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Environmental Control Interventions for Frontotemporal Dementia With Reversed Sleep—Wake Cycles

Department of Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, smiyatabu{at}sahs.med. osaka-u.ac.jp

Kazue Shigenobu, MD, PhD

Asakayama Hospital, Osaka

Kiyoko Makimoto, RN, PhD

Department of Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University

Canqun Zhu, BSN

Department of Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University

Nobuyuki Ashida, PhD

Koshien University, Takarazuka, Japan

Kaoru Tabushi, MD, PhD

Asakayama Hospital, Osaka

Background: This study aimed to evaluate the effectiveness of environmental control interventions using an integrated chip tag monitoring system for a frontotemporal dementia (FTD) patient.

Method: The subject was a male FTD patient (Pick type) with reversed sleep—wake cycles. For a 2-week period, the doors to all patients' rooms in the unit were kept open as a form of environmental control, and in the following 2 weeks, all doors were kept closed (intervention A). To increase his activity levels, a staff walked with him for 2 weeks (intervention B), while all the doors to patients' rooms in the unit were kept closed.

Result: In intervention A, daytime ambulation increased, whereas nighttime ambulation decreased significantly. During intervention B, nighttime ambulation increased significantly.

Conclusion: Environmental controls seem to be effective for restoring sleep—wake cycles in even an advanced-stage FTD patient, whereas exercise program by the staff aggravated the problem.

Key Words: IC tag monitoring system • frontotemporal dementia • environmental intervention • stimulus-bound behaviors

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