Influence of perspectives on user adoption of wander-management strategies.

Sixty-percent of Canadians with dementia will wander and become lost. Strategies, such as wall murals that camouflage doors, and locator devices, offer proactive options for keeping persons with dementia who wander safer. Information that describes available strategies to mitigate this issue is diverse and inconsistent, creating challenges for caregivers and persons living with dementia when choosing helpful strategies. This project aimed to describe the spectrum of risks and risk mitigation strategies associated with dementia-related wandering. Thirty-eight phone interviews from across Canada were conducted with stakeholders including persons with dementia, paid and family caregivers, health professionals, law enforcement, and Alzheimer societies. Interviewees were asked about strategies that they have used to manage dementia-related wandering, and how their perceptions of risk, culture, stigma and geographical location may influence strategy adoption. Overall, a wide range of high- and low-tech solutions were used or suggested by participants, and factors such as risk, culture, geography and stigma were considered essential elements to successful adoption of these strategies. Results from this study highlight the need for unique combinations of strategies based on the type of stakeholder and influencing factors involved.

What do we know about best police practices for lost persons with dementia? A scoping review.

Aim: To examine the efficacy of strategies used by the police for missing persons with dementia. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, we searched peer-reviewed and gray literature of existing police practices used for missing persons with dementia. Data from the studies were analyzed descriptively. Results: The literature described 16 articles and 18 websites. Strategies ranged from identification tools, successful field techniques, locating technologies and community engagement/education. Overall scientific evidence was low, with only three studies evaluating the usability and effectiveness of the suggested strategies. Conclusion: More rigorous research is required to demonstrate the efficacy of best police practices for missing persons with dementia, which in turn could assist in the development of a best practice guideline.

What do we know about strategies to manage dementia-related wandering? A scoping review.

Three of five persons with dementia will wander, raising concern as to how it can be managed effectively. Wander-management strategies comprise a range of interventions for different environments. Although technological interventions may help in the management of wandering, no review has exhaustively searched what types of high- and low-technological solutions are being used to reduce the risks of wandering. In this article, we perform a review of gray and scholarly literature that examines the range and extent of high- and low-tech strategies used to manage wandering behavior in persons with dementia. We conclude that although effectiveness of 49 interventions and usability of 13 interventions were clinically tested, most were evaluated in institutional or laboratory settings, few addressed ethical issues, and the overall level of scientific evidence from these outcomes was low. Based on this review, we provide guidelines and recommendations for future research in this field.

What do we know about technologies for dementia-related wandering? A scoping review: Examen de la portée : Que savons-nous à propos des technologies de gestion de l'errance liée à la démence?

BACKGROUND: Occupational therapists use technologies to manage wandering-related risks to promote safety and independence among individuals with dementia living in the community. PURPOSE: The purpose of this review was to examine types of technologies used to manage wandering behaviour. METHOD: Using a modification of Arksey and O'Malley's methodology, we systematically searched peer-reviewed and grey literature on technologies used in home or supportive care environments for persons with dementia at risk for wandering. Data from the studies were analyzed descriptively. FINDINGS: The literature described 83 technologies. Nineteen devices were clinically tested. Interventions ranged from alarm products to mobile locator devices. Benefits included reductions in risk and caregiver burden. IMPLICATIONS: Occupational therapy strategies include technologies to enhance function in persons with dementia. Technologies can also reduce risks of wandering and should be affordable. Ethical issues of the use of technology must be addressed. More research is needed to increase levels of evidence.

Handgrip Strength Related to Long-Term Electromyography: Application for Assessing Functional Decline in Parkinson Disease.

OBJECTIVE: To determine which clinical measures of physical function (ie, gait, balance, and grip strength) best represent long-term electromyography in persons with Parkinson disease (PD) compared with those without PD. DESIGN: Cross-sectional study. SETTING: Local community. PARTICIPANTS: A sample (N=37) of men and women with PD (n=23) and those without PD (n=14), living independently at home, older than 50 years of age, from the local community. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Measures of gait, balance, and grip strength were completed, and electromyography was examined in biceps brachii, triceps brachii, vastus lateralis, and biceps femoris during a 6.5-hour day. Muscle activity was quantified through burst in electromyography (>2% of the normalized maximum voluntary exertion with a continuous activity period of >0.1s). Stepwise multiple regression models were used to determine the proportion of variance in burst characteristics explained by clinical measures of physical function in PD. RESULTS: Grip strength was the best predictor of muscle activity in persons with PD (R2=.17-.33; P<.04), whereas gait characteristics explained muscle activity in healthy controls (R2=.40-.82; P<.04). CONCLUSIONS: Grip strength could serve as an effective clinical assessment tool to determine changes in muscle activity, which is a precursor to functional loss in persons with PD.