Symptoms with late stage dementia residents display
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Common symptoms for people in the low ranges of Allen Cognitive Levels include multi-sensory loss, personality and mood changes, and decreased ambulation (Allen, 1982)
Negative behaviors include unsafe wandering, combative behavior, agitation, and loss of attentiveness (Reisberg, 1984).
These symptoms tend to be exacerbated as their ability to navigate the environment decreases (Schaber, 2011)
People in the late-stages of dementia present further challenges when it comes to treatment, as they are generally unable to self-report their experiences, making it difficult to pinpoint the
root cause of their symptoms (Reimer, Slaughter, Donaldson, Currie, & Eliasziw, 2004).
Research question
•What forms of low sensory stimulation interventions are available for residents
with late stage dementia?
Low sensory stimulation interventions
•Simulated presence- homemade audio or video tapes (DVD) made specifically for
the resident by their family members and/or loved ones, for example: family
members may tape themselves talking, providing a “simulated presence.” (Bourgeois
and Hickey, 2011, p. 274)
•Multi-sensory experiences that integrate a variety of sensory stimuli are becoming
increasingly popular due to the therapeutic effects they have on individuals with
dementia (Winters, Krjsten, et al., 2014, p. 11).
•In the later stages, classic poems work well to help connect to a person’s long-term
memory; they can reach deeply into a person’s history and prompt reminiscence
(Glazner, Gary, 2006, p. 24).
•Studies were carried out in order to test the effect of introducing a humanoid robot
(NAO), a pet robot (PARO) and a real trained animal (DOG) in the therapeutic
sessions for patients with dementia (Valenti, Soler et al., 2015, p. 2).
Variable
Medication Adherence
During Intervention (CI)
Medication Adherence 3
Months Post (CI)
Medications Taken On
Schedule During
Intervention (CI)
Medications Taken On
Schedule After Intervention
(CI)
Hospital Admissions (SD)
Emergency Department
Visits (SD)
Treatment as Usual
n=192
67.9%
(63.8-72.1)
66.7%
(62.3-70.9)
47%3.4-)
Pharmacist Intervention
n=122
78.8%
(74.9-82.7)
70.6%
(64.9-76.2)
53%
(49.1-57.1)
48.6%
(44.7-52.6)
48.9%
(43.7-54.1)
0.97 (1.78)
8 (4.87)
0.78 (1.66)
2.16 (3.31)
Methods of Robotic pet therapy
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PARO (seal-like robot), NAO (human-like robot), 2 black lab dogs
(DOG) with 40 day care center residents and 156 nursing home
residents (Valenti, Soler, et al., 2015, p. 4).
Phase1: CONTROL, NAO(humanoid social robot), PARO (seal-like).
Phase 2:CONTROL, PARO(animal social robot),DOG(real animal)
(Valenti, Soler et al., 2015, p. 4).
The therapy sessions were performed 2 days a week during 3 months
(Valenti, Soler et al., 2015, p. 4).
The patient interacted with the robots, the animals and the
therapists to perform several therapeutic activities, including:
identifying numbers, words, and colors using flash cards; practicing
the use of everyday objects such as combs; sensory stimulation
exercises using different textured fabrics (Valenti, Soler et al., 2015)
Therapeutic exercises were small units of activities, focused on the
stimulation of memory, language, calculation, movement, praxis, and
the use of the different senses (Valenti, Soler et al., 2015, p. 4).
Results of Robotic pet therapy
• Nursing home residents with moderate to severe
dementia had statistically significant differences after
treatment in QUALID scores (a significant increase in the
PARO group), and several NPI items: hallucinations and
irritability/lability (a significant increase in the PARO and
the DOG groups vs. the CONTROL group than decreases),
disinhibition (a significant increase in the PARO group vs.
the DOG group) and night-time behavior disturbances (a
significant decrease in the PARO group vs. the DOG group)
• Day care center residents with severe to moderate
dementia after the sessions with NAO showed an increase
in GDS scores. At follow-up after sessions with PARO, GDS
scores increased
• The NAO group: Impairment in delusions and improving
in apathy (Phase1 nursing home),total score and
irritability/lability(day care center)
• The PARO group: Impairment in irritability/lability
(nursing home), hallucinations
• Phase 2 nursing home and disinhibition (vs. the DOG
group) improving in night-time behavior disturbances (vs.
the DOG group).
• The DOG group: impairment in hallucinations,
irritability/lability (Valenti, Soler et al., 2015, p. 10).
Conclusions
• In a study of robot therapy sessions for patients with
moderate to severe dementia cared for at a day care center,
participants showed improvements in irritability and global
neuropsychiatric symptoms after participating in sessions
with the humanoid robot, but not after sessions with the
animal-shaped robot (Valenti, Soler et al., 2015, p. 11).
• Nursing home
• Randomized controlled trials are needed with a larger
amount of patients, in order to better understand the
effects of robots and dogs on the therapy of people with
dementia (Valenti, Soler et al., 2015, p. 11).
References
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Bourgeois, M. and Hickey, E. (2011) p. 1-432 Dementia: From Diagnosis to Management- A Functional Approach ISBN: 1136874232, 9781136874239
Retrieved from:
https://books.google.com/books?id=60maKaSh2B8C&pg=PA270&lpg=PA270&dq=low+sensory+stimulation+intervention+for+resident+in+late+stage
+dementia&source=bl&ots=ZcyTm9n9JC&sig=KGoUy_ve_cDia35Z3OiHyRp850w&hl=en&sa=X&ved=0ahUKEwiwhLqoprbJAhVM22MKHe5bAhAQ6AEI
TTAG#v=onepage&q=low%20sensory%20stimulation%20intervention%20for%20resident%20in%20late%20stage%20dementia&f=false
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Winters, Kjirsten, et al. (2014). p. 1-31 Sensory programming for late stage dementia Retrieved from:
http://soundideas.pugetsound.edu/cgi/viewcontent.cgi?article=1094&context=ms_occ_therapy
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Glazner, Gary. (2006) p. 24-27 The Rhyme and Reason of Poetry therapy, care ADvantage Retrieved from:
http://www.bahaistudies.net/asma/poetry_therapy.pdf
Valentí Soler M, Agüera-Ortiz L, Olazarán Rodríguez J, Mendoza Rebolledo C, Pérez Muñoz A, Rodríguez Pérez I, Osa Ruiz E, Barrios Sánchez A, Herrero
Cano V, Carrasco Chillón L, Felipe Ruiz S, López Alvarez J, León Salas B, Cañas Plaza JM, Martín Rico F, Abella Dago G and Martínez Martín P (2015)
Social robots in advanced dementia. Front. Aging Neurosci. 7:133. doi: 10.3389/fnagi.2015.00133
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