Developments in Smart Assistive Technology to Support People With Dementia (Frontiers in Pharmacology)

Summary

A recent systematic investigates the use of remote “sensing technology” to assess behavioural and psychological symptoms of dementia (BPSD), and for monitoring people with dementia more generally. The broad categories of technology considered include (i) wearable sensors, (ii) non-wearable motion sensors and (iii) assistive technologies / smart home technologies.

The authors propose a framework for sustainable ethical innovation in the application of healthcare technology.

Full Text Link

Reference

Husebo, BS. Heintz, HL. [and] Berge, LI. [et al] (2020). Sensing technology to facilitate behavioral and psychological symptoms and to monitor treatment response in people with dementia. A systematic review. Frontiers in Pharmacology. February 7th 2020; Vol.10: 1699.

Posted in Assistive Technology, Commissioning, Community Care, Falls Prevention, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Integrated Care, International, Management of Condition, Models of Dementia Care, Non-Pharmacological Treatments, Person-Centred Care, Personalisation, Quick Insights, Systematic Reviews, Telecare, Telehealth, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Elderly Depression and Dementia: Underlying Relationships? (Frontiers in Pharmacology)

Summary

A systematic review examines the relationship(s) between depression and dementia in old age, exploring multiple possible explanations:

  1. Depressive symptoms may be a risk factor for dementia.
  2. Depressive symptoms may be a prodromal symptom of dementia.
  3. Depressive symptoms may be simply coincidental in dementia, connected only by common underlying risk factors.

“It seems unlikely that there is no connection at all”.

Uncertainties remain.

Full Text Link

Reference

Wiels, W. Baeken, C. [and] Engelborghs, S. (2020). Depressive symptoms in the elderly-an early symptom of dementia? A systematic review. Frontiers in Pharmacology. February 7th 2020; Vol.11: 34.

Posted in Depression, Diagnosis, For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), International, Management of Condition, Mental Health, Person-Centred Care, Quick Insights, Systematic Reviews, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

More on Sustaining Quality Improvement (CQC / PHSO)

Summary

The Care Quality Commission (CQC) has published further findings about sustaining improvement, based on the positive examples from four case studies, including:

  1. Cambridge University Hospitals NHS Foundation Trust.
  2. East Lancashire Hospitals NHS Trust.
  3. North Staffordshire Combined Healthcare NHS Trust.
  4. Lincolnshire Partnership NHS Foundation Trust.

Common themes are:

  • Formal Quality Improvement (QI) programmes in place.
  • Self-evaluation, assurance and accreditation.
  • Continuing focus on leadership.
  • Engagement.
  • Recruitment and retention.
  • Involvement with the wider local system.

Full Text Link

Reference

Sustaining improvement – the stories of four hospital trusts. [Online]: Care Quality Commission (CQC), March 5th 2020.

There is a series of Driving Improvement reports, relating to different health and care settings.

July 2020 Update

The Independent Medicines and Medical Devices Safety Review (Baroness Cumberlege) report, First Do No Harm: the report of the Independent Medicines and Medical Devices Safety Review, tends to make a lot of the fundamental principles ring hollow.

Further Developments on Complaints Handling in the NHS and Government Departments (PHSO)

The House of Commons Select Committee on Public Administration and Constitutional Affairs (PACAC) directed the Parliamentary and Health Service Ombudsman (PHSO) to review front-line complaints systems. Key sections in the PHSO report comprise:

Full Text Link

Reference

Making complaints count: supporting complaints handling in the NHS and UK Government departments. Ordered by the House of Commons to be printed on 15 July 2020. London: Parliamentary and Health Service Ombudsman (PHSO), July 15th 2020. HC 390. ISBN 978-1-5286-2066-6.

There is also an Executive Summary.

The need for greater consistency in complaint handling will be achieved using a Complaint Standards Framework (under development and public consultation).

Full Text Link

Reference

Complaint Standards Framework: Summary of core expectations for NHS organisations and staff. Public consultation version. London: Parliamentary and Health Service Ombudsman (PHSO), July 2020.

Posted in Acute Hospitals, Commissioning, Community Care, CQC: Care Quality Commission, For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Integrated Care, National, NHS, Person-Centred Care, Quick Insights, Standards, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Cerebral Amyloid Angiopathy (JGCR)

Summary

Cerebral Amyloid Angiopathy (CAA) is characterised mainly by impaired perceptual speed, episodic memory, semantic memory, attention and executive function. It has much in common with global cognitive impairment, and diagnosis may overlap with that for Alzheimer’s Disease or other forms of dementia. Other characteristics may include impulsivity, personality change .and depression. The authors consider the possibilities of devising a neuropsychological profile for CAA.

Full Text Link

Reference

Radhakrishnan, R. Dawith, R. [and] Mitchell, R. [et al] (2020). Neuropsychiatric patterns in cerebral amyloid angiopathy and psychiatric presentations in old age: a short report. Journal of Geriatric Care and Research (JGCR). May 2020, Vol.7(1): pp.17-22.

A quick PubMed search concerning cerebral amyloid angiopathy. A quick Google Scholar search on this subject.

Posted in Depression, Diagnosis, For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), International, Mental Health, Quick Insights, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Terminal Lucidity: a Brief Exploration (BBC Radio 4 / PubMed / Google Scholar)

Summary

Unexpected (apparent?) return of mental clarity and cognitive function in cases of severe dementia, shortly before death – a widely under-recognised phenomenon? Questions, about the fundamental relationship between brain and mind, are explored in an open-minded and even-handed manner.

Full Audio Link

Reference

Jenkins, J. (2020). Lightning before death. London: BBC Radio 4’s Out of the Ordinary, March 2nd 2020.

A quick PubMed search on this subject. A quick Google Scholar search on this subject.

Posted in End of Life Care, For Nurses and Therapists (mostly), For Researchers (mostly), International, Management of Condition, Quick Insights, UK, Universal Interest | Tagged , , , , , , , , , , | Leave a comment

More Statistics on Dementia Care in Acute Hospitals (The Pharmaceutical Journal)

Summary

Data, obtained from a Freedom of Information (FOI) request, indicates that 17% of acute trusts (there were 87 that did respond) offer the full range of non-pharmaceutical therapies suggested by NICE guidance, while less than 45% offer one or more such non-drug therapies. Perhaps surprisingly, 39% of the responding Trusts report that they do not offer any non-pharmacological therapies for agitation, aggression and similar BPSD.

Full Text Link

Reference

Robinson, J. (2020). Almost 40% of hospitals do not offer non-drug therapies to distressed dementia patients. [Online]: The Pharmaceutical Journal, February 20th 2020.

Posted in Acute Hospitals, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), In the News, Management of Condition, Mental Health, Models of Dementia Care, National, NHS, Non-Pharmacological Treatments, Person-Centred Care, Quick Insights, Standards, Statistics, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

The Marmot Review 10 Years On: Health Equity in England (BBC News / Institute of Health Equity / King’s Fund)

Summary

The Marmot Review has been updated (commissioned by the Health Foundation), to reflect developments since the Marmot Review of 2010. Austerity appears to have had an adverse impact on levels of social wellbeing. Life expectancy of women in the poorest communities in England has declined since 2011:

Full Text Link

Reference

Poorest women’s life expectancy declines, finds report. London: BBC Health News, February 25th 2020.

This relates to:

Full Text Link

Reference

Marmot, M. Allen, J. [and] Boyce, T. [et al] (2020). Health equity in England: the Marmot Review 10 years on. London: Institute of Health Equity, February 25th 2020.

A graphic on the 18.6 year gap in male healthy life expectancy at birth between local areas in the UK:

Full Text Link

Reference

Regional differences in health are large and growing. [Online]: Health Foundation, February 26th 2020.

Health Inequalities Explained

A King’s Fund “Explainer” on health inequalities:

Full Text Link

Reference

Williams, E. Buck, D. [and] Babalola, G. (2020). What are health inequalities? London: King’s Fund, February 18th 2020.

Posted in Acute Hospitals, BBC News, Charitable Bodies, Commissioning, Community Care, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Health Foundation, In the News, King's Fund, Local Interest, Mental Health, National, Quick Insights, Statistics, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Dog Therapy for Dementia? (BMC Psychiatry / Psychogeriatrics / Bazian / BMC Public Health)

Summary

An investigation into the effectiveness of animal assisted therapy (AAT) for people with dementia.

Full Text Link

Reference

Klimova, B. Toman, J. [and] Kuca, K. (2019). Effectiveness of the dog therapy for patients with dementia: a systematic review. BMC Psychiatry. September 6th 2019; Vol.19(1): 276.

Probably of related interest:

Full Text Link (Note: This article requires a suitable Athens password, a journal subscription or payment for access).

Reference

Marks, G. [and] McVilly, K. (2020). Trained assistance dogs for people with dementia: a systematic review. Psychogeriatrics. February 17th 2020. [Epub ahead of print].

Health Benefits of Dog Ownership, More Generally

On the advantages of dog ownership among the population at large, in terms of increased physical activity and survival / longevity:

Full Text Link

Reference

Owning a dog ‘may increase length of life’. London: NHS Digital; Behind the Headlines, October 9th 2019.

This relates to:

Full Text Link

Reference

Kramer, CK. Mehmood, S. [and] Suen, RS. (2019). Dog ownership and survival: a systematic review and meta-analysis. Circulation. Cardiovascular Quality and Outcomes. October 2019; Vol.12(10): e005554.

and:

Full Text Link

Reference

Mubanga, M. Byberg, L. [and] Egenvall, A. [et al] (2019). Dog ownership and survival after a major cardiovascular event: a register-based prospective study. Circulation. Cardiovascular Quality and Outcomes. October 2019; Vol.12(10): e005342.

See also:

Full Text Link

Reference

Owning a dog may encourage older people to exercise. London: NHS Digital; Behind the Headlines, June 9th 2017.

This relates to:

Full Text Link

Reference

Dall, PM. Ellis, SLH. [and] Ellis, BM. [et al] (2017). The influence of dog ownership on objective measures of free-living physical activity and sedentary behaviour in community-dwelling older adults: a longitudinal case-controlled study. BMC Public Health. June 9th 2017; Vol.17(1): 496.

Posted in Systematic Reviews, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

In the News: Reproduced Without Interpretation or Comment (The Guardian)

Summary

“The country’s largest dementia charity, the Alzheimer’s Society, has been accused of spending as much as £750,000 on payouts to staff who agreed to sign non-disclosure agreements, according to a whistleblower complaint… ).

Full Text Link

Reference

Murphy, S. (2020). Alzheimer’s Society ‘paid out £750,000’ to staff amid bullying claims. [Online]: The Guardian [Newspaper], February 21st 2020.

Posted in Alzheimer's Society, Charitable Bodies, In the News, National, Quick Insights, UK, Universal Interest | Tagged , , , , , , , , , , | Leave a comment

National Audit of Dementia Care in General Hospitals: Spotlight Audit on Psychotropic Medication (HQIP / RCP)

Summary

The Healthcare Quality Improvement Partnership (HQIP) and Royal College of Psychiatrists have published a spotlight audit on the use of psychotropic medicines in the care of people with dementia in general hospitals in England and Wales. Psychotropic medication may be used to treat behavioural and psychological symptoms of dementia (BPSD). This audit audit collected information about the following benchmark criteria:

  • Whether such medication prescriptions were pre-existent on admission (83%) or were new prescriptions (17%).
  • Whether prescriptions made in hospitals had reasons for the prescription recorded (57%); usually for agitation and aggression.
  • Whether new prescriptions for psychotropic medicines were reviewed on discharge (80%).

Full Text Link

Reference

Royal College of Psychiatrists (2020). National Audit of Dementia: Prescription of psychotropic medication initiated in hospital for behavioural and psychological symptoms of dementia. London: Royal College of Psychiatrists [and] Healthcare Quality Improvement Partnership Ltd. (HQIP), February 13th 2020.

Perhaps surprisingly:

“No evidence of hazardous prescriptions regarding dosages and interactions of psychotropic medications were reported”. p.3

Posted in Acute Hospitals, Antipsychotics, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), Local Interest, Management of Condition, Mental Health, Models of Dementia Care, National, NHS, Person-Centred Care, Pharmacological Treatments, Quick Insights, Royal College of Psychiatrists, Standards, Statistics, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment