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Coping strategies may vary according to working memory performance in individuals with Alzheimer's disease
S626
Poster Presentations P3
elderly respondents were women (77%), were married (60%), were illiterate (51%), lived in multigenerational households, and were independent with respect to basic activities of daily living (96%) but dependent with respect to instrumental activities of daily living (58%). The highest concentration of respondents in this sample was in the 71 to 75 age group (33%). Evaluations of family functioning made by these impoverished elderly people revealed that 62% of the women and 95% of the men rated their family functioning as being good, 21% of the women and 5% of the men indicated moderate family dysfunction, and 17% of the women rated their family as being highly dysfunctional. Results on the Family APGAR scale were influenced by gender, but not by age. With respect to their social support networks, the results indicate that these elderly people had large social networks, with a predominance of members in the innermost circle and, in addition, that they reported providing more help than they received. Conclusions: These results can contribute to improving the organization of health care services for elderly people with cognitive impairments in this city, via the Family Healthcare Program, especially in view of the fact that most healthcare received by the Brazilian elderly is provided by female family members.
P3-347
THE FRIENDSHIP PROJECT: SOCIAL INTERACTION AMONG DEMENTIA RESIDENTS IN LONG-TERM CARE
Pamela Saunders*1, Kate de Medeiros2, Patrick Doyle3, Amanda Mosby4, 1 Georgetown University School of Medicine, Washington, District of Columbia, United States; 2Miami of Ohio University, Oxford, Ohio, United States; 3UMBC, Baltimore, Maryland, United States; 4Copper Ridge Research Institute, Sykesville, Maryland, United States. Background: People with dementia living in long-term care facilities are faced with many personal challenges, including forming new friendships, feeling “at home” and finding social activities that are enjoyable. Although there are currently more than 750,000 people with dementia living in longterm care, few published studies have explored sociability and friendships among residents with dementia. This study examined social interactions among residents with dementia in a long-term care environment. Our primary objectives were to identify and understand successful (and unsuccessful) social units in long-term care; and to determine whether any measurable attributes contribute to the social compatibility of residents. Methods: This study used qualitative and quantitative methods. Data collected from residents included the MMSE, Functional Linguistic Communication Inventory, and the Severe Impairment Ratings Scale. In addition we conducted brief face-to-face, semi-structured interviews. Also we conducted direct observations of residents that produced written field notes, & video and audio tapes. We conducted a six-month observational study of residents within a 20-bed assisted living wing at a residential facility (126 total beds) in Maryland for the long-term care of persons with moderate to advanced dementia. We observed 25 residents (18 women, 7 men) with a mean age of 83.2 years (+7.9 years) and an age range 57 to 95 years. The mean years of education was 14 years (+3.6 years) with a range 8 to 20 years. We interviewed 10 staff participants from 3 departments: activities (n¼3), social work (n¼2) and nursing (n¼5). Residents were included if they had been living on the unit for at least one month. Only those staff where had been employed for at least 1 month were included in the study. Informed consent was collected from residents and their legal representatives and from staff participants. Results: Results from staff and resident interviews revealed that staff and residents reported different definitions of friendships. While most reported definitions were stereotypical (i.e., friends are people who help you out), staff showed a limited awareness of residents’ individual definitions. Results from observations of meal times revealed that social interactions among residents were influenced by animate and inanimate objects in the living area; specifically the dining table. For example, staff (i.e., animate objects) were found to hinder social interaction among residents by interrupting ongoing interactions with off topic comments and conversations. In contrast, table decorations (i.e., inanimate objects) stimulated con-
versation. Overall observations showed that conversation among residents with dementia in the AL setting is limited. We found three factors to help explain the patterns of social interaction: 1) the AL setting can be difficult due to the health and cognition of fellow residents, 2) staff interfere rather than enhance social interaction opportunities, 3) movement of residents in and out of the assisted living wing. Conclusions: In conclusion, residents’ ability to communicate remains a critical element of what staff members perceive to be friendships between people with dementia. These important opportunities for social interaction are essential to quality of life and well being for residents in long term care. Future research will examine intervention strategies to enhance communication and social interaction in the longterm care setting. Practice implications for long term care settings will be discussed.
P3-348
COPING STRATEGIES MAY VARY ACCORDING TO WORKING MEMORY PERFORMANCE IN INDIVIDUALS WITH ALZHEIMER’S DISEASE
Juliana Souza-Talarico*1, Eliane Chaves1, Ricardo Nitrini1, Paulo Caramelli2, 1University of S~ao Paulo, S~ao Paulo, Brazil; 2Federal University of Minas Gerais, Minas Gerais, Brazil. Background: Normal cognitive functioning is essential to cope with stressful events, since executive functions and planning are required on its process. Yet, little is known about this relationship in subjects with cognitive impairment. This issue is particularly significant since evidences have risen that the style how these subjects cope with daily stress may also play a role in the cognitive decline process. The present study aimed to characterize coping strategies style and to examine the association between coping and cognition, particularly working memory performance (WM), in healthy elderly, Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD) subjects. Methods: Jalowiec Coping Scale was applied to 40 healthy elderly, 30 MCI individuals and 32 mild probable AD patients. WM was assessed through the backward Digit Span test (BDS). Results: Confrontive coping style was predominantly observed in control (n ¼ 20, 50%) and MCI (n ¼ 13, 43.3%) group while optimistic strategies were frequently observed in AD participants (n ¼ 15, 46.9%). Despite control and MCI individuals elected problem-focused coping more frequently than AD patients, no significant difference was observed (p ¼ 0.464). However, an association between WM and coping was observed in AD. Those AD subjects who elected problem-focused coping exhibited higher BDS scores than those who elected emotion-focused coping (p ¼ 0.028). Conclusions: Besides cognitive impairment those AD individuals with a certain level of WM performance are still capable of coping with daily stressors using problem-focused strategies rather than to avoid the adverse situations.
P3-349
NEUROPSYCHIATRIC AND BEHAVIOURAL SYMPTOMS IN PATIENTS WITH ALZHEIMER’S DISEASE AS AN EFFECT TO CAREGIVERS’ STATE OF MENTAL HEALTH
Sandra Uett*1, Ulla Linnam€agi2, 1Tartu University Hospital, Tartu, Estonia; 2University of Tartu, Tartu, Estonia. Background: Behavioral and neuropsychiatric symptoms (BNS) affects caregiver burden (CB). Specialised nursing care of demented people in Es^ tonia is imperfect. Study was designed to evaluate Alzheimer’s patientsA’ BNS and provide information how CB and emotional status, is related to the severity of BNS. Methods: Patients and caregivers were interviewed during out-patient consultations. Cognitive impairment, dementia severity and BNS were assessed with MMSE and Neuropsychiatric Inventory (NPI). Caregivers were assessed with Emotional State Examination Questionnaire 2 (ESQ2). For evaluate CB, Zarit Burden Interview (ZBI) was used. STATA 9 was used, correlation 0,7 was considered strong. Results: 28 patients with caregivers were included. According to MMSE, 60,7% of
Poster Presentations P3
elderly respondents were women (77%), were married (60%), were illiterate (51%), lived in multigenerational households, and were independent with respect to basic activities of daily living (96%) but dependent with respect to instrumental activities of daily living (58%). The highest concentration of respondents in this sample was in the 71 to 75 age group (33%). Evaluations of family functioning made by these impoverished elderly people revealed that 62% of the women and 95% of the men rated their family functioning as being good, 21% of the women and 5% of the men indicated moderate family dysfunction, and 17% of the women rated their family as being highly dysfunctional. Results on the Family APGAR scale were influenced by gender, but not by age. With respect to their social support networks, the results indicate that these elderly people had large social networks, with a predominance of members in the innermost circle and, in addition, that they reported providing more help than they received. Conclusions: These results can contribute to improving the organization of health care services for elderly people with cognitive impairments in this city, via the Family Healthcare Program, especially in view of the fact that most healthcare received by the Brazilian elderly is provided by female family members.
P3-347
THE FRIENDSHIP PROJECT: SOCIAL INTERACTION AMONG DEMENTIA RESIDENTS IN LONG-TERM CARE
Pamela Saunders*1, Kate de Medeiros2, Patrick Doyle3, Amanda Mosby4, 1 Georgetown University School of Medicine, Washington, District of Columbia, United States; 2Miami of Ohio University, Oxford, Ohio, United States; 3UMBC, Baltimore, Maryland, United States; 4Copper Ridge Research Institute, Sykesville, Maryland, United States. Background: People with dementia living in long-term care facilities are faced with many personal challenges, including forming new friendships, feeling “at home” and finding social activities that are enjoyable. Although there are currently more than 750,000 people with dementia living in longterm care, few published studies have explored sociability and friendships among residents with dementia. This study examined social interactions among residents with dementia in a long-term care environment. Our primary objectives were to identify and understand successful (and unsuccessful) social units in long-term care; and to determine whether any measurable attributes contribute to the social compatibility of residents. Methods: This study used qualitative and quantitative methods. Data collected from residents included the MMSE, Functional Linguistic Communication Inventory, and the Severe Impairment Ratings Scale. In addition we conducted brief face-to-face, semi-structured interviews. Also we conducted direct observations of residents that produced written field notes, & video and audio tapes. We conducted a six-month observational study of residents within a 20-bed assisted living wing at a residential facility (126 total beds) in Maryland for the long-term care of persons with moderate to advanced dementia. We observed 25 residents (18 women, 7 men) with a mean age of 83.2 years (+7.9 years) and an age range 57 to 95 years. The mean years of education was 14 years (+3.6 years) with a range 8 to 20 years. We interviewed 10 staff participants from 3 departments: activities (n¼3), social work (n¼2) and nursing (n¼5). Residents were included if they had been living on the unit for at least one month. Only those staff where had been employed for at least 1 month were included in the study. Informed consent was collected from residents and their legal representatives and from staff participants. Results: Results from staff and resident interviews revealed that staff and residents reported different definitions of friendships. While most reported definitions were stereotypical (i.e., friends are people who help you out), staff showed a limited awareness of residents’ individual definitions. Results from observations of meal times revealed that social interactions among residents were influenced by animate and inanimate objects in the living area; specifically the dining table. For example, staff (i.e., animate objects) were found to hinder social interaction among residents by interrupting ongoing interactions with off topic comments and conversations. In contrast, table decorations (i.e., inanimate objects) stimulated con-
versation. Overall observations showed that conversation among residents with dementia in the AL setting is limited. We found three factors to help explain the patterns of social interaction: 1) the AL setting can be difficult due to the health and cognition of fellow residents, 2) staff interfere rather than enhance social interaction opportunities, 3) movement of residents in and out of the assisted living wing. Conclusions: In conclusion, residents’ ability to communicate remains a critical element of what staff members perceive to be friendships between people with dementia. These important opportunities for social interaction are essential to quality of life and well being for residents in long term care. Future research will examine intervention strategies to enhance communication and social interaction in the longterm care setting. Practice implications for long term care settings will be discussed.
P3-348
COPING STRATEGIES MAY VARY ACCORDING TO WORKING MEMORY PERFORMANCE IN INDIVIDUALS WITH ALZHEIMER’S DISEASE
Juliana Souza-Talarico*1, Eliane Chaves1, Ricardo Nitrini1, Paulo Caramelli2, 1University of S~ao Paulo, S~ao Paulo, Brazil; 2Federal University of Minas Gerais, Minas Gerais, Brazil. Background: Normal cognitive functioning is essential to cope with stressful events, since executive functions and planning are required on its process. Yet, little is known about this relationship in subjects with cognitive impairment. This issue is particularly significant since evidences have risen that the style how these subjects cope with daily stress may also play a role in the cognitive decline process. The present study aimed to characterize coping strategies style and to examine the association between coping and cognition, particularly working memory performance (WM), in healthy elderly, Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD) subjects. Methods: Jalowiec Coping Scale was applied to 40 healthy elderly, 30 MCI individuals and 32 mild probable AD patients. WM was assessed through the backward Digit Span test (BDS). Results: Confrontive coping style was predominantly observed in control (n ¼ 20, 50%) and MCI (n ¼ 13, 43.3%) group while optimistic strategies were frequently observed in AD participants (n ¼ 15, 46.9%). Despite control and MCI individuals elected problem-focused coping more frequently than AD patients, no significant difference was observed (p ¼ 0.464). However, an association between WM and coping was observed in AD. Those AD subjects who elected problem-focused coping exhibited higher BDS scores than those who elected emotion-focused coping (p ¼ 0.028). Conclusions: Besides cognitive impairment those AD individuals with a certain level of WM performance are still capable of coping with daily stressors using problem-focused strategies rather than to avoid the adverse situations.
P3-349
NEUROPSYCHIATRIC AND BEHAVIOURAL SYMPTOMS IN PATIENTS WITH ALZHEIMER’S DISEASE AS AN EFFECT TO CAREGIVERS’ STATE OF MENTAL HEALTH
Sandra Uett*1, Ulla Linnam€agi2, 1Tartu University Hospital, Tartu, Estonia; 2University of Tartu, Tartu, Estonia. Background: Behavioral and neuropsychiatric symptoms (BNS) affects caregiver burden (CB). Specialised nursing care of demented people in Es^ tonia is imperfect. Study was designed to evaluate Alzheimer’s patientsA’ BNS and provide information how CB and emotional status, is related to the severity of BNS. Methods: Patients and caregivers were interviewed during out-patient consultations. Cognitive impairment, dementia severity and BNS were assessed with MMSE and Neuropsychiatric Inventory (NPI). Caregivers were assessed with Emotional State Examination Questionnaire 2 (ESQ2). For evaluate CB, Zarit Burden Interview (ZBI) was used. STATA 9 was used, correlation 0,7 was considered strong. Results: 28 patients with caregivers were included. According to MMSE, 60,7% of