De Amicis Day Center - Italy

The CDD de Amicis, managed by ASP Terre d'Argine, is a semi-residential social-health facility, with 20 accredited places whose guests are welcomed for a period ranging from 6 to 24 months. 

It is a place of care aimed at the intensive treatment of a specific target of patients: people diagnosed with dementia associated with behavioural disorders of a significant level, preferably walking, able to benefit from an intensive and time-limited intervention. In principle, people are welcomed with an NPI test, which measures the presence and intensity of behavioural disorders, higher than 24/144.
Purpose of the CDD:

• Control, contain and reduce significant behavioural disorders associated with dementia, developing care strategies and prevention of the recurrence of disorders; stimulate residual cognitive and functional abilities.
  
  
• Support families in the ongoing care of the elderly.

At the De Amicis day centre we used RITA with the aim of observing the impact of solutions that improve the involvement of people who attend the centre, using cognitive stimulation, reminiscence therapy, creation and management of personal memories.

OBJECTIVES ACHIEVED AND LESSONS LEARNED

During a period of about four months, we were able to verify its positive effect in different situations.

Initially it was very useful for individual activities, especially for:

• greater involvement in the activities of people with cognitive impairment at an advanced stage, difficult to involve in most activities given the state of withdrawal. Specifically, for us it was a surprise to see them involved in simple games such as "hit the mole" or "bubble blaster", towards which they showed interest, fun and a greater level of attention.
• reduction of the state of anxiety and crying crises in a lady with severe cognitive impairment, who thanks to the 1: 1 ratio of the operator and listening to relaxing music associated with the vision of repetitive images, relaxed until falling asleep.
• greater involvement of a very performing gentleman accustomed to using the tablet tool, who used RITA independently, playing solitaire and taking an interest in quizzes.

With the passage of time the use of RITA has changed slightly, as it has been used much more for small group activities, mainly using the following functions: movies, listening to music, quizzes, motor exercises, reminiscence images from which themed chats began.

SUMMARY OF SPECIFIC RESULTS FOR IDENTIFIED OBJECTIVES

1. In the observed sample, the use of RITA is "frequent" (based on the patient / guest, every day or every other day).
2. In the observed sample the diagnosis associated with the patient / host results:
   1. Dementia
   2. Alzheimer 's
   3. Behavioural disorders
   4. Cognitive disorders

Summary of Specific Results by Objective: improvement of efficacy of non-pharmacological therapy

OUTCOME

Involvement in the proposed activities.
In 75% of the cases observed, RITA use increased attention during activity and increased time spent on activity by 50% after four weeks of use.

In addition, the use of RITA has favoured greater involvement in the activity of users who are usually difficult to involve in the activities given their state of withdrawal, especially in cases of apathy.

Promotion of a moment of well-being and gratification.
Compared to the initial state, in 75% of the cases observed, after the use of RITA the mood was Improved, and for 25% Partially Improved.
The recorded mood is on average "Happy" or "Extremely happy".

Only in some cases with advanced Alzheimer's disease did the mood not show significant improvements.

Socialization / social network
RITA has helped create a more serene environment, improving mental health and well-being in 100% of cases.

In group activities, people in a state of retreat appeared involved and moments of socialization and comparison were created thanks to activities such as group quizzes and listening to music.

In summary, RITA has helped to create a more serene environment and has improved mental health and well-being also favouring the involvement of users who usually perceive themselves as better performing. More generally, the contribution of RITA was satisfactory in 75% of cases and very satisfactory in 25%.

THE VOICE OF THE OPERATORS

"As a team we believe that RITA is a useful tool as it allows us to expand the range of activities that the operator can propose as a treatment tool for people living with a form of dementia. In addition, the fact that it can be continuously improved, going to insert new material, can facilitate the customization of the proposals and consequently of the assistance."