Antidepressant Strategies Used by Nursing Home Carers Alongside or Instead of Official Treatment in Dementia: Preliminary Results of a Group Concept Study

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Abstract

P15. Depression is an undertreated problem in nursing home (NH) residents with dementia (RwD), associated with increased mortality and low quality of life. Our previous research on a multidisciplinary depression care program suggested that NH staff might change their behaviour towards a RwD alongside or in place of an official treatment after a depression has been diagnosed. A carer can act deliberately (intentionally) or intuitively (spontaneously, e.g. a spontaneous hug to comfort a sad RwD). Research on such informal Deliberate and Intuitive Antidepressant Strategies (DIAS) is lacking. We conducted a Group Concept Mapping to reveal potential DIAS that professional carers might use alongside or in place of an official treatment. We used an online package to combine qualitative and quantitative approaches for generating and structuring content. Individual coding schemes were aggregated across professional carers (N=15) to objectively reveal thematic clusters. First, participants provided their ideas on DIAS. Second, they sorted the strategies and rated them on feasibility and importance to reduce depression in RwD. The hierarchical cluster analysis revealed seven categories: Planned Activities (e.g. painting, petting animals); Physical Contact (e.g. holding hands); Physical Involvement (e.g. involvement in housekeeping activities); Family Input and Reminiscence (e.g. using familiar items in the residents’ room); Acknowledging Emotions (e.g. listening to the RwD); Empathetic and Structuring Actions of Carers (e.g. providing structure); and Pleasant and Stable Environment (e.g. pleasant odours in the living area). Surprisingly, carers rated Planned Activities as the least important and least feasible, while the category Pleasant and Stable Environment was rated as most important and Acknowledging Emotions as most feasible to reduce depression in RwD. It is necessary to repeat this study with a larger group of participants to seek confirmation of the DIAS categories. Further research is needed to explore which strategies are the most effective for reducing depression in RwD. Furthermore, more insight is needed to understand whether our results reflect the attitudes of NH staff that may affect their deliberate or intuitive actions.

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