Risk Starvation Contributes to Dementias and Depressions: Whiffs of Danger Are the Antidote

This paper’s objective is to use SKAT, the author’s Stages of Knowledge Ahead Theory of risk, to shed fresh light on the treatment and prevention of mental disorders. SKAT employs a broad definition of risk that allows for nice – not merely nasty – possibilities. SKAT is here shown to solve eight epidemiological puzzles left unexplained by our current theories and associated treatments for the demented and depressed. SKAT does so by enabling a decision model of mental health that puts centre stage why people (and other soft-wired animals) have brains – to make decisions under risk. To make good decisions (be healthy), brains need exercise. Brains get beneficial exercise from what the paper terms “whiffs of danger”, namely sets of risks with the characteristics that the risks are 1) tiny, 2) varied, and 3) frequent. Brains deteriorate when there are shortfalls in such risk exercise. The paper terms such shortfalls “risk starvation”. Those lacking a history of whiffs find normal mishaps too stressful and frequently become depressed. A lot of time with an inadequate amount of whiffs generates the endemic co-morbidity of becoming demented as well as depressed. Socio-economic cultural changes such as the introduction of unemployment benefits and old age pensions and increasing protection of women and children have had the beneficial effects of removing big challenges and big dangers and thus of prolonging physical longevity. But these changes also removed the tiny challenges and tiny dangers formerly faced by those sub-groups in the population identified as more prone to depressions and dementias. Unintentionally, these sub-groups thus were deprived of whiffs of danger, and suffered from risk starvation. In both drug and psychotherapeutic stress research and treatments of the depressed and demented, there should be injections of whiffs of danger to enhance the likelihood of enduring improvements. It is unkind and dangerous for people’s brains to be treated with drugs while maintaining the modern socioeconomic culture of coddling parents and coddling college / university student counsellors, coddling unemployment benefits and coddling old age pensions. These coddles need to be complemented with whiffs of danger, tiny varied chances and challenges. These whiffs of danger need to be introduced in three forms: eliciting social security recipients’ whiffs of danger in the form of little obligations to help the community; educating the poor and other sub-groups that believe closeting females at home endangers their mental health; and educating parents on the damage from overprotection. Overprotection prevents children from becoming inoculated against depression with sensible hope developed over a childhood in which they were allowed to experience numerous failures, not merely numerous successes from parents too closely engineering their environment. Research is required on the likely role of risk starvation in mental disorders other than dementias and depressions and in some physical illnesses.stress; whiffs of danger; decision; dementia; depression; risk starvation; risk; learning; hope; fear; risk-based emotions

I-care-an interaction system for the individual activation of people with dementia

I-CARE is a hand-held activation system that allows professional and informal caregivers to cognitively and socially activate people with dementia in joint activation sessions without special training or expertise. I-CARE consists of an easy-to-use tablet application that presents activation content and a server-based backend system that securely manages the contents and events of activation sessions. It tracks various sources of explicit and implicit feedback from user interactions and different sensors to estimate which content is successful in activating individual users. Over the course of use, I-CARE’s recommendation system learns about the individual needs and resources of its users and automatically personalizes the activation content. In addition, information about past sessions can be retrieved such that activations seamlessly build on previous sessions while eligible stakeholders are informed about the current state of care and daily form of their protegees. In addition, caregivers can connect with supervisors and professionals through the I-CARE remote calling feature, to get activation sessions tracked in real time via audio and video support. In this way, I-CARE provides technical support for a decentralized and spontaneous formation of ad hoc activation groups and fosters tight engagement of the social network and caring community. By these means, I-CARE promotes new care infrastructures in the community and the neighborhood as well as relieves professional and informal caregivers

Improving living and dying for people with advanced dementia living in care homes: a realist review of Namaste Care and other multisensory interventions

© The Author(s). 2018Background: Seventy percent of people with advanced dementia live and die in care homes. Multisensory approaches, such as Namaste Care, have been developed to improve the quality of life and dying for people with advanced dementia but little is known about effectiveness or optimum delivery. The aim of this review was to develop an explanatory account of how the Namaste Care intervention might work, on what outcomes, and in what circumstances. Methods: This is a realist review involving scoping of the literature and stakeholder interviews to develop theoretical explanations of how interventions might work, systematic searches of the evidence to test and develop the theories, and their validation with a purposive sample of stakeholders. Twenty stakeholders - user/patient representatives, dementia care providers, care home staff, researchers -took part in interviews and/or workshops. Results: We included 85 papers. Eight focused on Namaste Care and the remainder on other types of sensory interventions such as music therapy or massage. We identified three context-mechanism-outcome configurations which together provide an explanatory account of what needs to be in place for Namaste Care to work for people living with advanced dementia. This includes: providing structured access to social and physical stimulation, equipping care home staff to cope effectively with complex behaviours and variable responses, and providing a framework for person-centred care. A key overarching theme concerned the importance of activities that enabled the development of moments of connection for people with advanced dementia. Conclusions: This realist review provides a coherent account of how Namaste Care, and other multisensory interventions might work. It provides practitioners and researchers with a framework to judge the feasibility and likely success of Namaste Care in long term settings. Key for staff and residents is that the intervention triggers feelings of familiarity, reassurance, engagement and connection.Peer reviewe

An Evaluation of Shared Reading Groups for Adults Living with Dementia: Preliminary Findings

Purpose – Although there is a growing evidence base for the value of psychosocial and arts based strategies for enhancing wellbeing amongst adults living with dementia, relatively little attention has been paid to literature-based interventions. This service evaluation assesses the impact of Shared Reading (SR) groups, a programme developed and implemented by The Reader Organisation, on quality of life for care home residents with mild/moderate dementia. Design/methodology/approach – Thirty one individuals were recruited from four care homes, which were randomly assigned to either reading-waiting groups (three months reading, followed by three months no reading) or waiting-reading groups (three months no reading, followed by three months reading). Quality of life was assessed by the DEMQOLProxy and psychopathological symptoms were assessed by the NPI-Q. Findings – Compared to the waiting condition, the positive effects of SR on quality of life were demonstrated at the commencement of the reading groups and were maintained once the activity ended. Low levels of baseline symptoms prevented analyses on whether the intervention impacted on the clinical signs of dementia. Limitations – Limitations included the small sample and lack of control for confounding variables. Originality/value – The therapeutic potential of reading groups is discussed as a positive and practical intervention for older adults living with dementia

Why Do Family Members Reject AI in Health Care? Competing Effects of Emotions

Artificial intelligence (AI) enables continuous monitoring of patients’ health, thus improving the quality of their health care. However, prior studies suggest that individuals resist such innovative technology. In contrast to prior studies that investigate individuals’ decisions for themselves, we focus on family members’ rejection of AI monitoring, as family members play a significant role in health care decisions. Our research investigates competing effects of emotions toward the rejection of AI monitoring for health care. Based on two scenario-based experiments, our study reveals that emotions play a decisive role in family members’ decision making on behalf of their parents. We find that anxiety about health care monitoring and anxiety about health outcomes reduce the rejection of AI monitoring, whereas surveillance anxiety and delegation anxiety increase rejection. We also find that for individual-level risks, perceived controllability moderates the relationship between surveillance anxiety and the rejection of AI monitoring. We contribute to the theory of Information System rejection by identifying the competing roles of emotions in AI monitoring decision making. We extend the literature on decision making for others by suggesting the influential role of anxiety. We also contribute to healthcare research in Information System by identifying the important role of controllability, a design factor, in AI monitoring rejection

Why do Family Members Reject AI in Health Care? Competing Effects of Emotions

Artificial intelligence (AI) enables continuous monitoring of patients’ health, thus improving the quality of their health care. However, prior studies suggest that individuals resist such innovative technology. In contrast to prior studies that investigate individuals’ decisions for themselves, we focus on family members’ rejection of AI monitoring, as family members play a significant role in health care decisions. Our research investigates competing effects of emotions toward the rejection of AI monitoring for health care. Based on two scenario-based experiments, our study reveals that emotions play a decisive role in family members’ decision making on behalf of their parents. We find that anxiety about health care monitoring and anxiety about health outcomes reduce the rejection of AI monitoring, whereas surveillance anxiety and delegation anxiety increase rejection. We also find that for individual-level risks, perceived controllability moderates the relationship between surveillance anxiety and the rejection of AI monitoring. We contribute to the theory of Information System rejection by identifying the competing roles of emotions in AI monitoring decision making. We extend the literature on decision making for others by suggesting the influential role of anxiety. We also contribute to healthcare research in Information System by identifying the important role of controllability, a design factor, in AI monitoring rejection