Category Archives: Dementia: Therapeutic Activities

Alarming amounts of noise demand ways to silence noisy hospital environments

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Spending a night in the hospital is not only stressful, but also loud. The constant beeps, whirrs and alarms ascend to a cacophony that produces anything but a relaxing, restful environment. Researchers will summarize the limited number of studies available on hospital noise and discuss the different approaches health care facilities are taking to bring restful repose to patients across the country during the 174th ASA Meeting, Dec. 4-8, 2017, in New Orleans, La.

Source: Alarming amounts of noise demand ways to silence noisy hospital environments

Hospital noise is a growing concern for patients, family and staff, but many facilities are looking for new approaches to reduce the din and bring peace back to their environment.

Public Release: ACOUSTICAL SOCIETY OF AMERICA

WASHINGTON, D.C. December 6, 2017– Spending a night in the hospital is not only stressful, but also loud. The constant beeps, whirrs and alarms ascend to a cacophony that produces anything but a relaxing, restful environment. Ilene Busch-Vishniac, of BeoGrin Consulting in Baltimore, Maryland, will summarize the limited number of studies available on hospital noise and discuss the different approaches health care facilities are taking to bring restful repose to patients across the country.

According to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, noise is the top complaint of patients, staff and visitors. “Nearly everyone has a stay in a hospital at some point,” Busch-Vishniac said. “Noise is a universal problem in hospitals around the world.”

Busch-Vishniac will explore these concepts during the 174th Meeting of the Acoustical Society of America, being held Dec. 4-8, 2017, in New Orleans, Louisiana. Noises emanate from a variety of sources at the bedside. Airflow and the noisy machines controlling it are kept on high to prevent pathogens from lingering near patients, and overhead pages alert staff of needs or announcements. Equipment alarms are the most egregious source, and although they are designed to alert staff of changes in the patient’s medical condition, many also sound when medication needs to be changed or when battery conditions are low.

“Alarms in hospitals are being horribly abused,” Busch-Vishniac said. “Most of the time, they don’t in fact indicate urgent situations.”

Previous studies showed that alarms at a patient’s bedside sound an average 133 times per day. With so many alarms, staff often face alarm fatigue as well.

“Most alarms are being responded to eventually, but not all in a timely fashion,” said Busch-Vishniac. “Staff also may not respond quickly because they recognize that the sound is not critical and the situation will right itself.”

Besides the obvious barrier to rest, high noise levels have been associated with changes in the patient’s heart rate, respiration and blood pressure. These changes increase stress levels and may impair healing. The noise can also impair communication between patients and staff.

With noise levels on the rise, the Centers for Medicare and Medicaid Services (CMS) initiated the HCAHPS survey in 2008 to assess consumer perception of health care providers and systems. Today, more than 5,500 hospitals contribute to the report, which consists of patients’ responses on seven composite measures, including questions focused on room cleanliness and quietness.

The survey has teeth. Hospital value-based purchasing links up to 30 percent of CMS payments to hospitals across the country to the results of the survey.

“Faced with a loss of money, many hospitals are looking for ways to address noise levels in a way that patients can see as an improvement,” said Busch-Vishniac.

Hospitals have been developing and implementing noise control programs that can be broken into two categories: engineering and administrative interventions.

Engineering interventions aim to find ways to quiet the room. The solutions can be as simple as closing the door to a patient’s room or as complex as installing acoustical absorption materials along the walls and ceiling to dampen the noise level. Administrative interventions focus on changing behaviors. Many hospitals have instituted quiet hours when doors are closed and voices are kept low.

One of the big changes during the past 10 years has shifted alarms from solely sounding at the patient’s bedside to also alerting a central monitor at the nursing station. This approach improves the ability of staff to identify and respond to alarms set at a reduced volume.

According to Busch-Vishniac, it may be possible in the future to remove alarms from the bedside. A quiet hospital may not be a pipedream for much longer.

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Presentation 3pIDa: “Hospital noise: how bad is it?” by Ilene Busch-Vishniac is at 1:45-2:05 p.m. CST, Wednesday, Dec. 6, 2017, in Salon E in the New Orleans Marriott. https://asa2017fall.abstractcentral.com/s/u/M8hKSrQu66E

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Digital life stories spark joy in people with dementia

 

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Creating a ‘digital story’ of their memories using photos, music, text and video, can hep dementia patients open up to their fear and move into optimism.
(Shutterstock)

Elly Park, University of Alberta

I was sitting on the sofa across from Christine in her home. She offered me a cup of coffee. Each time I visited, she sat in the same spot — the place where she felt most comfortable and safe. She had shared stories from the past and decided to talk about the birth of her daughters, grandchildren and great grandchildren.

For Christine, a research participant in a multi-sited study into dementia and digital storytelling, the fear dementia brings is that she won’t be able to be a part of special moments such as the celebration of birth.

As we worked together in Edmonton, creating a multimedia story from her memory, Christina started to remember new things. She became emotional when she talked about her daughters becoming mothers themselves. She pointed out that the project was so much more powerful than looking through a photo album. Like many participants, she said she recalled stories she hadn’t thought about for years.

As a post-doctoral fellow in occupational therapy under the supervision of Dr. Lili Liu, at the University of Alberta I worked with several participants in this study. Funded by the Canadian Consortium on Neurodegeneration in Aging, one of our goals was to investigate quality of life and how technology affects the lived experiences of persons with dementia.

Technology and quality of life

In this research project we defined digital storytelling as using media technology — including photos, sound, music and videos — to create and present a story.

Most previous research on digital storytelling and dementia has focused on the use of digital media for reminiscence therapy, creating memory books, or enhancing conversation. Collaboratively creating personal digital stories with persons with dementia is an innovative approach, with only one similar study found in the United Kingdom.

During this project, I met with seven participants over eight weeks. Our weekly sessions included a preliminary interview to discuss demographics and past experiences with technology. Then we worked on sharing different meaningful stories, selecting one to focus on and building and shaping the story. This included writing a script, selecting music, images and photographs and editing the draft story.

“I was blessed with wonderful parents, and I was a mistake,” begins Myrna Caroline Jacques, 77, a grandmother of five.

Participants worked on a variety of topics. Some told stories about family and relationships, while others talked about a particular activity or event that was important to them. After all participants completed their digital stories, we had a viewing night and presented the stories to family members.

Happiness in the moment

It was an intense process. Eight sessions working one-on-one with persons with dementia required a significant amount of thinking, remembering and communicating for the participants. There were challenges, such as when participants found themselves unable to express their thoughts or remember details.

In this digital story, Christine Nelson talks of her love for her children and her fear of forgetting special moments.

Although many participants were tired after a session, they all felt that it was a beneficial and meaningful activity. Working in their homes on a personally gratifying activity with a tangible outcome seemed to keep them motivated and eager to continue. The process was also enjoyable and gave the participants something to look forward to each week.

There was a sense of happiness in the moment. And the way that participants responded to me, along with their ability to remember who I was and the purpose of our sessions, all indicated a deeper positive connection. The participants all felt a sense of accomplishment and family members were proud to see the end product at the viewing night.

Into the future

I have met with one of the research participants again recently, and she still remembers me. I would like to follow up with the others to get a sense of the long term impact of this digital storytelling project. I am also eager to see how the findings in Edmonton line up with those from the studies in Vancouver and Toronto.

The ConversationFor the participants, talking about memories helped them open up about having dementia. Getting past the fear and looking ahead with optimism was the message I heard, and one that I hope to keep hearing.

Elly Park, Assistant Clinical Lecturer in Occupational Therapy, University of Alberta

This article was originally published on The Conversation. Read the original article.

Trishaws anyone?

A beautiful intergenerational activity to celebrate the love of cycling, a spot of reminiscence, and the great outdoors.

 

How lovely is this? As a child, my mother and I use to jump on a trishaw after our trip to the wet market. I use to watch the spokes go round and round and I still can hear the “Tak tak tak” sound the wheels make as we head home. It’s always a magical experience no matter how short the trip was. Took less than 5 minutes to reach our home from the market on a trishaw and I’ve sat in it for years and years with my mum, but it never grows old. With the wind in my face, the clicky round of the rickshaw, and just cuddled beside my mum with all our groceries at my feet, the world was our oyster.

When Cycling Without Age it just brought back all these lovely memories of my childhood. I wondered how wonderful would this be for it to be reintroduced into the community. There would be so many older adults in Asia whose main form of transport was the bicycle or the trishaw at a point of their time in their youth. As we aged and our physical abilities deteriorate, we lose our abilities to cycle and with it, our memories of freedom, that wind in your hair, the road just beneath your feet, to go wherever you wanted to go and be wherever you wanted to be.

Such an intervention can only bring generations together, a real intergenerational project of adventure and bonds. To bring people closer through the love of freedom and the outdoors.

I’m so glad to see this in Singapore and I hope that more Singaporeans will jump on board to support this movement!

If you have time, have a read of these 21 inspirational stories from Cycling without Age http://cyclingwithoutage.org/book/

A study shows that 1 truly remarkable change can improve lives and help save cost in residential care homes!

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In residential aged care, how many times have you heard the howls of frustrations as management and staff, shake their fist in the air, bicker and scratch their heads to work out how to improve dementia care at the same time balance the books. It’s a constant frustration, not just for the staff but for the residents with dementia and caregivers as well as they continue to pay for care and feel that they are unheard, unseen and their needs have gone unnoticed.

Good news, the latest study was presented at the Alzheimer’s Association International Conference from the University of Exeter and carried out in collaboration with University College London, Hull, Bangor and Alzheimer’s Society UK. The study evidently highlighted the fact that activities carried out in line with the philosophy of Person-Centred Care, coupled with a week of social activities resulted in a reduced in responsive behaviours in dementia and improve the quality of life for residents with dementia in a residential care home.

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The large scale study funded by the National Institute for Health Research was carried out in 69 residential care homes in the United Kingdom and consisted of 800 residents with dementia. Each of the 69 residential care home had two staff attend a four-day session, training them to socially engage with residents with dementia and finding out what residents would like in the areas of their care needs. When executed, this person-centred care approach coupled with an hour of social engagement found that not only was there a reported in the increase in quality of life but a reduction in responsive behaviours of dementia resulting in cost savings in dementia care to the organisation compared to care without such interventions.

“Taking a person-centred approach is about really getting to know the resident as an individual – knowing their interests and talking with them while you provide all aspects of care. It can make a massive difference to the person themselves and their carers. We’ve shown that this approach significantly improves lives, reduces agitation and actually saves money too. This training must now be rolled out nationwide so other people can benefit.”

-Dr Jane Fossey ( Oxford Health NHS Foundation Trust)

With the success of this study, the researchers are potentially aiming to have this intervention carried out in 28,000 residential care homes in the country, potentially positively impacting up to 300,000 residents with dementia.

The Lantern Project Australia

The Lantern Project Australia, founded by Cherie Hugo, is about giving aged care residents the quality of life they deserve through good food and nutrition.

Source: The Lantern Project Australia

Living Instruments: Music and our brain

I attended an A cappella performance last night by MICappella and they did a rendition of the Iron Maiden Trooper, non-traditional and challenging but the song in itself is really epic and to hear it purely in vocals is mind blowing. Like living instruments in a fireworks display of sound, i imagine the synapsis that must be firing not just within the musicians but within the audience themselves as they watch the performance, lights, vocal, instruments but not instruments, as the mind tries to make sense of the event, following visually one musician to another identifying and piecing together the concert in their minds with sound and sight. During the concert, you can witness the happiness it brings as the crowd jives with the music, smiles lit up the room, think of the rush of dopamine and adrenaline during the song with a fast beat or tempo, all within a span of an hour or two.

What our human minds can do never cease to amaze me. I think of what a live A Cappella performance or a session could do for people with dementia. We talk about how music brings out our inner self and I believe many are familiar with the documentary Alive inside. Oliver Sacks in the video below is quoted as saying that “music can do things that language cannot”.

 

Music brings us alive, invoking memories, emotions, even actions; a gentle tap of the foot, drumming of fingers, a secret smile or a giggle when we associate a memory with the music. More needs to be done to bring arts and health together. We know the benefits of music when it comes to health, and even in the positive benefits in the reduction of behavioural and psychological symptoms of dementia. Yet the streams of music and health continue to work in silos. How can we bring arts and health together to support the people, not just for entertainment but for physiological and cognitive benefits as well?

We certainly need to look into more ways in which we can utilise the beauty of music to support and provide culturally meaningful therapeutic interventions to the people with dementia. Understandably for many health care centres, the issues of cost, storage and even space for the provisions of  instruments are always an issueIf. With the numerous A cappella groups around the world, perhaps there should be an alignment with artist and healthcare professionals as a form of social responsibility to help the wider community. Music is the medicine that pills cannot provide. So how about A cappella, anyone?

The Art of Spoken Word & Dementia

Poetry sometimes for many of us who are not English Literature majors or come from a non-English speaking background, may sound like something that is really difficult and requires a high level of linguistic skill and perfection. However, poetry is found to be cathartic for many people with dementia and high therapeutic. So how do we get over that wall of stigma? For those who may wish to try an alternative, here is the Spoken Word.

This video above is an example of spoken word or some may call it spoken word poetry. The video above is performed by IN-Q, a professional spoken word artist. Spoken word unlike traditional poetry that is meant for paper is a contemporary high-energy performance of the heart, mind and soul. It embraces poetry, storytelling, theatre, and folk, jazz, hip hop and even R&B. It can be a performance by anyone of any age. Topics are mostly issues close to the heart and the home.

Bring spoken word to your home today and bring out the inner a spoken word artist in you. Here’s a video on how to write and perform Spoken Word by Khalil Smith.

Step 1: Brain Storming

Pick a topic that is personal and familiar. Think of words associated with the topic.

Step 2: Construction

Connect the words and carry out a process of association to enable word form and structure.

Step 3: Finalisation Phase

Writing and thinking of the tone and the beat.

Step 4: Performance

Memorise if possible, and add physical movements and ways to engage the audience.


 

For more spoken word performances please visit: http://blog.ted.com/10-spoken-word-performances-folded-like-lyrical-origami/. I’ll leave you with a spoken word performance by Raymond Antrobus Ode to his father’s dementia.