Limits...
Life review and life story books for people with mild to moderate dementia: a randomised controlled trial.

Subramaniam P, Woods B, Whitaker C - Aging Ment Health (2013)

Bottom Line: To evaluate the effect of different pathways for developing a life story book (LSB) for people with dementia.After the LSBs were produced - by either pathway - quality of relationship as rated by relatives improved significantly (F(2, 39) = 19.37, p < 0.001) and staff knowledge regarding the resident and attitudes to dementia improved.The creation of LSBs - either through a life review process or by relatives without involving the person with dementia - has benefits for people with dementia, relatives and staff in care homes.

View Article: PubMed Central - PubMed

Affiliation: a Dementia Services Development Centre Wales , Bangor University , Bangor , UK.

ABSTRACT

Objectives: To evaluate the effect of different pathways for developing a life story book (LSB) for people with dementia.

Method: Preliminary randomised control trial; 23 people with dementia in care homes (mean age 86) randomly assigned to receive either 12 individual life review sessions and co-creating a LSB or a personal LSB created by their relatives as a 'gift'

Results: No difference in quality of life (quality of life-Alzheimer's disease (QOL-AD)) was observed between the two groups, six weeks after having received the LSB (F(1,20) = 0.08, p = 0.77). At this point, QOL-AD had improved for both groups, but there was a significant between-group difference at an intermediate assessment immediately after the life review sessions had been completed, before the LSBs were received (F(1, 20) = 5.11, p = 0.035), in favour of life review. A similar pattern was observed on autobiographical memory (extended autobiographical memory interview), with the life review group improving significantly more than the gift group during the life review sessions, but no difference was observed once all participants had had their LSB for six weeks. After the LSBs were produced - by either pathway - quality of relationship as rated by relatives improved significantly (F(2, 39) = 19.37, p < 0.001) and staff knowledge regarding the resident and attitudes to dementia improved.

Conclusion: The creation of LSBs - either through a life review process or by relatives without involving the person with dementia - has benefits for people with dementia, relatives and staff in care homes. However, undertaking a life review requires training and supervision.

Show MeSH

Related in: MedlinePlus

Consort flowchart of study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4017276&req=5

Figure 1: Consort flowchart of study.

Mentions: The participants were all residents of care homes in North Wales (all but one privately owned). In total, 19 care homes were contacted and 14, with a total of 515 residents, agreed to an initial briefing meeting. Following this, the home manager or deputy manager together with the researcher scrutinised the list of residents at the care home to identify potential participants. The inclusion criteria for the study required the person to be a care home resident with a formal diagnosis of dementia, using the criteria from the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2000), in the mild to moderate range. Degree of dementia was operationalised with the clinical dementia rating (CDR) (Hughes, Berg, Danziger, Coben, & Martin, 1982). Participants were only included if judged to have mental capacity to give consent and had a relative willing and able to participate. Exclusion criteria included severe uncorrected impairment in vision or hearing, current or previous major psychiatric disorder and insufficient verbal ability in English to complete assessments. A total of 93 potential participants with a dementia diagnosis were shortlisted for further screening. Three care homes which had shortlisted 30 potential participants subsequently withdrew from the research. Ten potential participants’ relatives did not agree to participate, being too busy or living too distant from the care home. Seven potential participants refused to take part in the research (e.g. ‘not interested’, ‘tired’, ‘no time’), and three declined because they preferred to communicate through the medium of Welsh. Five potential participants were excluded as their dementia was rated as being severe, four in view of psychiatric disorders (schizophrenia, bipolar disorder) and four due to speech impairment. Five potential participants became ill or died before baseline assessment and one did not have an available relative. Thus 24 participants were eligible and entered the study (see Figure 1).


Life review and life story books for people with mild to moderate dementia: a randomised controlled trial.

Subramaniam P, Woods B, Whitaker C - Aging Ment Health (2013)

Consort flowchart of study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4017276&req=5

Figure 1: Consort flowchart of study.
Mentions: The participants were all residents of care homes in North Wales (all but one privately owned). In total, 19 care homes were contacted and 14, with a total of 515 residents, agreed to an initial briefing meeting. Following this, the home manager or deputy manager together with the researcher scrutinised the list of residents at the care home to identify potential participants. The inclusion criteria for the study required the person to be a care home resident with a formal diagnosis of dementia, using the criteria from the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2000), in the mild to moderate range. Degree of dementia was operationalised with the clinical dementia rating (CDR) (Hughes, Berg, Danziger, Coben, & Martin, 1982). Participants were only included if judged to have mental capacity to give consent and had a relative willing and able to participate. Exclusion criteria included severe uncorrected impairment in vision or hearing, current or previous major psychiatric disorder and insufficient verbal ability in English to complete assessments. A total of 93 potential participants with a dementia diagnosis were shortlisted for further screening. Three care homes which had shortlisted 30 potential participants subsequently withdrew from the research. Ten potential participants’ relatives did not agree to participate, being too busy or living too distant from the care home. Seven potential participants refused to take part in the research (e.g. ‘not interested’, ‘tired’, ‘no time’), and three declined because they preferred to communicate through the medium of Welsh. Five potential participants were excluded as their dementia was rated as being severe, four in view of psychiatric disorders (schizophrenia, bipolar disorder) and four due to speech impairment. Five potential participants became ill or died before baseline assessment and one did not have an available relative. Thus 24 participants were eligible and entered the study (see Figure 1).

Bottom Line: To evaluate the effect of different pathways for developing a life story book (LSB) for people with dementia.After the LSBs were produced - by either pathway - quality of relationship as rated by relatives improved significantly (F(2, 39) = 19.37, p < 0.001) and staff knowledge regarding the resident and attitudes to dementia improved.The creation of LSBs - either through a life review process or by relatives without involving the person with dementia - has benefits for people with dementia, relatives and staff in care homes.

View Article: PubMed Central - PubMed

Affiliation: a Dementia Services Development Centre Wales , Bangor University , Bangor , UK.

ABSTRACT

Objectives: To evaluate the effect of different pathways for developing a life story book (LSB) for people with dementia.

Method: Preliminary randomised control trial; 23 people with dementia in care homes (mean age 86) randomly assigned to receive either 12 individual life review sessions and co-creating a LSB or a personal LSB created by their relatives as a 'gift'

Results: No difference in quality of life (quality of life-Alzheimer's disease (QOL-AD)) was observed between the two groups, six weeks after having received the LSB (F(1,20) = 0.08, p = 0.77). At this point, QOL-AD had improved for both groups, but there was a significant between-group difference at an intermediate assessment immediately after the life review sessions had been completed, before the LSBs were received (F(1, 20) = 5.11, p = 0.035), in favour of life review. A similar pattern was observed on autobiographical memory (extended autobiographical memory interview), with the life review group improving significantly more than the gift group during the life review sessions, but no difference was observed once all participants had had their LSB for six weeks. After the LSBs were produced - by either pathway - quality of relationship as rated by relatives improved significantly (F(2, 39) = 19.37, p < 0.001) and staff knowledge regarding the resident and attitudes to dementia improved.

Conclusion: The creation of LSBs - either through a life review process or by relatives without involving the person with dementia - has benefits for people with dementia, relatives and staff in care homes. However, undertaking a life review requires training and supervision.

Show MeSH
Related in: MedlinePlus