Behavioral Improvement of Dementia Residents in a Group Home after the Great East Japan Earthquake of 2011 (Kenichi Meguro) May 2014
Behavioral Improvement of Dementia Residents in a Group Home after the Great East Japan Earthquake of 2011
Kenichi Meguro, MD, PhD, Department of Geriatric Behavioral Neurology, Tonoku University Graduate School of Medicine, Sendai, Japan
The Great East Japan Earthquake of 2011 occurred on March 11. Group homes (GH)-A and B, run by a private company, were located in the coastal area of Kesen-numa City and damaged by the disaster. A total of 14 of the 17 elderly residents living in GH-A and B prior to the disaster were evacuated to another group home (GH-C) run by the same company.
The number of residents prior to the disaster in GH-C was nine, but almost tripled to 23 after the disaster, and several residents started to live together in one room. Worsening of behavioral abnormalities caused by overcrowding was anticipated, but surprisingly behavior was improved.
A total of 23 residents were studied for MMSE, memories of the disaster, and the changes in the amount of care in daily life. The severity of dementia was determined using the MMSE score: >20, mild; 10-19, moderate; and <9, severe. There were three mild, nine moderate, and 11 severe dementia patients.
Memories of the disaster, including the earthquake, subsequent tsunami and the evacuation, were obtained in interviews. Memories of the earthquake were retained by all of the residents with mild and moderate dementia. Among the residents with severe dementia, less than 50% retained the memory. Of the 23 residents, behavior improved in 12, remained unchanged in eight, and aggravated in three patients. The ratio of residents with improved, unchanged, and aggravated behavior was the same in residents with moderate dementia (3:3:3), but eight of the 11 residents with severe dementia showed improved behavior. Living in a small group and dining in a large group might have reminded the residents of their family and school life.
Residents with severe dementia seem to have been particularly able to adjust to the new environment, probably due to the stimulation of their remote memories. Actually, most improved residents had lived in households with three generations prior to their admission to the group home, and also went to school; however, two of the three residents with aggravated behavior were from the oldest large families, and caring for their younger brothers prevented them from going to school. All the residents with mild to moderate dementia, but only half of the residents with severe dementia, retained the memory of the earthquake. Our findings suggest that care for residents in a small group might have good effect on older residents with dementia.