[Effects of emotion-oriented care on elderly people with cognitive impairment and behavioral problems in residential homes]. / Het effect van belevingsgerichte zorg op ouderen met cognitieve stoornissen en gedragsproblemen in verzorgingshuizen.

This study investigates the effects of emotion-oriented care on the behavior of elderly people with cognitive impairment and behavioral problems. This approach is mainly based on the validation approach, but uses also insights from other approaches like reminiscence and sensory stimulation. Sixteen homes for the aged with structured day care units were randomly allocated to an intervention or control group. 151 Residents with cognitive impairment and behavioral problems were included in the study. The eight intervention homes received a training program with regard to emotion-oriented care. In the eight control homes usual care was continued. Measurements were performed at baseline and after three, six and twelve months of follow-up (assessment by caregivers and relatives). The primary outcome measure was the change in behavior of the residents. The results of multilevel analyses (overall, subgroup and per protocol) showed no statistically significant, nor clinically relevant effects in favor of the intervention group on the behavioral outcome measures. A possible reason for this is that the intervention did not result in significant contrast between the study groups. There is insufficient scientific evidence yet to justify the implementation of emotion-oriented care in residential homes, for residents with moderate to severe cognitive impairment and behavioral problems, on a large scale. Additional studies are needed in which special attention should be given to the implementation process.

Ginkgo for elderly people with dementia and age-associated memory impairment: a randomized clinical trial.

Preparations based on special extracts of the Ginkgo biloba tree are popular in various European countries. Previous studies have suggested the clinical efficacy of Ginkgo in patients with dementia, cerebral insufficiency, or related cognitive decline. However, most of these studies did not fulfill the current methodologic requirements. We assessed the efficacy of the G. biloba special extract EGb 761 in patients with dementia and age-associated memory impairment in relation to dose and duration of treatment. Our study was a 24-week, randomized, double-blind, placebo-controlled, parallel-group, multicenter trial. Study participants were elderly patients with dementia (Alzheimer disease or vascular dementia) or age-associated memory impairment (AAMI). A total of 214 participants, recruited from 39 homes for the elderly in the Netherlands, were randomly allocated to Ginkgo (either 240 mg/d or 160 mg/d) or placebo (0 mg/d). After 12 weeks, the subjects in the two Ginkgo groups were randomized to continued Ginkgo treatment or placebo treatment. Primary outcome measures in this study were the Syndrome Kurz Test (SKT; psychometric functioning), the Clinical Global Impression of change (CGI-2; psychopathology, assessed by nursing staff), and the Nuremberg Gerontopsychological Rating Scale for Activities of Daily Living (NAI-NAA; behavioral functioning). One hundred twenty-three patients received Ginkgo (n=79, 240 and 160 mg/d combined) or placebo (n=44) during the 24-week intervention period. We found no statistically significant differences in mean change of scores between Ginkgo and placebo. The differences were SKT: +0.4 (90% confidence interval [CI] -0.9-1.7); CGI-2: +0.1 (90% CI -0.3-0.4), and NAI-NAA: -0.4 (90% CI -1.9-1.2). A positive difference is in favor of Ginkgo. Neither the dementia subgroup (n=36) nor the AAMI subgroup (n=87) experienced a significant effect of Ginkgo treatment. There was no dose-effect relationship and no effect of prolonged Ginkgo treatment. The trial results do not support the view that Ginkgo is beneficial for patients with dementia or age-associated memory impairment.

Effects of emotion-oriented care on work-related outcomes of professional caregivers in homes for elderly persons.

OBJECTIVES: A randomized controlled trial was conducted on the effects of emotion-oriented care on professional caregivers in homes for elderly persons. Emotion-oriented care is used in the care for cognitively impaired elderly persons and is mainly based on the validation approach. METHODS: Sixteen homes for the aged were randomly allocated to an intervention or control group. Three hundred professional caregivers were included in the study. The eight intervention homes received a training program in emotion-oriented care. In the eight control homes, usual care was continued. Measurements about job satisfaction, burnout, and sick leave were performed at baseline and after 3, 6, and 12 months of follow-up. RESULTS: Modest positive effects were found in favor of the intervention group. These related to various aspects of job satisfaction and burnout. The effects were not very consistent over time. No differences in sick leave were found. DISCUSSION: From this study, as well as other studies in this field, no strong effects were found of emotion-oriented care on work-related outcomes in professional caregivers. Additional research is therefore needed. In these new studies, special attention should be given to the optimization of the implementation process of emotion-oriented care programs.

Effects of emotion-oriented care on elderly people with cognitive impairment and behavioral problems.

OBJECTIVE: This study investigates the effects of emotion-oriented care on the behavior of elderly people with cognitive impairment and behavioral problems. This approach is mainly based on the validation approach, but also uses insights from other approaches like reminiscence and sensory stimulation. METHODS: 16 Homes for the aged with structured day care units were randomly allocated to an intervention or control group. 151 Residents with cognitive impairment and behavioral problems were included in the study. The eight intervention homes received a training program with regard to emotion-oriented care. In the eight control homes usual care was continued. Measurements were performed at baseline and after 3, 6 and 12 months of follow-up (assessment by caregivers and relatives). The primary outcome measure was the change in behavior of the residents. RESULTS: The results of multilevel analyses (overall, subgroup and per protocol) showed no statistically significant, nor clinically relevant effects in favor of the intervention group on the behavioral outcome measures. CONCLUSIONS: There is insufficient evidence yet to justify the implementation of emotion-oriented care on a large scale. Additional studies are needed in which special attention is given to the implementation process.