Expression of emotions and social relations in persons with dementia: the effects of attending the Alzheimer Café

Introduction: social isolation, as indicated by a small social network or a reduced social engagement, has been associated with increased risk of late-life dementia and cognitive impairment. Moreover, it has been recently investigated the role of loneliness, i.e. the subjective feeling of poor social interactions. Research findings underline that the presence of loneliness feelings, regardless of the indicators of social isolation, double the probability of developing Alzheimer's disease and they are associated with more rapid cognitive decline. The negative effects of loneliness invade also the nocturnal life: lonely individuals’ sleep is fragmented by long-lasting night awakenings.
The Alzheimer Café concept  came and spread from the Netherlands in the late '90. Many Alzheimer Cafés exists in Europe and Italy at present. One of them opened its doors in Florence on January 2009. Here, according to the original idea by Bère Miesen, persons with dementia and their families and friends meet periodically each other in a safe and supportive environment. A typical afternoon at the Alzheimer Café in Florence begins with a welcome session, during which people with dementia and their families take a seat, get something to drink, and have a chat with other caregivers, volunteers and health care professionals. It is usually followed by deeper discussions and information exchanges. The meeting continue enjoying a small buffet and, occasionally, some music and other entertainment.
An aim of the Alzheimer Café is to promote social interactions of persons  with dementia and their families. In agreement with the belief which underlie the Alzheimer café concept, getting in touch with people that face the same problems let someone to understand that he/she is not the only one who is experiencing feelings of confusion and inability to cope with the consequences of dementia. In this context persons with dementia and their families can feel recognized and accepted. Moreover, making dementia something that can be discussed returns to all people involved in the disease the perception they can control their situation, at least in some measure.

Hypothesis and objectives: the purpose of this study is to verify if attending the Alzheimer Café has positive effect on people with dementia and on their family-caregivers. We hypothesize that attending the Alzheimer Café may reduce the frequency and duration of behaviors related to negative emotions in persons with severe dementia and it may increase those related to positive emotions. In addition, we hypothesize that attending the Alzheimer Café may improve the caregivers’ perception of having physical and emotional resources to care properly for their relative with dementia (construct of self-efficacy), and it may reduce the subjective experience of social isolation (construct of loneliness).

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