. It does not possess anti-cholinergic activity. Clinical trials have shown pirlindole to be effective as an antidepressive drug.