3205

Keywords: Namaste Care; Alzheimer’s Disease; Elderly; Quality of Life

Dear Editor,

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that affects millions of people worldwide [1]. It is a devastating disease that not only affects the individual but also their families and caregivers [2].

Namaste Care (NC) is a holistic approach to care for individuals with advanced dementia, including AD [3]. It was first introduced in the United Kingdom in the early 2000s as a way to provide personalized and compassionate care for those who are no longer able to communicate or participate in traditional activities [4]. The approach is based on the principles of person-centered care, which emphasizes the importance of treating each individual as a unique person with their own preferences, needs, and values [4]. Indeed, NC is designed to provide comfort and support to individuals with advanced dementia by engaging their senses and creating a calming and soothing environment [5]. It involves a range of activities, such as gentle massage, aromatherapy, music therapy, and sensory stimulation [6]. The primary aim of NC is to create a peaceful and relaxing environment that promotes a sense of well-being and reduces agitation and anxiety [6].

As shown in Table-1, previous studies [7-14] revealed that NC effectively reduced agitation as well as enhanced QoL.

In a pilot study, we evaluated the role of NC on the QoL of elderly patients with AD who were residents in a nursing home in Tehran. Briefly, 25 patients including 16 women were selected and the QoL was measured using the Persian version of the QoL in late-stage dementia (QUALID) questionnaire, and after received four months of NC by a trained caregiver, it was re-evaluated. Our finding indicated that NC could significantly improve the QoL of patients with AD in line with previous evidence.

Compared to other treatment options for individuals with advanced dementia, NC has several unique advantages. Unlike medication-based treatments, NC does not have any negative side effects and is not associated with the risk of drug interactions or complications [15]. Additionally, NC is a non-invasive and non-pharmacological approach that can be easily adapted to the individual needs and preferences of each person.

Overall, studies suggest that NC can have a positive impact on the QoL of elderly individuals with AD, which can lead to improved well-being. However, most of these studies have small sample sizes and are performed on one gender, which may not be generalizable to all individuals with AD. Hence, further research with a larger sample size as well as longer follow-up are needed to confirm the effectiveness of NC and determine the optimal components of the intervention.

Conflicts of Interests

All the authors declare there are no competing interests.

References

1. Tahami Monfared AA, Byrnes MJ, White LA, Zhang Q. Alzheimer’s disease: epidemiology and clinical progression. Neurol Ther. 2022;11(2):553-69.

2. Litke R, Garcharna LC, Jiwani S, Neugroschl J. Modifiable risk factors in Alzheimer disease and related dementias: a review. Clin Ther. 2021;43(6):953-65.

3. Latham I, Brooker D, Bray J, Jacobson-Wright N, Frost F. The impact of implementing a Namaste Care intervention in UK care homes for people living with advanced dementia, staff and families. Int J Environ Res Public Health. 2020;17(16):6004.

4. Stacpoole M, Hockley J, Thompsell A, Simard J, Volicer L. The Namaste Care programme can reduce behavioural symptoms in care home residents with advanced dementia. Int J Geriatr Psychiatry. 2015;30(7):702-9.

5. Karacsony S, Abela MR. Stimulating sense memories for people living with dementia using the Namaste Care programme: What works, how and why?. J Clin Nurs. 2022;31(13-14):1921-32.

6. Kochovska S, Garcia MV, Bunn F, Goodman C, Luckett T, Parker D, et al. Components of palliative care interventions addressing the needs of people with dementia living in long-term care: a systematic review. Palliat Med. 2020;34(4):454-92.

7. Zeisel J, Silverstein NM, Hyde J, Levkoff S, Lawton MP, Holmes W. Environmental correlates to behavioral health outcomes in Alzheimer’s special care units. Gerontologist. 2003;43(5):697-711.

8. van der Ploeg ES, Eppingstall B, Camp CJ, Runci SJ, Taffe J, O’Connor DW. A randomized crossover trial to study the effect of personalized, one-to-one interaction using Montessori-based activities on agitation, affect, and engagement in nursing home residents with dementia. Int Psychogeriatr. 2013;25(4):565-75.

9. Stacpoole M, Hockley J, Thompsell A, Simard J, Volicer L. Implementing the Namaste care program for residents with advanced dementia: exploring the perceptions of families and staff in UK care homes. Ann Palliat Med. 2017;6(4):327-39.

10. McMurdo ME, Witham MD, Johnston D, Struthers AD, Guthrie B, Matthews K. Identifying older heart failure patients with major depression in primary care: a feasibility study. Int J Geriatr Psychiatry. 2014;29(5):547-9.

11. Smaling HJ, Joling KJ, van de Ven PM, Bosmans JE, Simard J, Volicer L, et al. Effects of the Namaste Care Family programme on quality of life of nursing home residents with advanced dementia and on family caregiving experiences: study protocol of a cluster-randomised controlled trial. BMJ Open. 2018;8(10):e025411.

12. Van Haitsma K, Curyto K, Spector A, Towsley G, Kleban M, Carpenter B, et al. The preferences for everyday living inventory: Scale development and description of psychosocial preferences responses in community-dwelling elders. Gerontologist. 2013;53(4):582-95.

13. van der Steen JT, Smaling HJ, van der Wouden JC, Bruinsma MS, Scholten RJ, Vink AC. Music‐based therapeutic interventions for people with dementia. Cochrane Database Syst Rev. 2018;7(7):CD003477.

14. Amrollah Majdabadi Kohne Z, Nikpeyma N, Bayat F, Salsali M, Hunter PV, Kaasalainen S, et al. The effects of a Namaste care program on quality of life: A pilot study in Iranian women with late-stage Alzheimer’s disease. Geriatr Nurs. 2021;42(1):78-82.

15. Devi G. A how-to guide for a precision medicine approach to the diagnosis and treatment of Alzheimer’s disease. Front Aging Neurosci. 2023;15:1213968.

Table-1. Some Important Studies On the Role of Namaste Care On the Quality of Life of Elderly Individuals with Alzheimer’s Disease

Study	Participants	Intervention(s)	Outcomes
Zeisel et al. (2003) [7]	193 residents with AD in special care units	Implementation of environmental modifications, including NC	↑QoL ↓Agitation ↑Engagement in activities
van der Ploeg et al. (2013) [8]	14 nursing home residents	Sensory stimulation, music therapy, and massage	↑QoL ↓Agitation ↑Engagement in activities
Stacpoole et al. (2017) [9]	37 nursing home residents	Sensory stimulation, music therapy, and massage	↑QoL
McMurdo et al. (2014) [10]	27 nursing home residents	Sensory stimulation, music therapy, and massage	↑QoL ↓Agitation ↑Engagement in activities
Smaling et al. (2018) [11]	16 nursing home residents and their family members	Sensory stimulation, music therapy, and massage	↑QoL ↓Discomfort ↑Pleasure
Van Haitsma et al. (2013) [12]	1,003 community-dwelling elders	PELI*	↑Life satisfaction ↓Depression
van der Steen et al. (2018) [13]	128 nursing home residents	Sensory stimulation, music therapy, and massage	↑QoL ↓Agitation ↑Engagement in activities
Amrollah Majdabadi Kohne et al. (2021) [14]	25 nursing home residents	Implemented NC for two hours daily and four days per week for six months	↑QoL

* Includes items related to sensory stimulation and social interaction

NC: Namaste care; AD: Alzheimer’s disease; QoL: Quality of life; PELI: Preferences for everyday living inventory

Received 2023-09-27

Revised 2023-10-10

Accepted 2023-10-21

Dear Editor,

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that affects millions of people worldwide [1]. It is a devastating disease that not only affects the individual but also their families and caregivers [2]. Namaste Care (NC) is a holistic approach to care for individuals with advanced dementia, including AD [3]. It was first introduced in the United Kingdom in the early 2000s as a way to provide personalized and compassionate care for those who are no longer able to communicate or participate in traditional activities [4]. The approach is based on the principles of person-centered care, which emphasizes the importance of treating each individual as a unique person with their own preferences, needs, and values [4]. Indeed, NC is designed to provide comfort and support to individuals with advanced dementia by engaging their senses and creating a calming and soothing environment [5]. It involves a range of activities, such as gentle massage, aromatherapy, music therapy, and sensory stimulation [6]. The primary aim of NC is to create a peaceful and relaxing environment that promotes a sense of well-being and reduces agitation and anxiety [6].

As shown in Table-1, previous studies [7-14] revealed that NC effectively reduced agitation as well as enhanced QoL.

In a pilot study, we evaluated the role of NC on the QoL of elderly patients with AD who were residents in a nursing home in Tehran. Briefly, 25 patients including 16 women were selected and the QoL was measured using the Persian version of the QoL in late-stage dementia (QUALID) questionnaire, and after received four months of NC by a trained caregiver, it was re-evaluated. Our finding indicated that NC could significantly improve the QoL of patients with AD in line with previous evidence.

Compared to other treatment options for individuals with advanced dementia, NC has several unique advantages. Unlike medication-based treatments, NC does not have any negative side effects and is not associated with the risk of drug interactions or complications [15]. Additionally, NC is a non-invasive and non-pharmacological approach that can be easily adapted to the individual needs and preferences of each person.

Overall, studies suggest that NC can have a positive impact on the QoL of elderly individuals with AD, which can lead to improved well-being. However, most of these studies have small sample sizes and are performed on one gender, which may not be generalizable to all individuals with AD. Hence, further research with a larger sample size as well as longer follow-up are needed to confirm the effectiveness of NC and determine the optimal components of the intervention.

[GMJ.2023;12:e3205]

DOI:3205

Conflict of Interest

All the authors declare there are no competing interests.

Keywords: Namaste Care; Alzheimer’s Disease; Elderly; Quality of Life

GMJ

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 Correspondence to:

Rafat Rezapour-Nasrabad, Department of Psychiatric Nursing and Management, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Telephone Number: +98 2188896690

Email Address: Rezapour.r@sbmu.ac.ir

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Rezapour-Nasrabad R, et al.

NC and Improved QoL in Patients with AD

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