American Journal of Alzheimer's Disease

This study examines factors associated with decisions made by dementia patients and their caregivers regarding whether the patient should cease driving, live alone or with their spouse, and assign a Durable Power of Attorney. Using data collected by the Alzheimer's Disease Research Center (ADRC) in the Memory Disorders Clinic at the University of Kentucky Medical Center, we analyzed 827 first visits to predict patients’ and caregivers’ decisions. Caregiver relationship and patient gender and perceptions of patient abilities, as measured by Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) were more important than cognitive functioning, as measured by the MMSE, in predicting decisions made. These findings have theoretical implications for modeling the impact of the course of the disease and practical implications for interventions aimed at supporting the decision-making processes of patients and caregivers.

Sarah Wackerbarth

Mitzi M. S. Johnson

American Journal of Alzheimer s Disease

Predictors of driving cessation, independent living, and power of attorney decisions by dementia patients and caregivers

痴呆患者及护理者驾驶终止、独立生活及代理权决定的预测因素

This article reports the results of a series of focus groups conducted about males who provide care to females with Alzheimer's disease (AD). Male caregiver's coping skills, unique needs, role development, task provision, utilization of services, and potential service gaps were explored. These men were found to focus on the provision of concrete caregiving tasks and to minimize their emotional reactions to caregiving. Obtaining education about AD also proved to be important because it gave them a sense of control over their situation and thus improved their coping abilities. Through these findings, new strategies for practitioners working with male caregivers are suggested including; development of support networks and wellness programs, increased utilization of services, and the design of a male specific support group.

Peggy L. McFarland

Sara Sanders

Male caregivers: Preparing men for nurturing roles

男性护理者：为男性扮演养育角色做好准备

A number of studies suggest that spousal caregivers of persons with Alzheimer's disease (AD) have high rates of depressive disorders. Support groups were one of the earliest interventions to help these caregivers, but were found to be unsatisfactory with regard to addressing the affective needs of caregivers. Psycho-educational support groups, focused on helping caregivers to learn new behaviors to solve problems, appear to be the most promising intervention in reducing the depressive levels of these caregivers. Although there is only limited research on psychotherapy and counseling of caregivers, one study suggests the efficacy of cognitive therapy. Future research on psychoeducational cognitive/behavior problem solving groups and cognitive therapy is recommended.

Vincent K. Adkins

Treatment of depressive disorders of spousal caregivers of persons with Alzheimer's disease: A review

阿尔茨海默病患者配偶照护者的抑郁障碍治疗：综述

Stephanie Zeman

Person-centered care for the patient with mid- and late stage dementia

以患者为中心的护理：中晚期痴呆患者的护理

Educational programs for family caregivers of persons with dementia are quite popular, but vary in content and evaluation strategies. This article describes the development and content of the award winning How To Cope classes offered by the St. Louis Chapter of the Alzheimer's Association. Two methods were used to obtain feedback and revise the program. Results from a telephone survey of past participants (n=35) and two focus groups (n=16) were combined to validate the continued usefulness of the program and develop curriculum recommendations.

Ann M. Steffen

Susan Tebb

Janis McGillick

How to cope: Documenting the changing information needs of Alzheimer's caregivers

如何应对：记录阿尔茨海默病护理者信息需求的变化

Richard B. Lefroy

The legacy of Alois Alzheimer: An historical perspective

阿洛伊斯·阿尔茨海默的遗产：历史视角

The purpose of this study was to investigate the clinical and caregivers impression of Aricept ® treatment in patients suffering from Multi-Infarct Dementia (MID). In a prospective study 73 MID patients1 were treated with Donepezil (Aricept®) for 16-to 20-weeks. Donepezil was administered as a 5mg tablet once daily at bedtime. After four weeks, patients tolerant of the 5-mg dose were increased to 10 mg daily. All patients satisfied the DSM-III-R criteria for Multi-Infarct Dementia. 2 After 16-to 20-weeks of treatment, the patient's caregiver completed a questionnaire concerning the effectiveness of the drug. Subjective cognitive improvement, MMSE, 3 ADL4 and IADL5 outcomes were all assessed before and after treatment (referred to as Clinical Impression). Behavioral outcomes evaluated included depression, agitation, violence, anxiety, and paranoid thoughts. Functional and overall family satisfaction were also evaluated. Side effects as well as reasons for discontinuation from the study were also reported. Seventy-three patients participated in the study. Twelve patients (16 percent) terminated participation due to side effects. Total adverse events were reported in 34 (46.5 percent) of patients. Cognitive improvement was reported in 31 (42.4 percent) patients. Verbal skills and attention were the most commonly reported cognitive improvement. Average MMSE declined by 2.6 points after 16-weeks of treatment. No behavioral improvement was reported. Behavioral deterioration was reported in 16 (21.9 percent) of patients. Functional improvement was reported in 32 (42.8 percent) patients. Overall positive family satisfaction was reported in 54 (73.9 percent) patients. Although Donepezil treatment was approved by the FDA for the treatment of Alzheimer's Disease (AD), such treatment for MID patients appears to be a reasonably safe and effective treatment from the caregiver and family's point of view.

J. R. Shua-Haim

Vered Shua-Haim

Eric Comsti

J. S. Ross

Donepezil (Aricept®) treatment of multi infarct dementia: The caregivers and clinical impression

多梗塞性痴呆的多奈哌齐（安理申®）治疗：护理者和临床印象

Past research suggests that empathy levels between people vary as a function of individual characteristics. Although empathy has been studied in such health care professionals as physicians and nurses, there has been little evaluation of empathy in staff caring for patients with Alzheimer's disease (AD) and other senile dementia disorders. This study examines the relationship between levels of empathy and the demographic and personality characteristics of a sample of dementia care staff in Wisconsin. Results suggest that empathy is related to diverse caregiver characteristics and is associated more frequently with personality rather than demographic variables. Empathy levels also were found to be different between male and female caregivers, which is consistent with past studies. Recommendations are made for future research with this population of health care professionals. Clinical implications are discussed.

Aaron M. Gilson

Delores M. Moyer

Predictors of empathy in dementia care staff

痴呆护理人员共情能力的预测因素

Communication changes over time were studied in 55-persons with Alzheimer's disease (AD) who completed a picture description task at entry, six, and 12-months. Differences at three levels of AD severity (early, middle, late) were investigated using six discourse measures (total utterances, length of utterance, words, abandoned utterances, information units, and conciseness), and six pragmatic measures (questions, turns, unsure statements, judgments, egocentric comments, and giving names). Across all three groups, subjects were less concise over time, made shorter utterances, asked more questions, and provided fewer information units. Increasing percentages of subjects made unsure statements with time. However, performance varied by severity group, with increasing unsureness occurring only at early AD, and all other observed changes occurring at late AD. Persons with AD appear to strive for communication competence as language declines by increasing certain compensatory pragmatic aspects (questions and unsure statements) at different severity levels of the disorder. This suggests that compensatory pragmatic devices are used with flexibility, and that the desire to communicate is maintained throughout the course of AD.

Danielle N. Ripich

Thomas Fritsch

Elaine Ziol

Ellen Durand

Compensatory strategies in picture description across severity levels in Alzheimer's disease: A longitudinal study

阿尔茨海默病不同严重程度下图片描述的补偿策略：一项纵向研究

This study surveyed older drivers with Alzheimer's disease (AD), collaterals familiar with the patient's driving, and a control group for the purpose of obtaining information about driving habits and plans for driving cessation. Drivers with dementia are at a greater risk for getting lost and having crashes than other older drivers. Family members are concerned about crashes to the extent that they are trying to prevent the AD driver from driving. Despite their concerns, many AD drivers and their families have not made plans for driving cessation. These results can assist health care professionals in developing approaches to assist AD drivers and their families as they make the transition to non-driving status.

Publication Information	Publisher: Prime National Publishing Corp.，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2000，Proportion of original research papers: ，Self Citation Rate:， Gold OA Rate:

American Journal of Alzheimer's Disease

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