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Kong D, Romli MH, Devaraj NK, Sallehuddin H, Tan MP. A Meta-Synthesis on Sexuality in Persons with Dementia Mapped Using the Model of Human Occupation. Occup Ther Health Care 2024:1-31. [PMID: 38975945 DOI: 10.1080/07380577.2024.2375533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/29/2024] [Indexed: 07/09/2024]
Abstract
Dementia affects the individual's functional ability including sexual activity. Limited understanding is available to support sexual health practices. This meta-synthesis review aimed to identify the gaps in the study of sexuality in dementia using the Model of Human Occupation (MOHO). Electronic searches utilizing six databases for existing articles involving persons living with dementia, care partners, and healthcare workers. The result showed that available studies primarily explored sexuality from the viewpoint of spouses of persons living with dementia. The volition domain of MOHO was the most explored provides a deeper understanding of volition on intrinsic perspective on sexuality in people with dementia. The environment domain was the least explored, highlighting healthcare professionals' need for social support and training. The topic of sexuality remains sensitive, limiting the availability of evidence-based interventions in this area.
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Affiliation(s)
- Dinnee Kong
- Genting Dementia Care Centre, Kuala Lumpur, Malaysia
| | - Muhammad Hibatullah Romli
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Navin Kumar Devaraj
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Hakimah Sallehuddin
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur
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2
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El Haj M, Boutoleau-Bretonnière C, Gallouj K, Allain P, Antoine P. Neuropsychological assessment of patients with alzheimer's Disease in the presence or absence of spouses. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:376-381. [PMID: 35007449 DOI: 10.1080/23279095.2021.2023811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A common question in the neuropsychological testing of patients with Alzheimer's Disease is whether or not patients should be tested in the presence of their spouses. We addressed this issue by assessing the neuropsychological performances of Alzheimer's Disease patients in the presence or absence of spouses. Results showed no significant differences between patients' performances in the presence or absence of spouses on tests assessing general cognitive abilities, episodic memory, working memory, inhibition and flexibility. No significant differences were observed regarding either anxiety or depression in patients when tested alone, compared to when spouses were attending. However, patients demonstrated higher verbal fluency when tested alone compared to when spouses attended. Clinicians may carry out neuropsychological assessment in the presence or absence of spouses, except when assessing verbal fluency. In such cases, clinicians should privilege testing patients alone or, if spouses attend the test, take into account this variable when interpreting patients' performances.
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Affiliation(s)
- Mohamad El Haj
- Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), Nantes Université, Univ Angers, Nantes, France
- Centre Hospitalier de Tourcoing, Unité de Gériatrie, Tourcoing, France
- Institut Universitaire de France, Paris, France
| | | | - Karim Gallouj
- Centre Hospitalier de Tourcoing, Unité de Gériatrie, Tourcoing, France
| | - Philippe Allain
- Laboratoire de Psychologie des Pays de la Loire, LPPL EA 4638, SFR Confluences, UNIV Angers, Nantes Université, Maison de la recherche Germaine Tillion, Angers Cedex 01
- Département de Neurologie, CHU Angers, Angers, France
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3
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Mroz EL, Monin JK, Gaugler JE, Matta-Singh TD, Fried TR. Rewriting the Story of Mid- and Late-Life Family Caregiving: Applying a Narrative Identity Framework. THE GERONTOLOGIST 2024; 64:gnad040. [PMID: 37018754 PMCID: PMC10809219 DOI: 10.1093/geront/gnad040] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Indexed: 04/07/2023] Open
Abstract
Family caregivers of older people with health needs often provide long-term, intensive support. Caregivers are, in turn, shaped by these caregiving experiences. According to the narrative identity framework, self-narratives from lived experiences influence self-beliefs and behaviors. We assert that family caregiving experiences, filtered through individuals' memory systems as self-narratives, provide substantial scaffolding for navigating novel challenges in late life. Self-narratives from caregiving can guide positive self-beliefs and behaviors, leading to constructive health-focused outcomes, but they also have the potential to guide negative self-beliefs or behaviors, causing adverse consequences for navigating late-life health. We advocate for incorporating the narrative identity framework into existing caregiving stress models and for new programs of research that examine central mechanisms by which caregiving self-narratives guide self-beliefs and behavioral outcomes. To provide a foundation for this research, we outline 3 domains in which caregiving self-narratives may substantially influence health-related outcomes. This article concludes with recommendations for supporting family caregivers moving forward, highlighting narrative therapy interventions as innovative options for reducing the negative consequences of maladaptive caregiving self-narratives.
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Affiliation(s)
- Emily L Mroz
- Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Joan K Monin
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Joseph E Gaugler
- Center for Healthy Aging and Innovation, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
- School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Terri R Fried
- Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
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Dunn R, Wolverson E, Hilton A. Exploring the interplay between dementia, multiple health conditions and couplehood: A qualitative evidence review and meta-ethnography. DEMENTIA 2024; 23:41-68. [PMID: 37969077 DOI: 10.1177/14713012231214017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Background: On average, people with dementia live with 4.6 additional health conditions. Additionally, two thirds of carers of people with dementia are spouses, and are also likely to live with multimorbidity, given that older age is strongly associated with an increase in health conditions. Consequently, living with dementia and multimorbidity is often a shared experienced as a couple. However, research has not explored how living with both dementia and multimorbidity may impact on couplehood. Method: We conducted a qualitive evidence review using a meta-ethnographic approach, to answer the following question: In what way (if any) does living with dementia and multimorbidity impact on couplehood? No papers were found on couplehood, dementia and multimorbidity, therefore the review consists of a meta-synthesis of couples' experiences of living with dementia in relation to couplehood, with an additional search for any data related to health within the qualitative findings. Findings: Two major reciprocal themes and five subthemes were identified from the 14 study findings. 1. Change and adjustment in the relationship, which included themes around a sense of 'togetherness', change in roles and identity and developing shared coping strategies and 2. Commitment, which was encapsulated by themes on unconditional love and commitment to wedding vows. Health-related findings were limited but included the impact on emotional wellbeing and how other health conditions, rather than dementia, were attributed to a loss in physical sexual intimacy. Conclusion: This review found that couplehood was threatened when dementia symptoms progressed and couples experienced feelings of loss of independence and identity. However, a strong foundation of commitment, love and loyalty to each other developed over the course of the relationship, was the 'glue' that helped couples face dementia together. However, further research is needed to explore couples' experiences of living with both multimorbidity and dementia in relation to couplehood in order to develop holistic, relationship-centred interventions.
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Affiliation(s)
- Rosie Dunn
- School of Psychology and Social Work, Faculty of Health Sciences, University of Hull, UK
| | - Emma Wolverson
- School of Psychology and Social Work, Faculty of Health Sciences, University of Hull, UK
| | - Andrea Hilton
- School of Paramedical, PeriOperative and Advanced Practice, Faculty of Health Sciences, University of Hull, UK
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5
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Hochgraeber I, Köhler K, Stöcker H, Holle B. The dyadic relationship of family carers and people living with dementia - an umbrella review. Aging Ment Health 2023; 27:1965-1974. [PMID: 37390842 DOI: 10.1080/13607863.2023.2215191] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/11/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVES The dyadic relationship of people living with dementia and their family carers is highly relevant when considering the stability of home-based care arrangements. There is a solid body of research that covers issues related to dyadic relationships. However, a synthesis of qualitative research is missing. Therefore, the aim of this review is to give an overview of the dyadic relationship, with the leading research question of what influences the dyadic relationship and how it can be maintained during the trajectory of the disease. METHODS We performed an umbrella review of qualitative literature on the basis of thematic synthesis and used the SoCA-Dem theory as a theoretical framework. Literature searches in the databases PubMed (MEDLINE), CINAHL, Scopus, and PsycInfo were performed from July to September 2020, additional papers were included until September 2022. We searched without timeframe restrictions and considered publications in English or German. RESULTS After a systematic database search, resulting in 1325 records, we included 12 reviews. Five analytical themes and 11 subthemes were identified. The analytical themes were 'change in the relationship', 'activities to maintain the relationship', 'continued togetherness', 'home as a place for enacting relationship', and 'influencing factors'. CONCLUSION The dyadic relationship is a complex and multifaceted phenomenon. It is characterized by family carers' attempts to continue togetherness using different strategies and is mainly influenced by the quality of the premorbid relationship and the mindset of the family carer.
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Affiliation(s)
- Iris Hochgraeber
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Kerstin Köhler
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Hannah Stöcker
- Faculty of Health, School of Psychology, Witten/Herdecke University, Witten, Germany
| | - Bernhard Holle
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
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Shen S, Liu H. Cognitive Impairment Leads to Increased Feelings of Sexual Obligation Among a National Longitudinal Sample of Sexually Active Adults Aged 62 and Older. THE GERONTOLOGIST 2023; 63:297-307. [PMID: 35675363 PMCID: PMC9960026 DOI: 10.1093/geront/gnac078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES We work from a gendered life-course perspective to examine the relationship between cognitive impairment and feelings of sexual obligation among U.S. older adults. RESEARCH DESIGN AND METHODS Data are drawn from 2 rounds of the National Social Life, Health, and Aging Project (2010/2011 and 2015/2016). The analytic sample includes 575 sexually active respondents aged 62-86 at baseline. Cognitive impairment is measured using a survey-adapted version of the Montreal Cognitive Assessment, with categories of normal, mild cognitive impairment, and dementia. We estimate cross-lagged models to test the potential reciprocal relationships between cognitive impairment and feelings of sexual obligation. RESULTS Older adults with dementia at baseline had significantly higher odds of sexual obligation 5 years later than their peers with normal cognition at baseline, after adjusting for gender, race/ethnicity, education, income, age, marital status, self-rated health, depression, comorbidities, and sexual obligation at baseline. We find no evidence of a reciprocal relationship, as sexual obligation at baseline did not predict later cognitive status. DISCUSSION AND IMPLICATIONS Older adults with dementia often remain sexually active after their 60s, and many of them feel obligated to have sex with their partner. Our study highlights the importance of understanding the context of their sexual lives. The quality of their sexual relationship, such as whether they feel a duty to maintain their earlier sexual activity or please their partner, and the health implications of sexual obligation should be considered alongside the increase of older adults with dementia.
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Affiliation(s)
- Shannon Shen
- Department of Sociology, Texas A&M University-San Antonio, San Antonio, Texas, USA
| | - Hui Liu
- Department of Sociology, Michigan State University, East Lansing, Michigan, USA
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Albert SC, Eduardo Martinelli J, Costa Pessoa MS. Couples living with Alzheimer's disease talk about sex and intimacy: A phenomenological qualitative study. DEMENTIA 2023; 22:390-404. [PMID: 36594356 DOI: 10.1177/14713012221149759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To obtain a deeper understanding of the phenomenon of sexuality within the couple relationship when one of the partners has received a diagnosis of Alzheimer's Disease. This study aimed to listen to the voices of both partners, and to investigate how their intimate relationship has been impacted by an Alzheimer's diagnosis. METHODS This study adopted a qualitative phenomenological approach, and the method used was Interpretative Phenomenological Analysis. The data was collected based on interviews with six couples, where one of the spouses had a mild to moderate Alzheimer's diagnosis. The interviews were recorded and transcribed, and a detailed analysis of each interview was performed. FINDINGS From the detailed analysis of the transcribed interviews, six main themes emerged: Sexual expression today; Alzheimer's and sexuality; desire to be a sexual being; different sexualities; sense of couplehood; and uncertain future. CONCLUSIONS The findings of this study provide a deeper insight into experiences of sexuality for couples living with Alzheimer's. Sexuality and intimacy of couples living with Alzheimer's continues to be an important aspect of the relationship, and in general, the partners wish to have the opportunity to express their sexuality. The construction of a sense of couplehood during the marriage tends to be a significant factor to sustain the changes that arise in the intimate relationship because of the diagnosis. However, despite the growing recognition of the existence and importance of sexuality in later life, persons with Alzheimer's have only recently starting to be recognized as sexual beings who wish to be heard.
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Affiliation(s)
- Susan Carol Albert
- Jundiai Medical University, Department of Health Sciences, 146840Faculdade de Medicina de Jundiaí, Jundiai, Brazil
| | - José Eduardo Martinelli
- Jundiai Medical University, Department of Health Sciences, 146840Faculdade de Medicina de Jundiaí, Jundiai, Brazil
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Eskola P, Jolanki O, Aaltonen M. Through Thick and Thin: The Meaning of Dementia for the Intimacy of Ageing Couples. Healthcare (Basel) 2022; 10:healthcare10122559. [PMID: 36554082 PMCID: PMC9778010 DOI: 10.3390/healthcare10122559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
As the population ages, the number of people with dementia increases. An emerging body of research is focusing on living with dementia and understanding the experience of caring and the care burden. There is much less research on the meaning of dementia from the perspective of an older couple's spousal relationship and related intimacy. This qualitative study explores the meanings of emotional and physical intimacy and the changes brought by dementia in the couplehood of persons with dementia and their spousal carers. The data comprise semi-structured interviews with 35 persons. The interviews were analysed using inductive qualitative content analysis. Four themes describing the meanings of relational intimacy were identified: intimacy as a striving force, intimacy turning into worrisome behaviour, intimacy as physical and emotional dependency, and intimacy turning into one-sided caring for a partner. Dementia changes the intimate relationship in many ways, but shared affection and long-term partnership help maintain the spousal relationship. While dementia may bring about conflicts and behavioural challenges in an intimate relationship, the couple's shared intimacy and a sense of responsibility for one another may serve as a resource and support the continuity of couplehood.
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Affiliation(s)
- Päivi Eskola
- Gerontology Research Center, Faculty of Sport and Health Sciences, and Open University, University of Jyväskylä, 40014 Jyväskylä, Finland
- Correspondence:
| | - Outi Jolanki
- Gerontology Research Center, Faculty of Social Sciences and Centre of Excellence in Research on Ageing and Care, Tampere University, 33520 Tampere, Finland
- Centre of Excellence in Research on Ageing and Care, Department of Social Sciences and Philosophy, Faculty of Humanities and Social Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - Mari Aaltonen
- Gerontology Research Center, Faculty of Social Sciences and Centre of Excellence in Research on Ageing and Care, Tampere University, 33520 Tampere, Finland
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
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9
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Hedman R, Hillerås P, Tyrrell M. Living in uncertainty while a spouse is undergoing a cognitive assessment: Voices of women care partners. DEMENTIA 2022; 21:2631-2646. [PMID: 36131252 PMCID: PMC9583288 DOI: 10.1177/14713012221128448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Women often support partners with cognitive symptoms during the assessment process and when they are receiving a cognitive diagnosis. Living with a partner with cognitive symptoms can be stressful; however, there is limited insights into the specific experiences of older women during the assessment process. Previous research indicates that there are gender differences in the experiences of spousal caregiving; however, further research is needed in regard to the experiences of men and women as care partners. Therefore, the aim of the present study was to describe women's experiences of living with a partner undergoing a cognitive assessment. METHODS Semi-structured interviews were conducted with seven women when their male partners commenced a cognitive assessment and after the assessment had been completed. The interviews were analysed with abductive content analysis. FINDINGS Uncertainty permeated the women's experiences. Antecedents, attributes and strategies to manage the uncertainty were described. CONCLUSION The participants expressed informational and existential uncertainty when their partner underwent a cognitive assessment. A lack of knowledge regarding the assessment process and cognitive diagnoses, especially mild cognitive impairment, was identified. Further, there was a need to process existential uncertainty evoked by the situation.
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Affiliation(s)
- Ragnhild Hedman
- Department of Nursing Science, 25548Sophiahemmet University, Stockholm, Sweden
| | - Pernilla Hillerås
- Red Cross University College, Huddinge, Sweden.,Department of Neurobiology, Care Sciences and Society, 97092Karolinska Institutet, Stockholm, Sweden
| | - Marie Tyrrell
- Department of Nursing Science, 25548Sophiahemmet University, Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, 97092Karolinska Institutet, Stockholm, Sweden
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10
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Asfia SKBM, Bucholc J, McCaffrey N, Mihalopoulos C, Muldowney A, Engel L. Understanding the Quality of Life Impacts of Providing Informal Care to People with Dementia: A Systematic Review of Qualitative Studies. J Alzheimers Dis 2022; 88:1293-1309. [PMID: 35754273 DOI: 10.3233/jad-220219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is currently a lack of a comprehensive review identifying the broad scope of factors that impact quality of life (QoL) of informal carers of people with dementia to validate existing measures and inform the provision of support services for carers of people with dementia that impact QoL domains important to them. OBJECTIVE To explore and identify QoL impacts on informal carers from providing care to people with dementia. METHODS A systematic review was conducted across four databases: EMBASE, CINAHL, PsychINFO, and Medline. Eligible studies consisted of published, peer-reviewed, qualitative studies focusing on lived experiences of informal carers of people with dementia. Non-English studies and quantitative studies were excluded. Screening of included studies was conducted independently by three reviewers. A "best-fit" framework synthesis was used to combine the qualitative data, applying deductive and inductive analysis techniques. Quality assessment was conducted using the Critical Appraisal Skills Programme. RESULTS Of the 4,251 articles identified, 59 articles were included. Five main themes pertaining to QoL aspects were identified that included coping (emotion-coping and problem-coping), relationship with the person with dementia (sense of loss and change in relationship), support (formal support and informal support), interference with life (control over caring situation and freedom and independence), and health (physical health, emotional and mental health, and social health). CONCLUSION This study identified domains of QoL that are impacted by providing informal care to people living with dementia, offering a conceptual framework for instrument validation and development as well as guidance for service provision.
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Affiliation(s)
| | - Jessica Bucholc
- Deakin University, Institute for Health Transformation, Burwood, Victoria, Australia
| | - Nikki McCaffrey
- Deakin University, Institute for Health Transformation, Burwood, Victoria, Australia
| | - Cathrine Mihalopoulos
- Deakin University, Institute for Health Transformation, Burwood, Victoria, Australia.,Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Melbourne, Australia
| | - Anne Muldowney
- Carers Australia, Unit 2/11 McKay Ln, Turner, Australian Capital Territory, Australia
| | - Lidia Engel
- Deakin University, Institute for Health Transformation, Burwood, Victoria, Australia.,Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Melbourne, Australia
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11
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Albert SC, Eduardo Martinelli J, Costa Pessoa MS. Dementia and its impacts on the intimate, sexual couple relationship: A systematic review of qualitative research studies. DEMENTIA 2022; 21:1449-1466. [PMID: 35142230 DOI: 10.1177/14713012211073205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE There is growing evidence for the need to recognize persons with dementia as sexual beings who wish to continue expressing their sexuality, including within their couple relationship. The aim of this literature review was to investigate empirical qualitative studies that examined sexuality and sexual intimacy in the couple relationship when one spouse has dementia. METHOD A systematic literature review was performed in January 2021, five data bases were searched: Pubmed, MedLine, Lilacs, Scopus, and SciELO. The references of articles included in the review were screened together with the references of other relevant reviews. RESULTS Nine studies were identified that investigated sexuality and sexual intimacy from the perspective of the couple living with dementia or from the perspective of the spouse. The analysis identified four key themes: addressing dementia and sexuality; challenges to maintaining sexuality within the couple relationship; forms of sexual expression; and the desire to be seen as a sexual being. CONCLUSION Despite evidence of the importance of sexuality in later life and the positive effects it has on the quality of the couple relationship, research has identified the difficulty of destigmatizing sexuality and older persons, particularly when considering couples affected by dementia. Further research is required to better understand how living with the illness impacts sexual expression and the intimacy of the couple relationship.
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Affiliation(s)
- Susan Carol Albert
- Department of Health Sciences, 146840Jundiai Medical University, (Faculdade de Medicina de Jundiaí) Jundiai, Brazil
| | - José Eduardo Martinelli
- Department of Health Sciences, 146840Jundiai Medical University, (Faculdade de Medicina de Jundiaí) Jundiai, Brazil
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12
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‘Rekindling couplehood’ using a multisensory suitcase of memories: a pilot study of people living with moderate dementia and their partners. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x21001926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Creating individualised activities in partnership with people who have moderate dementia and their partners at home has rarely been achieved, as such interventions are usually pre-planned by researchers or professionals. The academic gap is in the activity design being led by the person who has dementia and their partner and how to engage them in a meaningful manner which rekindles positive joint memories and improves the quality of their current relationship. This article explores the meaning and significance of recalling shared holiday memories for people living with moderate dementia and their partners, using multisensory reminiscence. A sensory ethnography research methodology was employed which enhanced co-design of the activity over five home visits. The research culminated in the creation of a digital story, sharing of food and drink, and re-enactment through exploration of their holiday memorabilia: forming their suitcase of memories (SOM). The study extends the current academic debate of co-produced interventions and identifies the critical themes of ‘holidays as life’, ‘freedom’, ‘view seen, viewpoint heard’ and ‘strengthened self-identity with younger self’ which emerged from the research. Such areas of sensory reminiscence have supported positive recollections, discourse and, when combined, resulted in a beneficial impact on the partner's shared relationship. A significant research outcome was the transition from a negative life view dominated by dementia to rekindling their relationship positively as a result of the SOM intervention and sensory methodology. Future research to continue the work with new couples to see if similar results are achieved with more case studies is needed.
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Petrovic M, Bonanno S, Landoni M, Ionio C, Hagedoorn M, Gaggioli A. Healing with Stories: using the Transformative Storytelling technique to generate empowering narratives for informal caregivers. A Method Demonstration (Preprint). JMIR Form Res 2022; 6:e36405. [PMID: 35802492 PMCID: PMC9382549 DOI: 10.2196/36405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/11/2022] [Accepted: 06/01/2022] [Indexed: 01/19/2023] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Milica Petrovic
- ExperienceLab, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Marta Landoni
- Department of Psychology, Centro di Ricerca sulle Dinamiche Evolutive ed Educative, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Chiara Ionio
- Department of Psychology, Centro di Ricerca sulle Dinamiche Evolutive ed Educative, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Mariët Hagedoorn
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Andrea Gaggioli
- Research Center in Communication Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- IRCCS, Istituto Auxologico Italiano, Milan, Italy
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14
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Prato L, Abley C, Adamson J. Exploring online identity construction for the caregivers of adults living with dementia and the value of interactions with health and social care professionals. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:295-306. [PMID: 33894073 DOI: 10.1111/hsc.13403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 03/05/2021] [Accepted: 03/21/2021] [Indexed: 06/12/2023]
Abstract
Becoming an informal caregiver for an adult living with dementia has been shown to have a significant impact upon the conception of identity. This study aimed to identify how identity is constructed online amongst caregivers of individuals living with dementia and how healthcare interactions can influence identity development through the analysis of online web blogs. Sixteen online blogs (172 entries) were selected through purposive and snowball sampling, and discourse analysis was used to analyse online identity construction for informal caregivers of adults living with dementia. Six areas of online identity construction were identified: changing family role; powerful expert social campaigner; being an advocate; guardian of their relative's selfhood; sustaining creative and spiritual individuality and wider community member in online and real life. Further to this, the importance of health and social care service interactions in the development of caregiver identity revealed that professionals must ensure person-centred service contacts for caregivers. This is a challenging task in the pandemic climate where interactions between health and social care professionals and caregivers are limited due to isolation measures. It is evident that the blog format can provide a forum through which the identity of the caregiver of an adult living with dementia can evolve. The six areas of identity construction reveal the multifaceted nature of identity for the caregiver and the value of belonging to an online community both in relation to identity construction and support. This finding is especially applicable in the current pandemic when accessing a face-to-face community is challenging for caregivers who may be shielding or living in isolation. The findings of this research can aid health and social care professionals in understanding the development of caregiver identity and in providing appropriate support during service interactions, on accessing virtual and face to face community support.
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Affiliation(s)
- Laura Prato
- Newcastle University, Newcastle Upon Tyne, UK
| | - Clare Abley
- Newcastle University, Newcastle Upon Tyne, UK
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Sandberg LJ, Rosqvist HB, Grigorovich A. Regulating, fostering and preserving: the production of sexual normates through cognitive ableism and cognitive othering. CULTURE, HEALTH & SEXUALITY 2021; 23:1421-1434. [PMID: 32772835 DOI: 10.1080/13691058.2020.1787519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 06/22/2020] [Indexed: 06/11/2023]
Abstract
People with cognitive disabilities are commonly positioned as risky sexual subjects. This article discusses the discursive production of sexual normates in the form of desirable and normative able-minded sexual subjects, in scientific research on the sexuality and cognitive disabilities of younger and older individuals (in particular those with dementia). We identify three interrelated discourses: regulating sexuality; fostering sexuality; and preserving sexuality. The first of these, regulation, pathologises sexuality of people with cognitive disabilities as faulty and in need of restriction. The second discourse, fostering, is more affirmative and argues for educating for a 'healthy' sexuality of people with cognitive disabilities, to mitigate risks of abuse. This discourse is more salient with younger people. The third discourse, preservation, in contrast, is more visible with older people with dementia and affirms sexuality so long as it is consistent with a 'genuine' or 'authentic' sexuality of the past. In conclusion, scientific research reinforces the cultural ideal of the rational and autonomous individual (and as such the mature/adult) capable of making independent decisions and engaging in healthy, good sex, based on stable sexual identities. Findings demonstrate how age intersects with cognitive ableism to intensify the cultural anxiety that exists around the sexualities of people with cognitive disabilities.
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Affiliation(s)
- Linn J Sandberg
- School of Culture and Education, Södertörn University, Huddinge, Sweden
| | | | - Alisa Grigorovich
- The Kite Research Institute-UHN, University of Toronto, Toronto, Canada
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16
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Zygouri I, Cowdell F, Ploumis A, Gouva M, Mantzoukas S. Gendered experiences of providing informal care for older people: a systematic review and thematic synthesis. BMC Health Serv Res 2021; 21:730. [PMID: 34301248 PMCID: PMC8306003 DOI: 10.1186/s12913-021-06736-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/06/2021] [Indexed: 12/24/2022] Open
Abstract
Background and purpose The caregiving’s impact on informal carers’ quality of life and gender-based stereotypes make older individuals’ informal care a complex process for which our knowledge is still limited. The purpose of this review is to identify how gender relates to informal carers’ experiences of providing care for people aged 60 years and over with mental and physical health needs by synthesising the available empirical data published between 2000 to 2020. Design and methods The systematic method for reviewing and synthesising qualitative data was performed using the PRISMA checklist and ENTREQ statement. The CASP tool was used to examine the quality of the included papers. Thematic synthesis was used as the methodological framework. Results This review produced two analytical themes, the impact of gender on the caregivers’ labour and negotiating gender identity with self, society, and cultural norms. While informal caregivers share motivators, a linkage between traditional gender stereotypes impacts caregiving burden and coping strategies. Informal carers’ experiences entail a constant pursuit of self-agency after acquiring the caregiver role. Cultural values and their intersection with gender appear to influence caregivers’ healthy adjustment into their new caregiving identities. The flexibility to move beyond gender boundaries could mediate caregivers’ negotiations between self and society on developing their new caregiving identity. Providing intensive informal primary care to older people affects both men’s and women’s mental and physical health. Gender ideals of the feminine nurturing role further disadvantage women as they determine the caregiving arrangements, the strategies and resources to sustain the caring burden, and the adaptability to experience their new caregiving role positively. Men appear more flexible to debate their hegemonic masculinity and defend their existence in the caregiving role. Conclusion and implications Transgressing gender lines and expanding gender possibilities can ease the caregiving burden and strengthen caregivers coping potentials. Health professionals can empower informal careers to challenge gender binaries and expand gender possibilities by intentionally injecting the language of diversity in caring information and caring processes. The review findings outline a path for research on gender identity development in older people’s care. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06736-2.
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Affiliation(s)
- Ioanna Zygouri
- Department of Medicine, Faculty of Medicine, University of Ioannina, University Campus, P.O. Box: 1186, Zip: 451 10, Ioannina, Greece.
| | - Fiona Cowdell
- School of Nursing and Midwifery, Birmingham City University, Birmingham, UK
| | - Avraam Ploumis
- Department of Medicine, Faculty of Medicine, University of Ioannina, University Campus, P.O. Box: 1186, Zip: 451 10, Ioannina, Greece
| | - Mary Gouva
- Department of Nursing, University of Ioannina, Ioannina, Greece
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Goodall G, André L, Taraldsen K, Serrano JA. Supporting identity and relationships amongst people with dementia through the use of technology: a qualitative interview study. Int J Qual Stud Health Well-being 2021; 16:1920349. [PMID: 33955324 PMCID: PMC8118425 DOI: 10.1080/17482631.2021.1920349] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Meaningful activities in dementia care can promote the co-construction of narrative identity in caregiving relationships, helping to preserve the sense of self in people with dementia. Purpose: Informed by symbolic interactionism and Deweyan transactionalism, the aim of this study was to develop a transactional model of how narrative identity and relationships are promoted through the use of a new technological solution, SENSE-GARDEN, that uses digital technologies and multisensory stimuli to facilitate individualized, meaningful activities. Method: We conducted a qualitative interview study to explore the experiences of people with moderate to advanced dementia and their caregivers in Norway and Portugal. After using SENSE-GARDEN for 12–16 weeks, 20 participants (7 persons with dementia and 13 caregivers) were interviewed. The interviews were analysed using reflexive thematic analysis. Results: Three themes were generated: openness, learning, and connection. Findings suggest that SENSE-GARDEN can stimulate emotional experiences, preserve narrative identity, and foster interpersonal relationships. These findings are illustrated through a transactional model. Conclusion: This study highlights the complex multitude of factors affecting person-environment interactions in which narrative identity and relationships are constructed. To better understand these factors, future work should adopt a holistic approach to studying new methods of creating meaningful activities in dementia care.
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Affiliation(s)
- Gemma Goodall
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| | - Lara André
- Departamento de Ação Social e Saúde (Department of Social Action and Health), Santa Casa Da Misericórdia De Lisboa (SCML), Lisbon, Portugal
| | - Kristin Taraldsen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| | - J Artur Serrano
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.,Norwegian Centre for eHealth Research, University Hospital of North Norway, Tromsø, Norway
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Griffiths AW, Shoesmith E, Sass C, Nicholson P, Charura D. Relational counselling as a psychosocial intervention for dementia: Qualitative evidence from people living with dementia and family members. DEMENTIA 2021; 20:2091-2108. [PMID: 33382000 PMCID: PMC8361473 DOI: 10.1177/1471301220984912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Counselling and other psychotherapeutic interventions can be offered to people with
dementia and their caregivers, to treat specific conditions or symptoms (e.g. affective
disorders such as depression). Psychotherapeutic interventions also offer the opportunity
for individuals with dementia and their families/caregivers to engage in psychological
support for a wide range of presentations. However, little is known about how those within
this demographic who receive these interventions perceive the experience. This study aimed
to understand the experiences of individuals with dementia or caring for someone with
dementia, before and after a 12-week relational counselling intervention delivered through
a third sector organisation within England. Semi-structured interviews were completed with
participants (29 pre-intervention and 25 post-intervention). Framework analysis was
conducted, with four main themes identified; expectations and outcomes of counselling,
emotional impact of life with dementia, appraisals of identity and importance of
therapeutic relationship. Participants reported that counselling interventions addressed a
range of needs and concerns that they had, enabling them to reassess and reconsider these.
Specific training is needed before therapists deliver therapeutic interventions with
people with dementia, to ensure that appropriate support is provided for those with more
severe cognitive impairment or who may have fluctuating capacity. Future research should
explore the experiences of people with dementia and their caregivers, across different
counselling modalities, to establish the appropriateness and effectiveness of relational
counselling.
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Affiliation(s)
- Alys Wyn Griffiths
- School of Health & Community Studies, Leeds Beckett University, Leeds, UK
| | - Emily Shoesmith
- School of Health & Community Studies, Leeds Beckett University, Leeds, UK; Department of Health Sciences, University of York, UK
| | - Cara Sass
- School of Health & Community Studies, Leeds Beckett University, Leeds, UK; Leeds Institute of Health Sciences, University of Leeds, UK
| | - Paul Nicholson
- School of Health & Community Studies, Leeds Beckett University, Leeds, UK
| | - Divine Charura
- School of Health & Community Studies, Leeds Beckett University, Leeds, UK; School of Education, Language & Psychology, York St John University, UK
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Sweeney L, Wolverson E, Clarke C. Understanding the shared experiences of creating a digital life story with individuals with dementia and their spouse. DEMENTIA 2020; 20:1791-1813. [PMID: 33131329 DOI: 10.1177/1471301220970403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Life story books in dementia are used as a part of person-centred care. Whilst the current literature demonstrates associations between completing life story books and increased well-being, little is known about the process and how it is experienced by individuals living with dementia. Life stories are often created with a loved one, such as a partner or spouse; however, further research is required to explore experiences of life story work as a shared endeavour. Furthermore, the use of technology to create life stories is growing, with little known about how digital elements are experienced. This study aimed to understand these gaps by exploring the shared experiences of individuals with dementia and their partner/spouse creating a digital life story book. DESIGN AND METHODS Four couples participated in the six-week creation of their digital life story book. Following this, qualitative data relating to couples' experiences were collected via semi-structured interviews. FINDINGS Thematic analysis was used to interpret data and identified four superordinate themes relating to the shared experiences of creating their digital life story book: 'Creating a life story book is a huge undertaking', 'Looking back and looking forward: The emotional journey', 'Whose story is it and who does it belong to?' and 'Challenges of using technology to build the life story book'. CONCLUSIONS Overall, this study demonstrated that creating a digital life story was a positive experience that can support couples' well-being, but we should not underestimate the time it will take and range of emotions experienced. The experience of using technology varied, emphasising that we must be mindful of individual preferences before considering a digital approach.
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Affiliation(s)
- Laura Sweeney
- Department of Psychological Health, Wellbeing and Social Work, 4019University of Hull, UK
| | - Emma Wolverson
- Department of Psychological Health, Wellbeing and Social Work, 4019University of Hull, UK
| | - Christopher Clarke
- Department of Psychological Health, Wellbeing and Social Work, 4019University of Hull, UK
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Apesoa-Varano EC. "I know best:" women caring for kin with dementia. Soc Sci Med 2020; 256:113026. [PMID: 32474392 DOI: 10.1016/j.socscimed.2020.113026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 10/24/2022]
Abstract
The dementia care literature in the home is vast, particularly in the health sciences where the focus remains on intervention to address carer emotional distress and burden. The sociological literature on dementia care has primarily utilized the illness disruption and (bio)medicalization models to show how meaning and practices are negotiated in the non-expert setting. Instead, I apply a feminist labor process perspective to examine the question of why women dementia kin carers resist relinquishing care responsibilities to others. This qualitative grounded theory study is based on seven waves of interviews (total = 98) conducted over approximately five years with 15 Latina dementia kin carers recruited through clinic and community sites in Northern California. Findings show how Latina kin carers exercise a degree of control and autonomy over the care process because they have developed tacit knowledge and skills to craft quality care of kin. In facing the dilemma of ceding care to others they perceive as unprepared, they reject available help. This study reveals how carers maintain quality care with dignity and comfort for the care recipient and themselves.
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Affiliation(s)
- Ester Carolina Apesoa-Varano
- Betty Irene Moore School of Nursing, University of California, Davis, 2450 48th Street, Suite 2600, Sacramento, CA 95817, USA.
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21
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Arbel I, Bingham KS, Dawson DR. A Scoping Review of Literature on Sex and Gender Differences Among Dementia Spousal Caregivers. THE GERONTOLOGIST 2020; 59:e802-e815. [PMID: 30689840 DOI: 10.1093/geront/gny177] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Sex and gender differences among dementia spousal caregivers have been investigated, but never systematically reviewed or synthesized. A synthesis of findings can help facilitate specificity in practice and in health policy development. As a first step towards such a synthesis, this scoping review reports the available evidence, identifies research gaps, and suggests possible directions for future research. RESEARCH DESIGN AND METHODS A scoping review methodology was used to identify articles, and to chart and analyze data. Systematic searches for published, empirical studies, with an explicit goal or hypothesis related to sex or gender differences were conducted in seven databases. RESULTS Sixty-one studies met inclusion criteria. Most (n = 45) were quantitative, cross-sectional studies. Caregivers included in the studies were generally 61-70 years old, Caucasian, middle-class, and highly educated. The most extensively investigated differences are: depression, burden, objective physical health, and informal supports. DISCUSSION AND IMPLICATIONS This scoping review is the first to summarize and critique the research on sex and gender differences that are specific to dementia spousal caregivers. The review can be used by researchers to make decisions regarding future systematic reviews and primary studies. To further strengthen the evidence base, future studies may benefit from including more caregivers of ethnic minorities, using more qualitative, longitudinal, or experimental designs, and focusing on variables needed to inform caregiving models and theories. Overall, this scoping review contributes to furthering gender-sensitive practices and policies that are better tailored to the specific needs of this population.
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Affiliation(s)
- Ifah Arbel
- Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada.,Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Kathleen S Bingham
- Department of Psychiatry, University of Toronto, Ontario, Canada.,University Health Network, Toronto, Ontario, Canada
| | - Deirdre R Dawson
- Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada.,Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Ontario, Canada
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Sex and gender differences in caregiving burden experienced by family caregivers of persons with dementia: A systematic review. PLoS One 2020; 15:e0231848. [PMID: 32310969 PMCID: PMC7170244 DOI: 10.1371/journal.pone.0231848] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/01/2020] [Indexed: 01/29/2023] Open
Abstract
Objectives Much is known about the demands of caregiving for persons with dementia (PWD) and its effects on family caregivers, however sex and gender aspects have received less attention. We synthesized the evidence on sex and gender distinctions in: (1) the caregiving burden and (2) the impact of caregiving on the physical and mental health of family caregivers of PWD. Design Systematic review. Data sources Medline, Embase, PsycINFO and Cumulative Index to Nursing and Allied Health Literature between January 2007 and October 2019 were searched. Eligibility criteria for selecting studies Included studies met the following criteria: (1) examine experiences and/or impacts of caregiving among family caregivers of individuals with any form of dementia; (2) report sex and/or gender distribution of study population and/or report results stratified by sex and/or gender, and (3) include both male and female family caregivers. Data extraction and synthesis Two independent reviewers extracted the data and assessed risk of bias using the Critical Appraisal Skills Program checklist and National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. Data were synthesized using a narrative synthesis approach. Results A total of 22 studies were included. Caregiving burden was measured using various methods. A majority of studies reported higher burden among females. All studies that did not report a sex and gender difference in caregiving burden accounted for confounders. Findings on sex and gender differences on physical and mental health conditions were inconsistent with most studies failing to account for confounders in their analyses. Conclusions Current evidence on sex and gender differences in caregiving burden, mental and physical health is limited. Findings suggest presence of sex and gender differences in caregiving burden. Given the variety of mental and physical health constructs that were examined, further research is required to substantiate the evidence. PROPSERO Registration Number: CRD 42018070032.
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Sandberg LJ. Too late for love? Sexuality and intimacy in heterosexual couples living with an Alzheimer’s disease diagnosis. SEXUAL AND RELATIONSHIP THERAPY 2020. [DOI: 10.1080/14681994.2020.1750587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Linn J. Sandberg
- School of Culture and Education, Södertörn University, Huddinge, Sweden
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24
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‘When it faded in her … it faded in me’: a qualitative study exploring the impact of care-giving on the experience of spousal intimacy for older male care-givers. AGEING & SOCIETY 2019. [DOI: 10.1017/s0144686x19000850] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractOlder male care-givers play an increasingly important role in informal care-giving, yet they have received little attention in the literature. The aim of this study was to explore the impact of care-giving on the experience of spousal intimacy for older male care-givers. Twenty-four older male care-givers, drawn from a region of the United Kingdom, participated in one-to-one interviews about their care-giving role. Thematic analysis was used to analyse data, and the study was underpinned by theories of masculinity. Three main themes were identified: (a) ‘Impact of care-giving on the experience of sexual intimacy’; (b) ‘Impact of care-giving on the experience of emotional intimacy’; and (c) ‘Not up for discussion’. When sexual intimacy declined, some older male care-givers prioritised emotional intimacy; some struggled with the decline; and some were reluctant to discuss the issue. Additionally, some care-givers reported that they had not received support from external support providers for declining sexual or emotional intimacy. Intimacy has been highlighted as important for care-givers given its link with care-giver wellbeing and quality of life. Results of this study suggest that sexual and emotional intimacy was an issue for older male care-givers, and that this issue should be considered by external support providers as part of a holistic assessment of need in order to tailor effective support.
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Roberto KA, Mccann BR, Blieszner R, Savla J. A Long and Winding Road: Dementia Caregiving With Grit and Grace. Innov Aging 2019; 3:igz021. [PMID: 31528711 PMCID: PMC6735788 DOI: 10.1093/geroni/igz021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Many dementia caregivers provide care for numerous years. Exhibiting grit, or commitment and persistence in the face of adversity, may bolster their ability to manage caregiving challenges. We explored grit in relationship to memory and behavior problems and response to stressors among women engaged in long-term dementia care. RESEARCH DESIGN AND METHODS Informed by a life course perspective, and guided by stress-process theory, we interviewed 10 women with a spouse or parent initially diagnosed with mild cognitive impairment 4 times over 10 years. Using Charmaz's analysis methods and grit as a sensitizing concept, we employed an unfolding analytic strategy involving (a) thematic analysis to identify expressions of grit in response to caregiving stressors across interviews and (b) case-by-case comparisons to assess associations of grit with the use of care strategies across caregivers over time. RESULTS Dementia caregivers experienced unrelenting and changing psychosocial and physical challenges. Over time, most women exhibited a sustained commitment to the relationship through the ways in which they protected the identity of the person with dementia, modified their expectations for emotional intimacy, and managed their financial affairs. They persevered as their roles and relationships fluctuated, often finding purpose and relief through employment and leisure pursuits. As care intensified, women who took charge and consciously made decisions in the best interest of the care recipient and themselves minimized stress. DISCUSSION AND IMPLICATIONS While some caregivers exhibited grit from the outset, all showed enhanced perseverance and commitment to the ways they managed memory-related changes over time. Developing confidence in their ability to manage and provide care helped the caregivers respond to stressors with purpose and sustain their roles and responsibilities. Enhancing grit in long-term dementia caregivers may result in better individual and relational outcomes.
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Affiliation(s)
- Karen A Roberto
- Institute for Society, Culture and Environment, Virginia Tech, Blacksburg, VA
- Center for Gerontology, Virginia Tech, Blacksburg, VA
- Departments of Internal Medicine and Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA
| | | | | | - Jyoti Savla
- Center for Gerontology, Virginia Tech, Blacksburg, VA
- Department of Human Development and Family Science, Virginia Tech Blacksburg, VA
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Shen S. Chronic Disease Burden, Sexual Frequency, and Sexual Dysfunction in Partnered Older Adults. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:706-720. [PMID: 31018802 DOI: 10.1080/0092623x.2019.1610127] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This research evaluates the relationship between chronic disease burden and partnered sexuality of older adults by using data from the National Social Life, Health, and Aging Project. Ordinary least squares and logistic regressions identify how chronic disease burden is associated with sexual frequency and sexual dysfunction for men (N = 893) and women (N = 641). Results indicate that an increasing chronic disease burden is negatively associated with men's sexual frequency, while a greater burden of chronic disease is related to a greater risk of lubrication problems for women and orgasm problems for men. The findings reveal gender differences in how disease is linked to older adults' sexual lives.
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Affiliation(s)
- Shannon Shen
- Social Sciences, Texas A&M University - San Antonio , San Antonio , TX , USA
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27
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Abstract
UNLABELLED ABSTRACTBackground:The care of community-dwelling people with dementia often occurs in the context of pre-existing family relationships. The presence of dementia can result in changes to the quality of those relationships. The purpose of this systematic review is to identify factors that enhance or challenge the quality of spousal or offspring relationships in the context of dementia. METHODS Both qualitative and quantitative studies were included in a systematic review of the literature. Thematic analysis of results was conducted that examined factors related to the relationship quality of community dwelling people with dementia and their spousal or offspring carer. Meta-analysis was not possible due to the heterogeneity of the included studies. RESULTS Four themes were extracted from seven qualitative studies: connection to the carer role; identity of the people with dementia; current efforts to maintain relationship connection; and the dyads response to dementia. Each of these four themes incorporated positive and negative facets that impacted on relationship quality. An analysis of nine quantitative and one mixed methods studies identified four domains: influence of dementia characteristics; connection within the dyad; relationship response to stress and carer burden; and carer demographic factors. CONCLUSIONS The findings of this review highlight relationship factors that are important for supporting relationship quality for the people with dementia and the carer individually, as well as for the dyad together. These findings extend an existing framework of relationship quality in dementia. Implications for interventions to enhance relationship quality in the dementia context are discussed.
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Enright J, O’Connell ME, Branger C, Kirk A, Morgan D. Identity, relationship quality, and subjective burden in caregivers of persons with dementia. DEMENTIA 2018; 19:1855-1871. [DOI: 10.1177/1471301218808607] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of the current study was to examine the associations between informal caregivers’ perception of identity change in their care-partner, the quality of the caregiver/care-recipient relationship, and caregiver burden in a sample of 56 informal caregivers of persons with dementia. Most (96.4%) of the caregivers of persons who received a dementia diagnosis reported a perceived change in the identity of their care-partner. Caregivers’ perception of relationship satisfaction was measured with the Burns Relationship Satisfaction Scale for premorbid relationship and current relationship quality, and caregiver burden was measured with the Zarit Burden scale. After controlling for variance due to dementia severity, premorbid relationship satisfaction, and current relationship satisfaction, caregivers’ perceived change in the identity of the person with dementia accounted for significant variance in caregiver burden. Using a mediational model, we found support for a direct effect between perceived change in identity and caregiver burden, but we also found support for an indirect effect of relationship quality on the relation between perceived identity change and caregiver burden. The demonstrated model provides an empirically supported theoretical framework for guiding potential research and development of future interventions, which we suggest should emphasize dyads.
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Pozzebon M, Douglas J, Ames D. Facing the Challenges of Primary Progressive Aphasia: The Spousal Perspective. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:2292-2312. [PMID: 30208478 DOI: 10.1044/2018_jslhr-l-17-0492] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 05/22/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE Primary progressive aphasia (PPA) is a cognitive-neurodegenerative disorder. Little is known about the personal impact PPA has on those living with this condition, particularly from a spousal perspective. The aim of this qualitative study was to gain an understanding of the personal experiences of spouses living with a partner diagnosed with variant forms of PPA. METHOD Thirteen spouses whose partners were diagnosed with PPA participated in 1:1 semistructured, in-depth interviews to explore their lived experiences of this illness. Using a constructivist grounded theory approach, analysis moved through a process of data-driven open and focused coding for the identification of emergent categories, themes, and subthemes that captured the challenges faced by spouses while supporting their partners. RESULTS A constructivist grounded theory analysis of the interview data revealed an overarching theme of "facing the challenges of PPA" that captured the experience spouses encountered when living with a partner diagnosed with PPA. Four interdependent and overlapping themes that sat within this overarching theme included acknowledging disconnect in the spousal relationship, living the decline, readjusting sense of self, and getting on with living. Each of these core themes revealed how spouses dealt with the ongoing and evolving challenges of PPA, particularly concerning changing relational dynamics with their partner and adjusting their own self-conceptualization. CONCLUSIONS Greater understanding of the spousal experiences of PPA is crucial to the development of intervention to help sustain spouses' emotional and relational connections with their partner.
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Affiliation(s)
- Margaret Pozzebon
- La Trobe University, Melbourne, Victoria, Australia
- Royal Melbourne Hospital, Victoria, Australia
| | - Jacinta Douglas
- La Trobe University, Melbourne, Victoria, Australia
- Summer Foundation, Melbourne, Victoria, Australia
| | - David Ames
- University of Melbourne, Victoria, Australia
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The assessment experience of spousal dementia care-givers: ‘It's made me realise that I am a person also’. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18000557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractThis article is based on a study that used a validated care-giver assessment instrument known as ‘The C.A.R.E. (Caregivers’ Aspirations, Realities, and Expectations) Tool’ to understand its usefulness in working with older adults caring for a spouse with cognitive impairment. It draws on data collected as part of a larger, quasi-experimental pre- and post-test study examining the impact of a care-giver assessment on older spousal care-givers of a partner with cognitive impairment. One hundred community-living individuals (average age of 74) participated in the study. Participants met with a third-year nursing student who administered The C.A.R.E. Tool. Within three to seven days following this, a research team member conducted a semi-structured interview by telephone. This interview provided participants with the opportunity to comment on their experience and the usefulness of The C.A.R.E. Tool. Transcriptions of the interviews were analysed using a thematic analysis. Results indicate that the assessment experience was evaluated positively by most participants. Two broad themes emerged: assessment encourages care-givers to take stock of their situation, and it provides a relationship with a caring professional. In particular, the assessment experience gave these care-givers to have the opportunity to reflect, while expressing emotions and developing awareness, and provided them with an appreciated relationship with a caring professional who helped to validate and normalise their situation. For care-givers, the results suggest that assessment may serve as a catalyst for taking action in their care-giving situation or turning to services for help. For practitioners, assessment may increase awareness of the experience of spousal care-givers, potentially leading to interventions to support them. This study found that the attitudes and knowledge of practitioners play a role in care-givers’ experience of the assessment as positive. However, the goal of assessment must be clarified, as outcomes of other tools will differ depending on the aims.
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Sandberg LJ. Dementia and the gender trouble?: Theorising dementia, gendered subjectivity and embodiment. J Aging Stud 2018; 45:25-31. [DOI: 10.1016/j.jaging.2018.01.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Riley GA, Evans L, Oyebode JR. Relationship continuity and emotional well-being in spouses of people with dementia. Aging Ment Health 2018; 22:299-305. [PMID: 27809565 DOI: 10.1080/13607863.2016.1248896] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Qualitative research has suggested that spousal experiences of discontinuity in their relationship with a person who has dementia (i.e. the relationship is experienced as radically changed) may contribute to heightened feelings of burden, entrapment, isolation, guilt and intolerance of behaviours that challenge. By contrast, continuity in the relationship may contribute to a greater sense of achievement and gratification from providing care. The present study served as a quantitative test of these suggestions. METHOD A convenience sample of 71 spouses of people with dementia completed three questionnaires - the Zarit Burden Interview (ZBI), the Positive Aspects of Caregiving measure (PAC) and the Birmingham Relationship Continuity Measure (BRCM). RESULTS In accordance with the hypotheses, the experience of greater relationship continuity (higher BRCM scores) was correlated with fewer negative emotional reactions to caregiving (lower ZBI scores; rho = -.795) and more positive emotional reactions (higher PAC scores; rho = .764). CONCLUSIONS The study provided some quantitative support for suggestions arising from qualitative research about how perceptions of continuity/discontinuity in the relationship may impact on the caregiving spouse's emotional well-being. Helping couples to maintain a sense of continuity and couplehood may assist their emotional adjustment to dementia.
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Affiliation(s)
- Gerard A Riley
- a School of Psychology , University of Birmingham , Birmingham , UK
| | - Laura Evans
- b Children's Psychological Services - Fylde Coast , Whitegate Health Centre , Blackpool , UK
| | - Jan R Oyebode
- c Bradford Dementia Group, Faculty of Health Studies , University of Bradford , Bradford , UK
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Bekhet AK, Avery JS. Resilience from the Perspectives of Caregivers of Persons with Dementia. Arch Psychiatr Nurs 2018; 32:19-23. [PMID: 29413066 DOI: 10.1016/j.apnu.2017.09.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 09/14/2017] [Accepted: 09/17/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Abir K Bekhet
- Marquette University College of Nursing, Clark Hall 530 N. 16th Street, Milwaukee, WI 53233, United States.
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Holdsworth K, McCabe M. The Impact of Dementia on Relationships, Intimacy, and Sexuality in Later Life Couples: An Integrative Qualitative Analysis of Existing Literature. Clin Gerontol 2018; 41:3-19. [PMID: 29161218 DOI: 10.1080/07317115.2017.1380102] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES The onset and progression of dementia can have a profound effect on the couple dyad. The aim of this systematic review was to analyze the literature investigating the impact of dementia on the relationships, intimacy, and sexuality in older couples. METHODS A systematic literature search was conducted in May 2016 for relevant research articles. Five databases were searched: Web of Science, PsycINFO, MedLine, Scopus and CINAHL. The reference lists of articles included in the review were screened along with the reference list of other relevant reviews. RESULTS Thirteen studies were identified that investigated relationships, intimacy, and sexuality from the perspective of the partner, the person with dementia or from the perspective of the couple jointly. The analysis revealed several themes including changes in responsibilities and roles, identity and self-esteem, affection, commitment, reciprocity, and sexual activity and satisfaction. CONCLUSION The results strongly suggest dementia has a significant impact on the couple relationship. There is a dearth of research involving the perspective of the person with dementia or the couple jointly. Future research should investigate the impact of dementia on relationships, intimacy, and sexuality from the perspective of partners, the person with dementia, and the couple jointly to ensure the development of appropriate information and services that meet the needs of both people in the couple relationship. CLINICAL IMPLICATIONS Clinicians should work closely with couples to develop tailored information and supports to assist couples in managing the multiple changes that occur in their relationship, intimacy, and sexuality due to dementia.
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Affiliation(s)
- Kristen Holdsworth
- a Institute for Health and Ageing , Australian Catholic University , Melbourne , Australia
| | - Marita McCabe
- a Institute for Health and Ageing , Australian Catholic University , Melbourne , Australia
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The impact of younger-onset dementia on relationships, intimacy, and sexuality in midlife couples: a systematic review. Int Psychogeriatr 2018; 30:15-29. [PMID: 28927483 DOI: 10.1017/s1041610217001806] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The impact of dementia on relationships, intimacy, and sexuality has been documented in later life couples. However, little is known about the experiences of couples living with younger-onset dementia. The aim of this systematic review was to analyze the literature describing the impact of younger-onset dementia on relationships, intimacy, and sexuality in midlife couples. METHODS A systematic literature search was conducted in July 2016 for relevant research papers. Five databases were searched: Web of Science, PsycINFO, MedLine, Scopus, and CINAHL. A quality appraisal checklist was used to assess the methodological quality of included studies. RESULTS Eleven studies were identified that explored relationships, intimacy, and sexuality from the perspective of the spouse, the person with dementia or both members of the dyad. Several themes were identified including shifts in roles and responsibilities, declines in relationship quality, changes in identity, and self-esteem, increasing social isolation and loneliness, shifts in intimacy, and changes in sexual activity. CONCLUSIONS Many of the reviewed studies were subject to a range of methodological issues including small sample sizes, small number of studies, and a reliance on the perspective of only one member of the dyad. Future research should follow couples longitudinally to gain a clearer picture of the impact of younger-onset dementia on the couple relationship over time. The inclusion of people living with younger-onset dementia in research will assist in developing a deeper understanding of the experiences of the individual and dyad.
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Abstract
ABSTRACTThe aim of this interdisciplinary study is to describe and analyse the meaning of love in relationships between couples living with Alzheimer's disease (AD). Despite the wealth of studies describing relationships in the face of AD, little is known about the experience and changing meaning of ‘love’ between spouses when one of them is suffering from AD. A qualitative narrative approach was used to capture what love means for couples when one spouse is living with AD. A combination of open discussion along with a semi-guided interview was conducted with N = 16 spouses of persons living with AD. Data were analysed using Thematic Analysis. A leading theme that emerges from the interviews is that AD provides a significant indicator of the meaning and understanding of the experience of love. Five major types of relationship developments occurred after the disease emerged: love died, love became weaker, love did not change, love was enhanced and the spouse fell in love again. The need for further research is discussed. The findings of this study offer an additional perspective to the existing literature, thereby providing a more comprehensive outlook on marital relationships within the context of AD.
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Intimacy and Sexuality in Institutionalized Dementia Care: Clinical-Ethical Considerations. HEALTH CARE ANALYSIS 2017; 25:52-71. [PMID: 25270505 DOI: 10.1007/s10728-014-0287-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Intimacy and sexuality expressed by nursing home residents with dementia remains an ethically sensitive issue for care facilities, nursing staff and family members. Dealing with residents' sexual longings and behaviour is extremely difficult, putting a burden on the caregivers as well as on the residents themselves and their relatives. The parties in question often do not know how to react when residents express themselves sexually. The overall aim of this article is to provide a number of clinical-ethical considerations addressing the following question: 'How can expressions of intimacy and sexuality by residents with dementia be dealt with in an ethically responsible way?' The considerations formulated are based on two cornerstones: (1) the current literature on older peoples' experiences regarding intimacy and sexuality after the onset of dementia, and (2) an anthropological-ethical framework addressing four fundamental pillars of human existence namely the decentred self, human embodiment, being-in-the-world and being-with-others. The resulting considerations are oriented toward the individual sphere, the partnership sphere, and the institutional sphere. The continuous interaction between these spheres leads to orientations that both empower the residents in question and respect the complex network of relationships that surrounds them.
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Oliveira D, Vass C, Aubeeluck A. Quality of Life on the Views of Older Family Carers of People with Dementia. DEMENTIA 2017; 18:990-1009. [DOI: 10.1177/1471301217700741] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Deborah Oliveira
- Faculty of Medicine and Health Sciences, University of Nottingham, UK
| | - Catherine Vass
- Faculty of Medicine and Health Sciences, University of Nottingham, UK
| | - Aimee Aubeeluck
- Faculty of Medicine and Health Sciences, University of Nottingham, UK
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Older Adult Spouses with Multiple Chronic Conditions: Challenges, Rewards, and Coping Strategies. Can J Aging 2017; 36:209-222. [PMID: 28349856 DOI: 10.1017/s0714980817000095] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
There is a paucity of research exploring how spouses to older adults with multiple chronic conditions make meaning of their caregiving experience. For this study, we asked: What is the experience of spousal caregivers to persons with multiple chronic conditions? We applied Thorne's interpretive description approach, interviewing 18 spouses who provided a rich description of their caregiving experience; interviews were transcribed verbatim and thematically analysed. Themes were categorized according to challenges encountered, rewards gleaned, and sustaining strategies employed by participants in caregiving to their spouse with multiple chronic conditions. Unique findings relate to the challenges inherent in decision-making within the context of multiple chronic conditions. This article begins to address the gap in the literature regarding the caregiving experience within the context of multiple chronic conditions.
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Perception of change in sexual activity in Alzheimer's disease: views of people with dementia and their spouse-caregivers. Int Psychogeriatr 2017; 29:185-193. [PMID: 27719688 DOI: 10.1017/s1041610216001642] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION The onset of Alzheimer's disease (AD) affects couples' relationship. We investigated the perception of change and sexual satisfaction in spouse-caregivers and their partners diagnosed with AD. METHODS We compared 74 dyads of people with Alzheimer's disease (PwAD)/spouse-caregivers and 21 elderly dyads control. We assessed sexual satisfaction with Questionnaire on Sexual Experience and Satisfaction (QSES), cognition using a Mini-Mental State Examination (MMSE), disease severity using a Clinical Dementia Rating scale (CDR), awareness of disease with Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia (ASPIDD), functionality with Pfeffer Functional Activities Questionnaire (FAQ), depressive symptoms with Cornell Scale for Depression in Dementia (CSDD), quality of life using a Quality of Life in Alzheimer's Disease Scale (QoL-AD), and burden using a Zarit Burden Interview (ZBI). RESULTS We found differences between the perception and no perception of change in sexual activity of PwAD (p < 0.001), spouse-caregivers (p < 0.01), and controls (p < 0.05). Moderate to severe sexual dissatisfaction was observed in 36.5% of PwAD, 65% of spouse-caregivers, and 31% of controls. PwAD sexual satisfaction was related to cognitive impairment (p < 0.05). Spouse-caregivers sexual satisfaction was related to gender (p < 0.05) and the presence of sexual activity (p < 0.001). CONCLUSIONS The perception of change with higher sexual dissatisfaction, were significant in PwAD and their spouse-caregivers, in comparison with couples of elderly without dementia.
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Jang HY, Yi M. Hermeneutic Phenomenological Study on Caring Experience of Spouses of Elderly People with Dementia at Home. J Korean Acad Nurs 2017; 47:367-379. [DOI: 10.4040/jkan.2017.47.3.367] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 05/05/2017] [Accepted: 05/06/2017] [Indexed: 11/09/2022]
Affiliation(s)
| | - Myungsun Yi
- College of Nursing · Research Institute of Nursing Science, Seoul National University, Seoul, Korea
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Osman SE, Tischler V, Schneider J. 'Singing for the Brain': A qualitative study exploring the health and well-being benefits of singing for people with dementia and their carers. DEMENTIA 2016; 15:1326-1339. [PMID: 25425445 PMCID: PMC5089222 DOI: 10.1177/1471301214556291] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Dementia has detrimental effects on cognitive, psychological and behavioural functioning, as well as significant impact on those who provide care. There is a need to find suitable psychosocial interventions to help manage the condition, enhance well-being, and to provide support for caregivers. This study explored the impact of Singing for the Brain™, an intervention based on group singing activities developed by The Alzheimer's Society for people with dementia and their carers. This qualitative study used semi-structured interviews with people with dementia and their carers. Ten interviews involving 20 participants were analysed thematically. Social inclusiveness and improvements in relationships, memory and mood were found to be especially important to participants. As well as enjoying the sessions, participants found that attending Singing for the Brain™ helped in accepting and coping with dementia.
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Affiliation(s)
| | | | - Justine Schneider
- The Institute of Mental Health, University of Nottingham, Nottingham, UK
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Hooper EK, Collins T. An occupational perspective of the lived experience of familial dementia caregivers: A thematic review of qualitative literature. DEMENTIA 2016; 18:323-346. [PMID: 27758957 DOI: 10.1177/1471301216672489] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Dementia caregiving is thought to have a negative impact on health and wellbeing. This critical review of qualitative literature explored the lived experience of familial dementia caregivers from an occupational therapy perspective. The method was informed by systematic review and qualitative research methodologies and was structured within the occupational dimensions framework of doing-being-becoming-belonging. A comprehensive search of major databases was undertaken which identified 484 studies on the topic; 14 met the inclusion criteria and were included in the review. Ten themes emerged within the doing-being-becoming-belonging framework from the analysis of the studies. The occupational participation of caregivers is conveyed within the 'doing' domain. Ways in which caregiving impacts upon opportunities for self-nurture are presented within the 'being' domain. The 'becoming' domain elucidates ways in which caregivers redefine themselves, their values and their priorities through their caregiving role. The 'belonging' domain depicts ways in which caregivers' connections with their care recipient and others are shaped over time. Practice implications for health and social care practitioners who work with familial dementia caregivers are presented in light of the findings.
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Affiliation(s)
| | - Tracy Collins
- Directorate of Occupational Therapy, University of Salford, UK
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Spouses' experience of living with a partner diagnosed with a dementia: a synthesis of the qualitative research. Int Psychogeriatr 2016; 28:537-56. [PMID: 26750862 DOI: 10.1017/s1041610215002239] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The majority of people diagnosed with a dementia live at home with the support of their spouse. While this situation has advantages, it brings many challenges for the spouse, particularly dealing with the emotional impact of the behavioral changes associated with the dementia. A growing body of qualitative research has focused on understanding the spousal caregiver perspective of living with a partner diagnosed with dementia. The aim of this study was to complete a synthesis of the results of published qualitative studies that have explored the spousal experience. METHOD An electronic database search of Ovid Medline, CINAHL, EMBASE, and PsychINFO from January 1980 to September 2014 was conducted. Sixteen studies met the inclusion criteria. Verbatim quotes of the participant interview data derived from these studies were collated and a thematic analysis was conducted. RESULTS Synthesis of the published data revealed five major themes. The theme of "loss of partner" was central, and around this central experience spouses described various processes: acknowledging change, being in crisis, adapting and adjusting, accepting and moving forward. CONCLUSIONS These findings provide insights into the day-to-day adjustments and experiences of spousal caregivers whilst highlighting the importance of considering the impact of cognitive decline and dementia in a social-relational context.
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Eifert EK, Adams R, Dudley W, Perko M. Family Caregiver Identity: A Literature Review. AMERICAN JOURNAL OF HEALTH EDUCATION 2015. [DOI: 10.1080/19325037.2015.1099482] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Audulv Å, Packer T, Versnel J. Identifying gaps in knowledge: A map of the qualitative literature concerning life with a neurological condition. Chronic Illn 2014; 10:192-243. [PMID: 25085905 DOI: 10.1177/1742395313516133] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To describe patterns in the qualitative literature regarding the everyday experience of living with a neurological condition; to identify areas of depth as well as gaps in the existing knowledge base. METHODS An extensive search of the literature yielded 474 articles meeting the inclusion criteria. Data extraction, based on scrutiny of both abstract and full text article included country of origin, diagnosis, stated aim, methodological framework/design, participants, and data collection method(s). Studies were categorized into 27 topics within four broad foci. RESULTS Four broad foci describe the field: impact and management, daily activities and occupations, impact on family, and the healthcare experience. Overall the research is unevenly distributed by diagnosis; some are well represented while others are the subject of little research. Even diagnoses well represented in quantity can be limited in breadth. DISCUSSION Possible explanations for the patterns of emphasis include: a focus on issues and problems, highlighted points of contact between patients and healthcare providers, and ability of participants to voice their views. The literature is also characterized by limited across diagnoses research or that comparing the experience of people with different diagnoses. There is a need for more research in particular diagnoses; more varied data collection methods and acknowledgement of ethnicity, gender, discrimination, and social inequalities.
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Affiliation(s)
- Åsa Audulv
- Department of Nursing, Mid Sweden University, Sundsvall, Sweden School of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Tanya Packer
- School of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Joan Versnel
- School of Occupational Therapy, Dalhousie University, Halifax, Canada
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Hong SC, Coogle CL. Spousal Caregiving for Partners With Dementia. J Appl Gerontol 2014; 35:759-87. [DOI: 10.1177/0733464814542246] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 06/01/2014] [Indexed: 11/16/2022] Open
Abstract
Spousal caregiving allows stressed couples to continue living in the community rather than seeking institutional solutions. Dr. Toni Calasanti has postulated that there are gender differences in the care work styles and coping strategies used by spousal caregivers dealing with dementia. While caregiving husbands tend to adopt task-oriented (masculine) approaches, caregiving wives are more likely to take an emotionally focused (feminine) orientation. These differences result in the need for varied interventions. Male caregivers tend toward a managerial approach, whereas female caregivers generally adopt a relational approach. This distinction was examined in the course of a literature review through the deductive process. It was determined that the core thesis of such a gender-based view of care work as a tiered entity threaded with masculinity/femininity remains quite plausible in contrast to models based on self-perceived gender identity of caregivers that require more exploration. Recommendations for future investigations are offered as new questions arise.
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Affiliation(s)
- Sung-chull Hong
- Virginia Center on Aging, School of Allied Health Professions,Virginia Commonwealth University, Richmond, USA
| | - Constance L. Coogle
- Virginia Center on Aging, School of Allied Health Professions,Virginia Commonwealth University, Richmond, USA
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Kindell J, Sage K, Wilkinson R, Keady J. Living with semantic dementia: a case study of one family's experience. QUALITATIVE HEALTH RESEARCH 2014; 24:401-11. [PMID: 24532121 PMCID: PMC4361414 DOI: 10.1177/1049732314521900] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Semantic dementia is a variant of frontotemporal dementia and is a recently recognized diagnostic condition. There has been some research quantitatively examining care partner stress and burden in frontotemporal dementia. There are, however, few studies exploring the subjective experiences of family members caring for those with frontotemporal dementia. Increased knowledge of such experiences would allow service providers to tailor intervention, support, and information better. We used a case study design, with thematic narrative analysis applied to interview data, to describe the experiences of a wife and son caring for a husband/father with semantic dementia. Using this approach, we identified four themes: (a) living with routines, (b) policing and protecting, (c) making connections, and (d) being adaptive and flexible. Each of these themes were shared and extended, with the importance of routines in everyday life highlighted. The implications for policy, practice, and research are discussed.
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Affiliation(s)
| | - Karen Sage
- University of Manchester, Manchester, United Kingdom
| | | | - John Keady
- University of Manchester, Manchester, United Kingdom
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Skaalvik MW, Norberg A, Normann K, Fjelltun AM, Asplund K. The experience of self and threats to sense of self among relatives caring for people with Alzheimer's disease. DEMENTIA 2014; 15:467-80. [PMID: 24535820 DOI: 10.1177/1471301214523438] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This study explored how the relatives of people with Alzheimer's disease expressed Self 2 and Self 3 according to Harré's social constructionist theory of selfhood. Having a relative with Alzheimer's disease affects one's life. In this study, we concentrated on how close relatives of people with Alzheimer's disease experienced their sense of self. This study was descriptive and qualitative. Interviews were conducted with 20 relatives of 10 people with Alzheimer's disease from 2009 to 2011. The data were analysed according to Harré's social constructionist theory of selfhood including Selves 2 and 3. Participants reported that Alzheimer's disease challenged their personal attributes, relations and positioning. Understanding how Alzheimer's disease affects the sense of self among close relatives is important, as this knowledge is pivotal for supporting these relatives who are often informal caregivers in ways that enable a fulfilling and meaningful life.
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Affiliation(s)
- Mari Wolff Skaalvik
- Faculty of Health Sciences, Department of Health Care Sciences, Centre of Care Research, University of Tromsoe, Tromsoe, Norway
| | - Astrid Norberg
- Faculty of Health Sciences, Department of Health Care Sciences, Centre of Care Research, University of Tromsoe, Tromsoe, Norway
| | - Ketil Normann
- Faculty of Health Sciences, Department of Health Care Sciences, Centre of Care Research, University of Tromsoe, Tromsoe, Norway
| | - Aud-Mari Fjelltun
- Faculty of Health Sciences, Department of Health Care Sciences, Centre of Care Research, University of Tromsoe, Tromsoe, Norway
| | - Kenneth Asplund
- Faculty of Health Sciences, Department of Health Care Sciences, Centre of Care Research, University of Tromsoe, Tromsoe, Norway
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Robinson CA, Bottorff JL, Pesut B, Oliffe JL, Tomlinson J. The Male Face of Caregiving. Am J Mens Health 2014; 8:409-26. [DOI: 10.1177/1557988313519671] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this scoping review was to examine the empirical evidence published since 2007 on men as family caregivers of persons with dementia. Searches were conducted on Academic Search Complete, Ageline, CINAHL, Embase, Medline, PsychINFO, Social Work Abstracts, and Web of Science using database-specific controlled (i.e., MeSH terms) vocabulary related to dementia, men, and caregiving. Studies published in English between 2007 and 2012 that provided evidence of the experiences of male family caregivers of persons with dementia were included in the review. A total of 30 articles were selected for inclusion. Studies were grouped into three major themes for review: men’s experiences of caregiving, relational factors, and outcomes of caregiving. The reviewed studies build on and support previous findings related to stress, burden, accessing services, and the importance of relational factors to men’s caregiving experiences. However, there is a need for a framework that explains these findings in relation to masculinities. Such a framework would provide the necessary unifying context for a more powerful explanatory account. Furthermore, there appears to be the potential for great benefit in fully linking men’s caregiver research to men’s health issues as a means to articulate strategies to sustain the health and well-being of men caregivers. This seems especially relevant in light of the closing gender gap in life expectancy, which will ultimately see many men providing direct care to their partners.
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Affiliation(s)
- Carole A. Robinson
- University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
| | - Joan L. Bottorff
- University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
| | - Barbara Pesut
- University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
| | - John L. Oliffe
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Jamie Tomlinson
- University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
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