Little is known about the changes that occur for older persons with dementia in the practice of self-care routines. This study assesses the concordance of past and current self-care practices of day care and nursing home persons using spouse reports, the degree of spouse awareness of these changes, and spouse perception of how important self-care practices had been to their partner. Participants were spouses of 12 older persons with dementia in day care and spouses of 20 nursing home residents. Self-care routines were assessed using the Self-maintenance Habits and Preferences in Elderly (SHAPE) questionnaire. Day care attendees showed few changes in self-care routines compared to nursing home residents. Spouses of nursing home residents underestimate the changes in self-care that occur with nursing home admission. The importance of being aware of self-care changes lies in the value of maintaining continuity with the customary preferences and routines of the older person.
Center for the Study of Aging and Human Development.Multidimensional Functional Assessment: The OARS Methodology . Durham, NC: Duke University;1975.
2.
Katz S. , Ford AB , Moskowitz RW , Jackson BA , Jaffe MWStudies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function . JAMA.1963;185: 914-919 .
3.
Lawton MP , Brody EMAssessment of older people: self-maintaining and instrumental activities of daily living . Gerontologist. 1969;9: 179-186 .
4.
Atchley RCA continuity theory of normal aging . Gerontologist. 1989;29: 183-190 .
5.
Atchley RCContinuity theory. In: Maddox GL , ed. The Encyclopedia of Aging. New York: Springer;1995:227-230.
6.
Onega LL , Tripp-Reimer T.Expanding the scope of continuity theory: application to gerontological nursing . J Gerontol Nurs.1997;23: 29-35 .
7.
Bonder BR , Zadorzny C. , Martin RJDressing in Alzheimer's disease: executive function and procedural memory . Clin Gerontol.1998;19: 88-92 .
8.
Vogelpohl TS , Beck CK , Heacock P. , Mercer SO “ I can do it!” Dressing: promoting independence through individualized strategies . J Gerontol Nurs.1996;22: 39-42 .
9.
Raia P. , Habilitation therapy: a new starscape. In: Volicer L , Bloom-Charette L , eds. Enhancing the Quality of Life in Advanced Dementia. Philadelphia: Brunner/Mazel ; 1999: 21-37.
10.
Son GR , Therrien B. , Whall A.Implicit memory and familiarity among elders with dementia . J Nurs Scholarsh. 2002;34: 263-267 .
11.
Cohen-Mansfield J. , Jensen B.Do interventions bringing current self-care practices into greater correspondence with those performed premorbidly benefit the person with dementia? A pilot study . Am J Alzheimers Dis Other Demen.2006;21: 312-317 .
12.
Harper GJAssessing older adults who cannot communicate. In: Kane RL , Kane RA , eds. Assessing Older Persons: Measures, Meaning and Practical Applications. Oxford , UK: Oxford University Press;2000:483-515.
13.
Neumann PJ , Araki SS , Gutterman EMThe use of proxy respondents in studies of older adults: lessons, challenges, and opportunities . J Am Geriatr Soc.2000;48: 1646-1654 .
14.
Strauss ME , Pasupathi M.Primary caregivers' descriptions of Alzheimer patients' personality traits: temporal stability and sensitivity to change . Alzheimer Dis Assoc Disord. 1994;8: 166-176 .
15.
Jensen B. , Cohen-Mansfield J.How do self-care routines of nursing home residents compare to past self-care practices?Geriatr Nurs.2006;27: 244-251 .
16.
Cohen-Mansfield J. , Jensen B.Self-maintenance Habits and Preferences in Elderly (SHAPE): reliability of reports of self-care preferences in older persons . Aging Clin Exp Res. 2007;19: 61-68 .
17.
Cohen-Mansfield J. , Jensen B.Sleep-related habits and preferences in older adults: a pilot study of their range and self-rated importance. BehavSleep Med.2005;3: 209-226 .
18.
Cohen-Mansfield J. , Jensen B.Dressing and grooming preferences of community-dwelling older adults . J Gerontol Nurs.2007;33: 31-39 .
19.
Cohen-Mansfield J. , Jensen B.The preference and importance of bathing, toileting and mouth care habits in older persons . Gerontology . 2005;51: 375-385 .
20.
McCurry SM , Ancoli-Israel S.Sleep dysfunction in Alzheimer's disease and other dementias . Curr Treat Options Neurol.2003;5: 261-272
21.
Rogers JC , Holm MB , Burgio LD , et al. Improving morning care routines of nursing home residents with dementia . J Am Geriatr Soc.1999;47: 1049-1057 .
22.
McCann JJ , Hebert LE , Li Y. , et al. The effect of adult day care services on time to nursing home placement in older adults with Alzheimer's disease . Gerontologist . 2005;45: 754-763 .
23.
Lofgren AC , Bucht G. , Eriksson S. , Lundstrom T.Physical health and cognitive ability among married long-term—care patients and among their spouses: a comparison between home care and nursing home care . Int Psychogeriatr. 1993;5: 157-168 .
24.
Cohen-Mansfield J. , Culpepper WJ II , Werner P.The relationship between cognitive function and agitation in senior day care participants . Int J Geriatr Psychiatry.1995;10: 585-595 .
25.
Cohen-Mansfield J. , Creedon MA , Malone T. , Parpura-Gill A. , Dakheel-Ali M. , Heasley C.Dressing of cognitively impaired nursing home residents: description and analysis . Gerontologist. 2006;46: 89-96 .
26.
Engelman KK , Mathews RM , Altus DERestoring dressing independence in persons with Alzheimer's disease: a pilot study . Am J Alzheimers Dis Other Demen.2002;17: 37-43 .
27.
Friedenreich CM , Slimani N. , Riboli E.Measurement of past diet: review of previous and proposed methods . Epidemiol Rev.1992;14: 177-196 .
28.
Cohen-Mansfield J. , Jensen B.Are spouses reliable sources of information regarding older persons' self-care practices and their importance? An exploration of adequacy of report and sources of bias . Fam Syst Health . In press.
29.
Rudd MG , Viney LL , Preston CAThe grief experienced by spousal caregivers of dementia patients: the role of place of care of patient and gender of caregiver . Int J Aging Hum Dev.1999;48: 217-240 .
30.
Wright LKAlzheimer's disease afflicted spouses who remain at home: can human dialectics explain the findings?Soc Sci Med.1994;38: 1037-1046 .
31.
Kesselring A. , Krulik T. , Bichsel M. , Minder C. , Beck JC , Stuck AEEmotional and physical demands on caregivers in home care to the elderly in Switzerland and their relationship to nursing home admission . Eur J Public Health. 2001;11: 267-273 .
