Dementia patients living in long-term care often have very low levels of activity, and this strongly contributes to a low quality of life, according to a new large-scale national study by the Dementia Collaborative Research Centre and Griffith University in Australia.
The findings also show that family members and staff tend to be pessimistic regarding the capabilities of dementia patients to become engaged in meaningful activities.
“We already know that activity is really important and just because people with dementia may be cognitively impaired, it doesn’t mean that they should miss out on engagement in an activity,” said Dr. Wendy Moyle from Griffith’s Menzies Health Institute Queensland.
“Missing out in this way can result in not only further lowering cognitive ability, but also the potential for there being an unmet need in the person. This may be exhibited as behavioral and psychological symptoms of dementia such as agitation and wandering which can also result in an increased need for medication.”
The study involved 53 residential aged care facilities in Australia. The researchers measured the participation levels across 15 leisure activities for residents with dementia (five items indoors and 10 items outdoors). For the 191 residents who were able to rate their own activity, the average score was 11.4 out of 30, with zero being the lowest participation rate and 30 being the highest.
Among the 435 staff members surveyed in the study, the average score was 9.6, even lower than the people with dementia who self-reported on activities. Family members were found to be the most pessimistic regarding the degree to which they believed their loved one with dementia could engage in leisure activities, with an average score of seven.
The study also tested the levels of cognitive impairment (brain function) and found that this was not related to the resident’s assessment of their activity participation.
“It is particularly interesting that cognitive impairment was not found to be related to the residents’ activity score whereas staff and family members’ rating of a resident’s activity level was highly negatively related to their cognitive impairment, such that those with more severe impairment were seen as having lower activity levels,” Moyle said.
“There appears to be a wrongly held assumption by staff and family that people with severe or late stage dementia are not capable of leisure activity or that they do not require the stimulation of activities. However we can see that although these people see themselves as having low ability, they have the capacity for a lot more,” she says.
All three groups within the study rated those who they saw as more depressed, as having lower activity levels.
“When we looked at the resident’s self-report, for example, the more they rated themselves as depressed, the lower they rated their own overall activity level. Among staff the difference was particularly large; they rated those with no depression with an average score of 10.9 versus a score of 6.4 for those they saw as being severely depressed.”
“Maintaining quality of life for people with dementia living in long-term care is important, as there is no cure for this prevalent condition,” said Moyle. “When people with dementia go into long-term care, there is a belief that they will be more engaged in activities and will experience an improved quality of life. This unfortunately is not always the case.”
“Given that leisure activities are proven to be related to the overall quality of life of this group, then there needs to be a concerted look at how this can be improved.”
Moyle suggested that higher staff-to-resident ratios should be required in care homes, with the potential for integrating increased numbers of volunteers to provide more leisure activities within the care setting.
Moyle presented the findings at the 11th Gold Coast Health and Medical Research Conference.
Source: Griffith University