Monique A.A. Caljouw

• PhD
• Associate professor at Leiden University Medical Centre

Objectives This study compared whether the categories of activities that persons with dementia engage in changed between home and after nursing home admission. Also investigated were the methods for assessing the wishes, needs, and abilities regarding activities, and informal caregivers’ satisfaction with the degree of assessment of activities duri...

This cross-sectional study explores the frequency of going outside and characteristics that are associated with going outside for people living with dementia in nursing homes in the Netherlands. A subsample of a national survey in 353 nursing homes was used ( N = 693). Two-thirds (66.5%) go outside often. Compared to those who rarely or never go ou...

Purpose There is variation in organization of geriatric rehabilitation across Europe. The purpose of this study was to describe the selection criteria for referral to geriatric rehabilitation, care provided, and recovery trajectories of post-COVID-19 patients referred to geriatric rehabilitation in Europe. Methods This observational cohort study i...

Background After an acute infection, older persons may benefit from geriatric rehabilitation (GR). Objectives This study describes the recovery trajectories of post-COVID-19 patients undergoing GR and explores whether frailty is associated with recovery. Design Multicentre prospective cohort study. Setting 59 GR facilities in 10 European countri...

Background Active involvement of persons living with dementia (PLWD) and long-term care (LTC) users in research is essential but less developed compared to other patient groups. However, their involvement in research is not only important but also feasible. This study aims to provide an overview of methods, facilitators, and barriers for involving...

Background Pain medication may have an impact on the quality of life (QoL) in persons with dementia, but may also influence care dependency and daily functioning. The aim of this study is to investigate the effect of regularly scheduled paracetamol on care dependency and daily functioning in persons with advanced dementia with low QoL living in lon...

Background Relocations within and between nursing homes often induce stress, anxiety, and depression in residents and cause additional workload for and burnout in staff. To prevent this, many nursing homes deploy pre-transition initiatives, bridging initiatives, and post-transition initiatives to support residents and staff during the relocation pr...

Objectives: Visuospatial neglect (VSN) is a common cognitive deficit of lateralized attention after stroke and can have a negative influence on patients' daily activities, community participation, and caregiver burden. VSN prevalence has been investigated in several mixed-age populations, but rarely in only an older population. As the population i...

Background COVID-19 infection prevention measures can negatively impact nursing home residents’ well-being. Society has been concerned about the imbalance between infection prevention and residents’ well-being, and about nursing home residents’ autonomy in COVID-19 policymaking. Objective This study explores consensus among nursing home staff abou...

This study aimed to understand and gain insight into an informal caregiver program for caregivers of older stroke patients, which incorporates both skills training and education, in relation to caregiver burden. Semi-structured, in-depth interviews with individual informal caregivers were conducted at admission, at discharge, and six weeks after di...

Objectives Considering the importance of going outside in a natural environment for people in general, and people living with dementia in particular, we want to unravel the aspects by which garden use affects quality of life (QoL) and behavioral and psychological symptoms of dementia (BPSD) in people living with dementia in nursing homes. Design S...

In studies of recurrent events, joint modeling approaches are often needed to allow for potential dependent censoring by a terminal event such as death. Joint frailty models for recurrent events and death with an additional dependence parameter have been studied for cases in which individuals are observed from the start of the event processes. Howe...

Background: Nursing home (NH) staff and residents have been prioritized to receive COVID-19 vaccinations. However, NH staff have been hesitant. This study explored what strategies were used to overcome this hesitancy and which of these were found to be important by NH staff to increase their willingness to take a COVID-19 vaccine. Methods: This...

The most severe COVID-19 infections and highest mortality rates are seen among long-term care residents. To reduce the risk of infection, physical distancing is important. This study investigates what physical distancing measures were discussed by COVID-19 outbreak teams of Dutch long-term care organizations and what challenges they encountered. Th...

To protect nursing home residents from getting infected with COVID-19, several measures have been imposed. The aim of this study was to describe the impact of these measures on activities for Dutch nursing home residents, the conditions under which the activities could take place, and the considerations when making decisions about the (dis)continua...

Relocation of residents within or between long-term care facilities occurs regularly. To mitigate potential negative consequences, supportive relocation initiatives have been developed. This scoping review addresses types, aspects, and impact of relocation initiatives developed to relocate residents between or within long-term care facilities. A to...

This systematic review summarizes the experiences with maintaining meaningful activities for persons with dementia during transitions of care, including related barriers and facilitators, and interventions and strategies. A systematic search was performed in eight databases. The methodological quality was assessed with the Mixed Methods Appraisal T...

Objectives Nursing homes are hit relatively hard by the COVID-19 pandemic. Dutch long-term care (LTC) organisations installed outbreak teams (OTs) to coordinate COVID-19 infection prevention and control. LTC organisations and relevant national policy organisations expressed the need to share experiences from these OTs that can be applied directly i...

Samenvatting Hoewel het belang van burger- en patiëntenparticipatie wordt erkend, ontbreekt een Nederlandse maat om de impact van participatie te evalueren. De Canadese Public and Patient Engagement Evaluation Tool (PPEET) is een Engelstalig instrument dat ontwikkeld is om participatie te evalueren. Het instrument bestaat uit drie modules, gericht...

Background Observational studies have reported an inverse association between ultraviolet (UV) radiation and hypertension. The aim of this study was to assess differences in blood pressure changes between persons with dementia receiving UV light versus vitamin D (VD) supplementation. Methods Post-hoc analysis of randomized controlled trial data co...

Background Dementia palliative care is increasingly subject of research and practice improvement initiatives. Aim To assess any changes over time in the evaluation of quality of care and quality of dying with dementia by family caregivers. Design Combined analysis of eight studies with bereaved family caregivers’ evaluations 2005–2019. Setting/p...

Background Nursing home residents have increased rates of intestinal colonisation with multidrug-resistant organisms (MDROs). We assessed the colonisation and spread of MDROs among this population, determined clinical risk factors for MDRO colonisation and investigated the role of the gut microbiota in providing colonisation resistance against MDRO...

In studies of recurrent events, joint modeling approaches are often needed to allow for potential dependent censoring by a terminal event such as death. Joint frailty models for recurrent events and death with an additional dependence parameter have been studied for cases in which individuals are observed from the start of the event processes. Howe...

Visuospatial neglect (VSN) adversely impacts both the length of rehabilitation and activities of daily living (ADL) of patients after stroke and can reduce their participation in community activities. Therefore, it is important to assess VSN after stroke in neurorehabilitation facilities. The process of assessing VSN comprehensively in current geri...

Objectives There is insufficient knowledge about the functional and medical recovery of older people infected with SARS-CoV-2. This study aims to gain insight into the course of functional and medical recovery of persons who receive geriatric rehabilitation (GR) following SARS-CoV-2 infection across Europe. Special attention will be paid to the rec...

Abstract Background The objectives of this study are to determine the effects of regularly scheduled administration of paracetamol (acetaminophen) on quality of life (QoL), discomfort, pain and neuropsychiatric symptoms of persons with dementia living in long-term care facilities (LTCFs). Methods A multicentre randomised double-blind placebo-contro...

Aim To evaluate the process of daily going outside in a nursing home garden and explore the effect of garden use on quality of life and neuropsychiatric symptoms in persons with dementia. Design A feasibility study with quantitative and qualitative approaches. Methods Twenty residents with a diagnosis of moderate‐to‐severe dementia participated....

Background The Liverpool care pathway for the dying patient (LCP) is a multidisciplinary tool developed for the dying phase for use in palliative care settings. The literature reports divergent experiences with its application in a nursing home setting related to its implementation and staff competencies. The aim of this study is to understand how...

This study aims to qualitatively map problems and measures taken in Dutch nursing homes

There are indications that ultraviolet B (UVB) exposure has beneficial effects on well-being through mechanisms other than vitamin D synthesis alone. We conducted a randomized controlled multicenter trial to compare the effects of UVB light and vitamin D supplementation (VD) in terms of the well-being of nursing home residents with dementia. Partic...

Introduction Evidence concerning the effectiveness of non-pharmacological interventions that are applied to people with dementia living in long-term care facilities is inconsistent. The purpose of this protocol is to describe the methodological considerations that will guide the completion of a scoping review that will inventorise and assess the ef...

Meaningful activities can enhance quality of life, a sense of connectedness, and personhood for persons with dementia. Healthcare professionals play an important role in maintaining meaningful activities, but little is currently known about the impact of the transition from home to nursing home on these activities. This study explored the experienc...

Geriatrische revalidatie (GR) richt zich op het herstel van functioneren en de participatie van kwetsbare ouderen, na een acute functionele achteruitgang door verergering van een al bestaande aandoening of het ontstaan van een nieuwe aandoening. Eerder onderzoek bij deze groep ouderen heeft al voldoende bewijs opgeleverd dat de GR interdisciplinair...

Objectives Visuospatial neglect (VSN) is a common cognitive disorder after stroke. The primary aim of this systematic review was to provide an overview of the impact of VSN in 3 aspects: (1) activities of daily living (ADL), (2) participation, and (3) caregiver burden. The second aim was to investigate the differences in studies focusing on populat...

A prevalence study in two nursing homes (one each in the Netherlands and Ireland) found four (11%) Dutch and six (9%) Irish residents colonized with 11 extended-spectrum beta-lactamase-producing Escherichia coli, 10 of which contained CTX-M-15. Four Dutch isolates, from three residents of the same ward, belonged to E. coli O25:H4, sequence type (ST...

Objectives: In residents with dementia living in a long-term care facility (LTCF), un(der)treated pain may trigger behavioral disturbances, mood syndromes, and deterioration of physical functioning and self-maintenance. Because these factors can have considerable impact on the quality of life (QoL), this study aimed to (1) compare characteristics...

Visuospatieel neglect (VSN) is een veelvoorkomende cognitieve aandoening na een cerebrovasculair accident (CVA). De gevolgen kunnen ingrijpend zijn voor de revalidatie, patiënt en mantelzorger. Vroegtijdige en sensitieve diagnostiek is dan ook van groot belang voor een succesvol ontslag naar huis en het oppakken van het leven thuis. Hoe doen we dez...

Abstract Background No proven effective interventions on quality of life (QoL) are available for persons with dementia in a long-term care facility (LTCF). However, several interventions are effective in diminishing mediators of QoL (i.e. challenging behaviour, depressed mood, sleeping disorders), including pain treatment. Un(der)diagnosed and un(d...

ABSTRACT Introduction Geriatric Rehabilitation (GR) aims to restore functioning and participation in older persons after an acute functional deterioration. Our academic network (UNC-ZH) initiated a roadmap for a core set of generic measurement instruments to evaluate outcomes and enhance GR quality. These are the first results. Objectives The ai...

Objective The objective of this study was to examine whether implementation of a stepwise multicomponent intervention (STA OP!) for challenging behavior and pain affects quality of life (QoL) of nursing home residents with moderate to severe dementia after 3 and 6 months. Methods A cluster randomized controlled trial was conducted in 12 nursing ho...

Background Human and animal studies have shown that exposure to ultraviolet light can incite a chain of endocrine, immunologic and neurohumoral reactions that might affect mood. This review focuses on the evidence from clinical trials and observational studies on the effect of ultraviolet light on mood, depressive disorders, and wellbeing. Methods...

Objective: Understanding patient satisfaction from the perspective of older adults is important to improve quality of their care. Since patient and care variables which can be influenced are of specific interest, this study examines the relation between patient satisfaction and the perceived doctor-patient relationship in older persons and their ge...

Evaluation of the implementation of integrated care can differ from trial-based research due to complexity. Therefore, we examined whether a theory-based method for process description of implementation can contribute to improvement of evidence-based care. MOVIT, a Dutch project aimed at implementing integrated care for older vulnerable persons in...

Background. Although proper pain treatment may require opioids, discussion continues about possible undertreatment or overtreatment in persons with advanced dementia.

Background: Although proper pain treatment may require opioids, discussion continues about possible undertreatment or overtreatment in persons with advanced dementia. Objective: To investigate the prevalence of pain, frequency of opioid prescription use, and factors associated with strong opioid prescription use in nursing homes. Design: Cross-sect...

Objective: To determine whether the implementation of a national program to improve quality of care in geriatric rehabilitation (GR) in the Netherlands improves successful GR in terms of independence in activities of daily living (ADL), discharge destination, and length of stay. Design: Prospective longitudinal study, comparing 2 consecutive coh...

Background Social support, relationships, and closeness are emphasized as important by both people with dementia and their informal caregivers. Psychosocial interventions might be helpful to reinforce the relationship between a person with dementia and his or her informal caregiver. Therefore, this review explores what types of psychosocial interve...

Objectives: To describe care-related quality of life (CarerQoL) of informal caregivers after geriatric rehabilitation (GR) and identify associated determinants. Design: A cross-sectional analysis within a prospective longitudinal follow-up study. Setting: Evaluations at 4 weeks after finishing GR in 16 skilled nursing facilities. Participants: Incl...

BACKGROUND: Integrated care for older persons with complex care needs is widely advocated. Particularly professionals and policy makers have positive expectations. Care outcome results are ambiguous. Receiver and provider satisfaction is relevant but still poorly understood. METHODS: During implementation of integrated care in residential homes (Th...

Background: Insufficient pain management in vulnerable older persons living in long-term care facilities is common, and opiophobia might contribute to this. As opiophobia and its related factors have not been investigated in long-term care, this study evaluates the degree of knowledge of opioids among elderly-care physicians (ECPs) and ECP trainee...

Introduction In geriatric rehabilitation it is important to have timely discharge of patients, especially if they have low nursing support needs. However, no instruments are available to identify early discharge potential. Objective To evaluate if weekly scoring of a nursing support scorecard in the evenings/nights and discussing the results in th...

BACKGROUND: To determine which characteristics are associated with quality of life (QOL) in residents with moderate to very severe dementia in long-term care facilities (LTCFs). MATERIAL AND METHODS: This was a cross-sectional analysis of a cluster randomized controlled study in 12 Dutch LTCFs that enrolled 288 residents, with moderate to severe de...

Urineweginfecties komen vaak voor bij kwetsbare oudste ouderen, ze zijn moeilijk vast te stellen en vaak ook moeilijk te behandelen. Het is daarom belangrijk urineweginfecties te voorkomen. Het blijkt mogelijk om ouderen met een hoog risico op het krijgen van een urineweginfectie op te sporen. Van cranberry's wordt reeds lang beweerd dat ze urinewe...

Objective: To describe changes in the health service delivery process experienced by professionals, patients and informal caregivers during implementation of a national programme to improve quality of care of geriatric rehabilitation by improving integration of health service delivery processes. Study setting: Sixteen skilled nursing facilities....

Background Fear of falling (FoF) is regarded as a major constraint for successful rehabilitation in older people. However, few studies have investigated FoF in vulnerable older people who rehabilitate in a skilled nursing facility (SNF). Therefore, this study measures the prevalence of FoF during and after rehabilitation and assesses differences be...

In het verpleeghuis komen urineweginfecties vaak voor, ze zijn moeilijk vast te stellen en vaak ook moeilijk te behandelen. Het is daarom belangrijk urineweginfecties te voorkómen. Van cranberry’s wordt reeds lang beweerd dat ze urineweginfecties kunnen voorkomen. In een dubbelblinde gerandomiseerde placebogecontroleerde studie is nu ook bewezen d...

Purpose: To assess the measurement properties of the Falls Efficacy Scale-International (FES-I) in patients after a hip fracture aged ≥ 65 years. Methods: In a sample of 100 patients, we examined the structural validity, internal consistency and construct validity. For the structural validity a confirmatory factor analysis was carried out. For c...

As the population grows older, comorbidity and functional impairment lead to increasing medical, nursing and psychosocial care needs, including good palliative care. Whether these care needs are met at home or in an institution, attending to the complex problems is a professional challenge . This is hampered by the lack of evidence for many treatme...

As the population grows older, comorbidity and functional impairment lead to increasing medical, nursing and psychosocial care needs, including good palliative care. Whether these care needs are met at home or in an institution, attending to the complex problems is a professional challenge . This is hampered by the lack of evidence for many treatme...

Background Although dementia at the end of life is increasingly being studied, we lack prospective observational data on dying patients. In this study symptoms were observed in patients with dementia in the last days of life. Methods When the elderly care physicians in two Dutch nursing homes expected death within one week, symptoms of (dis)comfor...

Background: Insight in the natural course of care dependency of vulnerable older persons in long-term care facilities (LTCF) is essential to organize and optimize individual tailored care. We examined changes in care dependency in LTCF residents over two 6-month periods, explored the possible predictive factors of change and the effect of care dep...

In order to provide more patient-centered care for patients suffering from systemic lupus erythematosus (SLE), we studied their current satisfaction and preferences regarding future health care delivery. We sent questionnaires to all SLE patients visiting the rheumatology outpatient clinic in Leiden, the Netherlands. The questionnaire comprised thr...

OBJECTIVES: To determine whether cranberry capsules prevent urinary tract infection (UTI) in long-term care facility (LTCF) residents. DESIGN: Double-blind randomized placebo-controlled mul-ticenter trial. SETTING: Long-term care facilities (LTCFs). PARTICIPANTS: LTCF residents (N = 928; 703 women, median age 84). MEASUREMENTS: Cranberry and placeb...

Objectives To investigate whether the preventive use of cranberry capsules in long-term care facility (LTCF) residents is cost-effective depending on urinary tract infection (UTI) risk. DesignEconomic evaluation with a randomized controlled trial. SettingLong-term care facilities. ParticipantsLTCF residents (N=928, 703 female, median age 84), strat...

Objectives: To determine whether cranberry capsules prevent urinary tract infection (UTI) in long-term care facility (LTCF) residents. Design: Double-blind randomized placebo-controlled multicenter trial. Setting: Long-term care facilities (LTCFs). Participants: LTCF residents (N = 928; 703 women, median age 84). Measurements: Cranberry and placebo...

Objectives: To investigate whether the preventive use of cranberry capsules in long-term care facility (LTCF) residents is cost-effective depending on urinary tract infection (UTI) risk. Design: Economic evaluation with a randomized controlled trial. Setting: Long-term care facilities. Participants: LTCF residents (N = 928, 703 female, median age 8...

Objective: To identify factors that explain differences in patients with high and low levels of fear of falling after a hip fracture. Design: Cross-sectional study in 10 skilled nursing facilities in the Netherlands. Patients: A total of 100 patients aged ≥ 65 years admitted to a skilled nursing facility after a hip fracture. Methods: Participants...

Introduction.– Geriatric rehabilitation (GR) is mainly based on a fragmented approach. In order to achieve integrated care for GR, a national program for innovation in geriatric rehabilitation was initiated in the Netherlands. The aim of this study was to assess the effectiveness of this program. Methods.– During the implementation of the innovati...

This study aims to examine healthcare utilization and its determinants among patients with systemic sclerosis (SSc). A cross-sectional survey among all patients with SSc visiting an outpatient clinic of an academic hospital in the Netherlands was done. Assessments included sociodemographic characteristics and a survey on healthcare utilization incl...

Objective: Although geriatric rehabilitation (GR) is beneficial for restoration of activities and participation after hospitalization of vulnerable older persons, little is known about the optimal organization of care of these postacute facilities. This study examines the relationship of patient volume and service concentration with successful GR...

Background: ageing is frequently accompanied by a higher incidence of infections and an increase in disability in activities of daily living (ADL). Objective: this study examines whether clinical infections [urinary tract infections (UTI) and lower respiratory tract infections (LRTI)] predict an increase in ADL disability, stratified for the presen...

As a first step in the improvement of the organization of care for patients with systemic lupus erythematosus (SLE) we studied their health care usage and its determinants. A questionnaire was sent to 161 outpatients of the rheumatology clinic of a Dutch university hospital. The questionnaire comprised questions on health care usage, quality of lif...

This study aims to examine the needs and preferences regarding the delivery of health care services and information provision and their determinants in patients with systemic sclerosis (SSc). A questionnaire was sent to 77 SSc outpatients, comprising 27 items on health care needs within the domains physical, psychological, social support, employmen...

Urinary tract infections (UTI) are common among the oldest old and may lead to a few days of illness, delirium or even to death. We studied the incidence and predictive factors of UTI among the oldest old in the general population. The Leiden 85-plus Study is a population-based prospective follow-up study of 86-year-old subjects in Leiden, The Neth...

To investigate in surgical gynaecological patients the types of health problems arising or persisting up to six weeks after discharge and the effectiveness of telephone advice. The decreasing length of hospital stay has increased the need for specific instructions about the postdischarge period. Telephone advice could be a valuable tool to address...

This survey aimed to validate the English version of the multidimensional Leiden Perioperative Patient Satisfaction questionnaire (LPPSq) and use it to assess patient satisfaction with perioperative care and the influence of type of anesthesia. One hundred patients having orthopedic surgery under regional and general anesthesia verbally consented t...

Measuring patient satisfaction after anaesthesia care is complex. The existing patient satisfaction questionnaires are limited and omit aspects of patient satisfaction, such as professional competence, information provision, service, and staff-patient relationship. The aim of our study was to develop a valid and reliable self-reported multidimensio...