A Prospective Longitudinal Study of Caregivers of Community Dwelling Persons with Severe Dementia (PISCES): Study Protocol.

Although many persons with severe dementia (PWSDs) are cared for at home by their family caregivers, few studies have assessed end of life (EOL) care experiences of PWSDs. We present the protocol for the PISCES study (Panel study Investigating Status of Cognitively impaired Elderly in Singapore) which aims to describe the clinical course, health care utilization, and expenditures for community-dwelling PWSDs; and perceived burden, coping, resilience, anticipatory and prolonged grief among their caregivers. This ongoing multi-center prospective longitudinal study is recruiting primary informal caregivers of 250 PWSDs from major restructured public hospitals, community hospitals, home care foundations, and hospices in Singapore. Caregivers are surveyed every four months for two years or until the PWSD passes away and then at eight weeks and six months post-death to assess the bereavement of the caregiver. Survey questionnaires included validated tools to assess PWSDs' quality of life, suffering, behaviors, functional status, resource utilization; and caregiver's satisfaction with care, awareness of prognosis, care preferences, resilience, coping, perceived burden, distress, positive aspects of caregiving, anticipatory grief, and bereavement adjustment. We also conduct qualitative in-depth interviews with a sub-sample of caregivers. The survey data is being linked with medical and billing records of PWSDs. The study has been approved by an ethics board. Results from the study will be disseminated through publications and presentations targeting researchers, policy makers and clinicians interested in understanding and improving EOL care for PWSDs and their caregivers.

Person-centred creative dance intervention for persons with dementia living in the community in Singapore.

This paper examines the efficacy of the use of creative dance intervention for persons with mild to moderate dementia, living in the community. Pre- and post-intervention data were collected on the sample of 35 older people to track the impact of the intervention on the domains of function, quality of life and well-being and caregiving stress through the use of the gait speed test, CONFbal scale, Functional Independence Measure, Quality of Life-AD, Dementia Care Mapping and Zarit Burden Interview. There was an overall improvement in all the domains. Statistically significant improvement was found in the Quality of Life reports (p = 0.002) and well-being as measured by Dementia Care Mapping (p < 0.001). The findings assert the positive contributions of person-centred creative dance towards an approach and environment that promotes dementia care. Future studies on determining sustainability of such intervention are recommended.