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Hughes M, Hanna K, Wiles A, Taylor E, Giebel C. The experiences of caring for someone with dementia and a learning disability: A qualitative systematic review. DEMENTIA 2024; 23:817-849. [PMID: 38172089 PMCID: PMC11163849 DOI: 10.1177/14713012231225797] [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: 01/05/2024]
Abstract
BACKGROUND The life expectancy of people with a learning disability is increasing and with this comes a greater risk of developing dementia. Dementia poses new challenges for both family and formal learning disability carers as they try to support dementia's progressive nature and quality of life for their care recipient. This qualitative systematic review explores the evidence base of family and formal carers' experiences and needs of caring for someone with both a learning disability and dementia. METHODS Six electronic databases (PubMed, PsycINFO, Cochrane Library, Prospero, Scopus, CINAHL), were searched in May 2022, utilising a predefined search strategy. Thirteen papers fulfilled inclusion criteria and were included in in the review. RESULTS Thematic synthesis was used to explore and synthesise the qualitative findings of the studies. Four conceptual themes were identified following analysis: Knowledge and skills, Accessing support, Repercussions of dementia for carers, Influences of continuity of caring role. CONCLUSION There are significant training and educational needs for all carers who support the dual diagnosis of dementia and learning disability. Differences between family and formal carers relate to the organisational support and process available to formal carers. Parity across services combined with sufficiently trained carers may support dementia diagnosis and improve quality of care provided. Further research is needed to address environmental, and economic barriers carers face to facilitate ageing in place for their care recipients.
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Affiliation(s)
- Michelle Hughes
- Department of Primary Care and Mental Health, University of Liverpool, UK
| | - Kerry Hanna
- School of Health Sciences, University of Liverpool, UK
| | - Akpevwoghene Wiles
- Department of Primary Care and Mental Health, University of Liverpool, UK
| | | | - Clarissa Giebel
- Department of Primary Care and Mental Health, University of Liverpool, UK; NIHR Applied Research Collaboration North West Coast, UK
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Acton DJ, Jaydeokar S, Taylor R, Jones S. Exploring the lived experiences and care challenges of formal paid caregivers for people with intellectual disability and dementia. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024:17446295241259076. [PMID: 38816805 DOI: 10.1177/17446295241259076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
A greater number of people with intellectual disability are living into older age and are at increased risk of developing conditions such as dementia. Caring for a person with dementia presents several challenges for formal caregivers due to the progressive nature of the disease. An interpretive phenomenological analysis was used to understand the lived experiences of a purposive sample of formal caregivers in caring for people with intellectual disability and dementia. Discussions from 14 individual interviews generated data were analysed. Four key super-ordinate themes emerged which were: (1) recognising early indicators and diagnosis, (2) post diagnostic support, (3) coping with change and (4) need for future development. Themes reflected the experiences, barriers to dementia diagnosis and provide a valuable insight into the challenges faced by formal caregivers in providing aged care services.
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Affiliation(s)
- Daniel James Acton
- Cheshire and Wirral Partnership NHS Foundation Trust - Centre for Autism Neurodevelopmental Disorders and Intellectual Disability (CANDDID), UK
- University of Chester, UK
| | - Sujeet Jaydeokar
- Cheshire and Wirral Partnership NHS Foundation Trust - Centre for Autism Neurodevelopmental Disorders and Intellectual Disability (CANDDID), UK
- University of Chester, UK
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Pendl D, Glatz M, Gasteiger-Klicpera B. Intellectual disabilities and dementia: New tasks and experiences of Austrian formal caregivers. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13165. [PMID: 37849394 DOI: 10.1111/jar.13165] [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: 11/07/2022] [Revised: 07/18/2023] [Accepted: 09/28/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND In Austria, due to its history, only relatively little research on the topic of intellectual disabilities and dementia has been conducted to date. The present study thus aims to explore the challenges and tasks currently facing formal caregivers, together with assessing their wishes for further development. METHODS Ten semi-structured interviews were held with formal caregivers. Interviews were transcribed and analysed by means of structured qualitative content analysis. RESULTS Caregivers must deal with conflicts between residents, and with increasing demands for care and emotional support. Education and training on dementia and intellectual disability are mostly of high quality, but still remain insufficient. Caregivers would like to see suitable adaptation of care premises, smaller groups, more staff and better training on dementia and intellectual disability. CONCLUSION To ensure quality care and 'ageing in place', caregivers and providers need to pay greater attention to dementia-related changes when planning and adapting services.
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Affiliation(s)
- Dominik Pendl
- Inclusive Education Unit, University of Graz, Institute of Education Research and Teacher Education, Graz, Austria
| | - Mathieu Glatz
- Inclusive Education Unit, University of Graz, Institute of Education Research and Teacher Education, Graz, Austria
| | - Barbara Gasteiger-Klicpera
- Inclusive Education Unit, University of Graz, Institute of Education Research and Teacher Education, Graz, Austria
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Davidson AR, Zigori BD, Ball L, Morgan M, Gala D, Reidlinger DP. Family carers' experiences and perceived roles in interprofessional collaborative practice in primary care: A constructivist grounded theory study. Health Expect 2023; 26:2302-2311. [PMID: 37515464 PMCID: PMC10632645 DOI: 10.1111/hex.13828] [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: 04/04/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Chronic conditions can lead to physical, cognitive and social decline; thus, increasing an individual's dependence on family who assist with activities of daily living. Interprofessional collaborative practice (IPCP), involving two or more health professionals working with the patient and their family, is one model of care for the high-quality management of individuals with chronic conditions in primary care. Nevertheless, family carers have reported a disconnect between themselves and healthcare providers in previous research. This study aimed to explore the experiences and perspectives of family carers for individuals with chronic conditions, regarding their involvement in IPCP. METHODS Aspects of constructivist grounded theory methodology were used. Family carers of individuals with chronic conditions were invited to participate in a one-on-one, semistructured interview about their experiences with IPCP in the care of their loved one. Interview transcripts were analysed using Charmaz's four-step iterative process: (1) line-by-line coding, (2) focused coding, (3) categorisation of codes and (4) potential theme and subtheme development with memo writing to support each phase of analysis. The research team collaborated on reflexivity exercises, the conceptualisation of categories and the development of themes. RESULTS Constructivist data analysis of interviews (average 40 min) with 10 family carers resulted in two themes. (1) Stepping in for my loved one represents the notion that carers take on external roles on behalf of their loved ones (subthemes: working with interprofessional teams, supporting independence and learning as I go). (2) Taking on the carer role, represents the internal factors that influence the external roles described in theme 1 (subthemes: feeling obligated to be involved and changing relationship dynamics). CONCLUSION This study outlines the external actions and internal influences on family carer involvement in an interprofessional team. The required knowledge and support to care for their loved ones is currently learned in an ad hoc manner, and carers' resources should be better promoted by health professionals. Additionally, the relationship dynamics between a carer and their loved one change as the carer becomes more involved in IPCP and influences how and the extent health professionals involve family carers. PATIENT OR PUBLIC CONTRIBUTION Carers were the study population involved in this qualitative study. Patient advocates who have chronic conditions, and are informal family carers, were involved in the creation and design of this study, including a review of the research question, participant information sheet and the interview guide.
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Affiliation(s)
| | | | - Lauren Ball
- Centre for Community Health and WellbeingThe University of QueenslandBrisbaneAustralia
| | - Mark Morgan
- Faculty of Health Sciences and MedicineBond UniversityGold CoastAustralia
| | - Devanshi Gala
- Faculty of Health Sciences and MedicineBond UniversityGold CoastAustralia
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Jacobs P, Watchman K, Wilkinson H, Hoyle L, McGenily L. Experiences of people with intellectual disability and dementia: A systematic review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:241-258. [PMID: 36562340 PMCID: PMC10107172 DOI: 10.1111/jar.13063] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/13/2022] [Accepted: 11/24/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Dementia disproportionately affects people with intellectual disability. Most qualitative studies explore their experiences by utilising proxy-reports. A smaller number of studies illustrate the possibility of exploring perspectives directly from people with intellectual disability and dementia. METHOD This systematic review synthesised findings from existing studies (n = 8) that involve people with intellectual disability and dementia as participants to understand their experiences of dementia. Searches were conducted using CINAHL, PsychInfo and Social Services Abstracts. RESULTS Findings include descriptions of changes in individual functioning, a narrowing of social worlds and of how people made sense of the changes despite often having no knowledge of their dementia diagnosis. Additionally, discussion focuses on how people's experiences are shaped by their environments. CONCLUSION The review recognises the complexities of speaking to people with intellectual disability about dementia, challenges views that people with intellectual and dementia cannot be involved in research and makes recommendations to support inclusion in future studies.
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Affiliation(s)
- Paula Jacobs
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland, UK
| | - Karen Watchman
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland, UK
| | - Heather Wilkinson
- Edinburgh Centre for Research on the Experience of Dementia, University of Edinburgh, Edinburgh, Scotland, UK
| | - Louise Hoyle
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland, UK
| | - Laura McGenily
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland, UK.,Clinical Research Nurse, NHS Forth Valley, Larbert/Postgraduate Research Student, University of Stirling, Stirling, Scotland, UK
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Im D, Pyo J, Lee H, Jung H, Ock M. Qualitative Research in Healthcare: Data Analysis. J Prev Med Public Health 2023; 56:100-110. [PMID: 37055353 PMCID: PMC10111102 DOI: 10.3961/jpmph.22.471] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Abstract
Qualitative research methodology has been applied with increasing frequency in various fields, including in healthcare research, where quantitative research methodology has traditionally dominated, with an empirically driven approach involving statistical analysis. Drawing upon artifacts and verbal data collected from in-depth interviews or participatory observations, qualitative research examines the comprehensive experiences of research participants who have experienced salient yet unappreciated phenomena. In this study, we review 6 representative qualitative research methodologies in terms of their characteristics and analysis methods: consensual qualitative research, phenomenological research, qualitative case study, grounded theory, photovoice, and content analysis. We mainly focus on specific aspects of data analysis and the description of results, while also providing a brief overview of each methodology's philosophical background. Furthermore, since quantitative researchers have criticized qualitative research methodology for its perceived lack of validity, we examine various validation methods of qualitative research. This review article intends to assist researchers in employing an ideal qualitative research methodology and in reviewing and evaluating qualitative research with proper standards and criteria.
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Affiliation(s)
- Dasom Im
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan,
Korea
| | - Jeehee Pyo
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan,
Korea
- Ulsan Metropolitan City Public Health Policy’s Institute, Ulsan,
Korea
| | - Haneul Lee
- Ulsan Metropolitan City Public Health Policy’s Institute, Ulsan,
Korea
| | - Hyeran Jung
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan,
Korea
- Ulsan Metropolitan City Public Health Policy’s Institute, Ulsan,
Korea
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan,
Korea
- Ulsan Metropolitan City Public Health Policy’s Institute, Ulsan,
Korea
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul,
Korea
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Dennehy H, Allen AP, McGlinchey E, Buttery N, García-Domínguez L, Chansler R, Corr C, Dunne P, Kennelly S, Daly L, McCallion P, McCarron M. A scoping review of post-diagnostic dementia supports for people with intellectual disability. Aging Ment Health 2022:1-10. [PMID: 36218056 DOI: 10.1080/13607863.2022.2130171] [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] [Indexed: 11/01/2022]
Abstract
Objectives: People with intellectual disability, particularly people with Down syndrome, are at an increased risk for early-onset dementia, in comparison to people without an intellectual disability. The aim of this review was to scope the current landscape of post-diagnostic dementia supports for people with intellectual disability.Method: A systematic search of five electronic databases (CINAHL, Medline, PsycArticles, PsycInfo and Web of Science) was conducted for this scoping review. Results were screened independently by two reviewers, with a third reviewer for arbitration where necessary.Results: Forty-two studies met the inclusion criteria, and relevant information was extracted. The articles included focussed on the experiences of people with intellectual disability and dementia, as well as the role of carers, family members and staff. Key themes included ageing in place, environmental supports for people with intellectual disability and dementia, dementia-specific interventions and therapies, as well as the feasibility of these interventions. Besides the studies that focussed on these themes, other studies focussed on staff training and family supports.Conclusion: This review highlights the importance of implementing timely and appropriate post-diagnostic supports for people living with intellectual disability and dementia. More controlled trials are required on post-diagnostic dementia supports for people with intellectual disability.
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Affiliation(s)
- Holly Dennehy
- Trinity Centre for Ageing & Intellectual Disability, Trinity College Dublin, Ireland
| | - Andrew P Allen
- Trinity Centre for Ageing & Intellectual Disability, Trinity College Dublin, Ireland.,School of Nursing & Midwifery, Trinity College Dublin, Ireland
| | - Eimear McGlinchey
- Trinity Centre for Ageing & Intellectual Disability, Trinity College Dublin, Ireland.,School of Nursing & Midwifery, Trinity College Dublin, Ireland.,National Intellectual Disability Memory Service, Tallaght University Hospital, Dublin, Ireland
| | - Nadine Buttery
- Trinity Centre for Ageing & Intellectual Disability, Trinity College Dublin, Ireland
| | | | - Rachael Chansler
- School of Nursing, University of Pennsylvania, Philadelphia, USA
| | - Christina Corr
- Trinity Centre for Ageing & Intellectual Disability, Trinity College Dublin, Ireland
| | - Pamela Dunne
- National Intellectual Disability Memory Service, Tallaght University Hospital, Dublin, Ireland
| | - Seán Kennelly
- National Intellectual Disability Memory Service, Tallaght University Hospital, Dublin, Ireland.,Department of Medical Gerontology, Trinity College Dublin, Ireland
| | - Louise Daly
- School of Nursing & Midwifery, Trinity College Dublin, Ireland
| | - Philip McCallion
- Trinity Centre for Ageing & Intellectual Disability, Trinity College Dublin, Ireland.,School of Social Work, Temple University, Philadelphia, USA
| | - Mary McCarron
- Trinity Centre for Ageing & Intellectual Disability, Trinity College Dublin, Ireland.,School of Nursing & Midwifery, Trinity College Dublin, Ireland.,National Intellectual Disability Memory Service, Tallaght University Hospital, Dublin, Ireland
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