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Effectiveness of a home-based missing incident prevention program for community-dwelling elderly patients with dementia

Published online by Cambridge University Press:  03 May 2018

Wing Man Lau ,
Tak Yeung Chan  and
Sze Lok Szeto
Wing Man Lau*
Affiliation:
Department of Occupational Therapy, Kwong Wah Hospital, Kowloon, Hong Kong
Tak Yeung Chan
Affiliation:
Department of Medicine and Geriatrics, Kwong Wah Hospital, Kowloon, Hong Kong
Sze Lok Szeto
Affiliation:
Department of Medicine and Geriatrics, Kwong Wah Hospital, Kowloon, Hong Kong
*
Correspondence should be addressed to: Wing Man Lau, Occupational Therapist I, Department of Occupational Therapy, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong. Phone: +852-3517-5124; Fax: +852-2332-1549. Email: lwm418@ha.org.hk.
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Abstract

Background:

Getting lost is a recognized complication in patients with dementia. Preventive measures are lacking. This study aims to investigate the effectiveness of a home-based missing incident prevention program (HMIPP) in reducing missing incidents, time of searching, and caregivers' stress.

Methods:

The design was a pre- and post-intervention study. Patients were recruited from a hospital-based Geriatric Memory Clinic. Inclusion criteria were as follows: aged 60 years or above, established dementia, and Modified Functional Ambulation Categories score VI or VII. An occupational therapist performed the interventions at the patients's home. These included dementia education, prescription of assistive devices, on-site skills training, environmental modifications, community service referrals, and redesigning of daily life routine tasks. The number of missing incidents and caregivers’ stress at three months and one year were compared with baseline data from one year before and the secondary outcome was time for searching of the last incident.

Results:

A total of 54 patients were recruited. The mean age was 78.8 years and 54% were females. Majority of patients had moderate dementia. The mean number of missing incidents per year was significantly reduced at three months and one year (0.70, 0.22, and 0.14 at 0, 3, and 12 months, respectively; p < 0.001). The time for searching of last missing episode was reduced significantly (6.25, 0.13, and 0.35 hours, respectively; p < 0.001). The caregivers’ stress also decreased significantly at three months and one year.

Conclusion:

The HMIPP was effective in reducing the number of missing incidents, searching time, and caregivers’ stress at three months and one year.

Keywords

missing incidentsdementiacommunity-dwelling elderlyhome programcaregivers’ stress
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 1: Issue Theme: Parkinson's Disease , January 2019 , pp. 91 - 99
Copyright
Copyright © International Psychogeriatric Association 2018 

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References

Bourgeois, M. (2002). Where is my wife and when am I going home? The challenge of communicating with persons with dementia. Alzheimer Care Quarterly, 3, 132–1444.Google Scholar
Bowen, M. E., McKenzie, B., Steis, M. and Rowe, M. (2011). Prevalence of and antecedents to dementia-related missing incidents in the community. Dementia and Geriatric Cognitive Disorders 31, 406–412.Google Scholar
Camp, C. J. et al. (1997). An intergenerational program for persons with dementia using Montessori Methods. The Gerontologist, 37, 688–692.Google Scholar
Chan, T. S. F., Lam, L. C. W. and Chiu, H. F. K. (2005). Validation of the Chinese version of the Zarit Burden Interview. Hong Kong Journal of Psychiatry, 15, 9–13.Google Scholar
Healthcare Association of New York (2005). Elopement Resource Manual. New York, NY: Healthcare Association of New York.Google Scholar
Hwang, J., Yang, C., Tsai, S. and Liu, K. (1997). Behavioral disturbances in psychiatric inpatients with dementia of the Alzheimer's types in Taiwan. International Journal of Geriatric Psychiatry, 12, 902–906.Google Scholar
Kwok, T. C., Yuen, K. S., Ho, F. K. and Chan, W. M. (2010). Getting lost in the community: a phone survey on the community-dwelling demented people in Hong Kong. International Journal of Geriatric Psychiatry, 25, 427–432.Google Scholar
Leung, V. P. Y., Lam, L. C. W., Chiu, H. F. K., Cummings, J. L. and Chen, Q. L. (2001). Validation study of the Chinese version of the neuropsychiatric inventory (CNPI). International Journal of Geriatric Psychiatry, 16, 789–793.Google Scholar
McShane, R., Gedling, K., Keene, J., Fairburn, C., Jocoby, R. and Hope, T. (1998). Getting lost in dementia: a longitudinal study of a behavioral symptom. International Psychogeriatrics, 10, 253–260.Google Scholar
Mok, C. C. M., Siu, A. M. H., Chan, W. C., Yeung, K. M., Pan, P. C. and Li, S. (2005). Functional disabilities profile of Chinese elderly people with Alzheimer's disease – a validation study on the Chinese version of the disability assessment for dementia. Dementia and Geriatric Cognitive Disorders, 20, 112–119.Google Scholar
Rowe, M. et al. (2015). The concept of missing incidents in persons with dementia. Healthcare. 3, 1121–1132.Google Scholar
Sohlberg, M. and Mateer, C. (2001). Cognitive Rehabilitation: An Integrative Neuropsychological Approach (pp. 194–229). New York, NY: Guilford Press.Google Scholar
Wang, G. et al. (2008). The metric properties of Zarit Caregiver Burden Scale: validation study of a Chinese version. Alzheimer Disease and Associated Disorders, 22, 321–326.Google Scholar
Yeung, P. Y., Wong, L. L., Chan, C. C., Leung, J. L. and Yung, C. Y. (2014). A validation study of the Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) in Chinese older adults in Hong Kong. Hong Kong Medical Journal, 20, 504–510.Google Scholar
Zarit, S. H. and Zarit, J. M. (1987). Instructions for the Burden Interview. University Park, PA: Pennsylvania State University.Google Scholar
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