Multi-Sensory Stimulation in 24-hour Dementia Care - Nivel

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the day hospital, an occupational therapist or a psychology assistant. Baker et al. found that the experimental group had a significantly greater increase in attentiveness to their environment than the control group. Both groups showed significant improvements after the sessions in the following areas indicating the level of apathy: ‘spontaneous speech’, ‘relating to people’, ‘doing more from own initiative’, ‘active or alert’ and ‘less bored, inactive’. The second study into Multi-Sensory Stimulation is a randomized cross-over study, reported by Kragt et al. (1997) and Holtkamp et al. (1997), on the within session effects on apathy among nursing home residents in the Netherlands. The experimental method consisted of 1:1 Snoezel sessions of half an hour to an hour, for three successive days, by an activity therapist. The control method consisted of staying in the living room and receiving usual care. Participants received either the experimental method or the control method first. Between the conditions was a wash-out period of 4 days. Kragt et al. and Holtkamp et al. found that participants were significantly less apathetic in the experimental condition than in the control condition. The third included study on the effects of Multi-Sensory Stimulation was conducted by Robichaud et al. (1994) and measured the effects on depression of nursing home residents and residents of a hospital for long-term care in Canada. The experimental group followed a Sensory Integration Group program for 30 to 45 minutes, 3 times a week for 10 weeks provided by the first author, a doctoral student of gerontology and geriatrics. The Sensory Integration sessions also contained Reality Orientation and Cognitive Stimulation. The control group took part in the usual leisure activities of their institution. Robichaud et al. found no significant differences in the depression change scores between the experimental and control group. Reminiscence Two studies that were included in the review investigated the effects of reminiscence. The aim of reminiscence is to stimulate memory and mood in the context of the patient's life history (APA, 1997). The first study, reported by Goldwasser et al. (1987), measured the effects of Reminiscence Therapy Group sessions on depression among nursing home residents in the United States. The experimental group received Reminiscence Group Therapy sessions of 30 minutes, twice weekly for five weeks. There were 2 control groups. The first control group attended Support Group sessions that focused on present and future events and problems for half an hour, twice weekly, for 5 weeks. The second control group received usual care. The facilitators for the experimental and the first control group were a graduate student in clinical psychology and a social worker. The experimental group had lower self-reported depression change scores than the control groups. It is to be noted that the Literature review 51
experimental group was significantly more depressed at baseline than the control groups. The second study on reminiscence was conducted by Namazi and Haynes (1994) and investigated the effects of Sensory Reminiscence on apathy among nursing home residents in the United States. The experimental group attended Sensory Reminiscence Group sessions of 30 minutes, 3 times weekly for 4 weeks. The sensorystimulation part consisted of colored photographs of objects and sounds related to the objects. Participants in the control group attended discussion sessions in which the events of the day and future times were discussed, without the aid of sensory stimuli for 30 minutes, 3 times a week, for 4 weeks. Both groups were led by a trained instructor. Namazi and Haynes found no significant differences between the experimental group and the control group. Psychomotor therapy Two studies into the effects of psychomotor therapy were included. The aim of psychomotor therapy is to help people with dementia to cope with the changes they encounter as a consequence of their disease. Sporting activities and games are used to stimulate cognitive and psychosocial functions (Dröes, 1991). The first study was performed by Hopman-Rock et al. (1999) and measured the effects of psychomotor therapy on apathy and depression among cognitive impaired residents of homes for the elderly in the Netherlands. The experimental group attended Psychomotor Activation Program Group sessions provided by trained activity therapists. They were offered the opportunity to participate in the sessions twice a week, for 6 months. Participants were included in the analysis when they had attended at least 15 sessions during this period. The control group participated in usual activities. Hopman-Rock et al. found no significant changes in the scores of the experimental or the control group. The second study on the effects of psychomotor therapy, reported by Dröes (1991), investigated the effects of Psychomotor Therapy on depression, aggression and apathy among nursing home residents in the Netherlands. The experimental group attended Psychomotor Therapy group sessions of 45 minutes, 3 times a week during 11 months. The sessions were conducted by a graduate (the author) and a doctoral student Human Movement Sciences. The participants in the control group attended Activity Group sessions with the same intensity. Dröes found significantly lower aggression scores after the psychomotor therapy in patients with more functional disorders (PADL
Page 1 and 2: Dit proefschrift is een uitgave van
Page 3 and 4: Multi-Sensory Stimulation in 24-hou
Page 5: niet naakt maar ontbloot het ontgli
Page 8 and 9: 8 Multi-Sensory Stimulation in 24-h
Page 10 and 11: Introduction The study described in
Page 12 and 13: equire special services such as the
Page 14 and 15: the biomedical nature of dementia a
Page 16 and 17: Holtkamp et al., 1997; Kragt et al.
Page 18 and 19: Figure 1.1 Research model ‘reside
Page 20 and 21: a decrease of negative instrumental
Page 22 and 23: measurements on the experimental an
Page 24 and 25: Figure 1.3 Design of the study Mont
Page 26 and 27: Chapter 2 to 7 are submitted for pu
Page 28 and 29: 2 A systematic review The effects o
Page 30 and 31: International Psychogeriatric Assoc
Page 32 and 33: Table 2.1 Included methods Behaviou
Page 34 and 35: Table 2.2 Criteria List for the Met
Page 36 and 37: The Best Evidence Synthesis is cond
Page 38 and 39: This section describes the features
Page 40 and 41: Treatment type and first author Val
Page 42 and 43: and first author (N; sex; age) seve
Page 44 and 45: -table 2.5 continued V- Treatment t
Page 46 and 47: Treatment type and first author Psy
Page 48 and 49: The second control group continued
Page 52 and 53: One included study researched the e
Page 54 and 55: There is limited scientific evidenc
Page 56 and 57: Another point related to the focus
Page 58 and 59: Abstract Many intervention studies
Page 60 and 61: characteristics of the programme (i
Page 62 and 63: implementation process and the resu
Page 64 and 65: Study group On the last day of trai
Page 66 and 67: Questionnaire In order to identify
Page 68 and 69: Table 3.1 Caregivers’ opinion abo
Page 70 and 71: Nursing home (H) Facilitating facto
Page 72 and 73: In four homes, the study group had
Page 74 and 75: ‘An obstacle was formed by centra
Page 76 and 77: patient outcomes. There were two pr
Page 78 and 79: interventions in the organisational
Page 80 and 81: centred work environments’, as de
Page 82 and 83: 4 Effects of snoezelen, integrated
Page 84 and 85: Introduction Effective communicatio
Page 86 and 87: The following research questions wi
Page 88 and 89: Subjects Residents To establish the
Page 90 and 91: CNAs was employed in the ward at pr
Page 92 and 93: Table 4.1 Nonverbal categories of t
Page 94 and 95: -table 4.2 continued Instrumental c
Page 96 and 97: the mean frequency of ‘smiling’
Page 98 and 99: Follow-up Allocation Enrollment Ana
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The table shows that the experiment
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Table 4.5 Change in nonverbal commu
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Table 4.6 Change in verbal communic
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Table 4.7 Change in verbal communic
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Conclusion and discussion Results T
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Strengths and limitations The findi
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communication despite demented resi
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Abstract Background. Caregivers in
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Background The intervention (implem
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In particular, it was hypothesized
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In the pre-test, 124 video-recordin
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Enabling Giving the resident the op
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Pearson correlation of 25 (10%) vid
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change scores indicate a change in
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- table 5.2 continued - Outcome mea
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they were considered particularly i
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dementia, which can be used by staf
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138 Multi-Sensory Stimulation in 24
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Abstract Objectives: To investigate
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2002; Sambandham and Schirm, 1995).
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Randomization took place at ward le
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eak) (Van Weert et al., 2004). Inte
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The caregivers were offered three i
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internal consistency (Cronbach’s
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The number of wards was too small t
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Background characteristics Table 6.
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* p< .05, ** p< .01 a The scores in
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- table 6.3 continued - Outcome mea
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al., 2002). The within-session impr
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Effects on resident's behaviour 163
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Abstract Background: Dementia among
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new model, reflecting the relations
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considerations (e.g., the presence
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working life. Outcome measures ‘Q
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value calculated from the valid ite
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Enrollment Allocation Follow-up Ana
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The table shows that the experiment
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Psychological outcomes The effects
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Table 7.4 Change in outcome measure
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Table 7.4 provides the adjusted est
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model takes into account the data o
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8 Summary and discussion Summary an
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analysis, which implied more power
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informal reciprocal consultation wa
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To study the adherence of CNAs to t
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Discussion Theoretical reflections
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The effects of improved quality of
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The results of the present study gi
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direction. Qualitative as well as q
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Schrijnemaekers, 2001; 2002). They
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This study helped to answer relevan
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The practical and complex methodolo
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expected. In the experimental group
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observation scale that included pos
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Stimulus preference screening and c
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Samenvatting In dit proefschrift wo
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Om de effecten van snoezelen op de
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van gewoontes. De follow-up bijeenk
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tijdsinvestering gedaan wordt op zo
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In hoofdstuk 7 zijn de effecten van
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ewonersgerichte houding van verzorg
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Samenvatting 233
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Ballard C, O’Brien J, James I, My
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Burns A. Psychotherapy in Alzheimer
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versus usual care to demented elder
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Grol RTPM, van Everdingen JJE, Casp
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observatiekliniek voor ouderen [Val
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Landeweerd JA, Boumans NPG, Nissen
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Ribbe MW, Ljunggren G, Steel K, Top
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Schrijnemaekers VJJ, Rossum E van,
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Volicer L, Camberg L, Hurley AC, As
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254 Multi-Sensory Stimulation in 24
Page 245 and 246:
Definitions for verbal communicatio
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Definitions for ‘Positive Person
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Definitions for behaviour/mood item
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Item Definition Wandering / restles
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Appendix 2 Gedragsobservatielijst I
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CODE B2-6- B VK 0=nee / 1=ja CODE B
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Zorg Afhankelijkheids Schaal voor d
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12 Reageert zichtbaar op muziek noo
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50 Schuift met de voeten heen en we
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AGITATIE (CMAI-D) De volgende 29 vr
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DEPRESSIE (CSDD-D) Hierna volgen ee
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2. Incontinentie De mate waarin de
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9. Vermijden van gevaar De mate waa
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Tot slot Wilt u a.u.b. controleren
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284 Multi Sensory Stimulation in 24
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1) TOELICHTING Met behulp van deze
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1 wisselend ga door naar vraag 10
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Heeft u in uw werk voldoende afwiss
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C. OMGANG DOOR VERZORGENDEN MET DEM
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22 ik krijg van de demente bewoners
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D. PROBLEMEN VAN VERZORGENDEN MET H
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schreeuwen) 1 2 3 4 5 8 29 depressi
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geen weinig niet weinig veel heel v
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13 de mate waarin u het gevoel hebt
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zien? 6. Voelde u zich de laatste B
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Eventuele aanvullende op- en aanmer
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Dankwoord Dankwoord 305
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“En nu de zon nog….!”, zei ee
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Curriculum Vitae Curriculum Vitae 3
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Julia van Weert werd op 1 november
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