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Publications
Publications (69)
Background
Neuropsychiatric symptoms occur frequently in many nursing home residents with dementia. Despite the availability of multidisciplinary guidelines, neuropsychiatric symptoms are often inadequately managed. Three proven effective methods for managing neuropsychiatric symptoms were integrated into a single intervention method: the STIP-Meth...
BACKGROUND
Neuropsychiatric symptoms occur frequently in many nursing home residents with dementia. Despite the availability of multidisciplinary guidelines, neuropsychiatric symptoms are often inadequately managed. Three proven effective methods for managing neuropsychiatric symptoms were integrated into a single intervention method: the STIP-Meth...
Recruiting older people as participants in research projects based in the use of new information and communication technologies (ICTs) is a challenge for health researchers, especially because persons with low IT skills self-perception are difficult to reach, but also when the eligibility criterion related to the technologies is sophisticated. This...
Background:
Concern has been raised that the COVID-19 pandemic and consequent social distancing measures may increase neuropsychiatric symptoms in people with dementia. Thus, we developed and delivered an e-learning training course to professional caregivers on using a web-based tool for psychosocial interventions for people with dementia.
Object...
BACKGROUND
Concern has been raised that the COVID-19 pandemic and consequent social distancing measures may increase neuropsychiatric symptoms in people with dementia. Thus, we developed and delivered an e-learning training course to professional caregivers on using a web-based tool for psychosocial interventions for people with dementia.
OBJECTIV...
Background:
There are no studies on how the same psychosocial dementia care program is adapted to both in-home and residential care settings.
Objective:
To evaluate the time investment required by professionals to implement a psychosocial dementia care program to manage neuropsychiatric symptoms.
Methods:
A prospective observational study desi...
Problem behavior is frequently present in older people living in nursing homes or needing home care services. When Personality disorders or maladaptive traits are involved these older people need specific care. In addition, they and their carers might experience psychological suffering as their behavior is not always properly recognized as the resu...
Background
A psychosocial dementia care programme for challenging behaviour (DEMBASE®) was developed in collaboration with a Swedish BPSD‐registry team for in‐home care services use in Japan. The programme consisted of a web‐based tool for the continued assessment of challenging behaviours and interdisciplinary discussion meetings. Effectiveness of...
Objectives:
Within an implementation study, we investigated the effectiveness of a combined community-based day care programme for persons with dementia and their carers versus traditional psychogeriatric nursing home-based day care. The effects on needs, sense of competence, burden and quality of life of the family carers were studied.
Methods:...
e23010
Background: Advances in oncology have resulted in prolonged disease trajectories in patients with incurable cancer. In this disease-phase, patients are aware that cancer is incurable but they do not approach the last phase-of-life yet. We examined experiences and wishes of GPs and specialists concerning appropriate care-provision, delivered...
De demografische shift van minder jongeren naar meer ouderen daagt de maatschappij en de gezondheidszorg uit nieuwe oplossingen te vinden voor de problemen die hiermee samenhangen. Zo is aandacht voor preventie van mogelijk functieverlies gedurende de gehele levensloop van belang. In dit hoofdstuk worden vijf tijdvensters van potentiële preventiewi...
Dit hoofdstuk bespreekt agressief gedrag in de zorg, inclusief onderliggende invloeden en oorzaken, de behandeling en begeleiding, de diagnostiek en managementaspecten. Onderwerp zijn verbale agitatie en fysiek agressief gedrag bij ouderen (met dementie), niet bij hun familie of andere betrokkenen.
Sociotherapie is gericht op het doelbewust creëren en hanteren van sfeer en ambiance in de woon-leefomgeving en op ritme, structuur en dagbesteding; het gaat hierbij steeds om cliënten, mantelzorgers en (een multidisciplinair team van) hulpverleners tegelijkertijd. Een woon-leefomgeving met kenmerken van een sociotherapeutisch klimaat draagt in bel...
Dit hoofdstuk beschrijft de kenmerken, prevalentie en verschillende typen van dementie, de onderliggende processen in de hersenen en factoren die het functioneren van mensen met dementie beïnvloeden, zoals het vermogen om zich aan te passen aan de veranderde omstandigheden, het ziektebesef, de persoonlijkheid en materiële en sociale omstandigheden....
Background
Neuropsychiatric symptoms (NPI) of dementia are important determinants of caregiver burden, while caregiver coping styles and competences can relieve burden. Caregivers differ in coping with the demands made on them and in experienced burden. What changes in caregivers explain recovery from burden, and which caregiver characteristics pre...
Voor elk mens is het belangrijk om emotioneel in balans te zijn. Dit gaat gepaard met gevoelens van het naar je zin hebben, wellicht zelfs geluk ervaren, vrij van angst of bedreigende gevoelens zijn, het gevoel om te kunnen gaan met de wereld waarin je leeft. Maar het begrip ‘balans’ geeft ook aan dat het handhaven ervan een dynamisch proces is.
In de diagnostiek en behandeling van dementie spelen artsen een belangrijke rol. Steevast blijkt uit onderzoek dat patiënten en mantelzorgers met name de rol van de huisarts bij dementie erg belangrijk vinden.
Background:
Geriatric rehabilitation concerns short-term integrated multidisciplinary care aimed at functional recovery and social participation for relatively frail elderly. Given the geriatric clients' complex care issues, nurses should possess sufficient and appropriate competencies in order to identify and assess the relevant symptoms and inte...
De laatste jaren is er veel te doen over de kwaliteit van de gezondheidszorg voor de snel groeiende groep kwetsbare ouderen, specifiek de kwaliteit van de verpleeghuiszorg. De bescheiden resultaten uit wetenschappelijk onderzoek naar mogelijke verbetering, zoals die naar voren komen in het NPO-programma, laten zien dat interventies bij kwetsbare ou...
Background
In the province of Zeeland (in the south of the Netherlands), elderly care is under pressure, due to the ageing population in combination with the associated complex nursing care in the local island-setting. The Stichting Ketenzorg Midden- en Noord Zeeland (SKMNZ) has developed the multidisciplinary Transmural Elderly Care Zeeland (TECZ)...
Background
The Prevention and Reactivation Care Program (PReCaP) provides a novel approach targeting hospital‐related functional decline among elderly patients. Despite the high expectations, the PReCaP was not effective in preventing functional decline (ADL and iADL) among older patients. Although elderly PReCaP patients demonstrated slightly bett...
Objectives:
To investigate whether community-based (CO) day care with carer support according to the proven effective Meeting Centres Support Programme model is associated with higher satisfaction of people with dementia (PwD) and their informal caregivers (CG) and with a higher job satisfaction among care staff compared to traditional nursing hom...
Background:
Several studies have shown that the combined community-based Meeting Centres Support Programme (MCSP) for people with mild to moderate dementia and their carers were more effective in reducing behavior and mood problems of people with dementia than traditional nursing home-based (NH) day care. We therefore investigated in this study wh...
Objectives:
Caring for a patient with dementia is a real challenge and can have considerable psychological consequences in the long run. Many caregivers, mostly relatives, feel highly burdened. To develop effective caregiver support to prevent caregivers from getting overburdened, insight is needed into the determinants of burden. The objective of...
Background: Older patients’ experiences with care delivery may be important for their quality of life over time.
Evidence is however lacking. Therefore, this study aims to identify the longitudinal relationship between older
patients’ experiences with hospital care, perceived quality of integrated care and quality of life after hospitalization.
Met...
The hospitalized elderly are at risk of functional decline. We evaluated the effects and care costs of a specialized geriatric rehabilitation program aimed at preventing functional decline among at-risk hospitalized elderly.
The prospective nonrandomized controlled trial reported here was performed in three hospitals in the Netherlands. One hospita...
INTEGRATED APPROACH TO PREVENT FUNCTIONAL DECLINE IN HOSPITALIZED ELDERLY: BACKGROUND: Hospital related functional decline in older patients is an underestimated problem. Thirty-five procent of 70-year old patients experience functional decline during hospital admission in comparison with pre-illness baseline. This percentage increases considerably...
AimTo identify predictors of relational coordination among professionals delivering care to older patients.Background
Relational coordination is known to enhance quality of care in hospitals. The underlying mechanisms, however, remain poorly understood.DesignThis cross-sectional study was part of a larger evaluation study examining the opportunity...
This study investigated relational coordination among professionals providing healthcare to hospitalized older patients and assessed its impact on integrated care delivery.
Previous studies have shown that relational coordination is positively associated with the delivery of acute, emergency and trauma care. The effect of relational coordination in...
The relationship of clinical variables for cognitive functioning and other variables such as multiple neuropsychiatric symptoms and quality of life are usually analyzed bivariately and multivariately. In randomized controlled trials analyses are mostly performed on individual outcome variables. To unravel interdependencies of determinants and outco...
It is known that interprofessional collaboration is crucial for integrated care delivery, yet we are still unclear about the underlying mechanisms explaining effectiveness of integrated care delivery to older patients. In addition, we lack research comparing integrated care delivery between hospitals. Therefore, this study aims to (i) provide insig...
Integrated care has emerged as a new strategy to enhance the quality of care for hospitalised elderly. Current models do not provide insight into the mechanisms underlying integrated care delivery. Therefore, we developed a framework to identify the underlying mechanisms of integrated care delivery. We should understand how they operate and interac...
InleidingOp 22 April 2013 werd het symposium ‘Transitie naar vitaal ouder worden’ gehouden. De inhoud van het symposium was gebouwd op de vier pijlers die worden geacht essentieel te zijn om de transitie van reguliere, traditionele ouderenzorg naar een gezondheidszorg gericht op vitaal ouder worden te realiseren.Het gaat hierbij om epidemiologisch...
There is an 80% prevalence of two or more psychiatric symptoms in psychogeriatric patients. Multiple psychiatric symptoms (MPS) have many negative effects on quality of life of the patient as well as on caregiver burden and competence. Irrespective of the effectiveness of an intervention programme, it is important to take into account its economic...
hospitalised older people are at risk for poor functioning after hospital discharge. We aimed to validate the predictive ability of the Identification Seniors At Risk-Hospitalized Patients (ISAR-HP) screening questionnaire to identify older patients at risk for functional dependence by comparing groups with different ISAR-HP scores on cognitive and...
De laatste tijd wordt in de media steeds vaker aandacht besteed aan pesten onder jongeren. Enkele gevallen van zelfdoding van pestslachtoffers hebben tot het besef geleid dat pesten soms vergaande gevolgen kan hebben en tot blijvende psychische schade kan leiden. Maar hoe staat het eigenlijk met pestgedrag in de ouderenzorg?
The Prevention and Reactivation Care Program (PReCaP) entails an innovative multidisciplinary, integrated and goal oriented approach aimed at reducing hospital related functional decline among elderly patients. Despite calls for process evaluation as an essential component of clinical trials in the geriatric care field, studies assessing fidelity l...
This study aimed to identify the relationship between self-management abilities, well-being and depression. Our study was conducted among older adults (>65 years of age) who were vulnerable to loss of function after hospital discharge. Three months after hospital admission, 296/456 patients (65 % response rate) were interviewed in their homes. The...
Background:
In this paper, we aim to test the long-term benefit of an integrative reactivation and rehabilitation (IRR) program compared to usual care in terms of improved psychogeriatric patients on multiple psychiatric symptoms (MPS) and of caregivers on burden and competence. Improvement was defined as >30% improvement (≥ a half standard deviat...
To test the effectiveness of an integrative reactivation and rehabilitation programme (IRR) for reducing multiple neuropsychiatric symptoms of psychogeriatric patients and caregiver burden.
Open RCT.
Of the 168 participants, 81 were in the IRR and 87 received standard care. The inclusion criteria were a) dementia, an amnestic disorder or other cogn...
Hospital related functional decline in older patients is an underestimated problem. Thirty-five procent of 70-year old patients experience functional decline during hospital admission in comparison with pre-illness baseline. This percentage increases considerably with age.
To address this issue, the Vlietland Ziekenhuis in The Netherlands has imple...
Purpose
This study aimed to increase our understanding of self-management abilities and identify better self-managers among older individuals.
Methods
Our cross-sectional research was based on a pilot study of older people who had recently been admitted to a hospital. In the pilot study, all patients (>65 years of age) who were admitted to the Vli...
Achtergrond Bij 35% van de oudere patiënten (>70 jaar) die in een algemeen ziekenhuis worden opgenomen is er sprake van toegenomen zelfzorgproblematiek ten gevolge van functieverlies vergeleken met die voor opname. Dit risico loopt op tot 65% bij negentigjarigen en ouder. De patiënten liggen ook langer in het ziekenhuis.
Doel van het onderzoek Om...
Elderly persons admitted to the hospital are at risk for hospital related functional loss. This evaluation aims to compare the effects of different levels of (integrated) health intervention care programs on preventing hospital related functional loss among elderly patients by comparing a new intervention program to two usual care programs.
This st...
To test the effectiveness of an integrative psychotherapeutic nursing home program (integrative reactivation and rehabilitation [IRR]) to reduce multiple neuropsychiatry symptoms (MNPS) of cognitively impaired patients and caregiver burden (CB).
Randomized controlled trial.
Psychiatric-skilled nursing home (IRR) and usual care (UC), consisting of d...
The prevalence of multiple psychiatric symptoms (MPS) in psychogeriatric patients is about 80%. MPS have negative effects on caregivers; 70-80% of caregivers are moderately to heavily burdened. We tested an integrative psychotherapeutic programme (IRR) focused on MPS as well as caregiver burden. To develop decision rules in indicating IRR, prognost...
Of elderly patients (> 70 years) admitted to a general hospital 35% suffer from loss of self-care abilities compared to the level before admission. Risk of loss of self-care ability increases with age up to 65% after tthe age of 90. In addition, for many of these patients the duration of hospitalisation is relatively long. OBJECTIVE It is important...
Psychiatrische functiestoornissen (PFS’en) hebben een hoge prevalentie bij kwetsbare ouderen en komen vaak in combinatie voor.
PFS’en hebben een grote negatieve impact op zowel patiënt als mantel-zorger. Een multidisciplinair revalidatieprogramma voor
kwetsbare ouderen gericht op multipele PFS’en is gewenst. Integratieve reactivering en rehabilitat...
A multidisciplinairy rehabilitation programme for frail elderly focused on multiple PFDs is needed. Integrative reactivation and rehabilitation (IRR), developed in psychogeriatrics, is such a person-oriented programme. A description is given about the IRR methodology. IRR is a clinical programme applying an integrative psychiatric/psychotherapeutic...
The prevalence of non-cognitive, psychiatric function disorders (PFD) in psychogeriatric patients, staying in a nursing home is high; it varies from 70 to 8%. It has a negative impact on the quality of life and life-expectancy. It affects caregiver distress and is an important predictor of permanent admission to an institution. In addition the PFD...
Psychiatric function disorders: association with cognitive function, activities of daily living and biographical data Background: The prevalence of non-cognitive, psychiatric function disorders (PFD) in psychogeriatric patients, staying in a nursing home is high; it varies from 70 to 80%.
It has a negative impact on the quality of life and life-exp...
This prospective, observation study (from June 2001 to October 2002) estimated the prevalence and co-occurrence of psychiatric function disorders (PFDs) in psychogeriatric patients suffering from cognitive function disorders at referral to clinical as well as non-clinical (transmural) psychogeriatric programmes. It is expected that PFDs, both total...
To estimate life expectancy of psychogeriatric patients having participated in a reactivation program. To identify prognostic characteristics - on admission - for survival after discharge.
A prospective, clinical-empirical observational study.
A Dutch psychiatric-skilled nursing home.
Psychogeriatric patients (n = 75) suffering from very mild to mo...
Literature indicates that the use of psychotherapeutic techniques in affective problems in patients with cognitive impairment is scarce and often considered to be ineffective. The feasibility of an individual treatment with Rational Emotive Therapy of a psychogeriatric patient was explored. The patient was diagnosed with moderate cognitive impairme...
In may 2002 the concept report "Task domains of nursinghome physician/social geriatrician" is presented by the "Dutch Society of Nursinghome physicians (NVVA). The report continues the policy of an undivided taskdomain regarding psychogeriatrics and somatics. In this article the limits of this point of view are pointed out especially with respect t...
To identify prognostic characteristics for the probability of discharge of psychogeriatric patients with functional-psychiatric pathology, in order to optimize patient selection for the reactivation programme.
A retrospective, clinical, empirical study in a Dutch psychiatric nursing home. A group of 102 patients, consecutively enrolled in a psychog...
In this case-study the relevance of psycho-social interventions for providing palliative care in the terminal phase of life of psycho-geriatric patients with functional-psychiatric co-pathology is described. The know-how, interventions and facilities such as available in a reactivation unit in a 'psychiatric-skilled' Dutch nursing home, were highly...
Projects
Projects (6)
The aim of this project is to optimally implement the STIP-method in order to proactively and effectively prevent or treat BPSD among clients. We do this by looking at facilitators and barriers to the implementation. The implementation is successful if the methodology, supported by the web application BPSD Care, has been applied in a timely and effective manner by more than half of the clients.
