Exploring interest and goals for videoconferencing delivered cognitive rehabilitation with rural individuals with mild cognitive impairment or dementia
Restricted accessResearch articleFirst published online August 4, 2016
Exploring interest and goals for videoconferencing delivered cognitive rehabilitation with rural individuals with mild cognitive impairment or dementia
BACKGROUND: Goal oriented cognitive rehabilitation is a promising intervention for individuals diagnosed with mild cognitive impairment (MCI) or dementia due to Alzheimer Disease (AD). Videoconferencing delivered cognitive rehabilitation is a potential avenue for increasing accessibility for rural patients and their families.
OBJECTIVE: First, we were concerned with the accessibility of the treatment for individuals in rural and remote areas. Second, client-centered goal setting was explored by asking this sample about their goals for cognitive rehabilitation.
METHOD: We mailed questions to all active patients with diagnoses of MCI or dementia due to AD of a rural memory clinic and compare features of the responders versus the non-responders. We asked about interest in videoconferencing delivered treatment and about goals for cognitive rehabilitation, which were thematically analyzed.
RESULTS: The responders (N = 25) were similar to non-responders in severity, depression, and caregiver burden. Of the responders, 80% were interested in videoconferencing developed treatment. A thematic analysis coded 95% of responses as amenable to cognitive rehabilitation. Participants’ goals were focused on memory, household activities, other cognitive domains, recreation, and higher order tasks.
CONCLUSIONS: This work informs the development of both in-person and videoconferencing delivered cognitive rehabilitation for individuals diagnosed with MCI or dementia.
BédardM., MolloyD. W., SquireL., DuboisS., LeverJ. A., & O’DonnellM. (2001). The Zarit burden interview: A new short version and screening version. Gerontologist, 41(5), 652–657.
2.
BédardM., KoivurantaA., & StuckeyA. (2004). Health impact on caregivers of providing informal care to a cognitively impaired older adult: Rural versus urban settings.decine Rurale: Le Journal Officiel De La Société De Médecine Rurale Du Canada. Canadian Journal of Rural Medicine: The Official Journal of the Society of Rural Physicians of Canada = Journal Canadien De La Médecine Rurale: Le Journal Officiel De La Société De Médecine Rurale Du Canada, 9(1), 15–23.
3.
BergL., MillerJ. P., StorandtM., DuchekJ., MorrisJ. C., RubinE. H., & CobenL. A. (1988). Mild senile dementia of the Alzheimer type: 2. Longitudinal assessment. Annals of Neurology, 23(5), 477–484.
4.
BirdM. (2001). Behavioural difficulties and cued recall of adaptive behaviour in dementia: Experimental and clinical evidence. Neuropsychological Rehabilitation, 11(3-4), 357–375
.
5.
Bovend’EerdtT. J. H., BottellR. E., & WadeD. T. (2009). Writing SMART rehabilitation goals and achieving goal attainment scaling: A practical guide. Clinical Rehabilitation, 23, 352–361. doi: 10.1177/0269215508101741
6.
BraunV., & ClarkeV. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. doi: 10.1191/1478088706qp063oa
7.
CarswellA., McCollM. A., BaptisteS., LawM., PolatajkoH., & PollockN. (2004). The Canadian Occupational Performance Measure: A research and clinical literature review. Canadian Journal of Occupational Therapy, 71(4), 210–222.
8.
ClareL., WilsonB. A., CarterG., HodgesJ. R., & AdamsM. (2001). Long-term maintenance of treatment gains following a cognitive rehabilitation intervention in early dementia of Alzheimer type: A single case study. Neuropsychological Rehabilitation, 11(3-4), 477–494.
9.
ClareL., & WoodsR. T. (2004). Cognitive training and cognitive rehabilitation for people with early-stage Alzheimer’s disease: A review. Neuropsychological Rehabilitation, 14(4), 385–401.
10.
ClareL. (2008), Neuropsychological rehabilitation and people with dementia. New York: Psychology Press.
11.
ClareL., EvansS., ParkinsonC., WoodsR., & LindenD. (2011). Goal-setting in cognitive rehabilitation for people with early-stage Alzheimer’s disease. Clinical Gerontologist, 34(3), 220–236. doi: 10.1080/07317115.2011.555937
12.
ClareL., LindenD. E. J., WoodsR. T., WhitakerR., EvansS. J., ParkinsonC. H., & RuggM. D. (2010). Goal-oriented cognitive rehabilitation for people with early-stage Alzheimer disease: A single-blind randomized controlled trial of clinical efficacy. American Journal of Geriatric Psychiatry, 18(10), 928–939. doi: 10.1097/JGP.0b013e3181d5792a
13.
CummingsJ. L., MegaM., GrayK., Rosenberg-ThompsonS., CarusiD. A., & GornbeinJ. (1994). The neuropsychiatric inventory: Comprehensive assessment of psychopathology in dementia. Neurology, 44(12), 2308–2314.
14.
CummingsJ. L. (1997). The neuropsychiatric inventory: Assessing psychopathology in dementia patients. Neurology, 48(5 Suppl. 6), S10–S16.
15.
DaltonC., FarrellR., De SouzaA., WujantoE., McKenna-SladeA., ThompsonS., & GreenwoodR. (2012). Patient inclusion in goal setting during early inpatient rehabilitation after acquired brain injury. Clinical Rehabilitation, 26(2), 165–173.
16.
ForbesD. A., MorganD., & JanzenB. L. (2006). Rural and urban canadians with dementia: Use of health care services. Canadian Journal on Aging, 25(3), 321–330.
KurzA., Thöne-OttoA., CramerB., EgertS., FrölichL., GertzH., & WerheidK. (2012). CORDIAL: Cognitive rehabilitation and cognitive-behavioral treatment for early dementia in alzheimer disease: A multicenter, randomized, controlled trial. Alzheimer Disease and Associated Disorders, 26(3), 246–253
.
19.
LevackW. M., TaylorK., SiegertR. J., DeanS. G., McPhersonK. M., & WeatherallM. (2006). Is goal planning in rehabilitation effective? A systematic review. Clinical Rehabilitation, 20(9), 739–755.
20.
LawM., BaptisteS., CarswellA., McCollM., PolatajkoH., & PollockH. (2005). Canadian Occupational Performance Measure. 4th ed. Ottawa. ON: CAOT Publications ACE.
21.
LewinS. A., SkeaZ. C., EntwistleV., ZwarensteinM., & DickJ. (2001). Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Database of Systematic Reviews (Online: Update Software)4.
22.
LewinsohnP. M., SeeleyJ. R., RobertsR. E., & AllenN.B. (1997). Center for epidemiologic studies depression scale (CES-D) as a screening instrument for depression among community-residing older adults. Psychology and Aging, 12(2), 277–287.
23.
MorganD. G., SemchukK. M., StewartN. J., & D’ArcyC. (2002). Rural families caring for a relative with dementia: Barriers to use of formal services. Social Science and Medicine, 55(7), 1129–1142. doi: 10.1016/S0277-9536(01)00255-6
24.
MorganD. G., CrossleyM., KirkA., D’ArcyC., StewartN., BiemJ., & McBainL. (2009). Improving access to dementia care: Development and evaluation of a rural and remote memory clinic. Aging and Mental Health, 13(1), 17–30. doi: 10.1080/13607860802154432
25.
ParryR. H. (2004). Communication during goal-setting in physiotherapy treatment sessions. Clinical Rehabilitation, 18(6), 668–682.
26.
ParsonsJ., RouseP., RobinsonE. M., SheridanN., & ConnollyM. J. (2012). Goal setting as a feature of homecare services for older people: Does it make a difference?Age and Ageing, 41(1), 24–29. doi: 10.1093/ageing/afr118
27.
PlayfordE. D., SiegertR., LevackW., & FreemanJ. (2009). Areas of consensus and controversy about goal setting in rehabilitation: A conference report. Clinical Rehabilitation, 23(4), 334–344. doi: 10.1177/0269215509103506
28.
RadloffL. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401. doi: 10.1177/014662167700100306
29.
RosL., LatorreJ., AguilarM., SerranoJ., NavarroB., & RicarteJ. (2011). Factor structure and psychometric properties of the center for epidemiologic studies depression scale (CES-D) in older populations with and without cognitive impairment. International Journal of Aging and Human Development, 72(2), 83–110.
30.
RosewilliamS., RoskellC. A., & PandyanA. D. (2011). A systematic review and synthesis of the quantitative and qualitative evidence behind patient-centred goal setting in stroke rehabilitation. Clinical Rehabilitation, 25(6), 501–514. doi: 10.1177/0269215510394467
31.
ScobbieL., WykeS., & DixonD. (2009). Identifying and applying psychological theory to setting and achieving rehabilitation goals. Clinical Rehabilitation, 23(4), 321–333. doi: 10.1177/0269215509102981
32.
SohlbergM. M., & MateerC. A. (2001), Cognitive Rehabilitation: An Integrative Neuropsychological Approach. New York: The Guilford Press.
33.
SpectorA., & OrrellM. (2010). Using a biopsychosocial model of dementia as a tool to guide clinical practice. International Psychogeriatrics, 22(6), 957–965. doi: 10.1017/S1041610210000840
34.
ThiviergeS., JeanL., & SimardM. (2014). A randomized cross-over controlled study on cognitive rehabilitation of instrumental activities of daily living in alzheimer disease. American Journal of Geriatric Psychiatry, 22(11), 1188–1199. doi: 10.1016/j.jag2013.03.008
35.
ZaritS. H., OrrN. K., & ZaritJ. M. (1985), Families under stress: Caring for the patient with Alzheimer’s disease and relateddisorders. New York: University Press.
