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Kloos N, Bielderman A, Gerritsen DL. Learning From People With Dementia What Works Well for Well-Being: Interviews and Focus Groups. THE GERONTOLOGIST 2024; 64:gnae077. [PMID: 38953169 PMCID: PMC11308173 DOI: 10.1093/geront/gnae077] [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: 09/29/2023] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Previous research has tended to prioritize the condition of dementia when investigating positive lived experiences, while there is no evidence that well-being becomes fundamentally different when living with dementia. The current exploratory qualitative study examined how people living with dementia describe how they realize their well-being, without treating dementia as a central concern, and specifically addressed people who are successful in maintaining their well-being. RESEARCH DESIGN AND METHODS Semistructured face-to-face interviews (n = 16) and 2 focus groups (n = 13) were conducted with community-dwelling older people living with dementia, aged 65-93 years (68% male). Conversations covered contributors to experienced life satisfaction, and life enjoyment, and were analyzed using inductive thematic analysis. RESULTS Two main themes described how people realize well-being. (1) To live a fulfilling life, participants engaged in activities in order to feel useful and relaxed, and they engaged with others, by interacting and sharing with others, and relying on others. (2) To have a positive attitude toward life, participants appreciated the good things in their current life, their lived life, and about their own person, and positively coped with difficulties by accepting them as part of life, not dwelling on the negative, and actively addressing difficulties. DISCUSSION AND IMPLICATIONS The results appear to reflect universal ways of realizing well-being, justifying the use of universal models of well-being for people living with dementia. We can learn from people living with dementia that living a fulfilling life and having a positive attitude toward life are key to realizing their well-being.
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Affiliation(s)
- Noortje Kloos
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud Alzheimer Center, University Knowledge Network for Older Adult Care Nijmegen (UKON), Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands
- Centre for eHealth and Well-Being Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Overijssel, The Netherlands
| | - Annemiek Bielderman
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud Alzheimer Center, University Knowledge Network for Older Adult Care Nijmegen (UKON), Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands
| | - Debby L Gerritsen
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud Alzheimer Center, University Knowledge Network for Older Adult Care Nijmegen (UKON), Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands
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Morgan BE, Hodgson NA, Massimo LM, Ravitch SM. The Listening Guide: Illustrating an underused voice-centred methodology to foreground underrepresented research populations. J Adv Nurs 2024; 80:3414-3424. [PMID: 38415935 PMCID: PMC11245374 DOI: 10.1111/jan.16054] [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: 03/08/2023] [Revised: 12/08/2023] [Accepted: 12/30/2023] [Indexed: 02/29/2024]
Abstract
AIM To highlight the value of utilizing the Listening Guide methodology for nursing research and provide an exemplar applying this methodology to explore a novel concept in an underrepresented group-inner strength in persons newly diagnosed with mild cognitive impairment along with their care partners. DESIGN Methodology discussion paper. METHODS The exemplar study used the Listening Guide methods for data elicitation and analysis. Methods included adaptations for the study population and novice qualitative researchers. RESULTS The Listening Guide methodology with adaptations enabled the research team to centre the voices of persons living with mild cognitive impairment, highlight an abstract phenomenon and attend to the influences of the sociopolitical context. Further, this methodology helped address common challenges emerging qualitative researchers encounter, including understanding methods of application, engaging reflexively and immersing in the data. CONCLUSION The Listening Guide is a voice-centred qualitative methodology that is well suited to foreground the experiences of groups underrepresented in research and explore emerging phenomena. IMPLICATIONS FOR NURSING Nurses are central to striving for health equity. The Listening Guide methodology offers a valuable and accessible research tool to understand the experiences and needs of underrepresented groups and shape healthcare in response. IMPACT The Listening Guide methodology can be broadly applied to research with persons with mild cognitive impairment, and other underrepresented groups, to explore other phenomena beyond inner strength and move the science forward in representing the perspectives of groups underrepresented by research. PATIENT OR PUBLIC CONTRIBUTION Persons living with cognitive impairment and their care partners participated in study conceptualization, interview guide development, methods development and dissemination plans.
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Affiliation(s)
- Brianna E Morgan
- Division of Geriatric Medicine and Palliative Care, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
- New Courtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Nancy A Hodgson
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
- New Courtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Lauren M Massimo
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
- New Courtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Sharon M Ravitch
- University of Pennsylvania Graduate School of Education, Philadelphia, Pennsylvania, USA
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Foster C. When Patients Are Not Themselves. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2024; 24:119-120. [PMID: 39158430 DOI: 10.1080/15265161.2024.2361878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
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Jackman V, Wolverson E, Clarke C, Quinn C. A participatory approach to understand what might be most meaningful to people living with dementia in a positive psychology intervention. Aging Ment Health 2024; 28:1090-1099. [PMID: 38189283 DOI: 10.1080/13607863.2023.2299967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/12/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVES This study aimed to understand which character strengths are most important for people living with dementia and therefore which strengths-based psychological interventions could be most meaningful and acceptable. METHODS A participatory design, utilising Delphi methodology, was incorporated into an iterative three stage framework: (1) literature reviewed for Positive Psychology (PP) interventions and patient public involvement to define the character strengths; (2) modified Delphi (N = 10) identified which character strengths are most important for living with dementia; (3) focus groups (N = 14) explored which PP interventions are most acceptable and meaningful. Qualitative data from the focus groups was analysed using thematic analysis. RESULTS Love, kindness and humour were deemed the most important character strengths for living with dementia. Qualitative data from the focus groups was captured in three superordinate themes: (1) lack of opportunity not capacity; (2) key considerations of PP interventions for people living with dementia; and (3) potential benefits of PP interventions. CONCLUSIONS Love, kindness and humour come naturally to people with dementia, but people may lack social opportunities to use these strengths. Therefore, a PP intervention promoting positive emotion, social relationships and connection to one's values appears most meaningful and acceptable as this may provide a social context to use and maintain these strengths.
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Affiliation(s)
| | - Emma Wolverson
- School of Psychology and Social Work, University of Hull, Hull
- Dementia UK, London, UK
| | | | - Catherine Quinn
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
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Dowlen R, McPherson DHJ, Swarbrick C, Hoskin L, Thompson J, Keady J. Creating and Reliving the Moment: Using Musical Improvisation and Care Aesthetics as a Lens of Connection and Self-Expression for Younger People Living with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:972. [PMID: 39200583 PMCID: PMC11354167 DOI: 10.3390/ijerph21080972] [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: 06/11/2024] [Revised: 07/15/2024] [Accepted: 07/18/2024] [Indexed: 09/02/2024]
Abstract
Musical improvisation is a generative process of spontaneously creating music 'in the moment'. For people with young onset dementia, musical improvisation provides an extended opportunity for creative self-expression and connection to one's own body and life story. Using visual research methods, including video elicitation interviews, this paper explores the 'in the moment' musical experiences of five people living with young onset dementia who took part in a 15-week improvised music-making programme (Music in Mind). We frame the exploration of the group's musical experiences through the emerging lens of 'care aesthetics'-a concept that identifies the sensory relations and embodied practices between two (or more) people in a caring relationship. In the context of this analysis, we look to the caring practices by, with, and between people living with dementia, their family members, and the musicians who lead the programme and the relationship of these practices to feelings of self-expression and meaningful connection. Musical improvisation has the potential to support the psychological, social, and spiritual wellbeing of people living with young onset dementia. In applying a lens of care aesthetics, it is possible to observe the micro-level experiences of people living with dementia and their family carers.
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Affiliation(s)
- Robyn Dowlen
- Division of Psychology and Mental Health, University of Manchester, Manchester M13 9PL, UK
| | | | - Caroline Swarbrick
- Division of Health Research, Lancaster University, Lancaster LA1 4YW, UK
| | - Lizzie Hoskin
- Manchester Camerata, The Monastery, Manchester M12 5WF, UK
| | - James Thompson
- School of Arts, Languages and Cultures, University of Manchester, Manchester, M13 9PL, UK
| | - John Keady
- Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Prestwich, Manchester M25 3BL, UK
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Skov SS, Berg ME, Andersen JR, Schou-Juul F, Jensen AMB, Folker AP, Lauridsen S. 'We had conversations we wouldn't have had otherwise'-Exploring home-dwelling people with dementia and family members' experiences of deliberating on ethical issues in a literature-based intervention. J Clin Nurs 2024; 33:2719-2731. [PMID: 38528439 DOI: 10.1111/jocn.17138] [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: 10/26/2023] [Revised: 02/07/2024] [Accepted: 03/14/2024] [Indexed: 03/27/2024]
Abstract
AIM To explore home-dwelling people with dementia and family members' perceptions of the feasibility and acceptability of an intervention using dementia-related literature excerpts to facilitate conversations on ethical issues related to living with dementia. BACKGROUND Ethical issues in dementia care emerge throughout the illness. In the early stages, they may involve decisions about disclosing the illness to the family, shifting roles and responsibilities, and considerations of transitioning to a nursing home. Addressing ethical issues and providing adequate support to home-dwelling people with dementia and their families are often lacking. DESIGN An exploratory-descriptive qualitative study. METHODS We conducted eight interviews with 14 home-dwelling persons with dementia and their family caregivers. Six were dyadic interviews, and two were individual interviews with family caregivers. We analysed the interview data using template analysis. We adhered to the COREQ checklist in reporting this study. RESULTS Using excerpts from dementia-related literature was a feasible and acceptable way of initiating discussions on ethical issues among home-dwelling persons with dementia and family caregivers. However, engaging the families of newly diagnosed individuals was challenging due to emotional distress. The intervention provided peer support, including identifying with others and sharing experiences. Moreover, participating couples found intimacy and relational attunement through shared reflections. CONCLUSION Based on the findings, it appears that the participants in this study felt that using excerpts from dementia-related literature to deliberate on ethical issues was feasible and acceptable. Deliberating on ethical issues with peers and family caregivers offers valuable social support and opportunities for strengthening relationships. IMPLICATIONS FOR PATIENT CARE This study makes an important contribution by providing valuable insights into how ethical issues related to living with dementia can be addressed using related literature and suggests how the intervention can be integrated into existing care initiatives for home-dwelling people with dementia and their families. REPORTING METHOD We have adhered to relevant EQUATOR guidelines with the COREQ reporting method. PATIENT OR PUBLIC CONTRIBUTION A healthcare professional working as a so-called dementia coordinator (a title used in the Danish context) was involved in the conduct of this study by being responsible for the recruitment of home-dwelling people with dementia and their family members. Moreover, she had joint responsibility for facilitating the intervention along with the first author.
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Affiliation(s)
- Sofie Smedegaard Skov
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Marie Eva Berg
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Frederik Schou-Juul
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Anja M B Jensen
- Section for Health Services Research, Center for Medical Science and Technology Studies, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anna Paldam Folker
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Sigurd Lauridsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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David AS, Deeley Q. Dangers of self-diagnosis in neuropsychiatry. Psychol Med 2024; 54:1057-1060. [PMID: 38379196 DOI: 10.1017/s0033291724000308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Affiliation(s)
- Anthony S David
- UCL Institute of Mental Health, University College London, London, UK
| | - Quinton Deeley
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Baril A, Silverman M. "We're still alive, much to everyone's surprise": The experience of trans older adults living with dementia in an ageist, cisgenderist, and cogniticist society. J Aging Stud 2024; 68:101208. [PMID: 38458727 DOI: 10.1016/j.jaging.2024.101208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 12/23/2023] [Accepted: 01/02/2024] [Indexed: 03/10/2024]
Abstract
Trans and non-binary older adults living with dementia experience forms of marginalization, pathologization, and discrimination embedded in epistemic violence that leads them to be mistreated and dismissed as knowledgeable subjects. Based on empirical findings from a Canadian study examining the experiences of trans and non-binary people living with dementia and their carers, we combat this epistemic violence by focusing on the first-hand narratives of this population and their carers. Narrative interviews were conducted with six participants (N = 6): four carers of trans and non-binary adults living with dementia and two trans (binary) people living with dementia. Through a thematic analysis, we examine the unique aspects of living with dementia as a trans or non-binary person. First, the findings show how cogniticism impacts the experience of gender identity and cisgenderism, for example through blocked surgeries, excessive gatekeeping, and not being taken seriously by practitioners. Second, the findings discuss how dementia impacts gender identity and cisgenderism, for example, by increasing the need for formal care that can in turn increase vulnerability to structural violence. Third, the findings illustrate how cisgenderism and gender identity impact the experience of dementia and cogniticism, for example by limiting care options and the ability to advocate for oneself. Fourth, the findings highlight the silo mentality among practitioners, since most of them do not work with an intersectional lens. The article concludes by offering recommendations.
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Affiliation(s)
- Alexandre Baril
- School of Social Work, University of Ottawa, 120 University, Room 12025, Ottawa, Ontario K1N 6N5, Canada.
| | - Marjorie Silverman
- School of Social Work, University of Ottawa, 120 University, Room 12044, Ottawa, Ontario K1N 6N5, Canada.
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Yaron G, Bakker F, de Bruin S. In constant search of the good: a qualitative study into insiders' perspectives on living well with dementia. Front Psychiatry 2024; 15:1285843. [PMID: 38362025 PMCID: PMC10867197 DOI: 10.3389/fpsyt.2024.1285843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/16/2024] [Indexed: 02/17/2024] Open
Abstract
Introduction The new concept of 'living well with dementia' is currently gaining traction in practice, policy, and research. However, people with dementia and their carers' own understanding of this concept has not received much scholarly attention. This is because empirical studies into living well with dementia are predominantly quantitative; there are only a few qualitative studies on this topic. This study therefore sets out to investigate what living well means for 'insiders' in an everyday context. Methods To explore insiders' own perspectives on living well with dementia, we conducted interviews and focus group discussions with 21 dementia stakeholders. The study included ten individuals with mild-to-moderate dementia living at home, five family carers who are or have been involved in the care for a person with dementia, and six health and social care professionals. Results Living well with dementia, for our study participants, revolves around shaping their daily lives according to their values. In this sense, living well with dementia is no different than without. As it involves the values of the person with dementia and those of their social network, living well is both an individual and a collective concern. Having dementia undermines people with dementia's ability to substantiate their values, but it is still possible to live well. As they attempt to shape living well with dementia, respondents encounter tensions within the social network and within the person with dementia. To handle these tensions, they work for mutual attunement by using sensitivity and switching between leading and following in social interactions. Discussion Living well with dementia in a daily context is a dynamic process in which people with dementia, family carers, and professionals constantly seek the good together. This insight contributes to a better understanding of stakeholders' ongoing, invisible efforts to mutually attune. It may also help bypass dichotomizing approaches to dementia. Finally, it opens up new venues for research into reciprocity in the care collective. The article closes with recommendations to improve dementia care and support in light of these findings.
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Affiliation(s)
- Gili Yaron
- Research Group ‘Living Well With Dementia’, Windesheim University of Applied Sciences, Department of Health and Well-being, Zwolle, Netherlands
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Gibson C, Yates M, Moore KJ. Lessons learnt from a community-driven digital social connection pilot program for people living with dementia: A qualitative interview study with key stakeholders. Aust J Rural Health 2023; 31:1229-1239. [PMID: 37837265 DOI: 10.1111/ajr.13052] [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: 11/09/2022] [Revised: 08/06/2023] [Accepted: 09/30/2023] [Indexed: 10/15/2023] Open
Abstract
INTRODUCTION In response to COVID-19 and mandated physical distancing, a new digital social connection program was developed and implemented by the local community in a large regional town in western Victoria, Australia. This pilot program, the Digital Inclusion-Social Connections (DI-SC) program, aimed to support people living with dementia to use a digital device to access social connection activities. OBJECTIVE The objective of this study is to inform the local community implementing the DI-SC program of key stakeholder experience of DI-SC process and outcomes to support future development and potential translation of digital social connections programs for people living with dementia. DESIGN Three semi-structured focus groups and two interviews were conducted with a total of fifteen participants. Data was transcribed verbatim and thematically analysed. FINDINGS Three main themes were identified describing factors as influencing the process and outcomes of the DI-SC program: understanding dementia; personal choice and control; and service planning and coordination. Six sub-themes were identified: matching capability; establishing a relationship; creating opportunities for different interactions; ownership of the device, program coordination and defining the volunteer digital mentor role. CONCLUSION Key stakeholders perceived the DI-SC program as an acceptable way of supporting people living with dementia to engage in activities they found enjoyable promoting social connection with care partners and others. DI-SC program outcomes were impacted by inappropriate training and a lack of program coordination. The findings of this study may inform future development and implementation of digital social connection programs for vulnerable populations at risk of social isolation.
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Affiliation(s)
- Caroline Gibson
- Grampians Health, Ballarat, Victoria, Australia
- University of Newcastle, Callaghan, New South Wales, Australia
| | - Mark Yates
- Grampians Health, Ballarat, Victoria, Australia
- Deakin University, Burwood, Victoria, Australia
| | - Kirsten J Moore
- Melbourne Ageing Research Collaboration, National Ageing Research Institute, Parkville, Victoria, Australia
- Medicine - Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
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Kim J, Shin N. Development of the "living well" concept for older people with dementia. BMC Geriatr 2023; 23:611. [PMID: 37773102 PMCID: PMC10542266 DOI: 10.1186/s12877-023-04304-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/10/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND An important goal in dementia care is how people with dementia can be supported in living well. To this end, we need a conceptualization of "living well" that is suitable for older people with dementia and then develop this conceptualization from the perspectives of both older people and caregivers. This study analyzed the concept of "living well" among older people with dementia. METHODS Following Schwartz-Barcott and Kim's hybrid model, this study comprised theoretical, fieldwork, and final analytic phases. In the theoretical phase, we reviewed the extant literature. In the fieldwork phase, we conducted in-depth interviews with 12 participants (five older people with dementia, two family members, and five nurses), followed by qualitative content analysis. In the final analytic phase, we defined the concept of "living well" by comprehensively analyzing the data from the theoretical phase and results from the fieldwork phase. RESULTS We derived physical, mental, and social relationship dimensions of the conceptualization of "living well" for older people with dementia. The physical dimensions were "ability for daily living" and "symptom management." The mental dimensions were "psychological health," "psychological stability," "maintaining identity and growth," and "human dignity." Finally, the social relationship dimensions were "maintaining social relations and community connectivity" and "government support." CONCLUSIONS Our analysis of the concept of "living well" can be used for developing tools and interventions to improve the ability of older people with dementia to live well.
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Affiliation(s)
- Jiyoung Kim
- Department of Nursing, Inha University, 100 Inha-ro, Michuhol-gu, Incheon, 22212, Republic of Korea.
| | - Nayeon Shin
- Unit manager, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
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Birt L, Charlesworth G, Moniz-Cook E, Leung P, Higgs P, Orrell M, Poland F. "The Dynamic Nature of Being a Person": An Ethnographic Study of People Living With Dementia in Their Communities. THE GERONTOLOGIST 2023; 63:1320-1329. [PMID: 36879407 PMCID: PMC10474587 DOI: 10.1093/geront/gnad022] [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: 09/06/2022] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVES A dementia diagnosis can affect social interactions. This study aims to understand how people living with dementia act as social beings within everyday interactions in their local communities. RESEARCH DESIGN AND METHODS Focused ethnography informed by Spradley's approach to data collection and analysis. Observations in community spaces. RESULTS Twenty-nine observations were undertaken in everyday social settings with 11 people with dementia who were part of a longitudinal interview study. Data consisted of 40 hr of observation, and researcher field notes. The overarching theme "the dynamic nature of being a person" encapsulates participants' exhibited experiences in negotiating to attain and sustain an acknowledged place in their communities. Two subthemes characterized contexts and actions: (1) "Being me-not dementia": Participants constructed narratives to assert their ontological presence in social settings. They and others used strategies to mediate cognitive changes evidencing dementia. (2) "Resisting or acquiescing to 'being absent in place'": Participants were often able to resist being absent to the gaze from others, but some social structures and behaviors led to a person being "in place," yet not having their presence confirmed. DISCUSSION AND IMPLICATIONS People living with dementia can actively draw on personal attributes, familiar rituals, objects, and social roles to continue to present themselves as social beings. Identifying how postdiagnosis people may self-manage cognitive changes to retain their presence as a person can help health and social care practitioners and families collaborate with the person living with dementia enabling them to have a continued social presence.
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Affiliation(s)
- Linda Birt
- School Health Sciences, University of East Anglia, Norwich, UK
| | - Georgina Charlesworth
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | | | - Phuong Leung
- Division of Psychiatry, University College London, London, UK
| | - Paul Higgs
- Division of Psychiatry, University College London, London, UK
| | - Martin Orrell
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Fiona Poland
- School Health Sciences, University of East Anglia, Norwich, UK
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Living with dementia during the COVID-19 pandemic: insights into identity from the IDEAL cohort. AGEING & SOCIETY 2023. [DOI: 10.1017/s0144686x22001350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Abstract
The continuing COVID-19 pandemic and social restrictions have impacted on the cognitive decline and mental health of people with dementia. Social isolation and loss of activities due to social restrictions may also have implications as to sense of identity for people with dementia. As part of the INCLUDE (Identifying and Mitigating the Individual and Dyadic Impact of COVID-19 and Life Under Physical Distancing on People with Dementia and Carers) component of the IDEAL (Improving the Experience of Dementia and Enhancing Active Life) cohort study, the overall aim of this subtle realist qualitative study was to explore the perspectives of people with dementia on living through the COVID-19 pandemic within the context of the ‘post-vaccine’ period and the national lockdowns in England and Wales; and to determine perceived challenges to and facilitators of ‘living well’ during the COVID-19 pandemic and beyond as restrictions were eased. In addition, the study findings are considered in relation to understandings of identity in dementia which the broader accounts of living through the pandemic have highlighted. Seven people with mild-to-moderate dementia were interviewed and themes were derived using framework analysis. Themes suggest interviewees' stoic acceptance of the pandemic and social restrictions but also fear of decline related to the temporality of their condition as well as loss of self-confidence to re-engage with the world. Interviewees managed threats to social identity by striving to maintain social and emotional connections, where the importance of a shared, social identity, particularly for people with young-onset dementia, was also apparent. Unlike in previous studies during the pandemic, the relevance of occupation for identity was observed, where maintaining previous or new activities or occupations was important to facilitate identity as well as to keep a sense of purpose. Therefore, as well as supporting people with dementia as the pandemic eases, future research into occupation and identity in dementia is of potential value.
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Shubina I. Scientific Publication Patterns of Systematic Reviews on Psychosocial Interventions Improving Well-being: Bibliometric Analysis. Interact J Med Res 2022; 11:e41456. [DOI: 10.2196/41456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 10/01/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Despite numerous empirical studies and systematic reviews conducted on the effectiveness of interventions improving psychological well-being, there is no holistic overview of published systematic reviews in this field.
Objective
This bibliometric study explored the scientific patterns of the effectiveness of different psychosocial interventions improving well-being among various categories of individuals with mental and physical diseases, to synthesize well-being intervention studies, and to suggest gaps and further studies in this emerging field.
Methods
The bibliometric analysis included identifying the most productive authors, institutions, and countries; most explored fields and subjects of study; most active journals and publishers; and performing citation analysis and analyzing publication trends between 2014 and 2022. We focused on data retrieved from known databases, and the study was conducted with a proven bibliometric approach.
Results
In total, 156 studies were found concerning the research domains and retrieved using LENS software from high-ranking databases (Crossref, Microsoft Academic, PubMed, and Core). These papers were written in English by 100 authors from 24 countries, among which, the leading country was the United Kingdom. Descriptive characteristics of the publications involved an increased number of publications in 2017 (n=35) and 2019 (n=34) and a decreased number in 2021 (n=4). The top 2 leading authors by citation score are James Thomas (3 papers and 260 citations) and Chris Dickens (3 papers and 182 citations). However, the most cited study had 592 citations. BMJ Open (n=6 articles) is the leading journal in the field of medicine; Clinical Psychology Review (n=5), in psychology; and Frontiers in Psychology, in psychological intervention (n=5) and psychology (n=5). The top 2 publishers were Wiley (n=28) and Elsevier (n=25).
Conclusions
This study indicates an overall interest in the declared domains within the last decade. Our findings primarily indicate that psychosocial interventions (PIs) were evaluated as being effective in managing mental and physical problems and enhancing well-being. Cognitive behavioral therapy was assessed as being effective in treating anxiety, psychoeducation in relapse prevention, and gratitude interventions in improving overall health, and the mindfulness approach had a positive impact on decreasing distress and depression. Moreover, all these intervention types resulted in an overall increase in an individuals’ well-being and resilience. Integrating social and cultural factors while considering individual differences increases the efficiency of PIs. Furthermore, PIs were evaluated as being effective in managing symptoms of eating disorders, dementia, and cancer. Our findings could help provide researchers an overview of the publication trends on research domains of focus for further studies, since it shows current findings and potential research needs in these fields, and would also benefit practitioners working on increasing their own and their patients' well-being.
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15
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Amponsem S, Wolverson E, Clarke C. The meaning and experience of hope by people living with dementia as expressed through poetry. DEMENTIA 2022; 22:125-143. [DOI: 10.1177/14713012221137469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Narratives of dementia can undermine the ability of people to live well. Positive psychology, concerned with the cultivation of personal strengths, is a model through which people’s capacity to have positive experiences can be researched. This study explored the meanings and experiences of hope, a positive psychological construct found to facilitate well-being, in people with dementia. Methods People with dementia submitted poems about the meanings and their experiences of hope through an online platform. The submitted poems ( n = 29) underwent thematic analysis. Findings There were three main themes: (1) “ hope is light in the darkness” encapsulated the meaning ascribed to hope as a resource that spotlights what is still possible, (2) “ poetry gives voice to experiences of hope” captured the role of poetry in communicating the otherwise elusive concept of hope, and (3 )“peers uphold hope and cast away the darkness” captured that participants’ hope was blocked by stigmatising views held and expressed by others but facilitated through positive social interactions. Conclusions People are capable of having hope in the context of dementia, with hope being a uniquely functional strength that supports wellbeing. Health professionals, family and society have a clear role in supporting people with dementia to maintain their hope.
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Affiliation(s)
- Sheriffa Amponsem
- Department of Psychological Health, Wellbeing and Social Work, University of Hull, Hull, UK
| | - Emma Wolverson
- Department of Psychological Health, Wellbeing and Social Work, University of Hull, Hull, UK
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16
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Getting lost with dementia: Encounters with the time-space of not knowing. Health Place 2022; 78:102940. [DOI: 10.1016/j.healthplace.2022.102940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/05/2022] [Accepted: 11/09/2022] [Indexed: 11/18/2022]
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17
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Ward R, Rummery K, Odzakovic E, Manji K, Kullberg A, Keady J, Clark A, Campbell S. Taking time: The temporal politics of dementia, care and support in the neighbourhood. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44:1427-1444. [PMID: 36062552 PMCID: PMC9825962 DOI: 10.1111/1467-9566.13524] [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: 10/28/2021] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
Dementia is a global health challenge and currently the focus of a coordinated international response articulated through the notion of 'dementia-friendly communities and initiatives' (DFCIs). Yet, while increasing research attention has been paid to the social and spatial dimensions to life with dementia in a neighbourhood setting, the temporalities of dementia have been largely overlooked. This article sets out different aspects of the lived experience of time for people with dementia and unpaid carers, before exploring the temporal politics of formal dementia care and support. The authors show that time is a site for material struggle and a marker of unequal relations of power. People with dementia and unpaid carers are disempowered through access to formal care, and this is illustrated in their loss of (temporal) autonomy and limited options for changing the conditions of the care received. The authors advocate for a time-space configured understanding of the relationship with neighbourhood and foreground a tempo-material understanding of dementia. Set against the backdrop of austerity policy in the UK, the findings reveal that ongoing budgetary restrictions have diminished the capacity for social care to mediate in questions of social justice and inequality, at times even compounding inequity.
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Affiliation(s)
- Richard Ward
- Faculty of Social SciencesUniversity of StirlingStirlingScotland
| | - Kirstein Rummery
- Faculty of Social SciencesUniversity of StirlingStirlingScotland
| | | | - Kainde Manji
- Independent Researcher (previously Faculty of Social Sciences University of Stirling)StirlingScotland
| | - Agneta Kullberg
- Faculty of Medicine and Health SciencesLinköping UniversityLinkopingSweden
| | - John Keady
- Division of NursingMidwifery and Social WorkUniversity of ManchesterManchesterUK
| | - Andrew Clark
- School of Health and SocietyUniversity of SalfordSalfordUK
| | - Sarah Campbell
- Department of Social Care and Social WorkManchester Metropolitan UniversityManchesterUK
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18
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Intergenerational family relationships and the impact of behavioural variant frontotemporal dementia (bvFTD): a qualitative longitudinal study. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22001088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Research concerning the reciprocal influence of relationships and dementia largely focuses on dyadic relationships despite evidence that whole families are affected. Furthermore, such research generally considers more common forms of dementia such as Alzheimer's disease. Behavioural variant fronto-temporal dementia (bvFTD) primarily although not exclusively affects people below the age of 65 and is distinctly different in its impact from more common forms of dementia, affecting social cognition and therefore relational functioning. We aimed to develop a detailed understanding of intergenerational family experiences of bvFTD over time. We adopted a social constructivist and pluralist approach, using Narrative Thematic Analysis and Grounded Theory. We interviewed seven families in their own homes, including the person with bvFTD, at up to three time-points every six to nine months from 2012 to 2014, resulting in 46 interviews with 19 family members. Three super-ordinate themes were identified: Theme 1: We before bvFTD: cohesive and connected – disconnected and distant; Theme 2: Challenges experienced by us; and Theme 3: Relational outcomes: a changing we – an entrenched we. Results emphasise bvFTD brought early and significant disruption to family relationships. The interplay of prior relational functioning, involving the nature of the relationship for family members, the specific impact of bvFTD on these relationships and family member's understanding of bvFTD was critical to how each family fared over the duration of the research, and the relational outcomes they experienced. These findings suggest health-care practice could enhance its support for families living with bvFTD, through the development of tailored, family-oriented approaches to assessment and practice. Such approaches are necessary to understand how families work together and identify interventions that address the family-specific challenges bvFTD brings. The provision of tailored, relational-focused and specialised information concerning the experience of living with bvFTD is needed to flexibly address families' needs and expectations.
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19
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McGee JS, McElroy M, Meraz R, Myers DR. A qualitative analysis of virtues and strengths in persons living with early stage dementia informed by the values in action framework. DEMENTIA 2022; 22:46-67. [PMID: 36215111 DOI: 10.1177/14713012221131857] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Despite evidence that individuals' virtues and character strengths can contribute to a sense of fulfillment, the majority of dementia research focuses on losses and decline. To date, virtues and character strengths in persons living with dementia is an understudied phenomena. This study begins to addresses this gap in the literature. OBJECTIVES The objectives of this study were to: (1) examine the expression of virtues and character strengths in persons living with dementia in the early stages; and (2) share implications and recommendations for strengths-based clinical practice and future research. METHODS Qualitative data was utilized to examine virtues and character strengths among persons living with dementia. This data was derived from semi-structured interviews with 25 persons living with dementia age 65 or older (average age of 77.88). The interviews were audio recorded with consent, professionally transcribed, audit checked, and subjected to Interpretive Phenomenological analysis which was informed by the Values in Action (VIA) framework. FINDINGS Each of the virtues and 24 corresponding character strengths from the VIA framework were observed in this sample. The most frequently observed character strengths were love, spirituality, perseverance, and gratitude. IMPLICATIONS Persons with dementia continue to express virtues and character strengths in the context of cognitive and functional changes. Positive strengths-based research and clinical practice should highlight and build upon these individual virtues and character strengths.
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Affiliation(s)
- Jocelyn S McGee
- Diane R. Garland School of Social Work, 14643Baylor University, Waco, TX, USA
| | - Michaela McElroy
- Diane R. Garland School of Social Work, 14643Baylor University, Waco, TX, USA
| | - Rebecca Meraz
- Louise Herrington School of Nursing, 14643Baylor University, Waco, TX, USA
| | - Dennis R Myers
- Diane R. Garland School of Social Work, 14643Baylor University, Waco, TX, USA
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20
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Tsuda S, Jinno M, Hotta S. Exploring the meaning of journal writing in people living with dementia: a qualitative study. Psychogeriatrics 2022; 22:699-706. [PMID: 35751403 DOI: 10.1111/psyg.12872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/18/2022] [Accepted: 06/06/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND People living with dementia face a constant struggle in re-establishing their means of living a meaningful life. Journal writing exhibits the potential to help them regain a sense of control over their lives. This study explores the experience, meaning, and value of journal writing for people living with dementia who autonomously engage in the activity. METHODS We conducted individual, semi-structured interviews with eight people living with dementia who each kept a personal, paper-based daily journal. The interviews were thematically analyzed. RESULTS We identified four main themes. Theme 1. Recognition of the harsh reality of life under dementia. Theme 2. Observation of and compensation for weaknesses. Theme 3. Reacknowledgement and reaffirmation of one's identity, and Theme 4. Resignation and regret over comparisons to one's 'former' self. Themes 2 and 3 suggest that journal writing enabled self-reflection on daily activity functions and sense of self. However, Theme 4 represents the downside where an individual more acutely realises their deteriorating condition and regrets over their perceived loss of self. CONCLUSION While acknowledging the possible adverse effect of amplifying pessimistic perceptions toward life, journal writing is a powerful 'self-help' strategy for people living with dementia and provides an avenue to recover and thrive.
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Affiliation(s)
- Shuji Tsuda
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | | - Satoko Hotta
- Hitomachi Lab, Tokyo, Japan.,Graduate School of Health Management, Keio University, Kanagawa, Japan
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21
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Bennett J, Wolverson E, Price E. Me, myself, and nature: living with dementia and connecting with the natural world - more than a breath of fresh air? A literature review. DEMENTIA 2022; 21:2351-2376. [PMID: 35939420 DOI: 10.1177/14713012221117896] [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
OBJECTIVE Despite growing awareness of the importance of engagement with the natural world for people living with dementia, little is known about the impact specifically for people living independently in their own home. This review identifies, analyses and synthesises existing research, incorporating first-person narrative accounts of the benefits and potential challenges experienced in forging meaningful connections with the natural world. METHODS Six databases were searched from February 2000 to February 2021. Relevant organisations and authors were contacted, and a hand search of included study reference lists was conducted. The findings of included studies were synthesised using a thematic analysis approach. FINDINGS Sixteen studies were included: 13 qualitative and three mixed methods. Eight themes and three sub-themes were identified, revealing how contact with the natural world held a significance for people living with dementia, associated with a sense of pleasure, comfort, stimulation, freedom and meaning. Support and the use of adaptive strategies afforded opportunities for continued engagement with meaningful outdoor activities and the promotion of identity, independence, social interaction, enhanced wellbeing and quality of life for people living independently with dementia. CONCLUSION Meaningful connections with the natural world offer far more than a 'breath of fresh air'. When support mechanisms are in place, engaging with the natural world can be a valuable arena for enablement and continuity, providing a sense of connectedness to self, place and others.
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Affiliation(s)
| | - Emma Wolverson
- University of Hull and Humber Teaching NHS Foundation Trust, Hull, UK
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22
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Sutin AR, Luchetti M, Stephan Y, Terracciano A. Self-reported sense of purpose in life and proxy-reported behavioral and psychological symptoms of dementia in the last year of life. Aging Ment Health 2022; 26:1693-1698. [PMID: 34166597 PMCID: PMC8976232 DOI: 10.1080/13607863.2021.1937055] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives:Behavioral and psychological symptoms of dementia (BPSD) are among the most challenging aspects of dementia for individuals living with dementia and their caregivers. Identifying factors associated with resilience to BPSD may inform interventions to reduce them. The present research examines whether purpose in life is associated with BPSD in the last year of life.Method:Participants from the Health and Retirement Study were selected if they reported on their sense of purpose, had evidence of a memory impairment, died across the follow-up, and a proxy completed the End of Life survey that included BPSD (N = 2473). Self-reported sense of purpose was tested as a predictor of the sum of symptoms and each indivdual symptom in the last year of life.Results:Purpose in life was associated with fewer BPSD overall. Of the individual symptoms, purpose was associated with less risk of psychological symptoms, specfiically less depression, periodic confusion, uncontrolled temper, but not with motor or perceptual symptoms.Conclusion: These results are consistent with growing evidence that purpose is associated with better cognitive outcomes. Purpose may be a useful target of intervention to improve outcomes across the spectrum of dementia.
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23
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Thoft DS, Ward A. "Just ask me what it means to live with dementia" - people with mild dementia's strategies and techniques shared through in-depth qualitative interviews. J Clin Nurs 2022; 31:1725-1737. [PMID: 33326649 DOI: 10.1111/jocn.15596] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/23/2020] [Accepted: 11/27/2020] [Indexed: 11/30/2022]
Abstract
This article presents results from interviews with twelve persons with mild dementia about how life had changed since they received their diagnosis, exploring their experiences of dementia and how they manage life by using different strategies and techniques. Knowledge about how people with mild dementia experience life is important to explore through their unique perspective, providing clinical practice with knowledge to improve dementia care. Twelve participants were recruited at a Danish school service for people with mild dementia where they receive cognitive stimulation. Semi-structured interviews were conducted, video recorded, transcribed and analysed by using Max Van Manen's five lifeworld existentials: spatiality, corporeality, temporality, relationality and materiality. SRQR checklist was used. Five themes were identified, illustrating the dilemmas and challenges the participants experience, as all existentials are compromised in some way: living a social and active life regardless of difficulties; trying to look at the bright side of life with dementia; it takes time to adapt but at the same time, time is being lost; it is possible to learn, but it is challenging; to try to remember but keep forgetting. The article concludes that all existentials are negatively influenced by dementia, setting the lifeworld of the participants under pressure. However, they still try to live their lives regardless of the difficulties. The study shows it is possible for people with mild dementia to describe their lived experience of dementia and what strategies and techniques they use to manage life. The experienced dilemmas and challenges in the lifeworld of people with mild dementia are of great relevance to be aware of and address in clinical practice. To support people with dementia to identify relevant strategies and techniques, as expressed in the study, that can support them managing life with dementia.
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Affiliation(s)
| | - Alison Ward
- University of Northampton, University Drive, Northampton, UK
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24
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Chejor P, Laging B, Whitehead L, Porock D. Experiences of older immigrants living with dementia and their carers: a systematic review and meta-synthesis. BMJ Open 2022; 12:e059783. [PMID: 35613772 PMCID: PMC9125757 DOI: 10.1136/bmjopen-2021-059783] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To systematically review and synthesise evidence on the experiences of older immigrants living with dementia and their carers. DESIGN A systematic review and meta-synthesis of qualitative studies. METHODS Studies exploring the experiences of older immigrants living with dementia and their carers were eligible. Databases were searched including CINAHL, MEDLINE, PsycINFO, PubMed, Embase, Web of Science and Cochrane Library from January 2000 to April 2021. Quality assessment was undertaken using the Critical Appraisal Skills Programme checklist for qualitative studies. Data were then synthesised using the thematic synthesis approach. RESULTS The results of this meta-synthesis were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and Enhancing transparency in reporting the synthesis of qualitative research statement. A total of 3857 studies were returned from the database search. Eighteen studies were included for meta-synthesis. Five synthesised findings were identified: living with dementia and caregiving; family relationships; barriers to dementia care services; stigma and discrimination; and legal and financial issues. The experiences of living with dementia and caregiving presented multiple challenges for older immigrants living with dementia and their families. However, there seems to be very little difference between the experiences of those who have migrated to a new country and those who were born and aged in the same country, but the ability to access and use the available services is different. CONCLUSION A lack of culturally appropriate dementia services, language barriers and dementia stigma can impede access to dementia care for older immigrants. Strategies to mitigate these barriers are urgently needed to ensure people from culturally and linguistically diverse backgrounds with dementia and their families have the information, education and support to access dementia services, in addition to research that explores the experiences of culturally and linguistically diverse populations. PROSPERO REGISTRATION NUMBER CRD42021277913.
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Affiliation(s)
- Pelden Chejor
- Centre for Research in Aged Care, Edith Cowan University, Perth, Western Australia, Australia
| | - Bridget Laging
- Centre for Research in Aged Care, Edith Cowan University, Perth, Western Australia, Australia
- Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
| | - Davina Porock
- Centre for Research in Aged Care, Edith Cowan University, Perth, Western Australia, Australia
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25
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O'Malley MP, Shortt O, Carroll C. Representations of the experiences of people with dementia in Irish newspapers. DEMENTIA 2022; 21:1343-1362. [PMID: 35354057 PMCID: PMC9109595 DOI: 10.1177/14713012221077526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The aims of the study were to explore what personal narratives in Irish broadsheet and tabloid newspapers reveal about the lived experience of people with dementia. The sample included twenty narratives collected from five Irish newspapers between 2011 and 2017 inclusively. The relative absence of narratives of people with dementia in Irish newspapers is shown as only twelve of the twenty narratives contained the voice of the person with dementia themselves. Inductive analysis and thematic analysis generated four main themes with a total of thirteen subthemes. The main themes are: (1) Dementia as a personal journey, (2) stereotypes and stigma, (3) barriers and (4) awareness. This study highlights the under-representation of personal narratives of people with dementia in Irish newspapers which is seen as a contributing factor in the lack of understanding and awareness of dementia in society in general. Exploring mediated representations of the lived experience of people with dementia through personal narratives provides insight into the naturalised discourses of dementia which impact on people's lived experiences. (172).
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Affiliation(s)
- Mary-Pat O'Malley
- Discipline of Speech and Language Therapy, 8799NUI Galway, Galway, Ireland
| | - Orlaith Shortt
- Speech and Language Therapy, 8004Carlow/Kilkenny Health Services Executive (HSE), Carlow, Ireland
| | - Clare Carroll
- Discipline of Speech and Language Therapy, 8799NUI Galway, Galway, Ireland
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26
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Lauritzen J, Sørensen EE, Pedersen PU, Bjerrum MB. Needs of carers participating in support groups and caring for a person with dementia: A focused ethnographic study. DEMENTIA 2022; 21:1219-1232. [DOI: 10.1177/14713012211072928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims The aim is to explore and understand how support group participation meets carers’ perceived needs for information and social and emotional support when caring for a person with dementia who lives at home. Design Focused ethnographic design. Methods Participant observations and semi-structured interviews with 25 carers were conducted. An inductive content analysis of the data was performed. Findings Two themes were identified: “Strengthening the sense of self” and “Managing uncertain benefits.” Conclusion Carers’ level of information about dementia was partly met, thereby strengthening their sense of self and joy. Maintaining shared decision-making in financial matters was viewed as an expression of respect and reciprocity. Getting acquainted with peers and dementia coordinators was viewed as emotional and social support but was also used strategically to gain easier access to health care services. By fulfilling their needs, support group meetings became meaningful, which motivated carers to continue providing care.
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Affiliation(s)
- Jette Lauritzen
- Department of Public Health, Health, Aarhus University, Aarhus, Denmark; and Department of Nursing, Aarhus, Faculty of Health Sciences, VIA University College, Aarhus, Denmark
| | - Erik E Sørensen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark; and Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Preben U Pedersen
- Danish Center of Clinical Guidelines, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Merete B Bjerrum
- Department of Public Health, Health, Aarhus University, Aarhus, Denmark
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27
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Living with dementia under COVID-19 restrictions: coping and support needs among people with dementia and carers from the IDEAL cohort. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21001719] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Stringent social restrictions imposed during 2020 to counter the spread of the COVID-19 pandemic could significantly affect the wellbeing and quality of life of people with dementia living in the community and their family carers. We explored the impact of COVID-19 restrictions on people with dementia and family carers in England and considered how negative effects might be mitigated. We conducted semi-structured telephone interviews with 11 people with dementia and 11 family carers who were ongoing participants in the IDEAL cohort during the initial ‘lockdown’ period in May and June 2020, and follow-up interviews with five people with dementia and two carers as restrictions were eased in July. We analysed interview data and triangulated the findings with issues raised in dementia-specific online forums. Findings showed some people with dementia were coping well, but others experienced a range of negative impacts, with varying degrees of improvement as restrictions were eased. The need for clear personalised information relating to COVID-19 and the value of support in the form of regular ‘just checking’ phone calls was emphasised. This exceptional situation provides a natural demonstration of how social and psychological resources shape the potential to ‘live well’ with dementia. While some support is recommended for all, a personalised approach to determine needs and coping ability would ensure that further practical and emotional support is targeted effectively.
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28
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Abstract
Abstract
Having opportunities to make decisions and choices regarding one's life is crucial when living with dementia. This inter-disciplinary study draws on the concept of relational autonomy to explore how working-age people living dementia seek to influence their lives, and what makes it easier or more difficult for them in their everyday life. The data consist of three focus group discussions conducted with 12 retired adults who developed dementia while still employed. The results illuminate various resources that enable a person to (a) handle their difficulties at work and related consequences with dignity, (b) manage everyday tasks and live a fulfilling life, and (c) fight the stigma associated with (working-age) dementia. Challenges related to these aspects reported by the participants reveal gaps and obstacles that impede the full realisation of the rights of people living with early onset dementia. This research highlights the need for workplace education for different stakeholders, equal and ongoing access to guidance and counselling for younger people who live with dementia, and an effort by society as a whole to eradicate stigma.
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29
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Dewitte L, van Wijngaarden E, Schellekens T, Vandenbulcke M, Dezutter J. Continuing to Participate in the Dance of Life as Oneself: The Lived Experience of Meaning in Life for Older Adults With Alzheimer's Disease. THE GERONTOLOGIST 2021; 61:1019-1029. [PMID: 33320192 DOI: 10.1093/geront/gnaa206] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Meaning in life is an important aspect of positive psychological functioning for older adults. Limited work suggests the relevance of the experience of meaning for people with dementia, but research into this experience from their personal perspective is lacking. The current study provides an in-depth investigation of the lived experience of meaning in life for older adults with Alzheimer's disease. RESEARCH DESIGN AND METHODS The study was conducted following the phenomenological reflective lifeworld approach. In-depth interviews were conducted with 16 older adults (+65) with Alzheimer's disease living either at home or in a nursing home in Belgium. Data analysis was an iterative process aimed at illuminating the constituents and essence of the phenomenon. RESULTS The essence of the experience of meaning in life for participants was understood as "continuing to participate in the dance of life as oneself." This experience was further clarified in four closely intertwined constituents: (a) feeling connected and involved, (b) continuing everyday life as oneself, (c) calmly surrendering and letting go, and (d) desiring freedom, growth, and invigoration. DISCUSSION AND IMPLICATIONS Our findings contribute to a deeper understanding of meaning in life as experienced by older adults with Alzheimer's disease themselves. They emphasize the relevance of the concept for psychological dementia research and offer original insight for the inclusion of meaning in life as an important aspect of holistic dementia care.
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Affiliation(s)
- Laura Dewitte
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
| | - Els van Wijngaarden
- Research Group Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands
| | - Tine Schellekens
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
| | | | - Jessie Dezutter
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
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30
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Lau WYT, Stoner C, Wong GHY, Spector A. New horizons in understanding the experience of Chinese people living with dementia: a positive psychology approach. Age Ageing 2021; 50:1493-1498. [PMID: 34107007 DOI: 10.1093/ageing/afab097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Indexed: 12/30/2022] Open
Abstract
As the global average age increases, the incidence of dementia is also rising. Given improvements in diagnosis and life expectancies, people now live longer with dementia. Thus, the wellbeing and quality of life among people living with dementia are increasingly important areas for research. Research with Western populations has recently begun to apply positive psychology concepts to understand wellbeing in people with dementia. Positive psychology focuses on positive emotions and traits that allow individuals to flourish and thrive-it highlights the possibility of positive subjective experiences in the face of loss and functional decline, and contrasts the traditional deficit-focused perception of dementia. Despite being a major driver in the global growth of dementia prevalence, there is a dearth of research using such positive concepts to understand people with dementia in non-Western communities. This review contains discussion of research on positive constructs in Chinese older adults, and parallels between traditional Chinese cultural values and positive psychology. On this basis, we propose the applicability of a positive psychology framework to Chinese people with dementia, and that 'harmony' is an important culturally specific concept to consider in this area of research. A positive psychology approach acknowledges that strengths and positive experiences can endure after dementia diagnosis. This not only adds to the under-researched area of lived experience of dementia in Chinese people, but highlights areas that could be the focus of interventions or measured as outcomes. By improving understanding, this approach also has potential to reduce carer burden and stigma around dementia.
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Affiliation(s)
- Wing Yin Tiffany Lau
- Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 7HB, UK
| | - Charlotte Stoner
- Centre for Chronic Illness and Ageing, School of Human Sciences, University of Greenwich, London SE10 9LS, UK
| | - Gloria Hoi-Yan Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR
| | - Aimee Spector
- Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 7HB, UK
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Pearson M, Clarke C, Wolverson E. The meaning and experience of gratitude for people living with dementia. DEMENTIA 2021; 21:335-352. [PMID: 34461753 DOI: 10.1177/14713012211040675] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
RATIONALE Supporting people to live well with dementia is an international government priority. People living with dementia experience a range of positive emotions despite the challenges associated with dementia. Further research is needed to explore how these positive experiences can be fostered to support well-being. There is empirical evidence of the benefits of gratitude in other clinical groups, but no studies have explored how gratitude is experienced by people living with dementia. METHODS In this mixed-methods study, eight people living with dementia shared their experiences of gratitude through interviews and gratitude diaries. Qualitative data were analysed using interpretative phenomenological analysis. Quantitative data regarding diary use were analysed using descriptive statistics. FINDINGS AND CONCLUSIONS Gratitude holds interpersonal and transpersonal meanings for people living with dementia, balanced with challenges of dementia and ageing. This study offers insight into the existence and relevance of gratitude for people living with dementia, highlighting the importance of using multiple methods in dementia research. Positive psychology interventions informed by these findings may be effective in supporting well-being for people with dementia.
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Affiliation(s)
- Martha Pearson
- Department of Psychological Health and Wellbeing, Faculty of Health Sciences, 4019University of Hull, Hull, UK
| | - Chris Clarke
- Department of Psychological Health and Wellbeing, Faculty of Health Sciences, 4019University of Hull, Hull, UK
| | - Emma Wolverson
- Department of Psychological Health and Wellbeing, Faculty of Health Sciences, 4019University of Hull, Hull, UK
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Li X, Keady J, Ward R. Neighbourhoods and dementia: An updated realist review of the qualitative literature to inform contemporary practice and policy understanding. DEMENTIA 2021; 20:2957-2981. [PMID: 34098765 DOI: 10.1177/14713012211023649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This realist review of the literature provided a contemporary understanding of neighbourhoods and dementia and described how people living with dementia and their neighbourhood interacted via ongoing place-making and remaking processes. Drawing on 44 articles, neighbourhoods were revealed to have fluid and dynamic qualities where people with dementia used their strength and resources to connect to significant people and places. The review also indicated that the person with dementia-neighbourhood relationship was underpinned by four themes: 'home', 'social interactions', 'activities' and 'transportation'. Further research is encouraged to use innovative, participatory methods to explore the neighbourhood-dementia nexus in depth whilst paying close attention to social inclusion and diversity.
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Affiliation(s)
- Xia Li
- 13985National Institute for Health and Care Excellence, Manchester, UK
| | - John Keady
- University of Manchester, Manchester, UK
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Wagner LM, Van Haitsma K, Kolanowski A, Spetz J. Recommendations to Deliver Person-Centered Long-Term Care for Persons Living With Dementia. J Am Med Dir Assoc 2021; 22:1366-1370. [PMID: 34044010 PMCID: PMC8996758 DOI: 10.1016/j.jamda.2021.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/24/2021] [Accepted: 05/05/2021] [Indexed: 12/27/2022]
Abstract
Person-centered care (PCC) is the standard for the delivery of long-term services and supports (LTSS). In this article, we summarize the state of the science on meaningful outcomes and workforce development and discuss what is needed to ensure that person-centered LTSS becomes a universal reality. These 2 themes are intimately related: the dementia care workforce’s capacity cannot be improved until care processes and outcomes that are significant to PCC are explicated. The LTSS workforce needs training in PCC as well as pragmatic measures to assess the quality of the care they provide. We conclude with several recommendations for future policy and practice-oriented workforce research.
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Affiliation(s)
- Laura M Wagner
- Philip R. Lee Institute for Health Policy Studies and the UCSF Health Workforce Research Center on Long-Term Care, University of California, San Francisco, San Francisco, CA, USA.
| | | | - Ann Kolanowski
- College of Nursing, The Pennsylvania State University, State College, PA, USA
| | - Joanne Spetz
- Philip R. Lee Institute for Health Policy Studies and the UCSF Health Workforce Research Center on Long-Term Care, University of California, San Francisco, San Francisco, CA, USA
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Mast BT, Molony SL, Nicholson N, Kate Keefe C, DiGasbarro D. Person-centered assessment of people living with dementia: Review of existing measures. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12138. [PMID: 34095438 PMCID: PMC8149970 DOI: 10.1002/trc2.12138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 10/19/2020] [Accepted: 10/27/2020] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Person-centered care and assessment calls for measurement tools that help researchers and providers understand people with dementia, their social relationships, and their experience of the care environment. This paper reviewed available measures and evaluated their psychometric properties. METHODS Literature searches of major databases (PsycInfo, PubMed, EBSCO, CINAHL) for papers examining person-centered constructs in samples of people living with dementia or mild cognitive impairment. Reliability and validity coefficients were reviewed and reported. RESULTS We identified 26 unique measures that had been tested in samples of people living with dementia. Twelve measures of hope, well-being, engagement, social relationships, meaning, resilience, stigma, spiritual beliefs and practices, values and preferences, and positive psychology constructs had strong psychometric properties in samples with dementia. DISCUSSION A variety of reliability and valid measures were identified for use in person-centered care and research with people living with dementia. Additional measure development is needed for key person-centered concepts including dignity and strengths.
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Affiliation(s)
- Benjamin T. Mast
- Psychological & Brain SciencesUniversity of LouisvilleLouisvilleKentuckyUSA
| | | | | | | | - Diana DiGasbarro
- Psychological & Brain SciencesUniversity of LouisvilleLouisvilleKentuckyUSA
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Moe A, Alnes RE, Nordtug B, Blindheim K, Steinsheim G, Malmedal W. Coping with Everyday Life for Home-Dwelling Persons with Dementia: A Qualitative Study. J Multidiscip Healthc 2021; 14:909-918. [PMID: 33935500 PMCID: PMC8079245 DOI: 10.2147/jmdh.s300676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/03/2021] [Indexed: 01/10/2023] Open
Abstract
Aim This study aimed to gain insight into factors that influence everyday coping strategies as described by persons with early to intermediate dementia. Background Living with dementia presents difficulties coping with everyday life. This study focuses on coping with everyday life for persons with mild to moderate dementia in order to facilitate their ability to live at home. Design A qualitative study. Methods Individual interviews with 12 persons with dementia were conducted in their own homes. Findings Coping with everyday life can be influenced by the experience of the diagnostic process and by information about dementia. It can also be affected by stigmatization of persons with dementia, as well as by challenges in everyday life. In addition, challenges in receiving help may include poor continuity of services and healthcare staff with limited competence. By contrast, person-centered care led to positive experiences that supported everyday coping skills. Most of the respondents wanted to participate in day care several days a week. Other positive experiences were making new friends and participating in meaningful activities; such experiences could enhance to coping strategies. Conclusion To strengthen everyday coping for persons with dementia living at home, there is a need for openness about the disease. Follow-up for persons with dementia must be carried out by reputable professionals trained and educated in dementia care. Finally, the municipalities must have contact persons, dementia coordinator/-team, who are available for persons with dementia at the time of diagnosis position and afterwards.
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Affiliation(s)
- Aud Moe
- Centre of Care Research Central Norway, Faculty of Health Science, Nord University, Bodø, Norway
| | - Rigmor Einang Alnes
- Department of Health Sciences Ålesund, Norwegian University of Science and Technology (NTNU), Ålesund, Norway
| | - Bente Nordtug
- Faculty of Health Science, Nord University, Bodø, Norway
| | - Kari Blindheim
- Centre of Care Research Central Norway, Faculty of Health Science, Nord University, Bodø, Norway.,Department of Health Sciences Ålesund, Norwegian University of Science and Technology (NTNU), Ålesund, Norway
| | - Gunn Steinsheim
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Centre for Development of Institutional and Home Care Services, Åfjord, Norway
| | - Wenche Malmedal
- Centre of Care Research Central Norway, Faculty of Health Science, Nord University, Bodø, Norway.,Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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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.
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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
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Assistive technology designed to support self-management of people with dementia: user involvement, dissemination, and adoption. A scoping review. Int Psychogeriatr 2020; 32:937-953. [PMID: 31762431 DOI: 10.1017/s1041610219001704] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Assistive technology is advocated as a key solution to the need for support among people living with dementia. There is growing awareness of the benefits of user involvement in the design and test of these technologies and the need to identifying applicable and effective methods for implementation. The aim of this review was to explore and synthesize research addressing assistive technology designed to be used by people with dementia for self-management. Further research aims were to explore if and how user involvement, dissemination, and adoption of assistive technology were addressed. METHOD Electronic databases were searched using specified search terms. Key publications and grey literature sources were hand-searched. Materials published until year end 2018 were included. The results were summarized according to the research aims. RESULTS Eleven papers derived from eight studies were included. The studies presented data from prototype design and testing, and the review showed great variation in study scope, design, and methodology. User involvement varied from extensive involvement to no user involvement. Methods for adoption also varied widely and only targeted prototype testing. None of the studies addressed dissemination. CONCLUSION The results of this review underline the need for well-designed high-quality research into all the aspects that are essential to deliver applicable, effective, and sustainable assistive technology to support self-management of people with dementia. There is a need for evidence-based methods to promote and qualify user involvement, dissemination, and adoption. The results also point to the need for standardized outcome measures and standards for conducting and reporting research to improve its quality and impact.
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Using the concept of activity space to understand the social health of older adults living with memory problems and dementia at home. Soc Sci Med 2020; 288:113208. [PMID: 32703683 DOI: 10.1016/j.socscimed.2020.113208] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/11/2020] [Accepted: 07/07/2020] [Indexed: 11/21/2022]
Abstract
Globally as the population ages, the prevalence of dementia will increase. Simultaneously, there is a trend toward people ageing at home. Therefore, more people will be ageing at home with dementia, as opposed to institutional environments. In this context, there has been a recent shift in research exploring ways that people can live well with the consequences of the disease. As a part of this emerging research, the social and spatial aspects of the lives of people living with memory problems are becoming increasingly of interest. The aim of this article is to use the concept of activity space to examine the social health of older adults with memory problems and dementia who live at home. Activity space data were collected from seven older adults experiencing memory problems and living at home in the Netherlands. Using a mixed-methods approach, insight into their activity spaces were gained through walking interviews, 14 days of global positioning system (GPS) movement data, travel diary entries and in-depth interviews. The GPS data, travel diary data and interview transcripts were analyzed using a grounded visualization approach. Our findings show that participants interact independently in routine activity spaces but depend on others to participate in occasional activity spaces. Interactions within both these spaces contribute to the social health of older adults with memory problems and dementia who live at home. Additionally, participants used coping strategies and decision-making to maintain autonomy in daily life. The findings can inform dementia-friendly initiatives and social health care planning.
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Clarke C, Woods B, Moniz-Cook E, Mountain G, Øksnebjerg L, Chattat R, Diaz A, Gove D, Vernooij-Dassen M, Wolverson E. Measuring the well-being of people with dementia: a conceptual scoping review. Health Qual Life Outcomes 2020; 18:249. [PMID: 32709238 PMCID: PMC7382062 DOI: 10.1186/s12955-020-01440-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 06/05/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Enabling people with dementia to 'live well' is a policy and research priority in many countries. However, instruments for measuring outcomes of psychosocial interventions designed to promote well-being in dementia are often derived from a symptom-focused, loss/deficit approach, or from broad quality of life concepts. A pan-European dementia working group called for research on the development of an alternative asset/strengths-based conceptual framework of well-being in dementia. This paper takes forward this recommendation by developing such a framework and using this to map relevant self-report outcome measures. METHODS Three scoping reviews of published studies were conducted iteratively. First, we examined the literature on lived experiences of well-being and quality of life in people with dementia and then the wider dementia literature for application of well-being constructs. The synthesised findings generated conceptual domains of well-being in people with dementia. Corresponding self-report instruments used in dementia research were scoped, categorised within the conceptual framework and their potential value in measuring outcomes for people with dementia was examined. FINDINGS Six conceptual domains for the measurement of well-being and 35 self-report instruments that have been used with people with dementia were identified. Six instruments were developed specifically for people with dementia, five were derived from the gerontological literature and 24 from the well-being literature. Fifteen instruments and one sub-scale have been examined for psychometric properties amongst people with dementia. To date, 20 have been used as outcome measures, with seven measuring change over time. A number of identified instruments utilise traditional retrospective Likert-scaling response formats, limiting their potential for use with some groups of people with dementia. CONCLUSION An assets/strengths-based framework is presented, outlining structural domains for selecting self-report measures of well-being in people with dementia. It provides a foundation for enhancing research into processes and outcomes of psychosocial interventions, including instrument development, more precise matching of intervention aims with outcome measurement, and newer technology-based 'in-the-moment' measurement.
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Affiliation(s)
- Chris Clarke
- Faculty of Health Sciences, University of Hull, Hull, HU6 7RX UK
| | - Bob Woods
- DSDC Wales, Bangor University, Ardudwy, Holyhead Road, Bangor, Gwynedd LL57 2PZ UK
| | - Esme Moniz-Cook
- Faculty of Health Sciences, University of Hull, Hull, HU6 7RX UK
| | - Gail Mountain
- School of Dementia Studies, University of Bradford, Richmond Rd, Bradford, BD7 1DP UK
| | - Laila Øksnebjerg
- Danish Dementia Research Centre, Rigshospitalet, University of Copenhagen, Section 6922, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Rabih Chattat
- Department of Psychology Università di Bologna - Via Zamboni, 33 - 40126 Bologna, Italy
| | - Ana Diaz
- Alzheimer Europe, L-1417 14, rue Dicks, Luxembourg
| | - Dianne Gove
- Alzheimer Europe, L-1417 14, rue Dicks, Luxembourg
| | - Myrra Vernooij-Dassen
- Radboud University Medical Centre, Scientific Center for Quality of Healthcare, IQ Healthcare 114, PO Box 9101, 6500HB Nijmegen, The Netherlands
| | - Emma Wolverson
- Faculty of Health Sciences, University of Hull, Hull, HU6 7RX UK
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Lamont RA, Nelis SM, Quinn C, Martyr A, Rippon I, Kopelman MD, Hindle JV, Jones RW, Litherland R, Clare L. Psychological predictors of 'living well' with dementia: findings from the IDEAL study. Aging Ment Health 2020; 24:956-964. [PMID: 30836765 DOI: 10.1080/13607863.2019.1566811] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objectives: Increasingly, research has explored how psychological resources enable adaptation to illness. However, it is unclear whether psychological resources protect against the potential negative effects on living well with a progressive and life-limiting condition such as dementia. This paper examines the association between psychological resources and the ability to 'live well' with dementia.Method: Data from 1547 people with mild-to-moderate dementia in the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort were used. Multivariate linear regression was employed to examine the association between self-reported measures of psychological resources (self-efficacy, optimism and self-esteem) and indices of capability to 'live well' (quality of life, well-being and life satisfaction).Results: All three measures of psychological resources had positive and independent associations with indices of living well and the effect sizes were similar. Effect sizes reduced when accounting for shared variance between psychological resources, showing some overlap in these constructs.Conclusion: Self-efficacy, optimism and self-esteem were each associated with capability to 'live well'. Overlap between these three resources is evident and when combined they may provide greater resilience when dealing with the challenges of living with dementia. Interventions for people with dementia could seek to improve levels of these potentially-modifiable psychological resources.
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Affiliation(s)
- Ruth A Lamont
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Sharon M Nelis
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Catherine Quinn
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Anthony Martyr
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Isla Rippon
- Department of Clinical Sciences, Brunel University, London, UK
| | - Michael D Kopelman
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - John V Hindle
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Roy W Jones
- Research Institute for the Care of Older People, Bath, UK
| | | | - Linda Clare
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
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Buggins SL, Clarke C, Wolverson E. Resilience in older people living with dementia - A narrative analysis. DEMENTIA 2020; 20:1234-1249. [PMID: 32460547 DOI: 10.1177/1471301220927614] [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] [Indexed: 11/16/2022]
Abstract
Dominant discourses surrounding dementia tend to focus on narratives of loss and decline. Simultaneously, individuals living with dementia are vulnerable to being dispossessed of personal narratives supportive of identity and well-being. How older people with dementia story their experiences of resilience in this context has not previously been investigated. In response, this qualitative study utilised a narrative approach to understand lived experiences of resilience shared by eight older people living with dementia. Structural analyses indicated that participants' personal narratives regarding resilience in living with dementia contained distinct and common phases (The Diagnosis, Initial Tasks, 'The High Point', Reflecting on Limitations and Focusing on Today) as well as a variety of dynamic characters. Overarching themes within participants' narratives included sense of self/identity, being connected to others, sense of agency and having positive attitudes. Participants narrated richer, more active personal stories than those typically represented in dominant social discourses surrounding dementia. As such, their narratives depict lived experiences of resilience that unfolded over time in response to adversity and uncertainty and involved a dialectical process in relation to adjustment and well-being. The findings have important implications for the way resilience in living with dementia is framed and supported.
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Ibsen TL, Kirkevold Ø, Patil GG, Eriksen S. People with dementia attending farm-based day care in Norway - Individual and farm characteristics associated with participants' quality of life. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1038-1048. [PMID: 31884707 DOI: 10.1111/hsc.12937] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/29/2019] [Accepted: 12/10/2019] [Indexed: 06/10/2023]
Abstract
Farm-based day care for people with dementia is supposed to improve the participants quality of life by using activities and resources of the farm environment to promote mental and physical health. In this paper, we describe the characteristics of those attending farm-based day care services in Norway and explore the association between individual and farm characteristics and the quality of life. A sample of 94 people with dementia who attended farm-based day care was recruited from 25 farms between January 2017 and January 2018. The data collection was performed using standardized instruments. Information about the farms was retrieved from a former study. The association between the participants' quality of life and their individual and/or farm characteristics was examined with a linear multilevel regression model. The participants had a mean age of 76 years, 62% were men, and 68% had additional education after primary school. Most of them had mild (54.3%) or questionable dementia (18.3%). A few participants used antipsychotics (3.7%), tranquilizers (9.9%) and painkillers (13.6%), while a higher number used antidepressants (30.9%). Quality of life was associated with the experience of having social support (p = .023), a low score on depressive symptoms (p < .001), and spending time outdoors at the farm (p < .001). The variation between the farm-based day care services in the participants' reported quality of life was related to time spent outdoors at the farm. In light of the present study, it seems as farm-based day care is addressing people with dementia in an early stage, dominated by men, with quite good physical and medical condition. The strong association between quality of life and spending time outdoors underscores that facilitation for outdoor activity should be prioritized in all types of dementia care.
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Affiliation(s)
- Tanja L Ibsen
- Norwegian National Advisory Unit on Aging and Health (Aging and Health), Vestfold Hospital Trust, Tønsberg, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Øyvind Kirkevold
- Norwegian National Advisory Unit on Aging and Health (Aging and Health), Vestfold Hospital Trust, Tønsberg, Norway
- Department of Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
- Centre of Old Age Psychiatry Research, Innlandet Hospital Trust, Gjøvik, Norway
| | - Grete G Patil
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | - Siren Eriksen
- Norwegian National Advisory Unit on Aging and Health (Aging and Health), Vestfold Hospital Trust, Tønsberg, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
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Birt L, Griffiths R, Charlesworth G, Higgs P, Orrell M, Leung P, Poland F. Maintaining Social Connections in Dementia: A Qualitative Synthesis. QUALITATIVE HEALTH RESEARCH 2020; 30:23-42. [PMID: 31550999 DOI: 10.1177/1049732319874782] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The clinical symptoms of dementia include difficulty with speech, poor short-term memory, and changes in behavior. These symptoms can affect how the person with dementia understands and performs in social interactions. This qualitative review investigated how people with mild to moderate dementia managed social connections. A systematic search of social science databases retrieved 13 articles; data were synthesized using thematic analysis. Results established the work undertaken by people with dementia to maintain and present a social persona seen as socially acceptable. Interpretations are contextualized within Goffman and Sabat's theories on "self." People with dementia were agentic in impression management: undertaking work to maintain recognized social roles, while being aware of when their illness led to others discrediting them. Wider recognition of strategies used to maintain a social self could inform interventions designed to increase capability and confidence in co-managing social connections following dementia diagnosis.
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Affiliation(s)
- Linda Birt
- University of East Anglia, Norwich, United Kingdom
| | | | - Georgina Charlesworth
- University College London, London, United Kingdom
- North East London NHS Foundation Trust, London, United Kingdom
| | - Paul Higgs
- University College London, London, United Kingdom
| | - Martin Orrell
- University of Nottingham, Nottingham, United Kingdom
| | - Phuong Leung
- University College London, London, United Kingdom
| | - Fiona Poland
- University of East Anglia, Norwich, United Kingdom
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Walsh S, O'Shea E, Pierse T, Kennelly B, Keogh F, Doherty E. Public preferences for home care services for people with dementia: A discrete choice experiment on personhood. Soc Sci Med 2020; 245:112675. [DOI: 10.1016/j.socscimed.2019.112675] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 11/04/2019] [Accepted: 11/08/2019] [Indexed: 11/16/2022]
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Olsson A, Skovdahl K, Engström M. Strategies used by people with Alzheimer's disease for outdoor wayfinding: A repeated observational study. DEMENTIA 2019; 20:505-517. [PMID: 31874572 DOI: 10.1177/1471301219896453] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to describe the wayfinding strategies used during outdoor walks by people with Alzheimer's disease. Inspired by an ethnographic approach, observations and conversations during repeated outdoor walks with five people with Alzheimer's disease living in their own homes were conducted. Data were analyzed using qualitative content analysis. The wayfinding strategies the participants described were: (1) landmarks, (2) used their senses, (3) stopped, looked around, and thought, (4) walking the same way or loop and in familiar areas, and (5) only walked in places and on routes where they could see other people and houses. Using wayfinding strategies might help people with Alzheimer's disease to be independent during outdoor walks, and discussing these strategies with relatives and nursing care staff may help finding people with Alzheimer's disease if lost outdoors. Wayfinding during the winter might be facilitated if temporary and changeable objects are avoided in people with Alzheimer's disease's walking route.
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Affiliation(s)
- Annakarin Olsson
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Kirsti Skovdahl
- Faculty for Health and Social Sciences, University College in Southeast-Norway, Drammen, Norway
| | - Maria Engström
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Nursing Department, Lishui University, Zhejiang, China
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Personhood and Dementia Care: A Qualitative Evidence Synthesis of the Perspectives of People With Dementia. THE GERONTOLOGIST 2019; 61:e85-e100. [DOI: 10.1093/geront/gnz159] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background and Objectives
Personhood is considered the cornerstone of person-centered care for people with dementia. However, there is little research on personhood in dementia care from the perspective of the person with dementia themselves. This article presents a qualitative evidence synthesis of the experiences and perceptions of people with dementia on personhood in dementia care.
Research Design and Methods
A systematic search of nine databases was conducted. In addition to initial screening, CART analysis was used to determine the most relevant papers. Thematic synthesis was conducted on 20 papers. The CASP tool was used to examine the quality of the included papers. GRADE CERQual analysis examined confidence in the review findings.
Results
People with dementia experience many changes due to the disease and the experience of being cared for in different settings. Personhood is affirmed through personal interactions with family, friends, other care recipients, and formal caregivers, as well as through continued engagement in social and occupational roles.
Discussion and Implications
The review has important implications for practice, regulation, and policy. The person and their personhood should be protected rather than undermined, and relationships should be enhanced not diminished by the formal care process. The focus should be on creating and amplifying opportunities for people with dementia to affirm the self through interactions with others and engaging in occupational and social roles to ensure continuity of self.
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Hicks B, Innes A, Nyman SR. Experiences of rural life among community-dwelling older men with dementia and their implications for social inclusion. DEMENTIA 2019; 20:444-463. [PMID: 31718267 DOI: 10.1177/1471301219887586] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Current international dementia care policies focus on creating 'dementia-friendly' communities that aim to support the social inclusion of people with dementia. Although it is known that the geo-socio-cultural rural environment can impact on the experiences of people living with dementia, this can be overlooked when exploring and implementing social inclusion policies. This paper addresses an important gap in the literature by exploring the perceptions of daily life for older men (65+ years) living with dementia in three rural areas of England. Open interviews were conducted with 17 rural-dwelling older men with dementia and the data elicited were analysed thematically to construct two higher order themes. The first focussed on 'Cracking on with life in a rural idyll' and highlighted the benefits of rural living including the pleasant, natural environment, supportive informal networks and some accessible formal dementia support. The second presented 'A challenge to the idyll' and outlined difficulties the men faced including a lack of dementia awareness amongst their family and the wider rural community as well as the physical and internal motivational barriers associated with the rural landscape and their dementia. The findings were interpreted through a lens of social inclusion and demonstrated how the geo-socio-cultural rural environment both enabled and inhibited facets of the men's experiences of life in their communities. Based on these findings, the paper offers recommendations for practitioners, researchers and policy makers wishing to promote social inclusion in rural-dwelling older men living with dementia.
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Affiliation(s)
- Ben Hicks
- Centre for Dementia Studies, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Anthea Innes
- Salford Institute for Dementia, The Dementia Hub, Allerton Courtyard, Salford, UK
| | - Samuel R Nyman
- Interim Deputy Head, Department of Medical Science and Public Health,and Ageing & Dementia Research Centre, Bournemouth University, Bournemouth, UK
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Bjørkløf GH, Helvik AS, Ibsen TL, Telenius EW, Grov EK, Eriksen S. Balancing the struggle to live with dementia: a systematic meta-synthesis of coping. BMC Geriatr 2019; 19:295. [PMID: 31666020 PMCID: PMC6822397 DOI: 10.1186/s12877-019-1306-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 10/07/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND People with dementia describe experiences of loss that threaten their autonomy and ability to contribute to society. They often have difficulties with orientation, loss of roll function, and fear about the future, and need help from others. An increasing body of literature also focuses on how people with dementia search for meaning and maintaining of quality to life, and how they find strategies to live with dementia. A review of the scientific literature on coping and dementia is warranted and can help to advice and inform healthcare personnel and decision makers on how they can support and plan for appropriate healthcare services for people with dementia. The aim of this systematic meta-synthesis was therefore to interpret and synthesize knowledge regarding people with dementia's experience of coping. METHODS We conducted a systematic, computerised search of Medline, Embase, Cinahl Complete, PsycINFO and Age Line combining MeSH terms and text words for different types of dementia with different descriptions of experience. Studies comprised 1) a sample of people with dementia, 2) a qualitative interview as a research method and 3) a description of experiences of coping were included. The search resulted in 7129 articles, of which 163 were read in full text, 80 were excluded due to the exclusion criteria or low quality according. The analysis was conducted in line with qualitative content analyses. RESULTS This interpretative qualitative meta-synthesis included 74 articles of good quality encompassing interviews with 955 persons with dementia. The material revealed two main resources of coping: (1) Humour and (2) Practical and emotional support, and four overall strategies in which people with dementia cope with the challenges they experience: (1) Keep going and holding on to life as usual; (2) Adapting and adjusting to the demands from the situation; (3) Accepting the situation; and (4) Avoiding the situation A comprehensive understanding of the categories led to the latent theme: Balancing the struggle of living with dementia. CONCLUSION This meta-synthesis indicates that people with dementia cope in different ways and using several parallel strategies. This insight is essential in dementia care to facilitate a supportive environment.
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Affiliation(s)
- Guro Hanevold Bjørkløf
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Postbox 2136, N-3103 Tønsberg, Norway
| | - Anne-Sofie Helvik
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Postbox 2136, N-3103 Tønsberg, Norway
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tanja Louise Ibsen
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Postbox 2136, N-3103 Tønsberg, Norway
| | - Elisabeth Wiken Telenius
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Postbox 2136, N-3103 Tønsberg, Norway
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Postbox 2136, N-3103 Tønsberg, Norway
- VID Spesialized University, Faculty of Health Studies, Oslo, Norway
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Pritchard-Jones L. Exploring the potential and the pitfalls of the United Nations Convention on the Rights of Persons with Disabilities and General Comment no. 1 for people with dementia. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2019; 66:101467. [PMID: 31706380 DOI: 10.1016/j.ijlp.2019.101467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 06/10/2023]
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Tatzer VC, Reitinger E, Plunger P, Heimerl K. ["I can live with it, if it doesn't get worse"-Caregivers of people with dementia in Austria talk about their needs and experiences]. Z Gerontol Geriatr 2019; 53:245-250. [PMID: 31338574 DOI: 10.1007/s00391-019-01581-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 06/25/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Family members undertake a large proportion of the care of people living with dementia. The purpose of this study was to explore the needs and caring experiences of family caregivers of people with dementia in Austria, who were organized in a self-help group. METHODS Using an explorative, qualitative research design, data were collected through 1 focus group and 3 in-depth interviews with a total of 10 family caregivers of people with dementia from a self-help group. An inductive qualitative analysis was applied and resulted in four themes: frightening images of dementia in society, continuity and conflicts in the relationship to the person with dementia, caring for one's own health and lack of support and community. RESULTS Continuity in the relationship to and joint activities with the person with dementia were positively described but simultaneously the frequently occurring conflicts were described as burdensome. Also described were bureaucratic, structural and financial hurdles for the utilization of support services. The existing support systems offered were mostly judged to be inadequate, inaccessible or unaffordable. The participating caregivers described the communication of the diagnosis of dementia in the environment as a prerequisite for support in the community. DISCUSSION Destigmatization and the further development of dementia-specific support offers and self-help groups for caring relatives and people living with dementia could represent further steps forward. Communicating the dementia diagnosis in the social environment and community seems to be an important but difficult step for caregivers organized in a self-help group.
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Affiliation(s)
- V C Tatzer
- Abteilung für Ergotherapie, Fachhochschule Wiener Neustadt, Johannes Gutenberg Straße 3, 2700, Wiener Neustadt, Österreich.
| | - E Reitinger
- Institut für Pflegewissenschaft, Universität Wien, Alser Straße 23/12, 1080, Wien, Österreich
| | - P Plunger
- Institut für Pflegewissenschaft, Universität Wien, Alser Straße 23/12, 1080, Wien, Österreich
| | - K Heimerl
- Institut für Pflegewissenschaft, Universität Wien, Alser Straße 23/12, 1080, Wien, Österreich
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