Development of the Train Therapy in a Nursing Home in Switzerland

With the aging population and the increasing number of major neurocognitive disorders in nursing homes, non-pharmacological interventions will play an important role in the future of care. The train therapy is an emerging intervention for coping with behavioral and psychological symptoms of dementia that relies on a railway travel simulator. Seniors, accompanied by healthcare professionals, can experience a train journey in a physical space disguised as a train wagon and displaying prerecorded videos from a train in a television disguised as a train window. This paper presents a novel and accessible railway travel simulator integrating an interactive ticket counter and we discuss the challenges and perspectives for the adoption of the train therapy

Does physical exercise improve ADL capacities in people over 65 years with moderate or severe dementia hospitalized in an acute psychiatric setting ? ::a multisite randomized clinical trial

Background : Several studies on the effect of physical exercise on activities of daily living (ADL) for people with dementia exist; yet, data concerning the specific context of acute psychiatric hospitals remain scant. This study measured the effect of a physical exercise program on ADL scores in patients with moderate to severe dementia hospitalized in an acute psychiatric ward. Methods : A multicenter clinical trial was conducted in five Swiss and Belgian psychiatric hospitals. Participants were randomly allocated to either an experimental group (EG) or a control group (CG). Members of the EG received 20 physical exercise sessions (strengthening, balance, and walking) over a fourweek period while members of the CG participated in social interaction sessions of equivalent duration and frequency, but without physical exercise. The effect of exercise on ADL was measured by comparing scores of the Barthel Index and the Functional Independence Measure in the EG and CG before and after the intervention, and two weeks later. Results : Hundred and sixty patients completed the program. Characteristics of participants of both groups were similar at the inception of the study. The mean ADL score of EG decreased slightly over time, whereas that of the CG significantly decreased compared to initial scores. Overall differences between groups were not significant; however, significant differences were found for mobility-related items. Conclusions : ADL scores in elderly with moderate to severe dementia deteriorate during acute psychiatric hospitalization. An exercise program delays the loss of mobility but does not have a significant impact on overall ADL scores