1
|
Clark I. The experiences of people living with dementia and their care partners participating in an online therapeutic songwriting program. DEMENTIA 2024; 23:251-271. [PMID: 38131325 PMCID: PMC10807188 DOI: 10.1177/14713012231224069] [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] [Indexed: 12/23/2023]
Abstract
BACKGROUND AND AIM Despite the impact of dementia on close care relationships, accessible therapeutic services for people living with dementia and their care partners remain scarce. Further, there is an increasing demand for online services, highlighting the need for ongoing telehealth research. This study aimed to explore the experiences of people living with dementia and their informal and formal care partners following participation in a 10-week online therapeutic songwriting program. METHODS The songwriting program included four duo and six group sessions facilitated by a music therapist. Post-program semi-structured interviews were analysed using thematic analysis. FINDINGS Nine people with dementia and six care partners (nine duos) participated in the program. Five duos were in spousal relationships and four people with dementia participated with a formal care partner. Participants attended an average of four duo sessions and three group sessions. Six people with dementia and five care partners participated in post-program interviews. Four themes were developed: (1) No one else does this; (2) It's all about us as people; (3) After the sessions we'd come out buzzing; and (4) The journey was as important as the product. CONCLUSIONS Participants highlighted songwriting as a unique opportunity to connect with music, experience welcomed challenges, and spend 'real time' together. The program drew on participants' lived experience and promoted connection with others, resulting in feelings of enjoyment, enhanced mood, and achievement. Participants valued both the songwriting process and song product, emphasising the importance of sensitive and skilful facilitation. Our findings suggest that these distinct benefits were not available through other support services. Further, online songwriting is a viable option for people living with dementia and their care partners where in-person sessions are not available or accessible.
Collapse
Affiliation(s)
- Imogen Clark
- Faulty of Fine Arts and Music, University of Melbourne, Australia
| |
Collapse
|
2
|
Tasseron-Dries PEM, Smaling HJA, Nakanishi M, Achterberg WP, van der Steen JT. What are best practices for involving family caregivers in interventions aimed at responsive behaviour stemming from unmet needs of people with dementia in nursing homes: a scoping review. BMJ Open 2023; 13:e071804. [PMID: 38149428 PMCID: PMC10711828 DOI: 10.1136/bmjopen-2023-071804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 11/03/2023] [Indexed: 12/28/2023] Open
Abstract
OBJECTIVES This study aimed to determine best practices for involving family caregivers in interventions aimed at preventing and reducing responsive behaviour stemming from unmet needs, including pain. DESIGN Scoping review, reported according to the Preferred Reporting Items for Systematic Reviews, Meta-Analyses extension for Scoping Reviews reporting guideline. DATA SOURCES PubMed, Embase, Emcare, Web of Science, COCHRANE Library, PsycINFO, Academic Search Premier and Cinahl searched up to 23 July 2023. ELIGIBILITY CRITERIA Studies reporting on family involvement in interventions for nursing home residents with dementia were included. DATA EXTRACTION AND SYNTHESIS Two researchers independently extracted the data, followed by a content analysis. RESULTS Of the 1486 records screened, 20 studies were included. Family caregivers were involved in interventions aimed at planning care, life review (eg, documentation of life experiences of their relative), and selecting activities for their relative. Family caregivers preferred an active role in developing optimal care for their relative. Drivers of success and barriers to family involvement centred around three themes: (1) communication between all involved; (2) prerequisites (organisational and other conditions) and (3) personal circumstances (family's coping and skills). CONCLUSION Best practices for involving family caregivers in interventions aimed at addressing responsive behaviour in residents with dementia concerned those interventions in which family caregivers were given an important role in managing responsive behaviour. This means that, in order to achieve an active role of family caregivers in the whole care process, their needs must be taken into account. TRIAL REGISTRATION NUMBER The protocol of the review was regisered at OSF; https://osf.io/twcfq.
Collapse
Affiliation(s)
- Petra E M Tasseron-Dries
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Stichting Warande (Nursing Home Organization), Zeist, The Netherlands
- University Network of the Care Sector South Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Hanneke J A Smaling
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- University Network of the Care Sector South Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Miharu Nakanishi
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- University Network of the Care Sector South Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Jenny T van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Primary and Community Care, and Radboudumc Alzheimer Center, Radboud university medical center, Nijmegen, The Netherlands
| |
Collapse
|
3
|
Masterson-Algar P, Egan K, Flynn G, Hughes G, Spector A, Stott J, Windle G. Hard to Reach and Hidden: Improving the Identification of Young Dementia Carers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7103. [PMID: 38063533 PMCID: PMC10871087 DOI: 10.3390/ijerph20237103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/01/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023]
Abstract
Young dementia carers (YDCs) rarely receive appropriate training and support. Their visibility and identification remain dangerously low, and, consequently, support initiatives being developed are failing to reach them. This study explored the success (or failure) of YDC identification pathways as well as the barriers and enablers to their implementation. An explorative qualitative approach was followed, drawing on the experiences of parents of YDCs, dementia researchers, professionals in the field of dementia/young carers, and young adult carers. Data collection involved semi-structured interviews (n = 17) and a participatory 2-h workshop to discuss and critique preliminary themes as well as explore strategies to increase the visibility and identification of YDCs. Five themes were identified: a "whole-family approach" (as a pathway to identification), "not a carer" (self/family identification), a postcode lottery (high variability of support services), tailored support that is "fit for purpose", and the "power" of peer support. Recommendations on potential initiatives and actions that can help raise awareness and increase the identification success of YDCs are proposed. Our findings support the need for a broad and holistic approach to the identification of YDCs that runs alongside the development of support initiatives that are accessible and relatable. The support itself will play a role in improving subsequent identification or hindering it if not "fit for purpose".
Collapse
Affiliation(s)
- Patricia Masterson-Algar
- School of Medical and Health Sciences, Bangor University, Bangor LL57 2EF, UK; (G.F.); (G.H.); (G.W.)
| | - Kieren Egan
- Department of Computer and Information Science, University of Strathclyde, Glasgow G11 XH, UK;
| | - Greg Flynn
- School of Medical and Health Sciences, Bangor University, Bangor LL57 2EF, UK; (G.F.); (G.H.); (G.W.)
| | - Gwenllian Hughes
- School of Medical and Health Sciences, Bangor University, Bangor LL57 2EF, UK; (G.F.); (G.H.); (G.W.)
| | - Aimee Spector
- Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK; (A.S.); (J.S.)
| | - Joshua Stott
- Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK; (A.S.); (J.S.)
| | - Gill Windle
- School of Medical and Health Sciences, Bangor University, Bangor LL57 2EF, UK; (G.F.); (G.H.); (G.W.)
| |
Collapse
|
4
|
McMahon K, McFerran K, Clark IN, Odell-Miller H, Stensæth K, Tamplin J, Baker FA. Learning to use music as a resource: the experiences of people with dementia and their family care partners participating in a home-based skill-sharing music intervention: a HOMESIDE sub-study. Front Med (Lausanne) 2023; 10:1205784. [PMID: 37275362 PMCID: PMC10232877 DOI: 10.3389/fmed.2023.1205784] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/03/2023] [Indexed: 06/07/2023] Open
Abstract
An increasing number of people with dementia receive informal care from family members to help them remain living in the community. Music therapy is particularly beneficial for supporting the wellbeing of people living with dementia. However, little is known about how music therapy might support people with dementia and their family care partners as dyads. This study explored the experiences of six dyads participating in a 12-week home-based skill-sharing music intervention facilitated by a music therapist. We examined their experiences during the intervention period and in the 3-6 months following. This study was conducted within a larger randomised control trial, HOMESIDE. Data was collected through video-recorded music-based interviews, participant diaries, and a semi-structured interview. Data was analysed using an abductive and relational-centred research approach in consideration of the Contextual Connection Model of Health Musicking for People Living with Dementia and Their Family Care Partners. The study found fifteen themes that describe dyads' supported experiences of sharing music in their homes. These were organised into three global themes: (1) experiences were shaped by complex influences; (2) a connected musical ecosystem; and (3) music was a resource for wellbeing. This study highlighted the important role of personalised facilitation and the therapeutic relationship as dyads learned to use music as a resource through a process of trial and error. The implications for skill-sharing, indirect music therapy and direct music therapy practice are discussed.
Collapse
Affiliation(s)
- Kate McMahon
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Katrina McFerran
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Imogen N. Clark
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, United Kingdom
| | - Karette Stensæth
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Felicity A. Baker
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| |
Collapse
|
5
|
Ramachandran M, Bangera K, Anita Dsouza S, Belchior P. A scoping review of family-centered interventions in dementia care. DEMENTIA 2023; 22:405-438. [PMID: 36495098 DOI: 10.1177/14713012221144485] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Families of persons living with dementia provide varying levels and forms of support to their loved ones and experience changes in familial dynamics, roles, and responsibilities over time. Family-centered care can enable their successful adaptation and participation in meaningful occupations. This scoping review aimed to explore available familycentered interventions for persons living with dementia, with a focus on occupational therapy. Three databases were searched and 31 eligible studies were found. Thirteen family-centered interventions were identified that were mostly multicomponent in nature, of which three involved occupational therapy. These interventions were investigated using a range of study designs and addressed outcomes related to the person with dementia, primary caregiver, and extended social network. With respect to study context, most interventions were developed in the United States and other Western countries with a limited number located in other contexts. The review findings underline the need for developing more family-centered interventions within occupational therapy, particularly for different contexts and cultures, and for translating available interventions to practice.
Collapse
Affiliation(s)
- Meena Ramachandran
- PhD student, School of Physical and Occupational Therapy, 574405McGill University, Montreal, QC, Canada; Research Coordinator, Bridgepoint Collaboratory for Research and Innovation, Toronto, QC, Canada
| | - Kshama Bangera
- PhD Scholar, Department of Occupational Therapy, 76799Manipal College of Health Professions, Manipal Academy of Higher Education, India
| | - Sebestina Anita Dsouza
- Professor, Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, 76799Coordinator, Centre for Studies on Healthy Aging, Manipal Academy of Higher Education, Manipal, India
| | - Patricia Belchior
- Associate Professor, School of Physical and Occupational Therapy, 574405McGill University; Chercheure, Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM)
| |
Collapse
|
6
|
Kokorelias KM, Markoulakis R, Hitzig SL. Considering a Need for Dementia-Specific, Family-Centered Patient Navigation in Canada. J Appl Gerontol 2023; 42:19-27. [PMID: 36503280 DOI: 10.1177/07334648221125781] [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: 12/15/2022] Open
Abstract
Patient navigation has been proposed as a novel family-centered, integrated care model to address the care needs of persons living with dementia and their family caregivers by helping them navigate the complex range of dementia services offered in hospital and community settings. A key informant qualitative descriptive study explored the perspectives of 48 healthcare professionals to explore the need for dementia-specific patient navigation. Data were analyzed thematically. We identified one overarching theme: "Variability in the Need for Illness-Specific Patient Navigation" and five themes that highlight considerations when providing navigation to individuals with dementia: (1) Taking Part in Ongoing Training, (2) Addressing Stigma, (3) Focusing on Quality of Life, (4) Defining Home, and (5) A Continuous Process of Support. These themes provide preliminary insights into the conceptual differences about the need for illness-specific patient navigation and the areas within patient navigation where healthcare professionals are encouraged to find consensus.
Collapse
Affiliation(s)
- Kristina M Kokorelias
- St John's Rehab Research Program, Sunnybrook Health Sciences Centre, 574553Sunnybrook Research Institute, Toronto, ON, Canada
| | - Roula Markoulakis
- Family Navigation Project, 574553Sunnybrook Research Institute, Toronto, ON, Canada.,Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sander L Hitzig
- St John's Rehab Research Program, Sunnybrook Health Sciences Centre, 574553Sunnybrook Research Institute, Toronto, ON, Canada.,Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada to, Rehabilitation Sciences Institute, Temerty Faculty of Medicine University of Toronto, Toronto, ON, Canada
| |
Collapse
|
7
|
Lassell RKF, Cross JE, Schmid AA, Davalos DB, Wood W. Feasibility of an adaptive riding pilot study and acceptability to dementia care partners: "Your spirits are lifted". Complement Ther Med 2022; 71:102897. [PMID: 36342022 DOI: 10.1016/j.ctim.2022.102897] [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: 08/08/2022] [Revised: 09/28/2022] [Accepted: 10/26/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES We sought to assess the feasibility and acceptability of an adaptive riding program with dyads (persons living with dementia, family care partners) and a gardening comparison condition. DESIGN This is a two-arm (adaptive riding and adaptive gardening), mixed methods, convergent, feasibility study that occurred February 2019-June 2019. INTERVENTIONS Upon enrollment, dyads (n=9) self-selected into either community-based adaptive riding (n=5) or adaptive gardening (n=4), two complementary interventions in Northern Colorado. Interventions occurred for hour-long, weekly sessions for eight weeks. OUTCOME MEASURES Feasibility was measured with recruitment (actual/planned, response rate, participants enrolled/month) retention, adherence to study procedures (attendance, retention, fidelity), and data collection processes (planned versus collected); and analyzed with descriptive statistics. Acceptability of adaptive riding was measured with pre/post care partner interviews and analyzed using thematic analysis. Afterwards, findings were converged. RESULTS We recruited n=10/24 dyads (6 dyads per month), with the highest response rates for referrals and in-person events, n=9 dyads enrolled. We adhered to study procedures with attendance (6/8 gardening, 8/8 riding), retention (100%), fidelity (100%) and data collected (98%). Care partners (n=5) found the adaptive riding intervention acceptable with two themes Overall hopes: "Joy in the present moment" and "Experience as a Whole: "Your spirits are lifted," affirming quantitative attendance and retention data. CONCLUSION Findings underscore the feasibility and acceptability of including care partners of persons living with dementia in complementary interventions involving horsemanship activities. Feasibility data can guide study designs and implementation processes for other nature-based complementary interventions for this population.
Collapse
Affiliation(s)
| | | | - Arlene A Schmid
- Department of Occupational Therapy, Colorado State University, USA
| | | | - Wendy Wood
- Departments of Animal Science and Occupational Therapy, Colorado State University, USA
| |
Collapse
|
8
|
Sociocultural insights on dementia care-giving in Arab and Muslim communities: the perspectives of family care-givers. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22000277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Abstract
Little is known about the experiences of informal family care-giving for persons with ADRD in the context of Arab and Muslim communities. This paper offers fresh insight into the less-studied private sphere of the home, showing how families respond to the onset and long-term care of persons with Alzheimer's disease and related dementias (ADRD). It considers the extent to which sociocultural and religious influences are appropriated by family care-givers as coping mechanisms and motivators for care. Drawing upon interviews with 32 family care-givers for older persons living with ADRD in Qatar, findings reveal the intersectionality of the care-giving experience with various sociocultural, religious and emotional influences through seven emergent themes: (a) reasons and motivations for care-giving; (b) role of the extended family; (c) socio-demographic attributes of care-givers, their allocated responsibilities and how these intersect; (d) socio-religious attitudes towards care-giving of older persons; (e) social stigma; (f) personal knowledge of ADRD; and (g) coping mechanisms. The paper is concluded with key implications of these sociocultural insights for theory, policy and practice, which could inform Qatar's health and social care provision sector as well as other Arab and Muslim communities that share similar cultural and religious belief systems.
Collapse
|
9
|
Nguyen AW, Wang F, Qin W, Hamler TC. The Role of Church Support Networks in the Relationship between Discrimination and Psychiatric Disorders among Older African Americans. REVIEW OF RELIGIOUS RESEARCH 2022; 64:35-54. [PMID: 35757388 PMCID: PMC9223494 DOI: 10.1007/s13644-021-00464-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 06/26/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Few studies have examined the effects of discrimination on mental health specifically among older African Americans despite it being a common experience in this population. Further, knowledge on social resources, such as social relationships, that could mitigate the effects of discrimination is limited in this population. Given the historical and contemporaneous importance of the Black church in African American communities, church members are important support network members and a major source of social support for older African Americans. PURPOSE To address these knowledge gaps, this study will (1) examine the association between racial discrimination and psychiatric disorders; and (2) determine whether church relationships moderate the impact of racial discrimination on psychiatric disorders. METHODS Data from African American respondents aged 55 and older were drawn from the National Survey of American Life (N = 837). Church relationship variables included receipt of emotional support from, frequency of contact with, and subjective closeness to church members. Regression analyses were used to test the study aims. RESULTS Analyses indicated that more frequent experiences of racial discrimination were associated with meeting criteria for any DSM-IV disorder and a greater number of DSM-IV disorders. Significant interactions revealed that frequency of contact with and subjective closeness to church members mitigated the association between discrimination and meeting criteria for any 12-month disorder and number of 12-month disorders. CONCLUSIONS AND IMPLICATIONS Altogether, these findings support the literature on the detrimental effects of discrimination on the mental health of older African Americans and provide a more nuanced understanding of the role of church members in the lives of older African Americans. The study findings suggest that church relationships are effective stress coping resources for older African Americans dealing with discrimination. Given the importance and relevance of church members, initial clinical assessments should assess clients' level of religious involvement and relationships with church members.
Collapse
Affiliation(s)
- Ann W Nguyen
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University
| | - Fei Wang
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University
| | - Weidi Qin
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University
| | - Tyrone C Hamler
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University
| |
Collapse
|
10
|
Experience of the Healthcare System for Caregivers of Persons with Dementia. AGING AND HEALTH RESEARCH 2022; 2. [PMID: 36405242 PMCID: PMC9670239 DOI: 10.1016/j.ahr.2022.100061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: Persons with dementia are generally older and often have multiple other chronic conditions, necessitating several healthcare visits each year. Most live in the community supported by unpaid family caregivers who often assist with healthcare management. Little is known about caregiver and person with dementia experience engaging with the healthcare system, which may be more complicated in the context of cognitive changes such as memory loss. Methods: This is a targeted subanalysis of a major code, experience of the healthcare system, which emerged from a qualitative study investigating perspectives of family caregivers (N = 24) of community-dwelling persons with dementia about telemedicine. Results: Caregivers were asked to describe their experiences taking persons with dementia to medical visits. Caregivers’ detailed descriptions of the process resulted in three categories related to their experience of the healthcare system: Preparing for Visits, Visit-Related Time and Travel, and In-Visit Experience. Categories revealed the complexity of dyads’ participation in healthcare both in and around actual clinic visits. Findings also highlighted the often-negative impact of person with dementia cognitive symptoms on various stages of the process, which was partly offset by perceived benefits related to social participation and interactions with care teams. Conclusions: This study improves our understanding of the experience of engaging with the healthcare system for caregivers and persons with dementia. By explicating the complex factors involved with participating in healthcare visits outside the bounds of clinic walls, this study offers insights for clinicians and systems supporting persons with dementia and caregivers.
Collapse
|
11
|
Gaudet K, Couture M, Ducharme F, Saïas T. Caregiver Emotions When Choosing A Living Environment for A Person with Dementia: A Qualitative Study on Social Workers' Perspectives. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2022; 65:78-96. [PMID: 34080529 DOI: 10.1080/01634372.2021.1936330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 06/12/2023]
Abstract
Social workers often address the emotional needs of family caregivers, which are particularly salient during the decision-making process regarding the choice of a living environment for a relative with dementia. In most home care settings, an assessment of caregivers' needs is not part of routine practices. This study aims to describe the intervention strategies adopted by social workers in relation to caregivers' emotions during their decision-making process. A qualitative research design was adopted. Seven social workers were recruited from three health and community service facilities in Montreal, Canada. One group and three individual semi-structured interviews were conducted. Data was analyzed using Miles, Huberman and Saldaña's method (2013). Seven intervention strategies were identified: investigating emotions, acknowledging emotions, encouraging caregivers to carry on their role, focusing on the rational aspects of the decision, mitigating prejudices against nursing homes, mediating family dynamics and acting upon families' needs. Some of these strategies are aimed at social workers meeting the demands of their jobs whilst others are centered around soothing caregiver emotions. These results can inform support services and future interventions by grounding them in the realities of service providers.
Collapse
Affiliation(s)
- K Gaudet
- Department of Psychology, Université De Montréal, Montréal, Canada
| | - M Couture
- Department of Psychology, Université De Sherbrooke, Sherbrooke, Canada
- Integrated Health and Social Services University Network for West-Central Montreal, Centre for Research and Expertise in Social Gerontology (CREGÉS), Montréal, Canada
| | - F Ducharme
- Faculty of Nursing, Université De Montréal, Montréal, Canada
- Montreal Geriatrics University Institute Research Center, Montréal, Canada
| | - T Saïas
- Department of Psychology,Université du Québec à Montréal, Canada
| |
Collapse
|
12
|
Cross H, Dawes P, Hooper E, Armitage CJ, Leroi I, Millman RE. Effectiveness of Hearing Rehabilitation for Care Home Residents With Dementia: A Systematic Review. J Am Med Dir Assoc 2021; 23:450-460.e4. [PMID: 34921761 DOI: 10.1016/j.jamda.2021.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/10/2021] [Accepted: 11/10/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To report the effectiveness of, and barriers and facilitators to, hearing rehabilitation for care home residents with dementia. DESIGN Systematic review. SETTING AND PARTICIPANTS Care home residents with dementia and hearing loss. METHODS No restrictions on publication date or language were set and gray literature was considered. Eligible studies were critically appraised and presented via a narrative review. RESULTS Sixteen studies, most of low to moderate quality, were identified. Hearing rehabilitation, including hearing devices, communication techniques, and visual aids (eg, flashcards), was reported to improve residents' communication and quality of life and reduce agitation, with improvements in staff knowledge of hearing loss and job satisfaction. Residents' symptoms of dementia presented barriers, for example, losing or not tolerating hearing aids. Low staff prioritization of hearing loss due to time pressures and lack of hearing-related training for staff were further barriers, particularly for residents who required assistance with hearing devices. Adopting a person-centered approach based on residents' capabilities and preferences and involving family members facilitated hearing device use. CONCLUSIONS AND IMPLICATIONS Residents with dementia can benefit from hearing rehabilitation. Identifying and implementing efficient, individualized hearing rehabilitation is necessary for those with complex cognitive needs. Increased funding and support for the social care sector is required to address systemic issues that pose barriers to hearing rehabilitation, including time pressures, lack of training for staff and access to audiology services for residents.
Collapse
Affiliation(s)
- Hannah Cross
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, United Kingdom.
| | - Piers Dawes
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, United Kingdom; School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Australia
| | - Emma Hooper
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, United Kingdom; Department of Rehabilitation and Sports Science, Institute of Health, University of Cumbria, United Kingdom
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, University of Manchester, Manchester, United Kingdom; Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom; NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, United Kingdom; NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Iracema Leroi
- Global Brain Health Institute, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Rebecca E Millman
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, United Kingdom; NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| |
Collapse
|
13
|
Family involvement with care homes following placement of a relative living with dementia: a review. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000957] [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
This review updated a previous review [Gaugler JE (2005) Family involvement in residential long-term care: a synthesis and critical review. Aging and Mental Health9, 105–118] and focused on dementia. Fourteen years of development in family involvement with care homes following placement of a relative was explored. The review aimed to investigate two questions: (1) What types of involvement do families have with care homes following placement of people living with dementia? (2) Which factors influence family involvement with care homes? PsycINFO, MEDLINE and CINAHL Plus were searched for publications between January 2005 and December 2018. Thirty-three papers representing 30 studies were included. Papers were appraised using a quality rating tool designed for use with mixed study designs. Studies were of a reasonable quality though some weaknesses included single-site samples, high attrition rates and poor reporting. Twenty-eight papers highlighted types of involvement including collaboration, family–staff relationship development, decision making and visiting. Twenty-five papers pertained to factors influencing involvement, which included outcome of care quality evaluation, wish for recognition and sense of integration into the care team. Type of family involvement has changed over time with increased emphasis on families’ desire for partnership, to be active rather than passive advocates, and to focus on care monitoring and evaluation. Seven themes of family involvement activities are featured and a non-linear process is proposed. When compared to patient and family-centred care principles, an analysis of family involvement types found good fit overall and potential for framework improvements. Over 30 diverse factors influence inter-family variation in the level and nature of family involvement. Consideration of these factors and resolution of the gaps in evidence, including intergenerational and cultural concerns, can improve care home facilitation of family participation. This dementia-specific review is a comprehensive timely complement to Gaugler's seminal work about older adults in care.
Collapse
|
14
|
A third of dying patients do not have end-of-life discussions with a physician: A nationwide registry study. Palliat Support Care 2021; 20:357-362. [PMID: 34158146 DOI: 10.1017/s1478951521000973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of the study was to explore the proportion of adult patients and next-of-kin who had end-of-life (EOL) discussions and associated factors. METHOD A retrospective nationwide registry study was reported with data from the Swedish Register of Palliative Care. All patients in Sweden in hospitals, nursing homes, own homes, community, and palliative care units during 2015-2017 and their next-of-kin were included. Data were reported to the register by healthcare staff, based on diseased patients' records regarding their last days of life, and were voluntary. Descriptive statistics illustrated the proportion of patients/next-of-kin who had EOL discussions and logistic regressions were used to examine associated factors. RESULTS About half of the patients (46%) did have an EOL discussion, but a third (32%) did not. Associated factors of those who did not have an EOL discussion were dementia (48.5%) or stroke (47.5%), older age (38.4%), being female (33.6%), being cared for in a nursing home (41.3%), or hospital (40.3%), having lost decision-making ability months before death (58.9%), and not having a documented decision to shift to EOL care (82.7%). Younger patients diagnosed with cancer and cared for at a palliative unit were more likely to have EOL discussions. The regression analysis showed similar results for next-of-kin. SIGNIFICANCE OF RESULTS The result shows that not all patients with palliative care needs have equal access to EOL discussions, despite efforts at a national level and the recognized benefits of timely communication about the EOL care. Further efforts must be made to achieve EOL discussions for all patients.
Collapse
|
15
|
Patel NK, Masoud SS, Meyer K, Davila AV, Rivette S, Glassner AA, James D, White CL. Engaging multi-stakeholder perspectives to identify dementia care research priorities. J Patient Rep Outcomes 2021; 5:46. [PMID: 34156561 PMCID: PMC8218276 DOI: 10.1186/s41687-021-00325-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/04/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES The purpose of this study was to partner with stakeholders to identify gaps in care for persons living with dementia and their family caregivers and from this list, identify priorities for dementia care research. METHODS Using a community-engaged research approach, a Stakeholder Advisory Council (SAC) consisting of diverse membership including persons living with dementia and family caregivers was convened. Through our work with the SAC, along with input from the wider network through a symposium, webinars, and an online learning community, gaps in dementia care and a list of topics for dementia care research was generated. This list was reduced to 46 topics for dementia care research and sent to stakeholders (persons living with dementia, family caregivers, and health/social care professionals in dementia care) to be prioritized by rating each of the 46 topics as "Not so important," "Important," or "Very important." Priorities for dementia care were summarized by frequencies and proportions. RESULTS A total of 186 participants completed the survey from August through October 2020, including 23 (12.4%) persons living with dementia, 101 (54.3%) family caregivers, and 62 (33.3%) health/social care professionals. Consistent across stakeholder groups was the focus on research on how best to support families following a diagnosis of dementia. Among persons living with dementia, research focused on support for continuing to live in their own homes was ranked as the highest priority, rated by 91.3% as "Very Important". High priority research areas for family caregivers included interventions to slow cognitive decline (76.3%) as well as non-pharmacological approaches to manage behavioral symptoms (74.7%). The highest priority research topics for health/social care professionals were focused on the diagnosis including benefits of an early diagnosis (71.4%), how best to deliver the diagnosis (70.9%), and supports needed following a diagnosis (78.6%). CONCLUSIONS This project draws on the strengths of its multi-stakeholder perspective to support patient-centered outcomes research. Findings are intended to inform those who conduct research and those who fund research about which research topics stakeholders believe are most important and thus have greatest potential to improve the quality of life among people living with dementia and their families.
Collapse
Affiliation(s)
- Neela K Patel
- Geriatrics and Supportive Care, Long School of Medicine, UT Health San Antonio, San Antonio, Texas, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas, USA
| | - Sara S Masoud
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, Texas, USA
| | - Kylie Meyer
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, Texas, USA
| | - Angelica V Davila
- Geriatrics and Supportive Care, Long School of Medicine, UT Health San Antonio, San Antonio, Texas, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas, USA
| | - Sheran Rivette
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, Texas, USA
| | - Ashlie A Glassner
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, Texas, USA
| | - Deborah James
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, Texas, USA
| | - Carole L White
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas, USA.
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, Texas, USA.
| |
Collapse
|
16
|
Clark IN, Baker FA, Tamplin J, Lee YEC, Cotton A, Stretton-Smith PA. "Doing Things Together Is What It's About": An Interpretative Phenomenological Analysis of the Experience of Group Therapeutic Songwriting From the Perspectives of People With Dementia and Their Family Caregivers. Front Psychol 2021; 12:598979. [PMID: 33868077 PMCID: PMC8044441 DOI: 10.3389/fpsyg.2021.598979] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 03/10/2021] [Indexed: 12/13/2022] Open
Abstract
Background The wellbeing of people living with dementia and their family caregivers may be impacted by stigma, changing roles, and limited access to meaningful opportunities as a dyad. Group therapeutic songwriting (TSW) and qualitative interviews have been utilized in music therapy research to promote the voices of people with dementia and family caregivers participating in separate songwriting groups but not together as dyads. Procedures This study aimed to explore how ten people with dementia/family caregiver dyads experienced a 6-week group TSW program. Dyads participated in homogenous TSW groups involving 2-4 dyads who were either living together in the community (2 spousal groups) or living separately because the person with dementia resided in a care home (1 family group, 1 spousal group). The TSW program, informed by personhood, couplehood, family centered and group process frameworks, involved creating original lyrics through song parody and song collage. Qualified Music Therapists facilitated sessions and interviewed each dyad separately. Interviews were analyzed using interpretative phenomenological analysis. Findings Five recurrent group themes were developed, indicating group TSW: (1) was a positive shared experience, benefiting both members of the dyad and motivating further engagement with music; (2) stimulated mental processes and reignited participants' interests and skills; (3) provided meaningful opportunities for reflection and connection with memories and life experiences; and (4) prompted interaction and collaboration, leading to social connections, empathic relationships and experiences of inclusion. Participants also highlighted how: (5) the facilitated process supported engagement, highlighting abilities and challenging doubts. Conclusion Dyads identified group TSW as an opportunity to recognize strengths, voice ideas and opinions, share meaningful experiences, and do "more with music." Participants valued TSW as a new, creative and stimulating experience that enabled connection with self and others and led to feelings of pride and achievement. Our findings further recognize how therapeutic intention and approach were reflected in participants' engagement and responses regardless of dementia stage and type, dyad relationship, or musical background. This research may broaden perspectives and expand understanding about how people with dementia and their family caregivers access and engage in music therapy.
Collapse
Affiliation(s)
- Imogen N Clark
- Melbourne Conservatorium of Music, Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Felicity A Baker
- Melbourne Conservatorium of Music, Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia.,Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Jeanette Tamplin
- Melbourne Conservatorium of Music, Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia.,Austin Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Young-Eun C Lee
- Melbourne Conservatorium of Music, Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia.,Austin Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alice Cotton
- Melbourne Conservatorium of Music, Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Phoebe A Stretton-Smith
- Melbourne Conservatorium of Music, Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|