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S48
Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
Conclusions:
People with dementia think, have feelings, may be
creative; several institutionalized elderly people with dementia
demonstrate creative and innovative skills.
P-060
Describing the population with dementia in a general hospital
setting
G. Crowther
University of Leeds, Leeds, United Kingdom
Objectives:
Around 12,500 people with dementia are admitted to
Leeds Teaching Hospitals Trust (LTHT) per year.
Rates of somatic and psychological symptoms, in people with
dementia in hospital are around 60% and 70% respectively. Delirium
is common in around 66% of admissions. Persistent symptoms can
cause distress, the minimisation of which is a treatment goal.
In order to minimise distress in dementia, one must first identify
those with dementia and recognise the symptoms that cause
distress.
This project aims to describe the accuracy of reported dementia,
and frequency of symptoms commonly associated with dementia
that cause distress in people on general hospital wards.
Methods:
I conducted a retrospective case notes review of
100 patients admitted to LTHT who have a known diagnosis
of dementia. I hand searched each patients psychiatric and
medical notes, identifying how accurately dementia diagnoses
were recorded and all episodes of documented somatic symptoms,
psychological symptoms, behaviour associated with distress.
Results:
81% of dementia diagnoses were recorded accurately in
the medical notes. 39% of patients were documented to be in
pain. 13% had documented psychological symptoms of which, 4%
had depression, 3% anxiety, 4% delusions and 4% hallucinations.
Delirium was documented in 13% of cases.
Conclusions:
This work demonstrates deficits in the recording of
known dementia diagnoses, and an under reporting of symptoms
commonly associated with dementia, that are potentially treatable.
It highlights the need for further work identifying barriers and
facilitators to distress reporting, which I intend to carry out using
semi-structured interviews with healthcare professionals.
P-061
Effects of music therapy in institutionalized elderly with
dementia
D. Curto Prieto
1
, C. Sole Serrano
2
, M. de Castro
3
, M. Mercadal
Brotons
4
, F.M. Asensio
2
1
Sanitas residencial-Bupa, Barcelona, Spain;
2
Universitat Ramon Llull,
Barcelona, Spain;
3
Universitat Ram´on Llull, Barcelona, Spain;
4
Escola
superior de musica de Catalunya, Barcelona, Spain
Number of people affected of dementia continues to growing.
Within the framework of Positive Psychology, we’ll study the
positive effects of musictherapy on QoL of people with dementia.
The main objective is to analyse, compare the effects of
musictherapy (experimental group), and reminiscence (control) in
institutionalized elderly. To evaluate the effect of musictherapy
program vs. reminiscence program on cognitive functioning, mood
and participation-interaction of individuals in moderate/advanced
stages of dementia.
Method:
Quasi-experimental study. Pre-post test design with a
control group. Participants were 24 people with dementia in
phases 5 and 6 who were randomly assigned to a musictherapy
group or a reminiscing group. Both groups received 12 sessions,
2 sessions per week. Instruments included: Cognitive functioning:
BIMS (Brief Interview Mental Status); Self-Perception Scale mood
OERS (Observed Emotion Scale); Observations of the therapists and
video analysis (sessions 1, 6, and 12).
Results:
It should be noted that individuals involved in the music
therapy group had a gradual increase in cognitive scores (attention,
memory, temporal orientation) throughout the duration of the
study, while the recreation/reminiscing group decreased. The score
of the participants in both groups indicate a more positive mood
before and after the sessions and a noticeable increase in interaction
between participants. Behaviors and apathy also decreased in the
advanced dementia musictherapy group.
Conclusions:
Musictherapy seems to contribute to maintain and
improve cognitive, behavioral and socio-emotional aspects of older
people with dementia in moderate to advanced stages to a higher
level than reminiscence-recreation.
P-062
Physical restraints reduction program
D. Curto Prieto
1
, B. Marco
1
, J.F. Tomas
2
1
Sanitas residencial-Bupa, Barcelona, Spain;
2
Sanitas residencial-Bupa,
Madrid, Spain
Objectives:
To demonstrate that he use of restraint has no benefits
in the care of people with dementia. In Spain, the average of
use of restraints is around 20% in big care home companies.
Sanitas Residencial, in 2011 started an ambitious program to reduce
restraints in all 40 care homes
Methods:
An all staff training program in dementia started in
2011. One of the main issues was restraints and how to eliminate
them. During all this years, all care homes developed an ambitious
program to reduce physical restraints.
Data was obtained from a review of electronical clinical records
and benchmark data from AESTE (a Spanish benchmark company).
Historical evolution of use of restraints and falls was necessary.
Results:
The use of restraints in sanitas residencial in the beginning
of 2012 was 27.8% and in Spain at around 25.4%.
At present day Sanitas Residencial has only 1.3% (the average in
Spain is around 20%) of residents with physical restraints. 28 care
homes (out of 40) certified free of restraints by an external audit
company (23 with final certify).
During this period, fall rates and its complications (most severe hip
fractures) hasn’t increased due to fall prevention program.
Conclusion:
People suffering from dementia don’t need, as a
common, the use of physical restraints. Deliver high quality care
without using restraints is possible. Fall and consequences are
not increasing because not using physical restraints. Infections,
constipation, fall risk improves by not using physical restraints
P-063
Relationship between oral health and cognition in older
patients admitted in a medical ward of a general hospital
S. Duque
1
, M.J. Serpa
2
, S. Velho
2
, C. Braco Forte
3
, M. Sequeira
4
,
J. Barrona
4
, ´A. Chipepo
2
, J. Francisco J ´unior
2
, F. Pestana Ara ´ujo
2
,
J. Pimenta da Gra ¸ca
2
1
Hospital Beatriz ˆAngelo / Faculdade de Medicina de Lisboa, Lisboa,
Portugal;
2
Hospital Beatriz ˆAngelo, Lisboa, Portugal;
3
Portugal;
4
Faculdade de Medicina de Lisboa, Lisboa, Portugal
Objectives:
Previous studies suggested that there is an association
between cognitive impairment, teeth loss and periodontal disease.
Our aim was to evaluate the relation between cognition and oral
health status (OHS) among patients ≥75 years admitted in an acute
medical ward.
Methods:
Cross-sectional study during 1 day. Comprehensive
Geriatric Assessment (including Global Deterioration Score and/or
subjective assessment of cognition, Mini Nutritional Assessment
and Barthel score). Dental examination by a dentist.
Results:
100 patients were included, average age 83.7 years,
63% males, 25% nursing home residents (NHR), average Cumulative
Illness Rating Scale Geriatrics 11.2, average Barthel score 62.6,
70% malnourished. Prevalence of mild cognitive impairment (MCI)
and dementia were 12% and 19%, respectively. Average number of
teeth (ATn) was 6.7
±
8.4 (0, 33), 36% used oral prosthesis. Prevalence