Marijke van Dijk, MSc

1. The Veder method (Preliminary) Results of the impact study on caregivers and people with Dementia in nursing homes Marijke van Dijk, MSc Dr. Julia van Weert Prof. dr. Rose-Marie Dröes

2. Content presentation • Introduction • The Veder Method • Impact study professional caregivers • Impact study people with dementia (preliminary results) • Conclusions

3. Background • Worldwide prevalence: 35.6 million people with dementia • 70% of Dutch people with dementia eventually in nursing homes • Prevalence of agitation, aggression, irritability and apathy in nursing homes: 30-35% ADI (2009), (Vasse 2010), Zuidema (2008), Clarke (2010)

4. Background (2) • Last two decades development of emotion-oriented care approaches and psychosocial interventions in dementia care - to improve and stimulate the communication and contact with people with dementia - to diminish behaviour and mood problems and - to improve quality of life.

5. Theater Veder Veder method Use of poetry and theatrical stimuli to stimulate reciprocity in the communication between caregiver and people with dementia ‘living room show’

6. Video

7. The Veder method • Fixed sequence: • Use of poetry, songs and theatre in combination with emotion-oriented care methods like reminiscence and Validation

8. The Veder method 880 caregivers on 149 wards have been trained. General impression of a training

9. Goal of the study To describe the Veder method To evaluate the implementation on psychogeriatric nursing home wards To evaluate the effects on people with dementia (PwD’s) and their professional caregivers

10. Phases of the study

11. Phase 3: Impact study Part 1: Professional caregivers

12. Applicability of the method Work experience • Self esteem Work satisfaction Design and sample • Focusgroups (N=5)with trained professional caregivers from 21 different nursing homes • Professional caregivers visiting refresh course (n= 29) • Professional caregivers not visiting refresh course (n=6) • Topics:

13. Results (1) Applicability of the method • Application • As a group activity • In 24-hours care • Importance of performance conditions

14. Results (2) Self esteem “I recognize things in the Veder method of what I already did. (group agrees) And that is really nice.”

15. Results (3) Work experience “When you have a basis, like the Veder method, you have something to hold on. A little bit routine in your job is not bad. There is space left for other nice things.”

16. Results (4) Work satisfaction “I see the residents enjoying it. When you normally don’t see a reaction, I now see a smile or another reaction like someone singing spontaneously!”

17. Phase 3: Impact study Part 2: People with dementia

18. Research questions and Design • What is the surplus value of a living room show according to the Veder method compared to a reminiscence group on behaviour, mood and quality of life of persons with dementia living in nursing homes? • Do trained caregivers reach the same effects with the Veder method as professional actors? Three groups: Exp 1 Exp 2 Control Joining Living room Show Offered by: Caregivers Joining Living room Show Offered by: Actors Joining Reminiscence Activity Offered by: Caregivers

19. Design (2) • Three measurements Day 1: Pretest (T1) Day 2: During intervention (T2) Posttest (T3) • Outcome measures • Qualidem, Interact, FACE Ettema (2007), van Weert (2005), DCM (2010)

20. Nursing homes • Psychogeriatric nursing homes (N=13) • Exp1: ‘Living room shows’ by trained caregivers (N=10) • Exp2: ‘Living room shows’ by professional actors (N=5) • Control: Reminiscence activities by caregivers (N=9) Impression of a ‘living room show’ Impression of a reminiscence activity

21. Sample • People with medical diagnosis of dementia • Exlusion criteria: deaf/blind/Korsakov syndrome/being bedridden • Included in analyses: • ANCOVA’s, with baseline scores and gender as covariates Control Exp1 Exp2 N = 69 N= 31 N= 55

22. Preliminary results INTERACT Touching Range 1-5 = Exp1 = Exp2 = Control Recalled memories Range 1-5

23. Preliminary results INTERACT Laughing Range 1-5 = Exp1 = Exp2 = Control Listened to voice Range 1-5

24. Preliminary results Qualidem Positive affect Range 0-18 = Exp1 = Exp2 = Control Social Isolation range 0-9 NB: Higher scores indicate less social isolation

25. Conclusion & Discussion • Aim of the Imagination Method is to enhance the reciprocity in care relations by means of theatrical stimuli combined with emotion-oriented care methods • (Preliminary) results show: • Positive work experiences with the Veder method reported by trained caregivers. • Positive effects on (social) behaviour of people with dementia during and after the use of the Veder method by actors. • Positiveeffectsonsocialbehaviour and mood of peoplewith dementia during the interventionfor all groups. • More research is neededon the use of the Veder method in 24-hours care.

26. End Thank you very much for your attention! Any questions? Contact: Marijke van Dijk (ma.vandijk@vumc.nl) Rose-Marie Dröes (rm.droes@vumc.nl) Julia van Weert (j.c.m.vanweert@uva.nl)

27. Conflict of Interest DisclosureMarijke van Dijk, MSC Has no real or apparent conflicts of interest to report.