Evaluation of Simulated Presence: A Personalized Approach to Enhance Well‐Being in Persons with Alzheimer's Disease
Abstract
Objective To evaluate the efficacy of Simulated Presence, a personalized approach to enhance well-being among nursing home residents with Alzheimer's disease and related dementia's (ADRD). Design Latin-Square, double blinded, 3-factor design with restrictive randomization of three treatments (the study intervention, a placebo audio tape of a person reading the newspaper, and usual care). The three factors were treatment, time, and facility type. Setting Nine nursing homes in Eastern Massachusetts and Southern New Hampshire. Participants Fifty-four subjects with documented ADRD who were aged 50 years or older, medically stable, had resided in their current nursing home for at least 3 months, and who had no planned discharge. All subjects had a history of agitated or withdrawn behaviors. Intervention The purpose of Simulated Presence is to provide a personalized intervention for persons with moderate to severe cognitive impairment. Through a unique testing process, some of the best loved memories of the ADRD person's lifetime are identified and then those memories are introduced to the patient in the format of a telephone conversation using a continuous play audio tape system. The intervention may be used for extended periods of time because each repetition is viewed as a fresh, live telephone call as a result of the short-term memory deficit of the person with ADRD. Measurements Direct observations of outcomes included using a newly developed scale, the Scale for the Observati…
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In multiple sclerosis, the frequency of anxiety disorders varies from 19 to 34%, which according to one study represents a prevalence three times higher than that of depressive disorders.
“Dans la sclérose en plaques, la fréquence des troubles anxieux varie de 19 à 34%, ce qui représenterait selon une étude, une prévalence trois fois supérieure à celle des troubles dépressifs [31].”
From Prise en charge des troubles anxieux dans le cadre d'atteintes neurologiques (2004) · cites this paper as [31]
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“therapy (25)], art activities (26), hand massage (27), and real, toy, or robotic animal-assisted therapy (28,29).”
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“Camberg et al. (1999) used a repeated measures design to compare simulated presence audiotapes with recorded readings from a newspaper.”
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“Some studies limited the rvention to just one aspect of Kitwood’s model: using idents’ life histories (Camberg et al., 1999) or targeting ir behavioral symptoms (Cohen-Mansfield et al., 2007). berg et al. worked on residents’ memory and positive otions and introduced those memories to residents…”
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“The third RCT found no differences when comparing an audio tape–simulated presence of family members to usual care in 54 agitated residents.(44) All the remaining observational studies of activities therapy suggest some degree of improvement (12% to 60%); three of the remaining seven studies achieved statistical signi…”
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“, 2002); Calming music and hand massage (Remington, 2002) Social contact Simulated presence (Camberg et al., 1999); Pet therapy (Churchill et al.”
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“Camberg et al. (1999) used a repeated measures design to compare simulated presence audiotapes with recorded readings from a newspaper.”
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“There are also no adequate trials of Simulated Presence Therapy, in which tapes of familiar voices are played to residents (Camberg et al., 1999; Miller et al., 2001; Peak & Cheston, 2002).”
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“have demonstrated intolerance of the headphones used to deliver the auditory message.(17,19,20,23) The majority of SPT studies have used an auditory format without a visual component, and there is limited research into how using a video format (video-simulated presence [VSP]) may promote improved outcomes of SPT.”
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“This can be real or simulated (by using videotapes of family members or simulated presence therapy; Hall & Hare, 1997; Camberg et al, 1999).”
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“In a later study, Camberg et al. (1999) also studied the impact of SPT on agitation and social withdrawal among nursing home residents with AD.”
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“In a further study with 54 people with dementia living in nursing homes, Camberg et al. (1999) claimed that SPT could be effective in enhancing well-being and decreasing problem behaviours.”
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“…therapy (Pulsford 1997); validation therapy and reminiscence therapy (Alzheimer’s Association Australia 2005); simulated presence therapy (Camberg et al 1999); psychotherapies (International Psychogeriatric Association 2002); Snoezelen (Diepen et al 2002); and alternative therapies…”
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“The use of audiotaped memories (Camberg et al., 1999), videos, music, conversation, and activity (Cohen-Mansfield & Werner, 1997) to increase positive affect and reduce agitation have received some empirical validation.”
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“Just more than half of the 15 trials (Burns et al., 2003; Camberg et al., 1999; Chang, 1999; Gaugler et al., 2013;”
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“SPT was more effective in reducing overall agitation (Camberg et al., 1999), physical agitation (Garland et al.”
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“SOAPD was used only in one study [51] but the definition of agitation used in the SOAPD was cited in a concept clarification article as marking the transition from the observer’s perspective to the patient’s perspective in the interpretation of agitation [52].”
MethodSelf-citationThe agitation-activity interface of people with dementia in long-term care
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“There have been reports stating that it is possible to reduce problem behavior by attempting to improve care deliberately using continuous memory that had been maintained (Camberg et al., 1999).”
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Méthode de prise en charge globale non médicamenteuse des patients déments institutionnalisés
Wenisch, E., Stoker, A., Bourrellis, C., Pasquet, C., Gauthier, É., Corcos, E., Banchi, M.-T., Rotrou, J. D., & Rigaud, A. (2005) · Revue Neurologique · doi:10.1016/s0035-3787(05)85035-0 · Cited by 11 · see citing works
Interventions Using Technologies for Older Adults in Long-term Care Facilities: A Systematic Review
Kim, D. E., Kim, H.-N., Hyun, J., Lee, H., Sung, H., Bae, S.-Y., Tak, S., Park, Y.-H., & Yoon, J. (2018) · Research in Community and Public Health Nursing · doi:10.12799/jkachn.2018.29.2.170 · Cited by 10 · see citing works
Role of Cholinesterase Inhibitors in Managing Behavioral Problems in Alzheimer's Disease
Masterman, D. L. (2004) · The Primary Care Companion For CNS Disorders · doi:10.4088/pcc.v06n0304 · Cited by 10 · see citing works
Evans, N., Cheston, R., & Harris, N. (2016) · Dementia · doi:10.1177/1471301215574363 · Cited by 9 · see citing works
“Simulated presence therapy, or SPT, involves playing a recording of a familiar voice to a person with dementia, typically with the aim of reducing anxiety or agitation (Camberg et al., 1999; Woods & Ashley, 1995).”
BackgroundAnxiety and Related Symptoms in Older Persons With Dementia: Directions for Practice
McClive-Reed, K. P., & Gellis, Z. D. (2010) · Journal of Gerontological Social Work · doi:10.1080/01634372.2010.524284 · Cited by 10 · see citing works
“Even when such outcomes were reported, many of the early trials were small or otherwise methodologically limited, and findings were inconsistent (Browne & Shlosberg, 2006; Camberg et al., 1999; Chin, 2007; Grasel, Wiltfang, & Kornhuber, 2003; Kajiyama et al., 2007; Kasl-Godley & Gatz, 2000; Livingston et al., 2005; Ma…”
ResultImproving the Quality of Life for Caregivers and Care Recipients with Personalized Video Channels
Kajiyama, B. K., Dib, L. R. C., Tymchuk, A., Boxer, A., Kixmiller, J., & Olinsky, C. J. (2007) · Clinical Gerontologist · doi:10.1300/j018v31n01_07 · Cited by 7 · see citing works
Stanford, J. A., & Just, S. (2024) · JMIR Mental Health · doi:10.2196/70321 · Cited by 5 · see citing works
“In people with dementia, simulated presence was associated with reduced verbal and physical agitation [71,81], and short videos recorded by family members were superior to treatment as usual and placebo conditions in bringing about changes in agitated and withdrawn behaviors [71].”
van Dorst, M. E. G., Rensen, Y. C. M., Nijsten, J. M. H., Janssen, G. T. L., & Kessels, R. (2024) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s483470 · Cited by 5 · see citing works
“51,53– Combined interventions”
InfluentialTsang, W., Oliver, D., & Triantafyllopoulou, P. (2022) · Journal of Applied Research in Intellectual Disabilities · doi:10.1111/jar.13050 · Cited by 5 · see citing works
Environment as non pharmacological intervention in the care of Alzheimer’s disease
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“To support the inability of people with dementia to learn or interpret a new environment (Camberg et al., 1999), interiors should be designed in order to facilitate the retrievement of memories related to past experiences through the use of environmental cues.”
BackgroundTreatment of Behavioural Disorders
Volicer, L. (2012) · Pathy's Principles and Practice of Geriatric Medicine · doi:10.1002/9781119952930.ch80 · Cited by 5 · see citing works
Self-citationZarei, S., Colman, S., Rostas, A., Burhan, A., Chu, L., Davies, S. J. C., Derkach, P., Elmi, S., Hussain, M., Gerretsen, P., et al. (2022) · Journal of Alzheimer's Disease · doi:10.3233/jad-215261 · Cited by 4 · see citing works
“• RCT [49] – stimulated presence in the form of reviewing best memories of the patient reduced agitation as measured by the Scale for the Observation of Agitation in Persons with Dementia.”
Bismuth, S., Villars, H., Durliat, I., Boyer, P., & Oustric, S. (2012) · Les cahiers de l année gérontologique · doi:10.1007/s12612-012-0308-4 · Cited by 4 · see citing works
Nursing Home Staff as Research Partners
Engle, V. (1999) · Journal of The American Geriatrics Society · doi:10.1111/j.1532-5415.1999.tb07246.x · Cited by 4 · see citing works
Telenursing in Aged-Care: Systematic Evidence of Practice
Edirippulige, S., & Marasinghe, R. (2011) · doi:10.4018/978-1-61520-825-8.ch017 · Cited by 4
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Kim, E. Y., Hwang, S.-D., & Kim, E. J. (2016) · Journal of Korean Academy of Nursing · doi:10.4040/jkan.2016.46.4.475 · Cited by 3 · see citing works
- Authors
- Camberg, L., Woods, P., Ooi, W. L., Hurley, A., Volicer, L., Ashley, J., Odenheimer, G., & McIntyre, K.
- Affiliations
- United States Department of Veterans Affairs (US)
- Hebrew SeniorLife (US)
- Northeastern University (US)
- Boston University (US)
- Boston College (US)
- University of South Carolina (US)
- Corresponding author
- Camberg, Lois
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 1999-04
- Volume
- 47
- Issue
- 4
- Pages
- 446-452
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- OpenAlex
- W2094581981
- Cited by
- 157
- References
- 0
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2022: 7 · 2021: 2 · 2020: 22 · 2019: 3 · 2018: 4 · 2017: 7 · 2016: 3 · 2015: 3 · 2014: 7 · 2013: 2 · 2012: 4
- FWCI
- 3.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- presence, Alzheimer's disease, dementia, nursing home residents, agitation, withdrawal, personalized interventions, well-being, mood, facial expressions, dementia severity, positive affect, long-term care, reminiscence therapy, behavioral symptoms of dementia
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Analysis of Variance, Double-Blind Method, Facial Expression, Family, Female, Humans, Male, Memory, Nursing Assessment, Nursing Homes, Patient Care Planning, Quality of Life, Tape Recording, Telephone, Geriatric Assessment, Chi-Square Distribution
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