Linking two new E-health caregiver interventions to meeting centres for people with dementia and their carers; a process evaluation.

Objectives: Research shows that carers of people with dementia experience worse physical and psychological functioning than non-caregivers or than caregivers of people with a different chronic illness. This study investigated the implementation of two new e-health interventions for carers of people with dementia, Dementelcoach (telephone coaching) and STAR e-learning (online platform to learn about dementia). The interventions were linked to existing Meeting Centres for people with dementia and their carers.Method: We conducted a qualitative multiple case study. Semi-structured interviews regarding experienced influencing factors were conducted with 15 key figures/stakeholders (14 interviews) in eight Meeting Centres during the preparation, starting and continuation phases of the implementation of Dementelcoach and STAR e-learning.Results: Several influencing factors were found on micro level (e.g. PR, training, qualified personnel), meso level (e.g. finances, division of tasks) and macro level (e.g. laws and regulations, national and regional policy) during the different phases of the implementation process. Factors mentioned by most stakeholders were human and financial resources. Another important factor found was the fit between the interventions and region.Conclusion: Insight into facilitators and barriers in the implementation of Dementelcoach and STAR e-learning provided by this study will inform and enable other Meeting Centres to adopt a fitting strategy to implement these interventions in their own centre. This is expected to help disseminate the intervention further, and will result in better-informed and supported carers. This will contribute to the prevention of overburdening in carers and will potentially enable carers to provide better care for their relatives with dementia.

Utilization, effect, and benefit of the individualized Meeting Centers Support Program for people with dementia and caregivers.

PURPOSE: There are few interventions on an individual basis to support community-dwelling people with dementia to continue to fulfill their potential in society and to support their informal caregivers via e-Health. This study explored the effectiveness of the individualized Meeting Centers Support Program (iMCSP) consisting of DemenTalent (people with dementia work as volunteers in a society based on their talents), Dementelcoach (telephone coaching), and STAR e-Learning for caregivers, compared to regular MCSP and No day care support. METHOD: An explorative randomized controlled trial with pre/post measurements (M0-M6) and two groups (iMCSP and regular MCSP). In addition, a comparison was made between iMCSP and a reference No day care control group. Standardized questionnaires were administered on self-esteem, neuropsychiatric symptoms, experienced autonomy and quality of life of the person with dementia, and on caregiver's sense of competence, quality of life, and happiness. RESULTS: The iMCSP interventions resulted in a broader group of participants utilizing the Meeting Centers. Compared to regular MCSP, DemenTalent had a moderate positive effect on neuropsychiatric symptoms, which also proved less severe. Positive affect of participants improved within the DemenTalent and regular MCSP group after six months. Caregivers of DemenTalent participants experienced less emotional impact of neuropsychiatric symptoms. No differences were found in experienced burden, sense of competence, or quality of life in caregivers using iMCSP or regular MCSP. Compared to those receiving No day care support, caregivers of DemenTalent participants and caregivers using Dementelcoach or STAR e-Learning proved happier. Post-hoc analyses, accounting for potential between-group differences in outcome measures at baseline, generally showed results in the same direction. People with dementia and caregivers highly appreciated iMCSP and regular MCSP. CONCLUSION: iMCSP can be effectively applied as alternative or additional support via regular Meeting Centers for people with dementia and caregivers who prefer individualized activities/support. DemenTalent decreased the severity of neuropsychiatric symptoms of people with dementia and emotional burden of caregivers. All iMCSP interventions tended to result in caregivers being happier compared to those receiving no support. Larger-scale studies are needed to investigate the effect of iMCSP on other domains of quality of life of participants.

Linking DemenTalent to Meeting Centers for people with dementia and their caregivers: a process analysis into facilitators and barriers in 12 Dutch Meeting Centers.

OBJECTIVES: There have been relatively few interventions on an individual level to support community-dwelling people with dementia to continue to fulfill their potential in society. This study investigated the implementation of DemenTalent, an intervention in which people with dementia become active as volunteers in society based on their talents. The intervention was linked to existing Meeting Centers for people with dementia and their informal caregivers. METHOD: We conducted a qualitative multiple case study. Semi-structured interviews regarding experienced facilitators and barriers were conducted with 22 key figures/stakeholders in 12 Meeting Centers during the preparation, starting and continuation phases of the implementation of DemenTalent. RESULTS: Several influencing factors were found on a micro level (e.g. Public Relations, training, management involvement), meso level (e.g. finances, collaborating with others) and macro level (e.g. laws and regulations, national and regional policy) during the different phases of the implementation process. Factors mentioned by most stakeholders were human and financial resources. Another important factor appeared to be the culture of the region. CONCLUSION: The insight into facilitating and impeding factors in the implementation of DemenTalent provided by this study will inform and enable other Meeting Centers to adopt a fitting strategy to implement DemenTalent in their own center. This is expected to help disseminate the intervention further, giving more people with dementia the chance to fulfill their potential, find a meaningful and pleasant way of spending their time, and actively participate in society. This will contribute to a more inclusive society and less stigmatization of people with dementia.

Effects of Exergaming in People with Dementia: Results of a Systematic Literature Review.

BACKGROUND: Physical exercise benefits functioning, health, and well-being. However, people living with dementia in particular hardly engage in exercise. Exergaming (exercise and gaming) is an innovative, fun, and relatively safe way of exercising in a virtual reality or gaming environment. It may help people living with dementia overcome barriers they can experience regarding regular exercise activities. OBJECTIVE: This systematic literature review aims to provide an overview of the cost-effectiveness of exergaming and its effects on physical, cognitive, emotional, and social functioning, as well as the quality of life in people living with dementia. METHODS: PubMed, Embase, Cinahl, PsycINFO, the Cochrane Library, and the Web of Science Core Collection were searched. Selection of studies was carried out by at least two independent researchers. RESULTS: Three studies were found to be eligible and were included in this review. Two of these showed some statistically significant effects of exergaming on physical, cognitive, and emotional functioning in people living with dementia, although based on a very small sample. No articles were found about the cost-effectiveness of exergaming. CONCLUSIONS: Only a few controlled studies have been conducted into the effectiveness of exergaming, and these show very little significant benefits. More well-designed studies are necessary to examine the effects of exergaming.