• Research in Community and Public Health Nursing
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• v.30 no.3
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• pp.295-306
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• 2019

Purpose: There has been a growing recognition that person-centered care enhances the quality of life of nursing home residents with dementia. This study was conducted to develop a person-centered dementia care online education program for direct care staff in long-term care facilities. Methods: Delphi method with expert group was used to validate contents. We developed 61 draft items based on literature review. Twenty experts participated in consecutive three round surveys including 5-point Likert scale questions and open-ended questions. Based on experts' opinions, the content validity ratio for content validity and the coefficient of variation for stability were calculated. Results: Three-round Delphi surveys and additional feedback from the expert panel established a consensus of core contents: 1) dementia (7 categories), 2) person-centered care (6 categories), 3) communication (8 categories), and 4) behavioral and psychological symptoms of dementia (6 categories). Specific sub-categories in each category were differentiated according to the job qualifications (65 sub-categories for registered nurses, 64 sub-categories for nursing aids, and 41 sub-categories for personal care workers). Conclusion: This delphi study identified person-centered dementia education curricula, in which the person-centered approach should be a key policy priority in Korean long-term care system. Now it is urgently needed to develop education programs utilizing online platforms that enable efficient and continuous learning for long-term care staff, which can contribute to behavior changes in the person-centered dementia care approach and improvement of care quality in long-term care facilities.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.1
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• pp.1-9
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• 2023

Patients with neurocognitive disorder show behavioral psychological symptoms such as agitation, aggression, depression, and wandering, as well as cognitive decline, which puts a considerable burden on patients and their families. For the treatment of behavioral psychological symptoms, patient-centered, non-pharmacological treatment should be used as a first line approach. This paper describes non-pharmacological interventions to manage and treat behavioral psychological symptoms in patients with neurocognitive disorder. In order to control behavioral psychological symptoms such as agitation, depression, apathy, insomnia, and wandering, it is important to identify and evaluate factors such as environmental changes and drugs, and then solve such problems. Non-pharmacological interventions include reassurance, encourage, distraction, and environmental change. It is necessary to understand behavior from a patient's point of view and to approach the patient's needs and abilities appropriately. Reminiscence therapy, music therapy, aroma therapy, multisensory stimulation therapy, exercise therapy, light therapy, massage therapy, cognitive intervention therapy, and pet therapy are used as non-pharmacological interventions, and these approaches are known to improve symptoms such as depression, apathy, agitation, aggression, anxiety, wandering, and insomnia. However, the quality of the evidence base for non-pharmacological approaches is generally lower than for pharmacological treatments. Therefore, more extensive and accurate effectiveness verification studies are needed in the future.

• The Journal of Korean society of community based occupational therapy
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• v.2 no.1
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• pp.85-96
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• 2012

Objective : The purpose of this study was to effects of the Participation in physical group occupational therapy on cognitive function, neuropsychiatric, social behavior in elderly with wandering dementia. Methods : Thirteen elderly with wandering dementia who live in nursing home in this study. Assessment tools were made by using Cognitive function scale(CFS), Algase Wandering Scale-V2(AWS-2), Neuropsychiatric Inventory-Questionaire(NPI-Q), social-behavioral function measure(SBFM). physical group occupational therapy performed for forty minute, once a week for 9weeks. the assessment tools were made twice: before, after the intervention. Results : Significant differences between pre-treatment and post-treatment were found in the AWS(p<0.05) score and SBFM(p<0.05) score, NPI-Q behabioral and psychological level(p<0.05) score. The cognitive function and neuropsychiatric number showed improvement. but score was not significantly(p>0.05) difference after physical group occupational therapy Conclusion : The findings suggest that the physical group occupational therapy used in this study may be helpful and effectiveness in elderly with wandering dementia, further studies with more subjects and longer treatment period, including will be performed to justify these findings.

• Journal of Music and Human Behavior
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• v.19 no.2
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• pp.1-26
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• 2022

This review was conducted to identify the research trends in music intervention studies with elderly patients with dementia. Korean- and English-written studies on music intervention for this population were searched and analyzed. Seventeen studies were included in the final analysis. The results showed that behavioral and psychological symptoms were the main dependent variables. In terms of the type of music intervention employed, interventions requiring the patient's active participation in producing music were more common than interventions that required the patient to only listen to music. The majority of studies provided live music, selected music that was familiar to and preferred by the patient, and utilized rhythm-based performance activities. In the studies using active music production as the intervention, the participants were asked to express the emotions evoked by group instrument playing or singing along with music, which doesn't reflect the functional limitations (e.g., cognitive impairment) of elderly patients with moderate to severe dementia. The results of this review point to the need in the field to develop music intervention programs for the elderly with moderate to severe dementia that meaningfully engage these patients in music-related behaviors that target their specific symptomology.

• Journal of Oriental Neuropsychiatry
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• v.32 no.2
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• pp.111-127
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• 2021

Objectives: To review and analyze clinical and preclinical evidence of effectiveness, safety, and underlying mechanisms of yokukansan (YKS), a herbal medicine, in alleviating aggression. Methods: Classical records on YKS were searched in the Korean Traditional Medicine Knowledge Database (KTMKD). By searching five electronic databases, prospective clinical studies and preclinical studies of YKS for alleviating aggression/agitation published up to March 30, 2021 were included. Results: Only two classical records on YKS were found from the KTMKD. A total of 11 clinical studies and 15 preclinical studies were found from the five electronic databases. Among 11 clinical studies, seven enrolled patients with dementia and four enrolled patients with other neuropsychiatric disorders. Most clinical studies reported significant improvement in one or more outcomes related to aggression in the YKS group after treatment. Among 15 preclinical studies, all studies except two reported a significant decrease in aggression/agitation-related behavior of YKS or yokukansankachimpihange. Suggested underlying mechanisms of YKS or yokukansankachimpihange for aggression/agitation in these studies included regulation of serotonin receptor, amelioration of abnormal glucocorticoid level related to the hypothalamic-pituitary-adrenal axis, regulation of orexin secretion, amelioration of degeneration in brain cells including glia cells, and suppression of excessive glutamatergic or dopaminergic activity. Conclusions: There were some clinical and preclinical evidence supporting the effectiveness and safety of YKS for alleviating aggression. Given that aggression is the most frequent and destructive symptoms of behavioral and psychological symptoms of dementia, applicability of YKS as a herbal medicine should be further investigated in future high-quality research.

• Korean Journal of Biological Psychiatry
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• v.27 no.2
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• pp.42-57
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• 2020

Electroconvulsive therapy (ECT) is indicated for various mental disorders (e.g., major depressive disorder, schizophrenia, and bipolar disorder) and the behavioral and psychological symptoms of dementia in elderly patients. Furthermore, ECT is a useful first-line treatment in emergency and crisis situations such as suicide risk, violent behavior, catatonia, and food refusal, which are more frequent in elderly patients. ECT is also effective in the treatment of the motor symptoms of neurological disorders, such as Parkinson's disease and Huntington's disease. Due to the high risk of various physical diseases, the comorbid physical conditions of elderly patients should be individually controlled to optimize ECT treatment. Compared to young adults, in elderly patients the seizure threshold is higher, the seizure duration is shorter, and the anesthetic dose is lower. On the contrary, the response rate in the elderly is both faster and higher. Considering potential cognitive decline and the prevention of further deterioration of cognitive function in elderly patients, in the absence of significant comorbidities, twice weekly sessions and right unilateral electrode placement with a lower seizure threshold and less cognitive effect are preferred to bilateral electrode placement, which has a high risk of adverse cognitive effects. After an acute course of ECT, continuation and maintenance of ECT, combined with prescription of therapeutic drugs, may prevent possible relapse or recurrence of mental disorders. In conclusion, ECT can be used to treat mental disorders in elderly adults, with safety and effectiveness comparable to that in young adults.

• 한국노년학
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• v.29 no.4
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• pp.1591-1609
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• 2009

Adult child caregivers and spousal caregivers might deal with differential challenges. Studies about caregivers' psychological outcomes, however, tended to investigate associations between caregiving and its outcomes by pooling adult child caregivers and spousal caregivers together. By using a U. S. sample of family caregivers who assisted a relative with dementia, this study examined whether the relationship of caregivers to care receivers (daughter caregivers or spousal caregivers) made a difference in levels of depressive symptoms. The result showed that wife caregivers were more likely to be depressed than daughter caregivers. For daughter caregivers, role overload, role captivity, and behavior problems significantly influenced on depression. Besides these variables, the level of education was a significant predictor for wife caregivers. Role captivity and behavior problems significantly impacted on depression for husband caregivers. Thus, role captivity and behavioral problems were common predictors for all the caregivers. Specifically, higher levels of role captivity and behavioral problems were likely to make caregivers more depressed. The implication of these results were discussed.