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.

Evaluation of small-group education on the shade determination ability of preclinical dental students-A controlled clinical trial.

OBJECTIVES: To evaluate the effect of small-group education including practical training on dental students' shade determination performance compared with a control group. METHODS: Sixty-three non-colour-blind preclinical students were asked to participate and belonged to an intervention (n = 31) and a control (n = 32) group, respectively. All students received a lecture on dental shade determination. The members of the intervention group were educated and practically trained in small groups in addition. Ten volunteers, each with unrestored upper right middle and lateral incisors, were recruited. The students of both the intervention and control groups were then asked to determine the colour of the volunteers' test teeth using the 3D-Master shade guide (Vita Zahnfabrik, Bad Säckingen, Germany) under artificial daylight illumination. For analytical purposes, the CIE L*a*b* coordinates were obtained using a spectrophotometer. Colour differences, ΔE, between all shade tabs selected by the students and the natural teeth were calculated. ΔE observed in the intervention and control groups were compared using t tests. In addition, a multi-level regression model was adjusted for age and gender. RESULTS: Mean (SD) ΔE between the shade tabs selected by the students and the natural teeth in the intervention and control groups were 3.8 (2.1) and 4.3 (2.3), respectively (P < .001). The effect of group membership was reproduced in multivariate analysis whereas age and gender did not reach statistical significance. CONCLUSIONS: With more intensive education and practical training the ability to perform clinical shade determinations improved for students without previous clinical experience. The results obtained support the idea of implementing thematic small-group education in the dental curriculum.

Comparison of oral health among older people with and without dementia.

UNLABELLED: Older people with dementia are very dependent on nursing, and caregivers are frequently confronted with oral-care-resistant behaviour which may lead to shortcomings in oral health. OBJECTIVE: To compare oral hygiene and health status of institutionalised older people suffering, or not, from dementia. BASIC RESEARCH DESIGN: Prospective cohort study (single-blind). CLINICAL SETTING: Institutionalised older population in south-west Germany. PARTICIPANTS: Ninety-three, allocated to two groups: dementia (n = 57) and non-dementia (n = 36) based on a mini mental state examination. MAIN OUTCOME MEASURES: Target variables were plaque control record (PCR), gingival bleeding index (GBI), community periodontal index of treatment needs (CPITN), and denture hygiene index (DHI). Differences between the dementia and non-dementia groups were evaluated by univariate testing of all target variables. RESULTS: Univariate analysis revealed the amount of plaque in the dementia group was significantly higher than in the non-dementia group (p = 0.004). Mean CPITN of participants in the dementia group was significantly worse than those of participants in the non-dementia group (p < 0.001). All participants in the dementia group had periodontitis in at least one of the sextants, compared with 74% in the non-dementia group (p < 0.001). For DHI (p = 0.198) and GBI (p = 0.275) no differences were found between the groups. CONCLUSIONS: Some aspects of oral hygiene and health seem to be worse for the institutionalised older people with dementia. Permanent specially adapted intervention for residents suffering from dementia in long-term care homes, and training for caregivers, is desirable to maintain life-long oral hygiene and health.