HOME CARE RESPITE FILMS

1. HOME CARE RESPITE FILMS Offering relief for caregivers by simulated multimodal presence and activation for persons with dementia? Respite films potentially offer a brief timeout for caregivers and can act as a stimulus for positive behaviours for persons with dementia. Adapted on the basis of Prof. Dr. Dale A. Lund’s work on respite films (U.S.A.) . S. Oppikofer Center for Gerontology, University of Zurich, Switzerland ADI London, 2012, 0C070

2. Objectives The objective of the study was to evaluate the impact of a purpose-made respite film on the following aspects: (1) the quality of life and behaviour of persons with dementia, (2) the respite for caregiving family members and (3) a potential intervention with patients exhibiting agitated behaviours. ADI London, 2012, 0C070

3. Respite Film «A Musical Hike» • «A Musical Hike» simulates the presence of a friendly visitor who directly addresses the viewers in a positive manner with familiar activities and topics. • The musical therapist Antoinette Niggli engages the person with dementia during 38 minutes in a virtual musical hike. • She stimulates conversation by asking direct questions, pausing for answers, inviting for simple movements and an easy memory training. ADI London, 2012, 0C070

4. Methods Design The effectiveness of the respite film was tested in a short-term longitudinal study involving 29 caregiver-patient dyads. Intervention Persons with dementia watched the respite or the control film on a regular basis during a four week intervention phase. ADI London, 2012, 0C070

5. Data Collection • Person living with dementia • Observed Emotional Rating Scale (Lawton, M. P. et al., 1996) • Mini-Mental-State Examination, Version Zurich (Folstein et al., 1975, modified by Brühwiler, 1986) • Smiley-Analogue-Scale • Caregiver • Multidimensional Caregiver Burden Inventory (Novak & Guest,1989) • Functional Assessment Staging (FAST),(Reisberg, 1984; German versionIhl & Fröhlich (1991) • Cohen-Mansfield Agitation Inventory CMAI- Long Form (Cohen-Mansfield, Marx & Rosenthal (1989) • Questionnaire of Satisfaction and effectiveness of the film • Single Item Quality of Life ADI London, 2012, 0C070

6. Sample persons living with dementia Dyad: person living with dementia and their caregiver MMSE: Mini-Mental-Status Examination (Folstein et al., 1975), values scale: 0-30 FAST: Functional changes through aging and dementia (Reisberg, 1984), values scale: 1-16 ADI London, 2012, 0C070

7. Results • Control Film • The control group participants demonstrated a lack of interest in watching the film (four out of five refused to watch it regularly). • The Film’s Applicability • During the four-week intervention, the caregivers showed the film to their relative with dementia regularly with a minimum of 10 viewings. • Most persons with medium to severe dementia did not remember they had already seen the home care film and were repeatedly pleased to watch it. ADI London, 2012, 0C070

8. Results • Participants’ general reactions to: • Questions • 30% of the participants answered all or some of the questions • 42% rarely and about 8% showed only some non-verbal reactions • 21% neverreactedverballyor non-verbally • Songs • 44% of the participants sang along always or sometimes, while 6% showed only non-verbal reactions, • 44% did not show any reactions • Movements • 8% oftheviewersimitatedmostofthemovementinstructions, • 22% performedsomemovements, 16% reactedrarely, • 54% did not respondatall. ADI London, 2012, 0C070

9. Results • Caregivers’ Benefits • 62% of caregiving family members reported respite, while 38% did not experience any change during the intervention. • Reasons for the experienced relief: caregivers • had more time for themselves to rest and to briefly do some activities. • considered their relative with dementia to be occupied with an enjoyable activity. • No significant reduction of caregivers’ burden (CBI) was found in the pre- and post-test comparison, ADI London, 2012, 0C070

10. Results • Participants’ Quality of Life • 38% of the caregivers recognized a visible increase in the participants’ quality of life, 52% did not • Participants evaluated their subjective well-being on a five-point smiley-analogue scale (from 1 = “not good at all” to 5 = “very good”)directly before and after the presentation of the film. However, ceiling effects made it impossible to analyse whether the film had a positive effect on the viewers’ quality of life or not. ADI London, 2012, 0C070

11. Results • Agitation • The hypothesis that agitated behaviours would be reduced due to the intervention could not be confirmed with the CMAI. • 81% of the participants remained quiet whilst watching the film, 14% showed agitated behaviours. ADI London, 2012, 0C070

12. Results – Summary • the respite film is appropriate for most persons with dementia; • 62% of the caregivers reported receiving relief as a result of the film; • the quality of life remained stable for participants watching the film on a regular basis; • most persons with dementia were calm while watching the respite film; and • caregivers expressed a need for further respite films. ADI London, 2012, 0C070

13. Outlook • Second respite film selecting Love for a recurrent theme. • Intervention study in six care facilities for people with dementia in Switzerland. • Preliminary Results: Respite films are also useful in care facilities. ADI London, 2012, 0C070