The design of caring environments and the quality of life of older people

There has been little systematic research into the design of care environments for older people. This article reviews empirical studies from both the architectural and the psychological literature. It outlines the instruments that are currently available for measuring both the environment and the quality of life of older people, and it summarises the evidence on the layout of buildings, the sensory environment and the privacy of residents. The conclusion is drawn that all evidence-based design must be a compromise or dynamic and, as demands on the caring environment change over time, this compromise must be re-visited in the form of post-occupancy evaluation

Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197

When technology cares for people with dementia:A critical review using neuropsychological rehabilitation as a conceptual framework

Clinicians and researchers have become increasingly interested in the potential of technology in assisting persons with dementia (PwD). However, several issues have emerged in relation to how studies have conceptualized who the main technology user is (PwD/carer), how technology is used (as compensatory, environment modification, monitoring or retraining tool), why it is used (i.e., what impairments and/or disabilities are supported) and what variables have been considered as relevant to support engagement with technology. In this review we adopted a Neuropsychological Rehabilitation perspective to analyse 253 studies reporting on technological solutions for PwD. We analysed purposes/uses, supported impairments and disabilities and how engagement was considered. Findings showed that the most frequent purposes of technology use were compensation and monitoring, supporting orientation, sequencing complex actions and memory impairments in a wide range of activities. The few studies that addressed the issue of engagement with technology considered how the ease of use, social appropriateness, level of personalization, dynamic adaptation and carers' mediation allowed technology to adapt to PWD's and carers' preferences and performance. Conceptual and methodological tools emerged as outcomes of the analytical process, representing an important contribution to understanding the role of technologies to increase PwD's wellbeing and orient future research.University of Huddersfield, under grants URF301-01 and URF506-01

Categorizing Health Outcomes and Efficacy of mHealth Apps for Persons With Cognitive Impairment: A Systematic Review

Background Use of mobile health (mHealth) apps is growing at an exponential rate in the United States and around the world. Mild cognitive impairment (MCI), Alzheimer disease, and related dementias are a global health problem. Numerous mHealth interventions exist for this population, yet the effect of these interventions on health has not been systematically described. Objective The aim of this study is to catalog the types of health outcomes used to measure effectiveness of mHealth interventions and assess which mHealth interventions have been shown to improve the health of persons with MCI, Alzheimer disease, and dementia. Methods We searched 13 databases, including Ovid MEDLINE, PubMed, EMBASE, the full Cochrane Library, CINAHL, PsycINFO, Ei Compendex, IEEE Xplore, Applied Science & Technology Source, Scopus, Web of Science, ClinicalTrials.gov, and Google Scholar from inception through May 2017 for mHealth studies involving persons with cognitive impairment that were evaluated using at least one quantitative health outcome. Proceedings of the Annual ACM Conferences on Human Factors in Computing Systems, the ACM User Interface Software and Technology Symposium, and the IEEE International Symposium on Wearable Computers were searched in the ACM Digital Library from 2012 to 2016. A hand search of JMIR Publications journals was also completed in July 2017. Results After removal of duplicates, our initial search returned 3955 records. Of these articles, 24 met final inclusion criteria as studies involving mHealth interventions that measured at least one quantitative health outcome for persons with MCI, Alzheimer disease, and dementia. Common quantitative health outcomes included cognition, function, mood, and quality of life. We found that 21.2% (101/476) of the fully reviewed articles were excluded because of a lack of health outcomes. The health outcomes selected were observed to be inconsistent between studies. For those studies with quantitative health outcomes, more than half (58%) reported postintervention improvements in outcomes. Conclusions Results showed that many mHealth app interventions targeting those with cognitive impairment lack quantitative health outcomes as a part of their evaluation process and that there is a lack of consensus as to which outcomes to use. The majority of mHealth app interventions that incorporated health outcomes into their evaluation noted improvements in the health of persons with MCI, Alzheimer disease, and dementia. However, these studies were of low quality, leading to a grade C level of evidence. Clarification of the benefits of mHealth interventions for people with cognitive impairment requires more randomized controlled trials, larger numbers of participants, and trial designs that minimize bias. Trial Registration PROSPERO Registration: PROSPERO 2016:CRD42016033846; http://www.crd.york.ac.uk/PROSPERO/ display_record.asp?ID=CRD42016033846 (Archived by WebCite at http://www.webcitation.org/6sjjwnv1M

Conversaciones sobre la propia identidad en la enfermedad de Alzheimer: ayuda de los libros de memoria de comunicación aumentativa y alternativa

[Abstract] Alzheimer disease (AD) is a progressive and degenerative neurological disorder that affects memory, language and communication, thinking, and social skills. The inability to recall incidents and events, especially when symptoms become more prevalent and severe, can cause a person to experience a loss of self or to have doubts about his or her identity. One approach to helping these patients with their memory and language problems is to use memory books, a kind of Augmentative and Alternative Communication (AAC) tool. The aim of this study was to verify whether the introduction of AAC books could have an impact on conversations about self-identity through an increase of ‘self’-positive conversational contents and on improving conversational skills. Three single case studies were carried out with three elderly women with mild, moderate and severe AD, respectively. Each participant was involved in a conversation about their ‘selves’ in an alternating treatment design (ABAB) without a memory book in phase A and with the aid of this AAC tool in phase B. The results showed a similar conversational response pattern in all participants. AAC aids increased the number of ‘self’-positive conversational statements with a reduction in negative, ambiguous and repetitive utterances. In conclusion, AAC memory tools seemed to help participants with dementia to focus their attention on relevant personal information, allowing them to centre the conversation on core positive identity contents, thus improving the quality of the conversations with fewer ambiguous utterances.[Resumen] La Enfermedad de Alzheimer es una enfermedad neurológica degenerativa y progresiva que afecta a la memoria, el lenguaje y la comunicación, el pensamiento y las habilidades sociales. La incapacidad para recordar incidentes y acontecimientos, cuando los síntomas son más prevalentes y severos, puede causar que la persona experimente una pérdida del self o tenga dudas sobre su identidad. Un enfoque que ayuda con los problemas de memoria y de lenguaje es el uso de los libros de memoria, herramientas de Comunicación Aumentativa y Alternativa (CAA). El objetivo de este estudio es comprobar si la introducción de libros de CAA tiene un impacto en las conversaciones sobre la propia identidad, a través del incremento de contenidos conversacionales positivos sobre “si mismo”, y en la mejora de habilidades conversacionales. Se llevaron a cabo tres estudios de caso único con tres mujeres mayores con enfermedad de Alzheimer, leve, moderada y severa, respectivamente. Se implicó a cada participante en una conversación sobre “si misma” en un diseño de tratamientos alternos (ABAB) sin libro de memoria en la fase A y con apoyo de la CAA en B. Los resultados muestran un patrón de respuesta conversacional similar para las tres participantes. Con las ayudas de CAA se incrementaron las frases positivas sobre “si misma” en la conversación y se redujeron las declaraciones negativas, ambiguas y repetitivas. La conclusión es que parece que las herramientas de memoria han ayudado a enfocar la atención sobre información personal relevante, permitiendo centrar la conversación en contenidos básicos de su identidad y mejorando su calidad con menos ambigüedades

Research Advances: January 2014

The VA has a comprehensive research agenda to help the newest generation of Veterans -- those returning from operations Enduring Freedom, Iraqi Freedom, and New Dawn. In addition to exploring new treatments for traumatic brain injury and other complex blast-related injuries, VA researchers are examining ways to improve the delivery of health care services for these Veterans and promote their reintegration back into their families, communities, and workplaces.This publication reviews recent advances in research about Veterans' health and well-being

The design of caring environments and the quality of life of older people

There has been little systematic research into the design of care environments for older people. This article reviews empirical studies from both the architectural and the psychological literature. It outlines the instruments that are currently available for measuring both the environment and the quality of life of older people, and it summarises the evidence on the layout of buildings, the sensory environment and the privacy of residents. The conclusion is drawn that all evidence-based design must be a compromise or dynamic and, as demands on the caring environment change over time, this compromise must be re-visited in the form of post-occupancy evaluation