Poster Presentations P3S646

scenario. Conclusions: Most participants supported paying out-of-pocket

for the AD medication. For each scenario, greater proportions of caregivers

supported out-of-pocket payment relative to patients. Also, regardless of

scenario, caregivers’ average maximum willingness to pay exceeded pa-

tients’ average maximum willingness to pay.

P3-408 A FRENCH INNOVATIVE DEPARTMENT

DEDICATED TO ALZHEIMER’S DISEASE

PATIENTS

Anne-Sophie Rebillat, Coralie Jean, Lisette Volpe-Gillot, Hopital Leopold

Bellan, Paris, France.

Background: Innovative units dedicated to Alzheimer’s disease patients are

recently emerging in France. Methods: Our Neuro-Psycho-Geriatrics De-

partment opened in November 2009. It is part of a larger geriatric structure

in Bellan teaching hospital, Paris, and has significant connections with sev-

eral medical facilities (memory clinics, geriatrics departments, emergency

units, nursing homes, family physicians). This implements a strong network.

Results: Bed capacity is 14. In 2010, 308 patients (182 women and 126

men) were hospitalized with an average age of 83. 14 young patients

were in the 45-65 range. Average length of stay was 14.1 days. Admission

criterion is impaired cognitive function (diagnosed or undiagnosed demen-

tia, mostly Alzheimer’s disease) with acute delirium or psycho-behavioral

symptoms. Non admission criteria are decompensation of a psychiatric dis-

order and bedridden state. As examples of psycho-behavioral symptoms, we

can mention: ambulation, aggressiveness, delusion, sleep disturbances,

emotional distress, hallucinations, yelling. Management of these troubles

includes identification of the causes (infection, metabolic perturbation, ep-

ilepsy, mood disorder, side effects of prescription medication), drug and

non-drug treatment strategies. To this, layout and environment of the depart-

ment have been adapted to make it as safe and stress-relieving as possible. A

multidisciplinary team is in charge of the patients and involves medical spe-

cialists (neurologist, geriatrician and psychiatrist), psychologists, therapists

(psychomotor, occupational, speech and language therapists), nursing su-

pervisor, nurses, orderlies, hospital cleaners, social worker and secretary.

All staff have been trained specifically in dementia care, families support

and education.Conclusions:One of the objectives of this specific care man-

agement is to see the patients returning home and to delay nursing home en-

try. In 2010,60% of our patients could return home, 21% were transferred to

rehabilitation units, 14% did enter nursing homes, and 5% died.

P3-409 REFINING PERSPECTIVES OF

MEMORY LOSS IN DEMENTIA:

THE MEMORYACCESS HYPOTHESIS

Karen Sinclair, National Coalition of Independent Scholars, St. Helena,

California, United States.

Background: Symptoms of memory loss are common to Alzheimer’s dis-

ease and dementia. What significant patterns are there in the way memory

gets lost, and what do these patterns mean? Patterns observed in displays

of memory loss may be interpreted to understand related cognitive, bio-

logical, neurological, and physiological connections, failures and compe-

tencies. Recognizing those patterns and relationships could serve as

a blueprint for understanding memory and developing approaches to

memory repair and cognitive restoration. Methods: The discussion is

based on experiences and observations derived from some eleven years of

home care of a dementia patient. It traces observed patterns of memory

loss. Analysis of evidence and application of systems theory provide a foun-

dation for refined understanding of the anatomy of memory, the memory

system and of possible bases for the confusion that defines dementia. Re-

sults: A model derived from memory experiences in dementia provides

a perspective of integrated memory relationships and suggests particular

paths to retrieval of memory and to understanding processes of “remember-

ing”. The memory model helps to pinpoint biomarkers by depicting a per-

spective of the integrated memory system. The memory model may help

understand some kinds of discrepancy that may be found in studies that

use statistics to evaluate data obtained from different biomarkers. Conclu-

sions: The results are consistent with previous understanding of memory:

provide opportunities for closer analysis of evidence of memory loss and al-

low refined interpretations. Furthermore, the results expose a definable

memory system that points the way to therapies for dementia beyond symp-

tomatic treatment. Results hold implications for diagnosis of memory frac-

ture, point to possibilities for use of biomarkers and neuroimages and for

prescribing for memory repair. Conclusions also reveal areas where addi-

tional research is required.

P3-410 TESTING MOOD-ENHANCING INTERVENTIONS

IN PERSONS WITH DEMENTIA

Kristine Williams, Ruth Herman, Yee-Ai See, University of Kansas,

Kansas City, Kansas, United States.

Background: New research verifies that positive mood ismaintained for sev-

eral hours after personswith severememory deficits similar to those of demen-

tia observe mood-enhancing video presentations. Positive mood is directly

linked to increased cooperation with care and improved cognition in persons

with dementia (PWD). Although standardized sets ofmood-enhancing photos

and video clips have been empirically verified to induce positivemoods in per-

sons with normal cognition and those with memory loss, the effects in PWDs

are not well established and could be used to improve care.Methods: Twenty

PWDs will be video recorded while viewing two 15-minute interventions,

each composed of 45 photos that induce positive mood from the International

Affective Picture System (IAPS), developed for research on emotion by the

National Institute on Mental Health Center for the Study of Emotion and At-

tention. Video recordings of each participant’s facial expressions that reveal

emotional responses to the photographs will be collected and coded to deter-

mine the proportion of time participants pay attention (direct eye gaze) to the

media stimuli. In addition, PWD affective responses will be coded from the

video recordings using the Lawton Observed Affect Scale and facial expres-

sions indicating positive emotional responses will be coded using the Facial

Expression Coding System (FACES). Mean proportions of time the partici-

pants attend to each stimulus, observed affect scores, and FACES ratings of

the frequency, intensity, and duration of positive responses to each photo stim-

uli will be computed. If data are normally distributed, t-tests will be used to

compare differences between photos with positive emotional valence and

control neutral photos, otherwise nonparametric tests will be used. Descrip-

tive statistics will used to describe effects of individual photos and to assess

for factors such as gender that may influence response to the intervention

stimuli. Results: Results of the study that will be conducted during spring

2011 will be reported to evaluate the feasibility of using positive mood induc-

ing photo interventions to improve mood for PWD in clinical care. Conclu-

sions: If effective in inducing positive moods in persons with dementia,

photographs and other media may be used in interventions to improve care

and quality of life for persons with dementia.

P3-411 A NEW EVIDENCE-BASED TOOLKIT

FOR OPTIMISING COMMUNICATION

WITH PEOPLE WITH DEMENTIA

Tony Young1, Christopher Manthorp2, David Howells3, 1Newcastle

University, UK, Newcastle Upon Tyne, United Kingdom; 2Barchester

Healthcare, Harrow, United Kingdom; 3Cardiff & Vale NHS Trust, Cardiff,

United Kingdom.

Background:Recent policy initiativesworldwide have highlighted commu-

nication as a target area for improvement in dementia care. Research evi-

dence indicates that improving communication involving people living

with dementia (PLWD) and carers can have a positive impact on quality of

life, but also suggests that available communications interventions exhibit

a number of shortcomings. Our research project was instigated to address

these, and to develop an evidence-based, free-to-all-users intervention that

would have a high international and intercultural applicability. Methods:

Research was facilitated by the Alzheimer’s Society UK. Participants

were a spectrum of lay and multiprofessional stakeholders - PLWD and

family members; institutional caregivers; dementia care specialist nurses;

managers of care institutions; speech and language therapists; psychoger-

iatricians and communications researchers. The iterative research design

consisted of a review of current best practice in a range of care contexts