Mental health promotion at the end of life
Principal Investigators: Prof. Jiska Cohen-Mansfield and Prof. Hava Golander
Behavioral and psychiatric symptoms are very common in persons with dementia at end of life. Many of these symptoms are burdensome to caregivers and sometimes to the individual. The Unmet Needs Model asserts that problem behaviors among people with dementia result from unmet needs due to the decreased ability to meet one’s needs because of increasing difficulty communicating these needs, and a decreased ability to provide for oneself. The needs may pertain to pain/health/physical discomfort, mental discomfort (evident in affective states: depression, anxiety, frustration, boredom), the need for social contacts (loneliness), uncomfortable environmental conditions, or an inadequate level of stimulation (too low, too high, inappropriate).
This study aims to clarify processes that can enhance the care of persons with dementia at the end of life stage. Specific aims are (a) to describe the unmet needs of persons with dementia who manifest behavior problems at the end of life; (b) to elucidate a methodology for systematically detecting discomfort in Long Term Care residents with dementia; (c) to clarify which nursing home residents most profited from non-pharmacological interventions (d) to compare the utility of different non-pharmacological interventions (e) to examine the match between the utilization of specific types of non-pharmacological interventions and background characteristics; and (f) to clarify the meaning of ‘delusions’ and ‘hallucinations’ from the point of view of the person with dementia.
The study is on-going, and involves statistical analyses of existing datasets.