Using art in an intergenerational program to improve students' attitudes toward people with dementia

Supporting technology access for older adults through in-home, intergenerational involvement: The case for ethnographic methods and student service-learning courses

This editorial comments on the article by Hawley et al. in this issue.

Helping behaviours of community members towards older adults and the related factors: a cross-sectional study

BACKGROUND

Community members can play important roles in helping older adults in their community. This study aimed to clarify the actual situation of community members' helping behaviours towards older adults and examine the related factors.

METHODS

This cross-sectional study was conducted using an online survey system with a sample of 1000 community members in the Tokyo metropolitan area selected using quota sampling. Participants were asked about their experiences with helping an older adult, involvement with older adults with dementia, knowledge of dementia and care resources in the community, and perceptions regarding the community. Content analysis was used to classify participants' freely answered responses about helping behaviours, with logistic regression analysis subsequently used to examine the related factors.

RESULTS

Community members provided older adults with various types of spontaneous help, including help with walking (20.0%), accident care (16.8%), giving directions to a destination (11.6%), accompanying them to a destination (12.9%), and support in daily life (10.4%). In the multinominal logistic regression analysis, advanced helping behaviours were associated with having a family member with dementia, experiences involving people living with dementia, knowledge of dementia and community support centres, and a stronger sense of community integration (P < 0.05). The reasons for not being able to help included being physically unable to (42.5%), not feeling responsible (19.3%), not knowing how to help (17.4%), and hesitating to help (14.4%).

CONCLUSION

The results suggest that providing learning opportunities for community members could further promote their helping behaviours for older adults. These could include interacting with older adults, especially those living with dementia; promoting a sense of community integration; or receiving training in helping actions. Such efforts could support the development of an effective community-based care system for older adults.

The transformative power of participating in Opening Minds Through Art (OMA), an expressive arts program for medical students

Opening Minds Through Art (OMA) is a standardized expressive arts-based program that improves student attitudes toward persons living with dementia. Understanding how this change occurs is important for both educators and clinicians. In this study, narrative analysis was used to explore the impact of OMA on participating medical students. 111 students at six medical schools accepted an invitation to be part of OMA during the 2018-2020 academic years. After completing the program, participants were asked to write briefly about the impact of their OMA experience on their work as future physicians. These narratives were analyzed to identify themes relevant to the impact of the program. Students described appreciating both pragmatic and novel creative experiences in OMA, which differed from their traditional studies. Themes from the evaluation included: Inter and Intrapersonal Connection and Growth; Mastery of Anticipated Challenges; Acquisition of Knowledge and Skills; and Appreciation of Health Care Team Members. Teaching students to embrace clinical work with challenging and perceived "difficult" patients is often unaddressed in the medical school curriculum. This study suggests that the combination of medical knowledge and artistic expression can be used to benefit both students and persons living with dementia.

The Role of an Exoskeleton Simulation of Senescence in Health Sciences Education

Background

Education in the formation of human capital in health constantly presents challenges. New tools in the emerging contexts may strengthen empathic attitudes. We developed an educational intervention that included a senescence simulator and assessed its impact on perception and attitudes in healthcare students.

Methods

A cross-sectional comparative study was conducted that assessed acquired knowledge and self-perception using a semistructured survey administered before and after the demonstration and intervention using the simulator and reported the experience through the role of the patient and caregiver. The data were analyzed statistically to identify the demographic characteristics and differences between the groups of students. The data were analyzed statistically to identify the demographic characteristics and differences between the groups of students in the responses pre-post intervention, using statistical software (IBM SPSS Statistics 26.0).

Results

Of the 256 participants surveyed before the intervention, 93.8% described cognitive deterioration as a significant disability and 53.1% considered the health system to be inadequate in meeting the needs of older individuals. Only 59.8% stated that the current academic training meets the educational requirements for the care of the elderly. In total, 98.9% of the participants reported that the simulator changed their perception by increasing their empathy. In total, 76.2% showed greater sensitivity to older adults and 79.3% reported that the experiential learning consolidated their professionalizing perspective. Among the younger participants (aged 18-20 years), sensitivity and reorientation toward pursuing an associated graduate degree were higher after the intervention (p=0.01).

Conclusions

Educational strategies, such as the senescence simulator, offer an experiential intervention that strengthens the knowledge and attitudes toward older individuals. During the pandemic emergency, it proved to be a useful educational strategy in consolidating caring behavior as a hybrid educational tactic. The senescence simulation enabled the participants to widen their educational and professional schemes to encompass the care of the older population.

Dementia education and training for the general public: A scoping review

The lack of public awareness and understanding of dementia affects the experiences of people living with dementia and their families. Dementia education and training for the general public have been gradually disseminated. We conducted a systematic scoping review guided by PRISMA-ScR to map existing evidence and identify dementia education and training available to the general public. From the four electronic databases, 41 articles were identified. Dementia education has three main purposes: dementia friendliness (n = 25), early diagnosis/help-seeking (n = 10), and prevention (n = 6). Education aimed at dementia friendliness was delivered in the community (n = 6), schools/universities (n =14), workplaces (n = 2), and online (n = 3). Interventions aimed at early diagnosis and prevention were often conducted in communities with middle-aged and older people or specific ethnic groups. Eleven dementia-friendliness studies reported on the interaction with people living with dementia to reduce stigma. Dementia knowledge, attitudes, and preventive behaviors were assessed as outcomes. Though randomized controlled trials were conducted in early diagnosis and prevention studies via e-learning, they were not performed in dementia-friendliness studies. Therefore, there is a need to further accumulate evidence of dementia education for each of these purposes.

Comparing Community-based Intergenerational Activities in Israel: Participants, Programs, and Perceived Outcomes

This study investigated whether the content of different community-based intergenerational programs (IGPs) affects their perceived impact on older and younger participants. Data were collected through direct structured questionnaires administered to 84 older, and 96 younger participants, and were assessed using both quantitative and qualitative analyses. Different IGP types involved participants with differing background characteristics and were associated with different benefits and challenges. In art programs, older participants reported being more active and younger participants indicated more awareness of others, but also greater stress. Learning programs contributed to older persons' happiness, and younger persons' acquisition of new skills, but were also associated with divergent expectations between young and old, and a perception that young participants lacked commitment. Assistance programs attracted older participants with greater needs, and were associated with such benefits as alleviating older persons' loneliness, improving younger participants' satisfaction from helping, but also involved challenges pertaining to the relationship termination. Generally, older participants reported more benefits than younger persons. The results highlight the need to differentiate between IGP types, a distinction not addressed in previous studies. The combination of activity content and participant characteristics and needs may lead to different perceived program impacts.

Comparison of long-term effects of exergaming (Xbox one kinet) and companionship programs on attitude towards dementia and the older adults among adolescents: a quasi-experimental longitudinal study

Background

Many studies have been performed on the use of intergenerational programs to improve the negative attitudes and misunderstandings of adolescents toward older people with dementia. However, the findings of these studies are inconclusive. The aim of this study was to compare the long-term effects of exergaming (Kinect) and companionship programs on attitudes toward dementia and the elderly among adolescents.

Methods

A quasi-experimental longitudinal design was used. A total of 200 adolescents aged 12–18 years old were recruited from nine schools in northern Taiwan. The adolescents were assigned to five different groups, namely, a 5-week exergaming group, a 5-week companion group, an 8-week exergaming group, an 8-week companion group, and a control group, using a single blinding procedure. Data collection was performed pretest, post-test and at 1, 3 and 6 months after the post-test. The long-term effects of the two programs (i.e., exergaming and companionship) were analyzed using a generalized estimating equation.

Results

Regarding attitudes toward dementia, the 8-week exergaming group had a significantly better attitude than the control group at the 6-month follow-up (p < 0.001). Similarly, the results of the 8-week companion group also showed a significantly improved attitude compared with the control group at the 6-month follow-up (p = 0.041). Regarding attitudes toward the elderly, the 8-week exergaming group had a significantly better attitude than the control group at the 6-month follow-up (p < 0.001). The 8-week companion group had a similar effect on better attitude compared with the control group at the 6-month follow-up (p = 0.016). Furthermore, the 5-week companion group showed a significant improvement compared with the control group at the 6-month follow-up (p = 0.004).

Conclusions

Spending companionship time with older adults is beneficial for improving the attitudes of adolescents toward the elderly. Furthermore, exergaming improves the attitudes of adolescents toward both dementia and older adults.

Trial registration

Chinese Clinical Trial Registry: ChiCTR2100053003. Retrospectively registered on 07/11/2021.

Effectiveness and sustainability of volunteering with older people living in care homes: A mixed methods systematic review

Older people living in care homes should be considered part of the wider local community; however, little is known about what enables them to connect with people not paid to look after them or family members. Volunteering can complement paid and familial support. While volunteering is common in community settings, care home residents are less likely to benefit from their input. We conducted a mixed methods systematic review and stakeholder consultation that aimed to identify volunteer activities in care homes and evidence for their effectiveness and sustainability. Databases were searched from 2000 to July 2021. Studies of all designs reporting volunteer-led activities with care home residents 65-years or over were included. Data on interventions, study population, study context, outcomes and implementation issues were extracted and synthesised. We identified 36 studies on the use, effectiveness and implementation of volunteering in care homes, although the overall strength of evidence was weak. Resident engagement and mood appeared to improve during volunteer-led activities, but there was little research examining the longer-term impact. Qualitative and stakeholder data suggest considerable investment is needed to initiate and maintain volunteering initiatives, but there are positive benefits for volunteers, residents and staff if an intervention is sustained. Financial cost for care home facilities is unclear. Interventions that address inequalities in accessing volunteer support within the resident population and between facilities should be considered.

A two-step model for encouraging the general public to exhibit helping behaviors towards people living with dementia

Background and Objectives

Dementia awareness initiatives aim to promote helping behaviors towards people living with dementia. We applied the bystander intervention process model in the context of the general public’s helping behaviors towards people living with dementia, and we sought to identify the mechanisms underlying the association between dementia knowledge and helping behaviors.

Research Design and Methods

In a survey featuring vignettes for the general public in Japan (N = 904), we presented four situations in which people could exhibit helping behaviors towards a person with dementia. Guttman scale analysis was used to test this sequential ordering of the bystander intervention process model: (1) interpreting the need to help, (2) perceiving personal responsibility, and (3) intention to provide help. Mediation analysis was used to examine whether the effects of knowledge on helping behaviors were mediated by attitude towards people living with dementia and the bystander intervention process.

Results

The results support the two-step model in which interpreting the situation as one where assistance is required is a prerequisite of helping behavior. Dementia knowledge had a significant total effect on intention to provide help (β = 0.136, p &lt; 0.001). Interpretation (indirect effect: β = 0.092, p &lt; 0.001), as well as attitude (indirect effect: β = 0.044, p &lt; 0.001), was found to completely mediate the effect of dementia knowledge on intention to provide help.

Discussion and Implications

Dementia awareness initiatives designed to promote helping behaviors should focus on knowledge transfer, improving the general public’s attitudes towards people living with dementia, and their ability to interpret when such people need assistance.

Stigma Reduction Interventions of Dementia: A Scoping Review

Despite its global importance and the recognition of dementia as an international public health priority, interventions to reduce stigma of dementia are a relatively new and emerging field. The purpose of this review was to synthesize the existing literature and identify key components of interventions to reduce stigma of dementia. We followed Arksey and O'Malley's scoping review process to examine peer-reviewed literature of interventions to reduce dementia-related stigma. A stigma-reduction framework was used for classifying the interventions: education (dispel myths with facts), contact (interact with people with dementia), mixed (education and contact), and protest (challenge negative attitudes). From the initial 732 references, 21 studies were identified for inclusion. We found a variety of education, contact, and mixed interventions ranging from culturally tailored films to intergenerational choirs. Findings from our review can inform the development of interventions to support policies, programs, and practices to reduce stigma and improve the quality of life for people with dementia.

Innovation in dementia education within undergraduate healthcare programmes: A scoping review

OBJECTIVES

The increase in the number of people living with dementia has resulted in a greater need for healthcare professionals from all disciplines to meet the needs of those living with the condition. This means a workforce which is competent in delivering dementia care which is person-centred, regardless clinical specialism. The aim of scoping review is to provide an overview of the novel education models being used to ensure the future healthcare workforce are able to meet this aspiration.

DATA SOURCES

Online databases PubMed, Web of Science, CINAHL, Medline, PsychInfo, ERIC were used.

REVIEW METHODS

Search terms 'Healthcare Student(s)', 'Dementia or Alzheimer's Education' were used. Inclusion criteria included papers published in English between 2009 and September 2019, with data pertaining to the assessment of dementia knowledge and attitudes among healthcare students. Abstracts were reviewed and identified for inclusion for full-text review. Included studies were assessed using the MMAT (Mixed Methods Appraisal Tool).

RESULTS

27 studies were included within the review. These were groups into five educational categories; long term experiential (n=5), activity-centered programmes with people with dementia (n=11), interprofessional education (IPE) (n=5), immersive conference style programmes (n=3) and dementia simulation (n=3). Long term experiential and activity centered programmes gave students the greatest increase in perceived confidence, and improvement in dementia attitudes. Programmes were most effective when directly involving people living with dementia.

CONCLUSION

The majority of the education programmes showed a potential benefit in improving either knowledge, confidence, attitude, or all three among healthcare students. This highlights the benefit that novel experiential programmes may have in aiding a culture of positive attitudes among future healthcare professionals who will be treating people with dementia. This review also demonstrates the positive benefit that directly involving people living with dementia within education can have on both student learners.

Attitudes toward people with dementia among communication science and disorders students

The purpose of this study was to: 1) explore attitudes among Communication Sciences and Disorders (CSD) students toward people with dementia, 2) investigate factors that might be associated with the expressed attitudes, and 3) suggest a means for promoting positive attitudes among CSD students. 94 CSD students completed a three-section online survey via Qualtrics. First, participants provided demographic information in three categories: person, courses, and experiences. Second, they completed a 25-item quiz on aging and dementia. Finally, each participant submitted responses to the Scale of Attitude toward People with Dementia. A stepwise regression analysis revealed two factors that best predicted positive attitudes of participants toward people with dementia. The first factor was having completed more courses on gerontology and/or dementia and the second factor was having found the courses beneficial for their future career as speech-language pathologists. The findings of this study imply that providing CSD students with more courses in gerontology and/or dementia may foster more positive attitudes toward people with dementia. These findings indicate that maximum benefit may be achieved by designing courses on gerontology and dementia that include professional practice-oriented activities and assessments.

Allophilia: Increasing college students' "liking" of older adults with dementia through arts-based intergenerational experiences

This study evaluates whether an arts-based intergenerational experience, Opening Minds through Art (OMA), increases positive attitudes or allophilia ("liking for the other"-in this case, older adults with dementia) in students who joined the OMA program as compared with the control group. Pre- and posttests of the Allophilia Scale were used to compare 216 students who participated in OMA and 499 students who did not. Hierarchical regression was used to investigate the association between OMA participation and students' Allophilia scores. After one semester, results showed that OMA participation is significantly positively associated with students' affection, comfort, kinship, engagement, and enthusiasm toward older adults living with dementia. We conclude that increasing students' allophilia toward older adults living with dementia is necessary and possible through well-designed intergenerational experiences.

Psychometric properties of dementia attitudes scale, dementia knowledge assessment tool 2 and confidence in dementia scale in a Greek sample

Aim

Τo validate the Greek version of the Dementia Knowledge Assessment Tool 2, the Dementia Attitudes Scale and Confidence in Dementia Scale.

Design

A quantitative cross-sectional design was applied for translation and validation. The STROBE checklist for observational research has been followed to this survey.

Method

Two hundred and twelve students from the School of Psychology (Aristotle University of Thessaloniki). Psychometric properties were assessed through construct validity (principal component analysis), internal consistency (Cronbach's alpha) and convergent validity.

Results

High internal reliability was found for Confidence in Dementia Scale (α = 0.85), adequate reliability for Dementia Attitudes Scale (α = 0.74) and acceptable reliability for Dementia Knowledge Assessment Tool 2 (α = 0.68). Construct validity was satisfactory for Dementia Attitudes Scale (two factors: social comfort and knowledge). The convergent validity was supported to this survey. All three tools are reliable and valid to measure knowledge, confidence and attitudes towards dementia in Greek research context.

Transforming Undergraduate Student Perceptions of Dementia through Music and Filmmaking

BACKGROUND

With nearly 6 million people with dementia (PWD) in the United States, there is a critical need to build an interprofessional dementia workforce. Among the novel approaches to expanding a new workforce, music and the arts show promise for engaging students and trainees. To understand how and why the arts affect attitudes about and engagement with PWD, we examined a service-learning general education undergraduate course centering on music, filmmaking, and dementia.

METHODS

The undergraduate course curriculum brought students to meet with PWD in dementia care settings, build personalized music playlists, coproduce short films about PWD, and write reflective essays. Two researchers independently completed inductive thematic analysis of the films, essays, and course evaluations. Differences were reconciled by consensus.

RESULTS

A total of 52 students from three classes completed the course; 24 (46%) were majoring in health sciences. Three key themes emerged: (1) Music helps students connect with people living with dementia in meaningful ways; (2) filmmaking offers students the opportunity to share unique, person-centered stories about dementia and music that empower the voices of PWD; and (3) reflective writing enables students to process new experiences and lessons learned. Unexpectedly, 29 students (56%) reported continued engagement with PWD in their careers, families, and communities after course completion.

CONCLUSION

This study identifies reproducible ways in which undergraduate arts courses thematically focused on dementia not only transform student perceptions about dementia but change the ways in which those students choose to engage with PWD following course completion. Arts and music departments may represent an untapped resource for building a geriatrics workforce. J Am Geriatr Soc 68:1083-1089, 2020.

Comparison of attitudes towards persons with dementia, knowledge of dementia and ageism amongst students in Taiwan and Japan: A cross-sectional study

INTRODUCTION

This study aimed to compare the attitudes towards people with dementia, knowledge of dementia and ageism amongst Taiwanese and Japanese dental hygiene students.

MATERIAL AND METHODS

A total of 328 students participated in this cross-sectional study. Attitudes, knowledge and ageism were assessed using self-reports. Participants' association with older adults or persons with dementia was also assessed. Primary outcomes included attitude, knowledge and ageism amongst students. Secondary outcomes were the factors related to their desire to work with persons with dementia.

RESULTS

Data of 175 Taiwanese and 91 Japanese students were analysed. There were significantly more Japanese (69.2%) than Taiwanese (33.2%) students without experience of cohabitation with older adults. More Taiwanese (45.1%) than Japanese students (30.8%) gave a neutral answer regarding their desire to work with persons with dementia. Japanese students scored significantly higher on the attitude and ageism scales than did Taiwanese students; however, the scores of knowledge assessment were approximately the same. Attitude or ageism did not correlate with knowledge amongst students from either country. Logistic regression analysis revealed that the desire to work with persons having dementia was related to ageism and the relationship with these people, irrespective of country.

CONCLUSION

Although the students had comparable levels of knowledge, there existed significant difference in the attitudes and the degree of ageism between students from Taiwan vs Japan. This finding may prompt improvement of education on dementia, where differences in nationality and lifestyle, including the rate of ageing and family structure, are taken into consideration.

Service-Learning with College Students toward Health-Care of Older Adults: A Systematic Review

Service-Learning (SL) has become a teaching methodology that promotes social and personal skills while helping groups in need and at risk of social exclusion. This paper is a systematic review of the literature on SL experiences and research on college subjects in the area of health-care promotion in settings for older adults. After an exhaustive search, 43 peer-reviewed publications were classified according to frequency and geographical distribution, sample and duration of the programs, research methodologies, data collection instruments used, and main outcomes investigated. The results indicate that the research methodologies used tended to be qualitative and mixed, while the variety of samples and duration of interventions was very broad. The instruments used were mainly interviews and questionnaires, and the programs were developed specially in the United States of America. The groups receiving most SL were healthy older adults and older adult populations with aging disabilities and illnesses. The articles in the present review highlight that SL can have a positive effect on older adults' health promotion and can enhance their community participation.

Implementation and impact of unforgettable: an interactive art program for people with dementia and their caregivers

ABSTRACTBackground:Previous research shows that museum programs can be beneficial for the quality of life of people with dementia. This study evaluated the implementation of "Unforgettable," an interactive museum program for people with dementia and their caregivers in the Netherlands, and investigated the impact of the program's implementation on the museums as an organization and on the attitudes toward dementia of the museum staff.

METHOD

Semi-structured interviews were held with 23 stakeholders to identify facilitators and barriers to the implementation of the Unforgettable program in 12 Dutch museums. Based on the model of Meiland et al. (2004), an overview is made of factors influencing the different levels and phases of the implementation process. The impact of Unforgettable on the attitudes of the museum staff was assessed using the Approaches to Dementia Questionnaire (n = 176).

RESULTS

The training in the Unforgettable method, regular evaluation with the program guides and hosts, and cooperation with other organizations appeared essential for successful implementation of Unforgettable. A lack of promotional activities was an impeding factor. Compared to before the implementation, the museum employees' attitudes toward people with dementia became more positive.

CONCLUSION

Both successful dissemination of the Unforgettable program and the more positive attitudes toward dementia of employees in museums implementing this program can contribute to the social participation of people with dementia and thereby to their quality of life.

Moving the needle: Providing evidence based care to older adults with behavioral issues through knowledge translation

Implementing evidence based practices into practice settings is exceedingly difficult. Knowledge translation is a framework used for moving practices from the literature into the real world. This article discusses how six articles in this special issue of Gerontology and Geriatrics Education use various knowledge translation approaches to implement evidence based practices in older adults with behavioral health issues including dementia, delirium and serious mental illness across a variety of settings, as well as lessons learned for future knowledge translation and implementation science studies.