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Lanthier-Labonté S, Chaudhury H, Wong J, Hung L. Dementia-Friendly Transportation Services: A Scoping Review. THE GERONTOLOGIST 2024; 64:gnae047. [PMID: 38767432 PMCID: PMC11200191 DOI: 10.1093/geront/gnae047] [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: 03/09/2023] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Transportation is an important component of dementia-friendly communities. People living with dementia have the right to access transportation services to keep their mobility in their community, which is essential for independence, well-being, and quality of life. This scoping review maps the literature on dementia-friendly transportation services and explores their characteristics to inform future development and research. RESEARCH DESIGN AND METHODS Empirical quantitative and qualitative studies in English or French that informed on transportation services for people living with dementia in the community were searched in 15 databases. Two authors independently screened records and charted relevant characteristics from selected publications. Important findings were summarized with a narrative synthesis approach. RESULTS Thirty-five studies informed on important dimensions of transportation services in urban and/or rural context: availability, accessibility, acceptability, adaptability, and affordability. Important insights were identified: the importance of staff training and attitude, and the challenges of availability of affordable services in the rural context. Emerging policy and program intervention areas include the need for access to quiet areas in transit hubs, training to use mass public transit and mobility management. DISCUSSION AND IMPLICATIONS The literature on dementia-friendly transportation services is important in the expansion and maintenance of mobility for people living with dementia in the community. The scope of the existing scientific literature remains limited. Although several studies indicated a clear need for better access to dementia-friendly transportation services, the best practices still need to be demonstrated in the scientific literature.
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Affiliation(s)
- Stéphanie Lanthier-Labonté
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, University of Sherbrooke, Quebec City, Quebec, Canada
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Joey Wong
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Lillian Hung
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
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Kjerland TM, Schroeder S, Tofaeono V. Increased community engagement of Indigenous Peoples in dementia research leads to higher context relevance of results. DEMENTIA 2024; 23:643-668. [PMID: 38445447 PMCID: PMC11059836 DOI: 10.1177/14713012241233651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Health research that focuses on Indigenous Peoples must ensure that the community in question is actively engaged, and that the results have context relevance for Indigenous Peoples. Context relevance is "the benefits, usability, and respectful conduct of research from the perspective of Indigenous communities." The purpose of this study was to apply two tools within an already-published scoping review of 76 articles featuring research on cognitive impairment and dementia among Indigenous Peoples worldwide. One tool assessed levels of community engagement reported in the corpus, and the other tool assessed the context relevance of recommendations in the corpus. We hypothesized that research with higher levels of reported community engagement would produce recommendations with greater context relevance for Indigenous Peoples. METHODS We employed semi-structured deductive coding using two novel tools assessing levels of reported community engagement and context relevance of recommendations based on studies included in the existing scoping review. RESULTS Application of the two tools revealed a positive relationship between increasing community engagement and greater context relevance. Community engagement primarily occurred in studies conducted with First Nations, Inuit, and Métis populations in Canada and with Australian Aboriginal and/or Torres Strait Islander Peoples. Research with Alaska Native, American Indian, and Native Hawaiian Peoples in the USA stood out for its comparative lack of meaningful community engagement. DISCUSSION There is opportunity to utilize these tools, and the results of this assessment, to enhance training and mentorship for researchers who work with Indigenous populations. There is a need to increase investigator capacity to involve communities throughout all phases of research, particularly in the pre-research stages.
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Affiliation(s)
- Tonya M Kjerland
- Department of Indigenous Health, University of North Dakota, USA
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Bryant J, Freund M, Ries N, Garvey G, McGhie A, Zucca A, Hoberg H, Passey M, Sanson-Fisher R. Volume, scope, and consideration of ethical issues in Indigenous cognitive impairment and dementia research: A systematic scoping review of studies published between 2000-2021. DEMENTIA 2022; 21:2647-2676. [PMID: 36054372 DOI: 10.1177/14713012221119594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION High quality research involving Indigenous people with cognitive impairment and dementia is critical for informing evidence-based policy and practice. We examined the volume, scope and ethical considerations of research related to dementia with Indigenous populations globally from January 2000-December 2021. METHODS Studies were included if they were published in English from 2000 to 2021 and provided original data that focused on cognitive impairment or dementia in any Indigenous population. RESULTS The search yielded 13,009 papers of which, 76 met inclusion criteria. The overall number of papers increased over time. Studies were mostly conducted in Australia with Aboriginal and Torres Strait Islander people (n = 30; 39%). Twenty-six papers directly involved Indigenous participants with cognitive impairment or dementia. Of these studies, ethics approval was commonly required from two or more committees (n = 23, 88.5%). Ethical and legal governance frameworks were rarely discussed. DISCUSSION There is a clear need for further robust studies examining cognitive impairment and dementia with Indigenous populations. Future research should consider the ethical aspects of involving Indigenous participants with cognitive impairment in research.
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Affiliation(s)
- Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Megan Freund
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Nola Ries
- Faculty of Law, 1994University of Technology Sydney, Sydney, NSW, Australia
| | - Gail Garvey
- Wellbeing and Preventable Chronic Diseases Division, Charles Darwin University, 10095Menzies School of Health Research, Causarina, Northern Territory, Australia
| | - Alexandra McGhie
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Alison Zucca
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Hana Hoberg
- Wellbeing and Preventable Chronic Diseases Division, Charles Darwin University, 10095Menzies School of Health Research, Causarina, Northern Territory, Australia
| | - Megan Passey
- University Centre for Rural Health, University of Sydney, Lismore, NSW, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Thalén L, Malinowsky C, Margot-Cattin I, Gaber SN, Seetharaman K, Chaudhury H, Cutchin M, Wallcook S, Anders K, Brorsson A, Nygård L. Out-of-home participation among people living with dementia: A study in four countries. DEMENTIA 2022; 21:1636-1652. [PMID: 35435030 PMCID: PMC9243454 DOI: 10.1177/14713012221084173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Social participation in out-of-home activities is important for people living with
dementia, yet little is known about such participation. The aim of this study was to
explore and compare out-of-home participation among people living with dementia in four
countries by assessing different types of places of participation visited or no longer
visited. A cross-sectional design was used to gather self-reported experiences concerning
out-of-home participation among people with mild stage dementia living in Canada
(n = 29), Sweden (n = 35), Switzerland
(n = 35) and the UK (n = 64). Interviews were
conducted using the Participation in ACTivities and places OUTside the Home for
older adults (ACT-OUT) instrument. Participants still visited 16
(Median) places out of a possible total of 24, and they had abandoned 5
(Median) places. Neighbourhood was the place most participants still
visited, whereas 50% of them had stopped going to a Sports facility, with no significant
differences between country samples regarding how many participants had abandoned that
place (Fisher’s exact test, p > 0.01). There were significant
differences between country samples in the frequency of present participation and
abandonment of the Hospital, Dentist’s office, Cemetery, Garden, and Forest (Fisher’s
exact test, all p < 0.01). Although the participants still visited a
variety of places, they had stopped going to places previously visited, which indicates
reductions in participation, posing an inherent risk to well-being. The similarities and
differences across samples from the four countries suggest that healthcare services and
access to public transport may contribute to the complex interactional process of
out-of-home participation for people living with dementia. The findings highlight the need
for initiatives targeting specific types of places to support continued participation in
society, especially places at a higher risk of abandonment such as places for recreation
and physical activity.
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Affiliation(s)
- Liv Thalén
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Camilla Malinowsky
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Isabel Margot-Cattin
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Department of Occupational Therapy, School of Social Work and Health, Lausanne (HETSL), University of Applied Sciences and Arts of Western Switzerland (HES-SO), Delémont, Switzerland
| | - Sophie N Gaber
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Ersta Sköndal Bräcke University College, Department of Health Care Sciences, and Uppsala University, Department of Women’s and Children’s Health, Clinical Psychology in Healthcare, Huddinge, Sweden
| | | | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Malcolm Cutchin
- Pacific Northwest University of Health Sciences, Yakima, WA, United States
| | - Sarah Wallcook
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Kottorp Anders
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden and Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Anna Brorsson
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Louise Nygård
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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Thijssen M, Daniels R, Lexis M, Jansens R, Peeters J, Chadborn N, Nijhuis‐van der Sanden MWG, Kuijer‐Siebelink W, Graff M. How do community based dementia friendly initiatives work for people with dementia and their caregivers, and why? A rapid realist review. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5662. [PMID: 34825742 PMCID: PMC9299867 DOI: 10.1002/gps.5662] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 11/18/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To describe and explain the outcomes of community dementia friendly initiatives (DFIs) for people with dementia and their caregivers to inform the development and tailoring of DFIs. METHODS Literature searches on DFIs were performed through two systematic online database searches of PubMed, Embase, ASSIA, CINAHL and Google scholar. Papers were only included if they evaluated outcomes using empirical data from people with dementia or caregivers. Data collection and analysis were guided by the categorization in the DEM-FACT taxonomy and RAMESES guidelines for realist reviews. RESULTS Of 7154 records identified, 22 papers were included with qualitative, mixed method and quantitative study designs. The synthesis led to a description of programme theories addressing caring, stimulating and activating communities. Outcomes for people with dementia and caregivers included having contact with others, enjoyment and decrease of stress and, lastly, support. This synthesis also indicated how people with dementia participated in a specific role in DFIs, such as patient, team member or active citizen. CONCLUSIONS DFIs generate different outcomes for people with dementia and caregivers, depending on the kind of initiative and the specific role for people with dementia. These findings could be a catalyst for initiation and further development of DFIs in a dementia friendly community (DFC). This draws attention to the multiple aspects of DFCs and supports reflection on their essential principles.
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Affiliation(s)
- Marjolein Thijssen
- Radboud Institute for Health SciencesScientific Center for Quality of Healthcare (IQ Healthcare), Radboud University Mmedical CenterNijmegenThe Netherlands,Radboud Alzheimer CenterRadboud University Medical CenterNijmegenThe Netherlands
| | - Ramon Daniels
- Academy of Occupational TherapyResearch Centre Assistive Technology in CareZuyd University of Applied SciencesHeerlenThe Netherlands
| | - Monique Lexis
- Academy of Occupational TherapyResearch Centre Assistive Technology in CareZuyd University of Applied SciencesHeerlenThe Netherlands
| | - Rianne Jansens
- Academy of Occupational TherapyResearch Centre Assistive Technology in CareZuyd University of Applied SciencesHeerlenThe Netherlands,Department of Occupational Science & Occupational TherapyUniversity College CorkCorkIreland,Department of Health, Education and TechnologyUniversity of TechnologyLuleåSweden
| | - José Peeters
- Radboud Institute for Health SciencesScientific Center for Quality of Healthcare (IQ Healthcare), Radboud University Mmedical CenterNijmegenThe Netherlands,Faculty of Health and Social StudiesHAN University of Applied SciencesNijmegenThe Netherlands
| | - Neil Chadborn
- School of MedicineUniversity of NottinghamNottinghamUK
| | - Maria W. G. Nijhuis‐van der Sanden
- Radboud Institute for Health SciencesScientific Center for Quality of Healthcare (IQ Healthcare), Radboud University Mmedical CenterNijmegenThe Netherlands
| | - Wietske Kuijer‐Siebelink
- Research Department of Public AffairsHAN University of Applied SciencesNijmegenThe Netherlands,Faculty of HealthHAN University of Applied SciencesNijmegenThe Netherlands
| | - Maud Graff
- Radboud Institute for Health SciencesScientific Center for Quality of Healthcare (IQ Healthcare), Radboud University Mmedical CenterNijmegenThe Netherlands,Radboud Alzheimer CenterRadboud University Medical CenterNijmegenThe Netherlands
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Racine L, Ford H, Johnson L, Fowler-Kerry S. An integrative review of Indigenous informal caregiving in the context of dementia care. J Adv Nurs 2021; 78:895-917. [PMID: 34806198 DOI: 10.1111/jan.15102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 09/24/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022]
Abstract
AIMS To appraise the empirical literature on the needs of Indigenous informal caregivers caring for people living with dementia in Indigenous communities. DESIGN Whittemore and Knafl's updated approach to integrative reviews, PRISMA guidelines, and CASP checklists for narrative analysis were followed. DATA SOURCES A systematic search of published empirical literature from January 2010 to August 2020 was undertaken in six databases. REVIEW METHODS Fifty-one studies met the research question and the inclusion criteria. RESULTS Five themes describe the findings: Decolonizing Western perspectives on dementia, the centrality of cultural safety, caregivers' experiences, pre-dementia community education and family and community-centred care emerged from the thematic analysis. Most of the studies used quantitative methodologies, and few studies were conducted using community-based approaches. CONCLUSION This review shows that Indigenous caregiving represents an emerging field in nursing and health sciences in a context of a global crisis. Researchers need to focus on Indigenous values and voices to adapt care and support informal caregivers. Our review emphasizes that working with Indigenous communities will likely translate into new care delivery models, policies and practices to support Indigenous informal caregivers and address the specific social determinants impacting caregivers' roles and tasks. IMPACT This review highlights the necessity of having community and family-based discussions on enhancing the delivery of dementia care for Indigenous peoples in Canada and worldwide. Decolonizing Western perspectives of dementia translate into culturally safe approaches that aim to integrate Indigenous cultural perspectives of holism, reciprocity, wisdom, respect of older people and relationality into nursing practice. The support of Indigenous informal caregivers requires future studies to address the stigmatizing Western views of dementia.
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Affiliation(s)
- Louise Racine
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Harris Ford
- College of Arts and Science, Department of History, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Letitia Johnson
- College of Arts and Science, Department of History, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Susan Fowler-Kerry
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Kung PC, Huang HL, Hsu WC, Hsu JL, Tang LY, Shyu YIL. Fluctuating interpretations: Striving to maintain a sense of self in early dementia. Geriatr Nurs 2021; 42:484-490. [PMID: 33721655 DOI: 10.1016/j.gerinurse.2021.02.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 11/25/2022]
Abstract
This study aimed to develop a conceptual framework of the experience of persons living with the early stages of dementia. A grounded theory approach examined the experience from the perspective of the patient. Data were collected from dyads of persons with mild dementia and their family caregivers (N = 17) using face-to-face interviews at three timepoints over a one-year period. Transcribed interviews were analyzed with constant comparative analysis. The core category was "Fluctuating interpretations: striving to maintain one's sense of self." Interpretations were comprised of three subcategories: being a stranger to oneself, sense-making, and strategies for coexistence. Different situations influenced the process and affected individuals' attitudes and behaviors. Interpretations were a protective vehicle and stabilizing force that enabled persons with dementia to coexist with disease changes. Perspectives of persons with dementia during the early stages should be considered when designing intervention strategies for patient-centered care.
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Affiliation(s)
- Pen-Chen Kung
- PhD student, School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Lecturer, Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Geriatric and Long-Term Care Research Center, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Huei-Ling Huang
- Associate Professor, Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Associate Researcher, Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Wen-Chuin Hsu
- Associate Professor & Visiting Staff, Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Director, Dementia Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Jung-Lung Hsu
- Associate professor, Attending, Department of Neurology, New Taipei Municipal Tu Cheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, New Taipei City, Taiwan; Adjunct Associate Professor, Taipei Medical University Shuang Ho Hospital, Graduate Institute of Humanities in Medicine and Research Center for Brain and Consciousness, Taipei, Taiwan
| | - Li-Yu Tang
- Secretary General, Taiwan Alzheimer's Disease Association, Taipei, Taiwan
| | - Yea-Ing L Shyu
- Lambda Beta Chapter-At-Large, Distinguished Professor, School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Professor and Group Project Leader, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Professor, Department of Gerontology and Health Care Management Chang Gung University of Science and Technology.
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Chang CY, Hsu HC. Relationship between Knowledge and Types of Attitudes towards People Living with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113777. [PMID: 32466533 PMCID: PMC7312095 DOI: 10.3390/ijerph17113777] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to examine the relationship between knowledge and attitudes towards dementia among adults. A cross-sectional online survey with purposive sampling was conducted in four district health centers in Taichung, Taiwan, in 2018. Knowledge was measured by the Taiwanese version of the Dementia Knowledge Assessment Scale. Attitudes towards people with dementia were measured by four kinds of feelings: discomfort, shame, avoidance, and fear. In total, 347 persons completed the questionnaire. Knowledge of dementia was modest. Higher education, a care-related background, chronic health conditions, experience caring for people with dementia, and knowledge of family history were related to higher knowledge of dementia. Attitudes towards people with dementia were grouped into four clusters: uncomfortable (22.2%), ashamed (2.6%), unfriendly (22.5%), and non-negative (52.7%). Knowledge of dementia was significantly related to the ashamed cluster but not to the other clusters. Lower education, a lack of caring experience, and a lack of knowledge of family history were related to uncomfortable feelings, and poorer financial satisfaction was related to uncomfortable, afraid, and avoidant feelings. The open-question expression of feelings towards dementia was more likely to be negative (55.3%). The public should be educated on knowledge of and friendly attitudes towards dementia.
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Affiliation(s)
- Chia-Yu Chang
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan;
- South District Public Health Center, Taichung City Government, Taichung 402332, Taiwan
| | - Hui-Chuan Hsu
- School of Public Health, Research Center of Health Equity, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
- Correspondence:
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