Background: The transition from hospital to community for psychiatric patients is often challenging due to difficulties in managing community life after discharge and receiving consistent mental health treatment (Marianne, 2019). Some systematic reviews reported on interventions to improve discharge from acute adult mental health inpatient care to the community (Tyler, 2019) and the effectiveness of crisis resolution/home treatment teams for older people with mental health problems (Toot, 2011). However, these reviews revealed inadequate evidence for nursing interventions in community. In Japan, home-visit nursing is considered to play an important role for people with mental disorders living in community.

This review aims to provide an overview of the effectiveness of home-visit nursing in supporting community life for individuals with mental disorders discharged from psychiatric hospitals.

Methods: We conducted a search in electronic databases including Medline (OVID) and CINAHL (EBSCOhost). The search was conducted using the following keywords: “mental disorders”, “hospitalization”, “patient readmission”, “home visit nursing”, “home nursing”, “home health care”, “home care services”, and “house calls”. The review included original articles and research reports. Conference reports and articles about other professions, and interventions conducted in hospitals or facilities were excluded.

Results: A total of 205 articles were extracted, with 109 from Medline and 96 from CINAHL. We retrieved 13 studies, including three randomized controlled trials, two interventional studies, and eight retrospective studies. Most participants were post-discharge individuals with mental disabilities, but some studies included individuals prior to hospital admission. Most studies reported that home-visit interventions reduced psychiatric rehospitalization, the duration of hospitalization, and medical costs. One study reported that community-based treatment for older persons with severe mental illness decreased depressive symptoms and psychiatric hospitalization at 6 months. Additionally, telephone follow-ups were reported to be more effective than regular interventions in some studies. However, the intervention and effectiveness measurement Methods varied among the studies.

Conclusions: Home-visit interventions appear to be effective in preventing hospitalization for individuals with mental disorders. However, it is difficult to make simple comparisons as the content of home-visit interventions varies according to the background system and the region. Further research and systematic reviews are necessary.

The World Health Organization (WHO) proclaimed September 21 as World Alzheimer’s Disease Awareness Day and extended the observance to the entire month. Various awareness campaigns are being conducted around the world, with special emphasis on the importance of education to improve the quality of life for patients, families, and the community at large, and to eliminate stigma and ageism.

It is estimated that there are approximately 44 million people worldwide with some form of dementia, while in the United States it reaches 5.4 million. In Puerto Rico, it is estimated that there are approximately 60,000 people with Alzheimer’s disease. An AARP study (2021) showed that there are over 500,000 caregivers of older adults, making Puerto Rico one of the top three countries with the largest aging population and the 6th country in the world. While in Latin America and the Caribbean there is a prevalence between 6.2 and 6.5 per 100 adults aged 60 years or older (WHO).

This health and social situation require an educated and empowered society to meet the challenges. Muñoz et. al (2023) conducted a qualitative study with caregivers and found that 91% of the participants stated that training would help them provide better care to the elderly. Social work is one of the main disciplines dealing with this social phenomenon and should therefore play a leading role in education and therapeutic intervention.

For the past five years, the Department of Social Work at Inter-American University, Metro Campus, has joined and supported the cause through the celebration of the Alzheimer’s Symposium: A Perspective from the Academy. This event involves the entire university community, as well as the community at large, which includes caregivers, government and non- profit agencies, and professionals from various disciplines. There will be concurrent lectures, Discussions among local and international professionals, a film forum, poster presentations, artistic expressions, and educational tables. The 6th Symposium will be held on September 20, 2024. The Symposium is promoted through various media. This activity has generated alliances, recommendations and new educational projects that contribute to the well-being of older adults.

Introduction: Resilience is a dynamic process involving the interaction between risk and protective factors that act to modify the effects of adverse life events. Understanding the resilience of caregivers of patients with AD and its predictors is essential for the development of intervention strategies aimed at solutions that can contribute to the improvement of their emotional disorders, such as anxiety, stress, anddepression.

Methods: 93 dyads of patients diagnosed with AD, where 60 (64.5%) dyads had Late-onset AD (LOAD) and 33 (35.5%) dyads had Young-onset AD (YOAD). Patients were assessed for: quality of life (QoL), disease awareness, and depression. Caregivers were assessed for: resilience, depression, anxiety, burden, and QoL. Additionally, caregivers provided information about mood, neuropsychiatric symptoms, dementia severity, and patients’ activities of daily living.

Results: Caregivers showed moderate levels of resilience, with an average score of 140 (SD = 13.20), moderate level of burden 28.94 (SD = 14.74), low level of anxiety 7.56 (SD = 7.44), and low level of depressive symptoms 8.17 (SD = 6.34). Patients had an average cognition score of 18.81, 63.4% had mild dementia, low depression index .2 (SD = 5.78), low index of neuropsychiatric symptoms 16.11 (SD = 14.47), and partially compromised disease awareness 9.06 (SD = 5.12).

Conclusions: No relationship was found between caregivers’ resilience and patients’ clinical condition, indicating that resilience seems to be associated with caregivers’ individual characteristics. Interventions such as psychoeducational groups, behavioral or religious counseling, may stimulate or develop resilience characteristics in caregivers who exhibit avoidance or denial behaviors regarding the patient’s diagnosis.

Jennifer Blumenthal-Barby (2024) has called for bioethics to end talk about personhood, asserting that such talk has the tendency to confuse and offend. It will be argued that this has only limited application for (largely) private settings. However, in other settings, theorizing about personhood leaves a gap in which there is the risk that the offending concept will get uptake elsewhere, and so the problem Blumenthal-Barby nominates may not be completely avoided. In response to this risk, an argument is presented in support of the idea that the role of philosophers and bioethicists, far from ending talk of personhood, ought to be to clarify the concept, and to do so in nuanced ways, given its application for specific kinds of impairments. The case of dementia is used to illustrate this in the context of person-centered care. Ironically, given the stigma attached to dementia, far from the need to end talk of personhood, bioethicists are needed to rescue the concept and clarify its role.

The evolution of the understanding of the intestinal microbiota and its influence on our organism leverages it as a potential protagonist in therapies aimed at diseases that affect not only the intestine but also neural pathways and the central nervous system itself. This study, developed from a thorough systematic review, sought to demonstrate the influence of the intervention on the intestinal microbiota in subjects with Alzheimer’s disease. Clinical trials using different classes of probiotics have depicted noteworthy remission of symptoms, whose measurement was performed based on screenings and scores applied before, during, and after the period of probiotics use, allowing the observation of changes in functionality and symptomatology of patients. On the other hand, faecal microbiota transplantation requires further validation through clinical trials, even though it has already been reported in case studies as promising from the symptomatology point of view. The current compilation of studies made it possible to demonstrate the potential influence of the intestinal microbiota on Alzheimer’s pathology. However, new clinical studies with a larger number of participants are needed to obtain further clarification on pathophysiological correlations.

According to Kant’s ethics, at least on one common interpretation, persons have a special worth or dignity that demands respect. But personhood is not coextensive with human life; for example, individuals can live in severe dementia after losing the capacities constitutive of personhood. Some philosophers, including David Velleman and Dennis Cooley, have suggested that individuals living after the loss of their personhood might offend against the Kantian dignity the individuals once possessed. Cooley has even argued that it is morally required on Kantian grounds for those who realize that they will lose their personhood as a result of dementia (e.g. Alzheimer’s) to hasten their deaths (e.g. commit suicide). This article specifies circumstances in which post-personhood living might indeed involve an affront to the Kantian dignity of a person who once was. However, the article contends, Kant implies that it is neither morally required nor even morally permissible for someone in an early stage of Alzheimer’s to hasten their death to avoid such an affront, even if they have autonomously chosen to do so. The article adds an ethical perspective to debate on physician-assisted dying, in particular on the moral permissibility of the soon-to-be-demented ending their lives.