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Quality of life in dementia patients: nursing home versus home care

Published online by Cambridge University Press:  24 June 2011

Azlina Wati Nikmat ,
Graeme Hawthorne  and
S. Hassan Al-Mashoor
Azlina Wati Nikmat*
Affiliation:
Department of Psychiatry, The University of Melbourne, Royal Melbourne Hospital, Victoria, Australia
Graeme Hawthorne
Affiliation:
Department of Psychiatry, The University of Melbourne, Royal Melbourne Hospital, Victoria, Australia
S. Hassan Al-Mashoor
Affiliation:
Department of Psychiatry, Faculty of Medicine, University Teknologi MARA Malaysia, Selayang Campus, Selangor, Malaysia
*
Correspondence should be addressed to: Azlina Wati Nikmat, PhD candidate, Department of Psychiatry, The University of Melbourne, Level 1, North Block, Royal Melbourne Hospital, Victoria 3050, Australia. Phone: +61 3 8344 5467; Fax: +61 3 9349 2792. Email: [email protected].
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Abstract

Background: Care management providing a high quality of life (QoL) is a crucial issue in dealing with increasing numbers of dementia patients. Although the transition from informal (home-based) care to formal (institutional) care is often a function of dementia stage, for those with early dementia there is currently no definitive evidence showing that informal or formal care provides a higher QoL, particularly where informal care is favored for local cultural reasons. This paper outlines the research protocol for a study comparing formal and informal care in Malaysia. It seeks to provide evidence regarding which is more appropriate and results in higher QoL in early dementia.

Methods: This is a quasi-experimental study design involving 224 early dementia patients from both nursing home and community settings. Participants will be assessed for cognitive severity, QoL, needs, activities of daily living, depression and social isolation/connectedness by using the Mini-Mental State Examination (MMSE), Cognitive Impairment Scale – 4 items (CIS-4), EUROPE Health Interview Survey-Quality of Life (WHO8), Assessment of Quality of Life (AQoL8), Camberwell Assessment of Need for the Elderly – Short Version (CANE-S), Barthel Index (BI), Cornell Scale for Depression (CSDD), Geriatric Depression Scale – 15 items (GDS-15), and Friendship Scale (FS) respectively.

Conclusion: This study aims to provide a better understanding of care needs in early dementia. Given population aging, the study findings will provide evidence assisting decision-making for policies aimed at reducing the burden of caregiving and preserving the QoL of dementia patients.

Keywords

study protocolagingAlzheirmer's diseasecommunityinstitutional care
Type
PROTOCOL-ONLY PAPER
Information
International Psychogeriatrics , Volume 23 , Issue 10 , December 2011 , pp. 1692 - 1700
Copyright
Copyright © International Psychogeriatric Association 2011

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References

Alexopoulos, G. S., Abrams, R. C., Young, R. C. and Shamoian, C. A. (1988). Cornell Scale for Depression in dementia. Biological Psychiatry, 23, 271–284.CrossRefGoogle ScholarPubMed
Aneshensel, C. S., Pearlin, L. I., Levy-Storms, L. and Schuler, R. H. (2000). The transition from home to nursing home mortality among people with dementia. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 55, S152–S162.CrossRefGoogle ScholarPubMed
Ball, M. M. et al. (2000). Quality of life in assisted living facilities: viewpoints of residents. Journal of Applied Gerontology, 19, 304–325.CrossRefGoogle Scholar
Brink, T. L., Yesavage, J. A., Lum, O., Heersema, P. H., Adey, M. and Rose, T. L. (1982). Screening tests for geriatric depression. Clinical Gerontologist, 1, 37–43.CrossRefGoogle Scholar
Burns, A. and Rabins, P. (2000). Carer burden dementia. International Journal of Geriatric Psychiatry, 15 (Suppl. 1), S9–S13.3.0.CO;2-N>CrossRefGoogle Scholar
Chene, B. (2006). Dementia and residential placement: a view from the carers’ perspective. Qualitative Social Work, 5, 187–215.CrossRefGoogle Scholar
Cohen, J. (1988). Statistical Power Analysis for the Behavioural Sciences. Hillsdale: Lawrence Erlbaum.Google Scholar
Davison, A. G., Fayers, P. M., Nunn, A. J., Venables, K. M. and Taylor, A. J. (1986). Number of patients required in lung function studies. Thorax, 41, 830–832.CrossRefGoogle ScholarPubMed
Debruyne, H. et al. (2009). Is the Geriatric Depression Scale a reliable screening tool for depressive symptoms in elderly patients with cognitive impairment? International Journal of Geriatric Psychiatry, 24, 556–562.CrossRefGoogle Scholar
Folstein, M., Folstein, S. and McHugh, P. (1975).”Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Gerritsen, D. L., Steverink, N., Ooms, M. E., De Vet, H. C. and Ribbe, M. W. (2007). Measurement of overall quality of life in nursing homes through self-report: the role of cognitive impairment. Quality of Life Research, 16, 1029–1037.CrossRefGoogle ScholarPubMed
Giles, L. C., Hawthorne, G. and Crotty, M. (2009). Health-related quality of life among hospitalized older people awaiting residential aged care. Health and Quality of Life Outcomes, 7, 71.CrossRefGoogle ScholarPubMed
Hamid, T. A., Krishnaswamy, S., Abdullah, S. S. and Momtaz, Y. A. (2011). Sociodemographic risk factors and correlates of dementia in older Malaysians. Dementia and Geriatric Cognitive Disorders, 30, 533–539.CrossRefGoogle Scholar
Hancock, G. A., Reynolds, T., Woods, B., Thornicroft, G. and Orrell, M. (2003). The needs of older people with mental health problems according to the user, the carer, and the staff. International Journal of Geriatric Psychiatry, 18, 803–811.CrossRefGoogle Scholar
Hawthorne, G. (2006). Measuring social isolation in older adults: development and initial validation of the Friendship Scale. Social Indicators Research, 77, 521–548.CrossRefGoogle Scholar
Hawthorne, G. (2009). Assessing utility where short measures are required: development of the short assessment of Quality of Life-8 (Aqol-8) Instrument. Value in Health, 12, 948–957.CrossRefGoogle ScholarPubMed
Hawthorne, G. and Elliott, P. (2005). Imputing cross-sectional missing data: a comparison of common techniques. Australian and New Zealand Journal of Psychiatry, 39, 583–590.CrossRefGoogle Scholar
Hoe, J., Hancock, G., Livingston, G. and Orrell, M. (2006). Quality of life of people with dementia in residential care homes. British Journal of Psychiatry, 188, 460–464.CrossRefGoogle ScholarPubMed
Hogan, A. J. and Mickus, M. A. (2002). Through rose-colored glasses: public perceptions of nursing home quality. In Baumer, A. J. (ed.), State of the State Survey. East Lansing, MI: Institute for Public Policy and Social Research, Michigan State University.Google Scholar
Ibrahim, N. M. et al. (2009). Validation study of the Mini-Mental State Examination in a Malay-speaking elderly population in Malaysia. Dementia and Geriatric Cognitive Disorders, 27, 247–253.CrossRefGoogle Scholar
Iwarsson, S. et al. (2007). Importance of the home environment for healthy aging: conceptual and methodological background of the European enable-age project. Gerontologist, 47, 78–84.CrossRefGoogle ScholarPubMed
Korner, A. et al. (2006). The Geriatric Depression Scale and the Cornell Scale for Depression in Dementia: a validity study. Nordic Journal of Psychiatry, 60, 360–364.CrossRefGoogle ScholarPubMed
Lin, L. C., Wu, S. C., Kao, C. C., Tzeng, Y. L., Watson, R. and Tang, S. H. (2009). Single ability among activities of daily living as a predictor of agitation. Journal of Clinical Nursing, 18, 117–123.CrossRefGoogle ScholarPubMed
MacKenzie, J. (2006). Stigma and dementia: East European and South Asian family carers negotiating stigma in the UK. Dementia, 5, 233–247.CrossRefGoogle Scholar
Mahoney, F. and Barthel, D. (1965). Functional evaluation: the Barthel Index. Maryland State Medical Journal, 14, 61–65.Google ScholarPubMed
Malaysia (2010). Laman Web Rasmi Jabatan Kebajikan Masyarakat. Social Welfare Department. Available at http://www.jkm.gov.my/jkm/index.php?lang=ms; last accessed 10 August 2010.Google Scholar
Moyle, W., McAllister, M., Venturato, L. and Adams, T. (2007). Quality of life and dementia: the voice of the person with dementia. Dementia and Geriatric Cognitive Disorders, 6, 175–191.Google Scholar
Orrell, M. and Hancock, G. (2004). CANE: Camberwell Assessment of Need for the Elderly: A Needs Assessment for Older Mental Health Service Users. London: Gaskell.Google Scholar
Power, M. (2003). Development of a common instrument for quality of life. In Nosikov, A. and Gudex, C. (eds.), Eurohis: Developing Common Instruments for Health Surveys (pp. 145–163). Amsterdam: Ios Press.Google Scholar
Reynolds, T. et al. (2000). Camberwell Assessment of Need for the Elderly (CANE): development, validity and reliability. British Journal of Psychiatry, 176, 444–452.CrossRefGoogle ScholarPubMed
Rigaud, A. S., Fagnani, F., Bayle, C., Latour, F., Traykov, L. and Forette, F. (2003). Patients with Alzheimer's disease living at home in France: costs and consequences of the disease. Journal of Geriatric Psychiatry and Neurology, 16, 140–145.CrossRefGoogle ScholarPubMed
Sansoni, J. et al. (2007). Final Report: Dementia Outcomes Measurement Suite Project. Wollongong: Centre For Health Service Development, University of Wollongong, Australia.Google Scholar
Schmidt, S., Muhlan, H. and Power, M. (2006). The Eurohis-QOL 8-Item Index: psychometric results of a cross-cultural field study. European Journal of Public Health, 16, 420–428.CrossRefGoogle ScholarPubMed
Schultz-Larsen, K., Kreiner, S. and Lomholt, R. K. (2007). Mini-Mental Status Examination: mixed Rasch Model item analysis derived two different cognitive dimensions of the MMSE. Journal of Clinical Epidemiology, 60, 268–279.CrossRefGoogle ScholarPubMed
Scocco, P., Rapattoni, M. and Fantoni, G. (2006). Nursing home institutionalization: a source of eustress or distress for the elderly? International Journal of Geriatric Psychiatry, 21, 281–287.CrossRefGoogle ScholarPubMed
Selvaratnam, D. P. and Tin, P. B. (2007). Lifestyle of the elderly in rural and urban Malaysia. Annals of the New York Academy of Sciences, 1114, 317–325.CrossRefGoogle ScholarPubMed
Sheikh, J. I. and Yesavage, J. A. (1986). Geriatric Depression Scale: recent evidence and development of a shorter version. Clinical Gerontologist, 5, 165–173.Google Scholar
Sloane, P. D., Zimmerman, S., Williams, C. S., Reed, P. S., Gill, K. S and Preisser, J. S. (2005). Evaluating the quality of life of long-term care residents with dementia. Gerontologist, 45 (special no. 1), 37–49.CrossRefGoogle ScholarPubMed
Suh, G. H., Kil Yeon, B., Shah, A. and Lee, J. Y. (2005). Mortality in Alzheimer's disease: a comparative prospective Korean study in the community and nursing homes. International Journal of Geriatric Psychiatry, 20, 26–34.CrossRefGoogle ScholarPubMed
Tabachnick, B. G. and Fidell, L. S. (2001). Using Multivariate Statistics, New York: Harper Collins.Google Scholar
Teh, E. E. and Hasanah, C. I. (2004). Validation of Malay version of Geriatric Depression Scale among elderly inpatients. Geriatric Depression. Available online at: http://www.priory.com/psych/MalayGDS.htm; last accessed 7 December 2009.Google Scholar
Tombaugh, T. N., Mcdowell, I., Kristjansson, B. and Hubley, A. M. (1996). Mini-Mental State Examination (MMSE) and the Modified MMSE (3MS): a psychometric comparison and normative data. Psychological Assessment, 8, 48–59.CrossRefGoogle Scholar
Vida, S., Des Rosiers, P., Carrier, L. and Gauthier, S. (1994). Depression in Alzheimer's disease: receiver operating characteristic analysis of the Cornell Scale for Depression in Dementia and the Hamilton Depression Scale. Journal of Geriatric Psychiatry and Neurology, 7, 159–162.CrossRefGoogle ScholarPubMed
Whelan, P. J., Oleszek, J., Macdonald, A. and Gaughran, F. (2009). The utility of the Mini-Mental State Examination in guiding assessment of capacity to consent to research. International Psychogeriatrics, 21, 338–344.CrossRefGoogle ScholarPubMed
WHO (2008). The Global Burden of Disease: 2004 Update. Geneva: World Health Organization.Google Scholar
WHO (2011). Definition of an Older or Elderly Person. Available at http://www.who.int/healthinfo/survey/ageingdefnolder/en/index.html; last accessed 24 March 2011.Google Scholar
Zimmerman, S. et al. (2005). Dementia care and quality of life in assisted living and nursing homes. Gerontologist, 45 (Special No. 1), 133–146.CrossRefGoogle ScholarPubMed