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Background: Staff caregivers of day care centers provide many activities for older people. However, there is a lack of a systematic curriculum based on Taiwanese culture to improve cognitive function, self-care ability, and depressive mood status in these individuals. Purpose: This study was designed to test the effectiveness of a series of localized cognitive stimulation training courses implemented by direct caregivers and aimed at improving cognitive function, self-care ability, and depressive mood in older people at day care centers. Methods: This cluster-randomized controlled trial research was conducted over a four-month period. The participants were randomly assigned to the experimental, comparison, or control groups based on their day care center affiliation. The experimental group received a series of localized cognitive stimulation training sessions with musical rhythm courses from day care center direct caregivers. The cognitive function, self-care ability, and depression mood state of the three groups were then tested. Results: The experimental group reported statistically significant changes in average scores for attention, feeding, and depressive mood. After controlling for time and degree of participation in activities, the comparison group reported a lower average score for cognitive function at timepoint 3. Conclusions/Implications for Practice: The results of this study support caregivers at day care centers implementing a series of localized cognitive stimulation training course interventions to prevent declines in activities of daily living and cognitive function and ameliorate depressive mood in older adults. In the future, a larger sample size should be used to improve the effectiveness of the intervention. [ABSTRACT FROM AUTHOR]

Background: In addition to playing significant role in the decline of physiological functions and the onset of depression, frailty is involved in a vicious circle with depression that has serious physical and mental impacts on sufferers. Furthermore, elderly people with frailty are less mobile, at increased risk of dissociative interpersonal relationships, and prone to develop a sense of loneliness, which also pose health threats. Purposes: This study was designed to explore the improvement effects of an aromatherapy intervention on depression and loneliness in the elderly with frailty living in daycare centers. Method: This study adopted a quasi-experimental, pre-and-post-test research design. This study enrolled 82 frail elderly people from six daycare centers in Taipei City as the research subjects. The subjects in the experimental group received aromatherapy twice a week for 30 minutes each session for four weeks. The researcher guided the experimental group in a small group setting to perform self-massage on the face and hands with lavender essential oil. The control group was guided in the same self-massage routine using pure base oil. Results: Depression in the subjects was found to be positively cor related with degree of frailty. After the intervention, depression and loneliness was found to have decreased significantly in the experimental group (p <.05). Conclusions: The findings support the beneficial effects of aromatherapy interventions on depression and loneliness in the elderly with frailty living in daycare centers without adverse reactions. Aromatherapy may be used to improve depression and loneliness in elderly people with frailty. [ABSTRACT FROM AUTHOR]

Background: Day care centers provide supportive services to older individuals with disability and dementia. Those who suffer from cognitive impairment typically also suffer from depression. Purpose: To explore whether TimeSlips, a reminiscence creative storytelling approach, improves depressive symptoms and quality of life (QoL) in older individuals of day care centers who have mild to moderate cognitive impairment. Methods: A randomized non-blind controlled trial design was conducted. A total of 20 older individuals who met the inclusion criteria were recruited and randomly assigned to the experimental group and control group using the Internet randomization system, with 10 subjects in each group. The experimental group participated in the one-hour TimeSlips intervention once a week for six consecutive weeks, while the control group maintained their normal daily activities. We used the Cornell Scale for Depression in Dementia (CSDD) to measure depressive symptoms and used EQ-5D (EuroQol-5 dimensions) VAS (visual analogue scale) and utility values to measure QoL. Result: (1) With the exception of age, there were no significant differences in the demographic data between two groups. (2) Under ANCOVA, when age was used as the covariate and the change in CSDD before and after the intervention was used as the dependent variable, the score of the experimental group was significant lower than that of the control group (p < .05). The interaction between group and age was also a significant difference in the change of CSDD before and after the intervention (p < .05). In terms of QoL, the EQ-5D VAS and EQ-5D utility value both decreased after the intervention in the experimental group. ANCOVA was performed separately using the change of EQ-5D VAS and the ranked change of EQ-5D utility values as dependent variables, with no significant differences found between the groups (p = .37 and p = .20, respectively). Conclusion: The results indicate that using TimeSlips may significantly improve depressive symptoms in mild to moderate cognitively impaired older individuals of day care centers. However, no evidence was found to support an effect of TimeSlips on QoL. Our findings provide information to help day care centers staffs design related activities. [ABSTRACT FROM AUTHOR]

Background & Problems: Attending rehabilitation programs at psychiatric daycare wards has been shown to stabilize psychiatric patients’ daily routines, reduce patient symptoms, and help them regain social functions. Non–attendance increases risks of patient decompensation and return to the inpatient unit, which reduces quality of care and increases medical costs. The attendance rate for psychiatric daycare patients at our hospital was 73%. To maximize rehabilitation and treatment success, we developed a special project to raise patient program-attendance motivation. Purpose: This study aimed to enhance the attendance rate of our psychiatric day care patients to improve patient independence and their capacity to return to the community. Resolution: Methods used included rehabilitation game cards, holding medication educational workshops, utilizing reward systems, making attendance passports, and designing activity booklets. Results: The attendance rate of psychiatric day care patients rose from 73% to 89%, a 16% increase. Conclusions: This program not only increased the attendance rate of psychiatric day care patients but also improved communications between professional care staff and patient family members. In addition, this program strengthened daycare ward staff teamwork, which further enhanced treatment quality. We suggest considering rehabilitation program attendance as an important ward quality control criterion to assess and improve treatment and nursing care quality. [ABSTRACT FROM AUTHOR]

ABSTRACT:The project was aimed to improve the attendance rate to rehabilitation activities in a psychiatric daycare center. A survey conducted during January to May 2009 showed the average attendance rate of daycare patients to rehabilitation activities was as low as 51.6%. The underlying main factors were as followed: 1) the rehabilitation activities lack diversity; 2) the content and goal of each activity were not clearly instructed to the patients; 3) there were no individualized rehabilitation planned in accordance to patient preferences; 4) the staffs were incapable in terms of group leading; 5) the designs of therapeutic activities were not differentiated in accordance to therapeutic goals due to limitation of space,and 6) overcrowded during each session.. Methods of improvement were as followed: 1) redesigning rehabilitation program and its duration; 2) individualized rehabilitation schedule; 3) clearly state the purpose and the labels prior to each rehabilitation session; 4) implement reward system to increase attendance incentives, and 5) schedule and plan employee training. As result, the attendance rate to rehabilitation activities increased from 51.6% to 95.4%, demonstrating the efficacy of the implemented project. With well-planned rehabilitation activities, we not only improve our quality of care but also strengthen the patients' ability to live independently in their respective community. (Tzu Chi Nursing Journal, 2012; 11:5, 69-79) [ABSTRACT FROM AUTHOR]