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P3‐634: FORGOTTEN FACES: FAMILY CAREGIVER VOICES
Author(s) -
Tiller Robert W.
Publication year - 2018
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2018.06.2001
Subject(s) - wife , psychology , narrative , empathy , daughter , social psychology , qualitative research , developmental psychology , sociology , linguistics , social science , philosophy , evolutionary biology , political science , law , biology
Background: As Alzheimer’s disease advances, pharmaceutical tools lose their efficiency, giving urgency to research into interventions that provide help to persons at the end stages of dementia. No single drug or treatment strategy is likely to address all of the many complex symptoms so we have turned to interaction with the natural world. Some type of horticultural activity has repeatedly been shown to be effective for persons with dementia. Although a garden is thought of as an outdoor space that people can walk through, Japanese gardens are an exception. They are designed to be viewed while seated in an indoor location. Our current study in two dementia care facilities extends previous work and provides more evidence that the complex visual stimulus of a Japanese garden may have positive impact on a person with dementia. Methods:Two Japanese gardens were constructed: one on the roof of a hospital with a dementia unit, the second in an outdoor courtyard of a nursing home. Both facilities were located in Sasebo, Japan. Subjects were transported to the garden site by a familiar caregiver who placed a heart rate monitor on the subject’s finger. The researcher then monitored the subject’s heart rate and behavior over a 15 min viewing period. Results: In the pre-garden spaces, the average pulse rate remained mostly unchanged during the entire viewing session. After the garden installation, however, the subjects’ average pulse rate dropped significantly in the same locations. The person’s cognitive status (MMSE) had no significant effect on this outcome. Qualitatively we noted that the subjects often spontaneously told stories from their past, in distinct contrast to their normal behavior. The subject of the related event was usually from the distant past and related to nature. Notably the emotion attached to the memory was almost universally positive. Conclusions:The design principles of a Japanese garden are meant to create an abstract representation of nature and encourage meditative thought. For an individual with dementia, it would appear that that these effects result in an improvement in behavior measures and a calmer physiological state.