3 results
P114: Experiences of nursing home residents with dementia and chronic pain using an interactive social robot: A qualitative study of multiple stakeholders
- Lihui Pu, Michel W. Coppieters, Martin Smalbrugge, Cindy Jones, Joshua Byrnes, Michael Todorovic, Wendy Moyle
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, pp. 171-172
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Objective:
To explore the benefits and barriers of using an interactive robotic seal (PARO, Figure 1) based on the experiences of nursing home residents living with dementia and chronic pain, their family members, and formal caregivers.
Methods:Semi-structured interviews were conducted alongside a feasibility randomized controlled trial at one nursing home in Brisbane, Australia between July 2021 and January 2022 (Trial registration: ACTRN 12621000837820). Residents with dementia and chronic pain interacted with PARO individually for 15 min once or twice daily, five days per week for three consecutive weeks. After which, individual interviews were conducted with residents who were capable of communicating (n=13), family members (n=3), registered nurses (n=4), care assistants (n=11), a physical therapist (n=1), a diversional therapist (n=1) and the facility manager (n=1) who experienced or observed the residents’ interactions with PARO. The interviews were audio-recorded, transcribed, and analyzed using thematic analysis.
Results:Almost all participants reported that interacting with PARO benefited residents with dementia and their caregivers. These benefits included (1) reducing pain by providing distraction and stimulation; (2) reducing behavioral and psychological symptoms of dementia; (3) promoting positive emotions by recalling memories; and (4) reducing anxiety and care burden for family and formal caregivers. Neutral attitudes toward PARO were reported by three residents with mild cognitive impairment as they reported it did not make any difference. Barriers to using PARO included limited staff training and the implementation of person‐ centered care due to limited resources.
Conclusion:Overall, multiple stakeholders were positive about using PARO to reduce pain and behavioral symptoms of nursing home residents living with dementia and chronic pain. PARO may also reduce the care burden of family and formal caregivers. PARO might be incorporated into daily practice to support nursing home residents living with dementia. Improving staff training and understanding individual preferences of residents may enhance the implementation of PARO in this population.
Figure 1
A resident living with dementia and her family after interacting with PARO (Distribution of this photo has been approved by the resident and her family)
327 - The Course and Predictors of Quality of Life in Nursing Home Residents with Young-onset Dementia
- Lihui Pu, Christian Bakker, Britt Appelhof, Jeannette C.L. Van Duinen-van den Ijssel, Sandra A. Zwijsen, Steven Teerenstra, Martin Smalbrugge, Frans R.J. Verhey, Marjolein E. de Vugt, Sytse U. Zuidema, Raymond T.C.M. Koopmans
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- Journal:
- International Psychogeriatrics / Volume 32 / Issue S1 / October 2020
- Published online by Cambridge University Press:
- 04 November 2020, pp. 85-86
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Background:
People with young-onset dementia (YOD) living in nursing homes may experience poor quality of life (QoL) due to advanced dementia, high prevalence of neuropsychiatric symptoms and psychotropic drug use. However, the course of QoL in institutionalized people with YOD and factors that predict this course are unclear. This knowledge could help health professionals identify appropriate interventions to improve QoL in YOD.
Objective:To explore the course of QoL in institutionalized people with YOD and resident-related predictors of that course.
Methods:Secondary analyses were conducted with longitudinal data from the Behavior and Evolution in Young-ONset Dementia (BEYOND)-II study. A total of 278 people with YOD were recruited from 13 YOD special care units in the Netherlands. QoL was measured by the proxy assessment of Quality of Life in Dementia (QUALIDEM) questionnaire at four assessments over 18 months. Independent variables included age, gender, dementia subtype, length of stay, dementia severity, neuropsychiatric symptoms and psychotropic drug use at baseline. Multilevel modeling adjusted for correlation within nursing homes and residents was used to determine the course and predictors of QoL.
Results:The total QUALIDEM score (range: 0–111) decreased over 18 months with a statistically significant decline of 0.73 points per six months. A significant increase of QoL over time was seen in the subscales “Care relationship”, “Positive self-image”, and “Feeling at home”. However, a significant decline was observed in the subscales “Positive affect”, “Social relations”, and “Something to do”. Residents’ course of QoL was positively associated with the baseline scores of the QoL, age and longer duration of stay; however, being male, having advanced dementia, Alzheimer’s disease and high rates of neuropsychiatric symptoms at baseline were negatively associated with the course of QoL
Conclusion:Longitudinal changes in QoL in residents with YOD were small over 18 months and QUALIDEM subscales showed multidirectional changes. The largest QoL decline in the subscale “Positive affect” suggests that interventions should be targeted to improve positive emotions, in particular for male residents with neuropsychiatric symptoms and advanced dementia.
468 - Can a Robotic Seal Called PARO Manage Chronic Pain in People with Dementia Living in Nursing Homes?
- Lihui Pu, Wendy Moyle, Cindy Jones, Michael Todorovic
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- Journal:
- International Psychogeriatrics / Volume 32 / Issue S1 / October 2020
- Published online by Cambridge University Press:
- 04 November 2020, p. 190
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Objective: To evaluate the effect of interaction with a robotic seal (PARO) for pain management in nursing home residents living with dementia.
Methods: Registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12618000082202), a pilot randomized controlled trial followed by semi-structured interviews were conducted between January 2018 and January 2019. Forty-three residents aged ?65 years living with dementia and chronic pain were recruited from three nursing homes in Australia. Participants were randomized to either a PARO group (individual, non-facilitated, 30-minute sessions, five days per week for six weeks) or a usual care group using a computer-generated random number. Observational pain behaviors were rated by researchers using the Pain Assessment in Advanced Dementia (PAINAD) scale and staff-rated pain levels were measured by the numeric rating scale. Medications regularly prescribed and as needed were quantified by the Medication Quantification Scale-III (MQS-III). Generalized estimating equation model and thematic analysis were used to analyze the data.
Results: Participants in the PARO group had significantly lowered level of observed pain (-0.514, 95% confidence interval [CI] -0.774 to -0.254, p<0.001) and used fewer PRN medications (-1.175, 95% CI - 2.205 to -0.145, p=0.025) than those in usual care after controlling for age, gender, cognitive function and medications at baseline. There were no significant differences in staff-rated pain levels and regularly scheduled medications between the two groups. Interviews also indicated that the PARO intervention may reduce the pain experience through distraction and reminiscence of previous positive memories. Limitations of weight, voice and characteristics of PARO were identified.
Conclusions and Implications: PARO shows promise in reducing pain and medications for nursing home residents living with dementia and chronic pain. This intervention might be incorporated into daily practice as an alternative to manage pain in people with dementia. Care staff need to balance the benefits and limitations of incorporating social robots into their clinical practice and residents’ individualized preferences need to be considered. Larger randomized controlled trials with longer time frames are warranted to further test the use of PARO in long-term care settings.