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Håkansson T, Svensson H, Karlsson S. Living with a person with young onset dementia - spousal experience. Int J Qual Stud Health Well-being 2024; 19:2330233. [PMID: 38493492 PMCID: PMC10946261 DOI: 10.1080/17482631.2024.2330233] [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: 04/26/2023] [Accepted: 03/11/2024] [Indexed: 03/19/2024] Open
Abstract
PURPOSE Being of working age while at the same time needing to help a partner with young onset dementia has specific consequences for spouses. Research to date has been sparse concerning this particular group of spouses. The aim of the study was to explore spouses' everyday experiences when living with a person with young onset dementia. METHOD The study had a descriptive qualitative design with semi-structured interviews with nine spouses. The interviews were analysed using content analysis. RESULT The interviewed spouses experienced emotions that varied from feelings of loneliness, frustration, and worry to peace of mind. They said that they used coping strategies, which included adopting a positive mindset, adapting to inabilities, adopting an avoidant approach, and finding ways to recharge. Spouses also felt that they could use more support, both formal and informal. CONCLUSION The spouse of a person with young onset dementia has a range of emotional experiences and has resourceful ways of handling everyday life. Various types of support are offered to spouses, however, they seemed to desire more from health care services.
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Affiliation(s)
- Tania Håkansson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Hilda Svensson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Staffan Karlsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
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Smeets B, Janssen N, Peetoom K, Boots L, Bakker C, de Vugt M. 'Too young to sit at home': a qualitative study conducted among employees with young-onset dementia and their relatives. Aging Ment Health 2024; 28:1119-1128. [PMID: 38669151 PMCID: PMC11262426 DOI: 10.1080/13607863.2024.2345132] [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: 01/16/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES Young-onset dementia (YOD) symptoms often first present in the workplace, resulting in work performance challenges and eventually loss of employment. This study aims to investigate the experiences, work values, and support needs of employees with YOD and their relatives. METHOD Semi-structured interviews were conducted to explore the experiences, work values, and support needs of (former) employees with YOD and their relatives. Subsequently, separate focus group discussions were conducted for employees and relatives to review and prioritize interview findings. Inductive thematic analysis was applied to both datasets. RESULTS A total of 15 interviews (six employees; nine relatives) and four focus group discussions (ten employees; six relatives) were conducted. Six themes emerged, with five revolving around the central theme: desire to work. The other themes represent essential contributing factors, including importance of receiving a YOD diagnosis; knowledge, awareness, and understanding regarding YOD; open communication, joint decision making, and collaboration; work adjustments, involvement, and support; phasing out work and future perspectives. CONCLUSION The findings highlight a strong desire to work post-YOD diagnosis, serving as a foundation for developing workplace support tools and guidance. This has the potential to help individuals with YOD preserve their self-confidence and identity while working within their capabilities.
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Affiliation(s)
- Bo Smeets
- Department of Psychiatry and Neuropsychology/Alzheimer Center Limburg, Mental Health and Neuroscience Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Niels Janssen
- Department of Psychiatry and Neuropsychology/Alzheimer Center Limburg, Mental Health and Neuroscience Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Kirsten Peetoom
- Department of Psychiatry and Neuropsychology/Alzheimer Center Limburg, Mental Health and Neuroscience Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Lizzy Boots
- Department of Psychiatry and Neuropsychology/Alzheimer Center Limburg, Mental Health and Neuroscience Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Christian Bakker
- Radboudumc Alzheimer Center, Nijmegen, The Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
- Groenhuysen, Center for Specialized Geriatric Care, Roosendaal, The Netherlands
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology/Alzheimer Center Limburg, Mental Health and Neuroscience Research Institute, Maastricht University, Maastricht, The Netherlands
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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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Peoples H, Larsen Maersk J, Kristensen HK. Enabling work for people with dementia - Recommendations for interventions: A mixed-methods review. DEMENTIA 2024:14713012241267122. [PMID: 39039891 DOI: 10.1177/14713012241267122] [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: 07/24/2024]
Abstract
Worldwide, 50 million people are living with dementia. As more individuals develop dementia while still working, dementia will increasingly become a workplace issue and a societal concern. Interventions targeted at work retainment, can reduce, and postpone the loss of cognitive functioning following dementia. However, there is a small body of research focused on recommendations for work interventions for people with dementia. The aim of this mixed-methods review was to investigate experiences of work following a dementia diagnosis from the perspective of people with dementia, their relatives, employers, co-workers and HR-professionals, with the objective of formulating recommendations for work interventions for people with dementia. A mixed-method approach guided the review. 16 original studies published between 1989 to 2023 were included, with a collective sample of 684 participants. The review shows that it is possible to live and work well with dementia, if collaborative solutions are continuously negotiated to meet the needs of the person with dementia and the workplace, and with attention to possible contextual enablers and barriers. The review highlights four key elements for successful work interventions for people with dementia: 1) Person-centered Approach, 2) Contextual Relevance, 3) Knowledge-based and 4) Dynamic Approach.
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Affiliation(s)
- Hanne Peoples
- Health Sciences Research Centre, UCL University College, Denmark
| | | | - Hanne K Kristensen
- Health Sciences Research Centre, UCL University College, Denmark
- Centre for Innovative Medical Technology, Department of Clinical Research, University of Southern, Denmark
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Kogata T, Saito C, Kato F, Kudo J, Yamaguchi Y, Lee S, Washimi Y. An analysis of the contents of the young-onset dementia helpline: profiles of clients who consulted the helpline themselves. Psychogeriatrics 2024; 24:617-626. [PMID: 38433324 DOI: 10.1111/psyg.13105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/08/2024] [Accepted: 02/20/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Young-onset dementia (YOD) community care requires personalised approaches. Yet, the specific details of YOD consultations are unclear. This study explored how initial consultations correlate with client profiles. METHODS Data from regional YOD helplines were used to analyze the main characteristics of people living with YOD or who had concerns about the possibility of YOD (n = 132). Among several categorical variables, the following were used for analysis: age group, sex, type of living arrangement, employment status, presence of dementia, and content of the consultation. To identify groups of items that frequently occur together, strongly connected rules were identified using association rule analysis with the a priori algorithm. To focus on the characteristics of clients, rules related to client characteristics were extracted based on the type of consultation. RESULTS A total of 51 rules were identified for the consultations. These rules fell into two categories: (1) consultations for medical matters, which mainly involved employed individuals with undiagnosed dementia, and (2) other consultations on daily life or work, which mainly involved individuals diagnosed with dementia and were characterised by the influence of sex. These rules indicate the importance of medical involvement in confirming the diagnosis and specific individualised care following diagnosis for people living with YOD. CONCLUSION Clients with or without a dementia diagnosis were consulted differently in the YOD helplines. Before receiving a diagnosis, medical matters were the main theme of consultations, whereas after receiving a diagnosis, adjustments to daily life or work were the main themes. The results of this study suggest that the needs of people living with YOD and the services they require may vary depending on their backgrounds.
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Affiliation(s)
- Tomohiro Kogata
- Obu Centre for Dementia Care Research and Practices, Obu, Japan
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Chiaki Saito
- Obu Centre for Dementia Care Research and Practices, Obu, Japan
| | - Fukiko Kato
- Obu Centre for Dementia Care Research and Practices, Obu, Japan
| | - Jumpei Kudo
- Obu Centre for Dementia Care Research and Practices, Obu, Japan
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
| | | | - Sangyoon Lee
- Obu Centre for Dementia Care Research and Practices, Obu, Japan
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
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Wilson SA, Byrne P, Rodgers SE. 'I'd be lost without my smartphone': a qualitative analysis of the use of smartphones and tablets by people living with dementia, mild cognitive impairment, and their caregivers. Aging Ment Health 2024; 28:595-603. [PMID: 37139944 DOI: 10.1080/13607863.2023.2205585] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 04/12/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES Smartphone and tablet devices appear to offer some benefits for enhancing the quality of life of people living with dementia, especially enabling them to stay independent and socially engaged in the early stages of the disease. However, there remains a need to understand the ways that these devices may enhance the lived experience of people living with dementia, mild cognitive impairment, and their caregivers. METHODS We interviewed 29 people living with dementia, mild cognitive impairment, and their caregivers to explore their experiences of and attitudes towards smartphones and tablets. RESULTS We generated three main themes: smart devices in practice as a person living with cognitive impairment; living in a digital world, and smart devices as appropriate and easily accessible support for everyday living. Smart devices were seen as valuable, versatile tools to complete essential and meaningful activities, and as necessary devices to participate in modern life. There was a strong desire for greater support to learn to use smart devices to facilitate living well with cognitive impairment. CONCLUSION The lived experience of people living with dementia and mild cognitive impairment emphasises the central role of smart devices in their lives, and the need for research to move beyond rehearsal of what is needed to co-production and evaluation of smart technology-based educational interventions.
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Affiliation(s)
- Samantha A Wilson
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Paula Byrne
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Sarah E Rodgers
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
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du Toit SHJ, Jessup GM. JAVA Memory Care program: Facilitating social and occupational engagement for older adults living with advanced dementia. Aust Occup Ther J 2024; 71:64-75. [PMID: 37842971 DOI: 10.1111/1440-1630.12911] [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: 07/17/2023] [Revised: 09/24/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND AND OBJECTIVES Residents in aged care homes often report lack of life purpose and meaning and limited opportunities to contribute to their community. The JAVA Memory Care program is designed to facilitate engagement for older adults with advanced dementia. This study explored whether JAVA Memory Care engaged such adults meaningfully, on social and occupational levels, within one Australian residential care home. METHODS A mixed method design guided this exploration. Trained staff facilitated six JAVA groups over 2 months. Three sources of data were utilised. Observational data (qualitative and quantitative) were obtained using a narratively enhanced Assessment Tool for Social and Occupational Engagement (ATOSE). The other two data sources were qualitative and analysed thematically: reflections by the lead JAVA facilitator and data generated by a research discussion group. RESULTS The quantitative data comprised 564 ATOSE behaviour markers. Participants were categorised as being engaged in 93% of these markers. Two of the three qualitative themes focused on the collective and self-expressive nature of participant engagement. The third theme focused on practicalities such as time pressures, facilitator training, resident selection, and resource preparation. For residents, the groups provided a context for relating meaningfully to others. CONCLUSION The JAVA program achieved a high level of engagement. However, it was a time intensive intervention and required a person-centred philosophy, appropriate staff training, organisational support, and a suitable quiet space. The program had positive benefits, but practical issues identified needed to be considered before implementation.
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Bielderman A, van Corven CTM, Koopmans RTCM, Leontjevas R, de Vugt ME, Bakker C, Gerritsen DL. Evaluation of the SPAN intervention for people living with young-onset dementia in the community and their family caregivers: a randomized controlled trial. Aging Ment Health 2024; 28:275-284. [PMID: 37776001 DOI: 10.1080/13607863.2023.2260335] [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: 05/06/2023] [Accepted: 09/12/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVES To evaluate the effectiveness of the SPAN-intervention, a psychosocial intervention aiming at improving a sense of usefulness and engaging in meaningful activities, for community-dwelling people living with young-onset dementia (YOD) and their family caregivers. METHODS A cluster-randomized controlled trial with two parallel groups (SPAN-intervention vs. care as usual) with assessments at baseline and five-month follow-up was performed. Sixty-one persons living with YOD and their family caregivers were included (SPAN-intervention group: n = 35; care as usual group: n = 26). Outcomes included, for the person living with YOD, empowerment (operationalized by self-management abilities using the SMAS-30; primary outcome), quality of life, neuropsychiatric symptoms, disability, apathy; and, for the family caregiver, quality of life, emotional distress, sense of competence. Data were analyzed using linear mixed models. RESULTS We found no statistically significant effects of the SPAN-intervention on empowerment, nor on the secondary outcome measures for persons living with YOD or their family caregivers. CONCLUSION Although the SPAN-intervention may provide concrete opportunities to engage in activities and stimulate reciprocity, such as meaningful social activities, this study did not demonstrate intervention effects. Additional qualitative evaluations may provide more insight into the implementation process and experiences of people living with YOD and their family caregivers.This trial was registered at ClinicalTrials.gov (NCT02937883).
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Affiliation(s)
- Annemiek Bielderman
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
| | - Charlotte T M van Corven
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
| | - Raymond T C M Koopmans
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
- De Waalboog 'Joachim en Anna', Center for Specialized Geriatric Care, Nijmegen, the Netherlands
| | - Ruslan Leontjevas
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
- Faculty of Psychology, Open University of The Netherlands, Heerlen, the Netherlands
| | - Marjolein E de Vugt
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands
| | - Christian Bakker
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
- Groenhuysen, Center for Specialized Geriatric Care, Roosendaal, The Netherlands
| | - Debby L Gerritsen
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
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Danby A, Benson T, Garip G. 'Turbulence even in a bubble': a reflexive thematic analysis with family caregivers of people with dementia in the United Kingdom during and beyond the COVID-19 pandemic. Psychol Health 2023:1-26. [PMID: 38054849 DOI: 10.1080/08870446.2023.2289460] [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: 09/05/2023] [Accepted: 11/25/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVE This study aimed to understand how family caregivers of people with dementia managed changes caused by COVID-19 restrictions and how they adjusted to the lifting of restrictions. A particular focus of the study was on understanding the impact of social isolation, a reduction of social interactions, and reduced access to healthcare services. METHODS AND MEASURES Fourteen voluntary caregivers (nine women) were interviewed using a semi-structured interview schedule. RESULTS Five themes were identified based on reflexive thematic analysis: (i) Outlets to cope with lockdown; (ii) 'Not all doom and gloom': A silver lining amid COVID-19; (iii) Optimism helps provide resilience; (iv) The challenges and joys of reopening; and (v) Caregiving toward a new normality. CONCLUSION The research highlighted difficulties reported by family caregivers and people with dementia during COVID-19, while also showing how such carers coped. Interviews also identified ways that family caregivers often used optimism to help navigate through lockdown and to tackle the reopening stage. Family caregivers in this study reported coping well overall, but welcomed the lifting of restrictions.
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Nygard L, Nedlund AC, Mäki Petäjä Leinonen A, Astell A, Boger J, Issakainen M, Engvall AL, Heuchemer B, Rosenberg L, Ryd C. What happens when people develop dementia whilst working? An exploratory multiple case study. Int J Qual Stud Health Well-being 2023; 18:2176278. [PMID: 36799733 PMCID: PMC9946300 DOI: 10.1080/17482631.2023.2176278] [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: 05/04/2022] [Accepted: 01/31/2023] [Indexed: 02/18/2023] Open
Abstract
PURPOSE This study is an in-depth exploration of the unfolding experiences of five persons who developed dementia while still in paid work/employment, and of their significant others. Namely, we explore how they experienced the actions and decisions taken with respect to work, and what the consequences meant to them. METHODS A qualitative longitudinal case study design with multiple cases was used, including five participants with dementia and significant others of their choice. Interviews were undertaken longitudinally and analysed with the Formal Data-Structure Analysis approach. RESULTS The joint analysis resulted in two intertwined themes: 1) The significance and consequences of a dementia diagnosis: a double-edged trigger, and 2) Sensemaking and agency. The prevalent images of what dementia is, who can/cannot get it and what it will bring, were revealed as the critical aspects. Having the opportunity to make sense of what has happened and participate in decision-making, contributed decisively to the participants' experiences. CONCLUSIONS Findings illustrate how a dementia diagnosis is alien in work-life, but once diagnosed, it may trigger self-fulfiling expectations based upon stereotypical understanding of dementia. A shift is needed from a deficit-focused perspective, to viewing people with dementia as citizens capable of agency.
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Affiliation(s)
- Louise Nygard
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden
| | - Ann-Charlotte Nedlund
- Division Society and Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | | | - Arlene Astell
- Department of Occupational Sciences & Occupational Therapy & Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Jennifer Boger
- Systems Design Engineering, University of Waterloo, Waterloo, Canada
| | - Mervi Issakainen
- Department of Social Sciences, Faculty of Social Sciences and Business Studies, Kuopio
| | - Ann-Louise Engvall
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden
| | - Birgit Heuchemer
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden
| | - Lena Rosenberg
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Charlotta Ryd
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
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Kang MJY, Farrand S, Evans A, Chiu WH, Eratne D, Kelso W, Walterfang M, Velakoulis D, Loi SM. Carer burden and behavioral disturbance is similar between younger-onset Alzheimer's disease and behavioral variant frontotemporal dementia. Int Psychogeriatr 2023:1-8. [PMID: 36756758 DOI: 10.1017/s1041610222001259] [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: 02/10/2023]
Abstract
OBJECTIVES Carer burden is common in younger-onset dementia (YOD), often due to the difficulty of navigating services often designed for older people with dementia. Compared to Alzheimer's disease (AD), the burden is reported to be higher in behavioral variant frontotemporal dementia (bvFTD). However, there is little literature comparing carer burden specifically in YOD. This study hypothesized that carer burden in bvFTD would be higher than in AD. DESIGN Retrospective cross-sectional study. SETTING Tertiary neuropsychiatry service in Victoria, Australia. PARTICIPANTS Patient-carer dyads with YOD. MEASUREMENTS We collected patient data, including behaviors using the Cambridge Behavioral Inventory-Revised (CBI-R). Carer burden was rated using the Zarit Burden Inventory-short version (ZBI-12). Descriptive statistics and Mann-Whitney U tests were used to analyze the data. RESULTS Carers reported high burden (ZBI-12 mean score = 17.2, SD = 10.5), with no significant difference in burden between younger-onset AD and bvFTD. CBI-R stereotypic and motor behaviors, CBI-R everyday skills, and total NUCOG scores differed between the two groups. There was no significant difference in the rest of the CBI-R subcategories, including the behavior-related domains. CONCLUSION Carers of YOD face high burden and are managing significant challenging behaviors. We found no difference in carer burden between younger-onset AD and bvFTD. This could be due to similarities in the two subtypes in terms of abnormal behavior, motivation, and self-care as measured on CBI-R, contrary to previous literature. Clinicians should screen for carer burden and associated factors including behavioral symptoms in YOD syndromes, as they may contribute to carer burden regardless of the type.
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Affiliation(s)
- Matthew J Y Kang
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
- Melbourne Neuropsychiatry Centre & Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Sarah Farrand
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
- Melbourne Neuropsychiatry Centre & Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Andrew Evans
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Wei-Hsuan Chiu
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Dhamidhu Eratne
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
- Melbourne Neuropsychiatry Centre & Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Wendy Kelso
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Mark Walterfang
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
- Melbourne Neuropsychiatry Centre & Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Dennis Velakoulis
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
- Melbourne Neuropsychiatry Centre & Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Samantha M Loi
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
- Melbourne Neuropsychiatry Centre & Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
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Good practice in needs-based post-diagnostic support for people with young onset dementia: findings from the Angela Project. AGEING & SOCIETY 2023. [DOI: 10.1017/s0144686x22001362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Abstract
Evidence on post-diagnostic support for people with young onset dementia is scarce. Previous studies have employed a problem-focused approach; however, evidence on ‘what works’ in real-life practice is essential to develop recommendations for service design and delivery. This study aimed to provide insight into ‘what works’ from the perspectives of people with young onset dementia and their supporters. We gathered free-text responses on positive service experiences via a UK cross-sectional survey. Inductive thematic analysis was used to identify the objectives of positive services and the needs these met. Follow-up interviews enabled in-depth insights from people with diverse diagnoses, ages and social situations. These were analysed using a template drawn from the survey. The 233 survey respondents gave 856 examples of positive support. Analysis of 24 follow-up interviews led to 16 themes clustered under three superordinate themes: ‘maintaining autonomy’, ‘being myself’ and ‘togetherness’. We found that positive services address the disruptions to sense of agency, selfhood and meaningful relationships that are experienced by those with young onset dementia. The study provides an in-depth understanding of the needs met by positive services for younger people with dementia. Our nuanced findings on good practice can inform age-specific guidelines for young onset dementia and indicate how personalisation can work in practice to help people with young onset dementia to maintain identity, autonomy and connections.
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Perin S, Lai R, Diehl-Schmid J, You E, Kurz A, Tensil M, Wenz M, Foertsch B, Lautenschlager NT. Online counselling for family carers of people with young onset dementia: The RHAPSODY-Plus pilot study. Digit Health 2023; 9:20552076231161962. [PMID: 36908377 PMCID: PMC9998420 DOI: 10.1177/20552076231161962] [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: 06/06/2022] [Accepted: 02/17/2023] [Indexed: 03/11/2023] Open
Abstract
Objective Compared to late life dementia, Young Onset Dementia (YOD) has its own distinct challenges, including a lack of specialised and age-appropriate support services. Carers of people with YOD experience higher levels of psychological and physical symptoms, and lower quality of life. This study (RHAPSODY-Plus) assessed the acceptability and feasibility of combining RHAPSODY (Research to Assess Policies and Strategies for Dementia in the Young; a web-based information and skill-building programme for carers of people with YOD) with individually tailored support sessions with health professionals (a social worker and a clinical psychologist) provided via online videoconferencing. Methods Participants (n = 20) were informal carers aged over 18 years, who were caring for a person with YOD (either Alzheimer's disease or frontotemporal dementia type). Participants used the RHAPSODY programme for 4 weeks, then attended 2 support sessions. Participants and the health professionals then attended individual feedback sessions. Feedback was collected via open-ended and Likert-style questions. Results The majority of carers rated the RHAPSODY-Plus programme as good to very good, demonstrating a high level of acceptability. Positive feedback about the programme included being able to receive personal advice additionally to the information provided in RHAPSODY. The healthcare professionals also thought the programme was acceptable and beneficial for access to support. Some limitations in the feasibility of videoconferencing included network and technical issues and the loss of non-verbal communication. Conclusions This online pilot study had a high level of acceptability, demonstrating the potential of an individualised multi-modal intervention for carers of people with YOD which offers opportunities to overcome geographical and service access barriers.
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Affiliation(s)
- Stephanie Perin
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Rhoda Lai
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany.,kbo-Inn-Salzach-Klinikum, Wasserburg, Germany
| | - Emily You
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Alexander Kurz
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Maria Tensil
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Michael Wenz
- Schön Clinic Bad Aibling Harthausen, Alzheimer Therapy Centre, Bad Aibling, Germany
| | - Bettina Foertsch
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Nicola T Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Australia
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Novek S, Menec V. Conceptualizing access to community-based supports from the perspectives of people living with young onset dementia, family members and providers. DEMENTIA 2023; 22:180-196. [PMID: 36377262 PMCID: PMC9772890 DOI: 10.1177/14713012221138145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
People living with young onset dementia and their families have significant support needs, but experience difficulties accessing services. This study explored the process of accessing community-based services drawing on semi-structured interviews with people living with dementia, family members and providers in Winnipeg, Canada. Data analysis involved a combination of inductive coding and theoretical analysis using the candidacy framework as a conceptual lens. Forced to navigate services that do not recognize people with young onset dementia as a user group, participants experienced ongoing barriers that generated continuous work and stress for families. Access was constrained by information resources geared towards older adults and restrictive eligibility criteria that constructed people with young onset dementia as "not impaired enough" or "too impaired". At the organizational level, fragmentation and underrepresentation of young onset dementia diminished access. Our findings underscore the need for continuous, coordinated supports alongside broader representation of young onset dementia within research, policy, and practice. We conclude with a discussion of how the candidacy theory could be extended to account for the social and political status of user groups.
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Affiliation(s)
- Sheila Novek
- Sheila Novek, School of Nursing, University of British Columbia.
| | - Verena Menec
- Department of Community Health Sciences, Rady Faculty of Health Sciences, 423134University of Manitoba, Winnipeg, Canada
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15
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Kirve S. Exploring nursing students' knowledge of Alzheimer's disease. Nurs Older People 2022; 34:e1393. [PMID: 36128728 DOI: 10.7748/nop.2022.e1393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND As the number of people with a diagnosis of dementia continues to increase, it is essential that nurses have the skills required to provide high-quality care. However, there may be gaps in dementia teaching in undergraduate nurse education programmes in the UK. AIM To assess knowledge of Alzheimer's disease among one cohort of third-year nursing students to improve the education content of the dementia module at Oxford Brookes University, England. METHOD A total of 35 participants completed the Alzheimer's Disease Knowledge Scale, a validated tool that measures knowledge about risk factors, assessment and diagnosis, symptoms, course (disease progression), life impact, caregiving, and treatment and management. Data were analysed using quantitative methods. RESULTS Participating students appeared to have greater knowledge about dementia in relation to treatment and management, life impact, caregiving, and assessment and diagnosis, and less knowledge about risk factors, course and symptoms. This may be because the focus of teaching is on caregiving and medical treatment. CONCLUSION This study identified strengths and gaps in nursing students' knowledge of Alzheimer's disease. The results have informed recommendations for ways to improve the education content of the dementia module for future cohorts and to enhance dementia education in nursing, health and social care undergraduate programmes in general.
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16
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Kang M, Farrand S, Walterfang M, Velakoulis D, Loi SM, Evans A. Carer burden and psychological distress in young-onset dementia: An Australian perspective. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5765. [PMID: 35708197 PMCID: PMC9328388 DOI: 10.1002/gps.5765] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Carer burden in dementia is associated with poor outcomes, including early nursing home placement for people with dementia and psychological distress for their carers. Carers of people with young-onset dementia (YOD) are particularly vulnerable to carer burden. Yet they are often overlooked by clinicians as dementia services are generally designed for older people. We sought to estimate the rate of burden and psychological distress in carers of YOD at a state-wide tertiary service based in Australia. METHODS We conducted a cross-sectional study examining 71 dyads from a Neuropsychiatry service. We collected patient demographic and clinical data including the Neuropsychiatry Unit Cognitive Assessment tool (NUCOG) and Mini-Mental State Examination (MMSE). Carer data, such as demographics and psychological distress, were obtained using Depression Anxiety Stress Scale 21 (DASS-21). Carer burden was rated using the Zarit Burden Inventory-short version (ZBI). RESULTS Higher carer burden, measured using ZBI, was associated with longer duration of dementia and greater severity of overall cognitive impairment. Carers who felt burdened reported higher levels of stress, depression, and anxiety measured using DASS-21. Multiple linear regression analysis found carer burden was independently predicted by duration of dementia, total cognition score and carers experiencing psychological stress. DISCUSSION We found that patient variables of dementia duration and cognitive impairment and carer variable of carer stress to be associated with carer burden. Poor executive function was associated with carer stress. Early identification and management of carer burden and psychological distress is important for outcomes. Ideally, this should be provided by a specialist YOD service.
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Affiliation(s)
- Matthew Kang
- NeuropsychiatryRoyal Melbourne HospitalParkvilleVICAustralia
- Melbourne Neuropsychiatry Centre & Department of PsychiatryUniversity of MelbourneParkvilleVICAustralia
| | - Sarah Farrand
- NeuropsychiatryRoyal Melbourne HospitalParkvilleVICAustralia
- Melbourne Neuropsychiatry Centre & Department of PsychiatryUniversity of MelbourneParkvilleVICAustralia
| | - Mark Walterfang
- NeuropsychiatryRoyal Melbourne HospitalParkvilleVICAustralia
- Melbourne Neuropsychiatry Centre & Department of PsychiatryUniversity of MelbourneParkvilleVICAustralia
| | - Dennis Velakoulis
- NeuropsychiatryRoyal Melbourne HospitalParkvilleVICAustralia
- Melbourne Neuropsychiatry Centre & Department of PsychiatryUniversity of MelbourneParkvilleVICAustralia
| | - Samantha M. Loi
- NeuropsychiatryRoyal Melbourne HospitalParkvilleVICAustralia
- Melbourne Neuropsychiatry Centre & Department of PsychiatryUniversity of MelbourneParkvilleVICAustralia
| | - Andrew Evans
- Department of NeurologyRoyal Melbourne HospitalMelbourneVICAustralia
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17
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Gerritzen EV, McDermott O, Orrell M. Towards the development of a best practice guidance on online peer support for people with Young Onset Dementia: a mixed-methods study protocol (Preprint). JMIR Res Protoc 2022; 11:e38379. [PMID: 35788470 PMCID: PMC9297145 DOI: 10.2196/38379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/09/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Esther Vera Gerritzen
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Orii McDermott
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Martin Orrell
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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18
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Abstract
Background While it is less common, young onset dementia manifests at a significantly younger age (< 65). Many people with young onset dementia are parents; however, little is known about impact of the condition on children and young adults. A qualitative thematic analysis was conducted to synthesise the literature on the perspectives of children and young adults with a parent living with young onset dementia. Methods Electronic databases were searched in order to identify all peer-reviewed literature in relation to the perspectives of children and young adults with a parent living with young onset dementia. A thematic analysis was conducted on the relevant literature. Results The electronic database search resulted in 15 full texts articles. Four main themes with related subthemes emerged from the thematic analysis. The four main themes were: changing family dynamics; psychological and physical strain; stigma and coping strategies. Conclusion The current synthesis outlines the perspectives of children and young adults with a parent living with young onset dementia. There is a significant lack of research in this area which adds to the stereotypical view of dementia as an older person’s disease. This can lead to children and young adults being impacted by lack of awareness and stigma resulting in significant psychosocial problems. As the number of people living with dementia (including young onset) is set to increase, future research with children and young adults with a parent with young onset dementia is important in order to better support this cohort.
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Affiliation(s)
- Cathal Blake
- School of Psychology, 8818Dublin City University, Dublin, Ireland
| | - Louise Hopper
- School of Psychology, 8818Dublin City University, Dublin, Ireland
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19
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Talbot CV, Briggs P. The use of digital technologies by people with mild-to-moderate dementia during the COVID-19 pandemic: A positive technology perspective. DEMENTIA 2022; 21:1363-1380. [PMID: 35333111 PMCID: PMC8960751 DOI: 10.1177/14713012221079477] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A growing body of research has shown that people with dementia are using digital technologies to enhance lived experience. The COVID-19 pandemic has brought new digital opportunities and challenges and so provides a unique opportunity to understand how people with dementia have adapted to this new digital landscape. Semi-structured interviews were conducted with 19 people with dementia and analysed thematically. We generated five themes, showing how participants used digital means to combat the stresses of the pandemic by facilitating social connection, self-actualisation, enhanced well-being and by assisting with activities of daily life. These technologies helped to reduce isolation, provide access to support groups, create opportunities for cognitive stimulation and self-development, and engendered a sense of identity at a time of perceived loss. Despite these benefits, participants also reported challenges regarding cognitive fatigue and usability issues. We recommend that training on how to use digital technologies is co-produced with people with dementia and designers engage with the voices of people with dementia throughout the design process. In turn, this could promote the social connectedness, well-being and self-worth of people with dementia.
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Affiliation(s)
| | - Pam Briggs
- Department of Psychology, 5995Northumbria University, Newcastle upon Tyne, UK
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20
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Ikeuchi S, Omote S, Tanaka K, Okamoto R, Morikawa Y, Iritani O. Work-related experiences of people living with young-onset dementia in Japan. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:548-557. [PMID: 32893417 DOI: 10.1111/hsc.13157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 08/05/2020] [Accepted: 08/14/2020] [Indexed: 06/11/2023]
Abstract
Dementia that occurs before age 65 years is defined as young-onset dementia (YOD). YOD develops during the prime of a person's working life and has a major impact on not only work but life in general. Therefore, Japan is promoting measures to support work and social participation, taking into account the characteristics of people living with YOD. Given the rarity of YOD, few studies have examined the difficulties faced by people living with YOD during this life stage or the kinds of support they require. We believe that studying these difficulties and support requirements will contribute to prolonging the careers of people living with YOD and to providing them support during social, emotional and economic crises. This qualitative study aims to clarify the experiences of working-age Japanese people living with YOD to examine, from their perspective, possibilities for employment support. For this study, people living with YOD who were currently working were recruited by snowball sampling. This study was conducted in Japan between September 2018 and February 2019. A semi-structured interview was conducted, and the contents were transcribed and analysed using Colaizzi's qualitative methodology. Four categories were derived: (a) crisis from continuing to work, (b) seeking support, (c) overcoming challenges to work and (d) reaffirming a sense of purpose by resuming work and social participation. Participants were able to continue working and socialising by letting others know about their illness and seeking support. In the process of reaffirming a sense of purpose by resuming work and social participation, participants continued working or transitioned to socially active lives after leaving their job thanks to the support of work colleagues and medical and healthcare/welfare professionals who understand YOD. The results indicate a need for awareness raising in the workplace to promote understanding of such professional support and its significance.
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Affiliation(s)
- Satomi Ikeuchi
- School of Nursing, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
- Division of Health Sciences, Doctoral Course of Graduate School of Medical Sciences, Kanazawa University, Kahoku-gun, Ishikawa, Japan
| | - Shizuko Omote
- Division of Nursing, Faculty of Health Science, Kanazawa University, Kahoku-gun, Ishikawa, Japan
| | - Koji Tanaka
- Division of Nursing, Faculty of Health Science, Kanazawa University, Kahoku-gun, Ishikawa, Japan
| | - Rie Okamoto
- Division of Nursing, Faculty of Health Science, Kanazawa University, Kahoku-gun, Ishikawa, Japan
| | - Yuko Morikawa
- School of Nursing, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Osamu Iritani
- School of Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
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21
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Stamou V, La Fontaine J, O'Malley M, Jones B, Parkes J, Carter J, Oyebode JR. Helpful post-diagnostic services for young onset dementia: Findings and recommendations from the Angela project. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:142-153. [PMID: 33951252 DOI: 10.1111/hsc.13383] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 03/04/2021] [Accepted: 03/15/2021] [Indexed: 06/12/2023]
Abstract
There is a significant lack of evidence regarding optimum models for service provision in young onset dementia (YOD). Our study aim was to gather detailed information about services experienced as helpful by those with YOD and family carers. The objective was to identify the core features of these services to inform service design, delivery and improvements. A qualitative approach based on appreciative inquiry was used, posing open-ended questions about services experienced as helpful, as part of a national UK survey of people with YOD and carers. We used inductive thematic analysis to analyse the free-text responses. The resulting template was used as a basis for analysis of in-depth follow-up interviews, conducted to acquire greater in-depth understanding. Two hundred and thirty-three survey respondents provided 856 examples of helpful support. Twenty-four follow-up interviews were conducted (two with dyads, so 26 participants in total: 8 with people with YOD, 14 with carers, 2 with dyads). Twelve themes capturing the features of helpful services were clustered into three super-ordinate themes. 'Person-centredness' reflects micro levels of person-professional interaction (positive attitude, flexibility, collaborative, user-friendly materials, and in-person). 'Functional consistency' captures the meso level, demonstrating that services were helpful when organised consistently with needs (age-appropriate, holistic, responsive, and accessible). 'Organisational coherence', at the macro level, emphasises the need for service integration, specialist services and service continuity. Key conclusions are that the needs for flexibility and a collaborative stance may be particularly important for those under 65 years with dementia, who have full lives and are used to being in control; to be age-appropriate, helpful services need to provide activities and opportunities suitable for active middle-aged people; and to be holistic, services need to provide for needs associated with rare dementias and be family-centred. Specialist services need to be commissioned and arrangements need to be stable over time to enable continuity.
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Affiliation(s)
- Vasileios Stamou
- Faculty of Health Studies, Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Jenny La Fontaine
- Faculty of Health Studies, Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Mary O'Malley
- Faculty of Health, Education and Society, University of Northampton, Northampton, UK
| | - Bridget Jones
- Department of Economics, Surrey Health Economics Centre, University of Surrey, Guildford, UK
| | - Jacqueline Parkes
- Faculty of Health, Education and Society, University of Northampton, Northampton, UK
| | - Janet Carter
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Jan R Oyebode
- Faculty of Health Studies, Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
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22
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Popok PJ, Reichman M, LeFeber L, Grunberg VA, Bannon SM, Vranceanu AM. OUP accepted manuscript. THE GERONTOLOGIST 2022; 62:1311-1323. [PMID: 35442443 PMCID: PMC9579459 DOI: 10.1093/geront/gnac050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Young-onset dementias (YODs) are a set of progressive illnesses that are stressful for both persons with the diagnosis and their care-partners. Although the stressors differ based on their roles and individual experiences, both individuals are at risk for heightened emotional distress (e.g., depression and anxiety). Understanding the unique stressors for each partner and adaptive coping strategies to manage these stressors is important for informing individual and couples-based psychosocial interventions. RESEARCH DESIGN AND METHODS We conducted open-ended individual interviews with persons with YOD (N = 12) and their care-partners (i.e., romantic partner; N = 17) over live video. We utilized a hybrid of deductive and inductive analysis techniques to extract individual-level themes and subthemes regarding stressors and adaptive coping strategies. RESULTS Persons with YOD identified stressors including burden of YOD symptoms, loss of familial roles, resentment toward partner, isolation, and fear of the future. Care-partners identified stressors including managing their partners' symptoms, increased responsibilities, caregiving role, loss of intimacy, social isolation, and grief. For adaptive coping strategies, persons with YOD endorsed use of acceptance, promotion of independence, social support, and engaging in pleasurable activities. Care-partners endorsed value of learning about the diagnosis, using resources, optimism, social support, and self-care. DISCUSSION AND IMPLICATIONS Findings highlight the unique experiences of persons with YOD and their care-partners. Identified themes can be used to inform role-specific psychosocial interventions for both individuals and couples coping with YOD.
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Affiliation(s)
- Paula J Popok
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Mira Reichman
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Lisa LeFeber
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Victoria A Grunberg
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Sarah M Bannon
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Ana-Maria Vranceanu
- Address correspondence to: Ana-Maria Vranceanu, PhD, Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, One Bowdoin Square, 1st Floor, Suite 100, Boston, MA 02114, USA. E-mail:
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23
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Ruiz-Adame M. A Systematic Review of the Indirect and Social Costs in Early and Young Onset Dementias. J Alzheimers Dis 2021; 85:21-29. [PMID: 34806610 DOI: 10.3233/jad-215204] [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
BACKGROUND The World Health Organization has estimated that worldwide around 50 million people have dementia. The World Alzheimer Report estimated that between 2 and 10% of all cases of dementia begin before the age of 65. Early and young onset dementias (EYOD) provoke more working, social, family, and economic consequences than late onset dementias. All general studies about costs of dementias show that most of them are indirect or social costs. Despite that, very few studies have been performed in EYOD. OBJECTIVE To do a systematic review of literature about indirect or social costs in EYOD to know the state of knowledge and to discover gaps that should be filled. METHODS A systematic review was performed in the main database: Scopus, PsychInfo, Web of Science (Web of Science Core Collection, Medline and SciELO), and CINAHL. Additionally, we looked for reviews in Cochrane and in the International Prospective Register Of Systematic Reviews (PROSPERO). RESULTS Most of the studies are about costs of dementias in general, but they do no differentiate costs for the case of EYOD. Many studies highlight the increased costs for EYOD but very little included evidence of that. 135 papers were selected. Finally, only two were studies providing data. EYOD reduce the odds to get or maintain a job. Most of the care is provided by informal caregivers. The costs in EYOD are 39.26% higher among EYOD than in late onset. CONCLUSION There is a lack of studies about social and indirect costs in EYOD. More evidence is needed.
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Shastri K, Boger J, Marashi S, Astell A, Dove E, Nedlund AC, Mäki-Petäjä-Leinonen A, Nygård L. Working towards inclusion: Creating technology for and with people living with mild cognitive impairment or dementia who are employed. DEMENTIA 2021; 21:556-578. [PMID: 34749536 PMCID: PMC8811323 DOI: 10.1177/14713012211051885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Earlier diagnosis and longer working careers is resulting in more individuals being identified as having Mild Cognitive Impairment or Early Onset Dementia (MCI/EOD) when they are still in the workforce. While there is growing interest in the dementia research community and beyond to develop technologies to support people with dementia, the use of technology for and by people with MCI/EOD in the workplace has had very little attention. This paper presents a two-part study involving interviews and participatory sessions to begin to understand the workplace experiences and the role of technology among people living with MCI/EOD. We present our findings from working with seven people with MCI/EOD and two care partners to explore technology design. Our results indicate several similarities as well as a few differences between MCI/EOD and later-onset dementia with respect to challenges using technology and design considerations for supporting engagement and use of technology. Lessons learned through the process of working with people with MCI/EOD through participatory methods is presented along with recommendations to foster an inclusive, respectful, and empowering experience for participants with MCI/EOD.
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Affiliation(s)
| | - Jennifer Boger
- University of Waterloo, Canada; Research Institute for Aging, Canada
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25
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Grunberg VA, Bannon SM, Reichman M, Popok PJ, Vranceanu AM. Psychosocial treatment preferences of persons living with young-onset dementia and their partners. DEMENTIA 2021; 21:41-60. [PMID: 34151598 DOI: 10.1177/14713012211027007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Persons living with young-onset dementia and their partners often experience elevated emotional distress as they cope with an unexpected progressive illness during an active life stage (typically ages 45-64 years). Despite their heightened emotional distress, psychosocial resources are both limited and lack the specificity to meet the unique needs of both partners. Our aim was to gain an in-depth understanding of the psychosocial treatment preferences of persons with young-onset dementia and their partners-an important first step in developing a tailored intervention. We conducted semi-structured dyadic interviews with persons with young-onset dementia and their partners (N = 23) and used a hybrid deductive-inductive approach to thematic analysis. We identified 12 themes across four domains: (1) perceptions of available and lacking resources, (2) preferences for program content, (3) preferences for program format, and (4) barriers and facilitators to participation. Couples indicated there is a lack of specific and family-oriented resources, which can create more stress and relationship strain. Couples endorsed support for a virtual, dyadic intervention delivered shortly after diagnosis focused on providing tools to cope with difficult emotions and symptom progression and enhance communication and meaningful daily living. They also identified potential barriers to program participation and offered suggestions to promote engagement. By using a qualitative approach, we were able to gather nuanced information that can be used to directly inform a feasible, accepted, and person-centered psychosocial intervention for persons with young-onset dementia and their partners.
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Affiliation(s)
- Victoria A Grunberg
- Integrated Brain Health Clinical and Research Program, 2348Department of Psychiatry, Massachusetts General Hospital; 1811Harvard Medical School, Boston, MA, USA
| | - Sarah M Bannon
- Integrated Brain Health Clinical and Research Program, 2348Department of Psychiatry, Massachusetts General Hospital; 1811Harvard Medical School, Boston, MA, USA
| | - Mira Reichman
- Integrated Brain Health Clinical and Research Program, 2348Department of Psychiatry, Massachusetts General Hospital; 1811Harvard Medical School, Boston, MA, USA
| | - Paula J Popok
- Integrated Brain Health Clinical and Research Program, 2348Department of Psychiatry, Massachusetts General Hospital; 1811Harvard Medical School, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, 2348Department of Psychiatry, Massachusetts General Hospital; 1811Harvard Medical School, Boston, MA, USA
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26
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Pan J, Wang P, Wang Y. Expanding role of nurses in management of dementia in geriatrics: improving well-being of geriatric patients through quality nursing care. PSYCHOL HEALTH MED 2021; 27:707-714. [PMID: 34130559 DOI: 10.1080/13548506.2021.1939890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The potential nurses role to include the recognition and management of dementia has been acknowledged. Practice Nurses are well-positioned to provide comprehensive dementia information and support so that people living with dementia are better equipped to self-manage their health and live well with dementia. However, treatment of geriatric dementia has become difficult owing to co-morbidities and cognitive and physical deterioration of these patients. Thus, geriatric dementia patients require special attention during care in homes and clinical settings. In modern medical practice, the role of nurse has become dynamic, ranging from education and personal care. The profession of nursing is considered as critical to meets the needs of the elderly population with dementia and ensure the delivery of high-quality care. Since nurses play such an important role in caring for these individuals, comprehensive reviews lack on their role and experience in geriatric dementia treatment and issues. This review summarizes the expanding role of nurses in the management of geriatric dementia in terms of nurse's knowledge, role, communication, attitude and maintaining patient's quality of life through diverse activities. Furthermore, we also explain the future direction for improving the nursing care to treat dementia in elderly population.
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Affiliation(s)
- Jiangxia Pan
- Nursing Department, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang Province, P.R. China
| | - Pingping Wang
- Chronic Rehabilitation Department, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang Province, P.R. China
| | - Yannan Wang
- Department of Scientific Research, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang Province, P.R. China
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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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Stamou V, Fontaine JL, O'Malley M, Jones B, Gage H, Parkes J, Carter J, Oyebode J. The nature of positive post-diagnostic support as experienced by people with young onset dementia. Aging Ment Health 2021; 25:1125-1133. [PMID: 32067481 DOI: 10.1080/13607863.2020.1727854] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Studies on service needs of people with young onset dementia have taken a problem-oriented approach with resulting recommendations focusing on reducing service shortcomings. This study aimed to build on 'what works' in real-life practice by exploring the nature of post-diagnostic support services that were perceived positively by younger people with dementia and carers. METHOD Positive examples of support were gathered between August 2017 and September 2018, via a national survey. Inductive thematic analysis was employed to explore the nature of positively experienced services provided for younger people with dementia, including analysis of what was provided by positively experienced services. RESULTS Two hundred and thirty-three respondents reported 856 positive experiences of support. Data analysis yielded eight themes regarding the objectives of positive services: Specialist Advice and Information on Young Onset Dementia, Access to Age-appropriate Services, Interventions for Physical and Mental Health, Opportunities for Social Participation, Opportunities to Have a Voice, Enablement of Independence while Managing Risk, Enablement of Financial Stability, and Support Interventions for Family Relationships. CONCLUSION The study findings (a) suggest that positive services may collectively create an enabling-protective circle that supports YPD to re-establish and maintain a positive identity in the face of young onset dementia, and (b) provide a basis from which future good practice can be developed.
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Affiliation(s)
- Vasileios Stamou
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Jenny La Fontaine
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Mary O'Malley
- The UoN Dementia Research & Innovation Centre, Faculty of Health, Education and Society, University of Northampton, Northampton, UK
| | - Bridget Jones
- Surrey Health Economics Centre, Department of Economics, University of Surrey, Guildford, Surrey, UK
| | - Heather Gage
- Surrey Health Economics Centre, Department of Economics, University of Surrey, Guildford, Surrey, UK
| | - Jacqueline Parkes
- The UoN Dementia Research & Innovation Centre, Faculty of Health, Education and Society, University of Northampton, Northampton, UK
| | - Janet Carter
- Division of Psychiatry, Faculty of Brain Sciences, Maple House, University College London, London, UK
| | - Jan Oyebode
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford, UK
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29
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Goh AMY, You E, Perin S, Lautenschlager NT, Clay FJ, Loi SM, Chong T, Ames D, Chiu E, Ellis KA. Alcohol Use, Mental Health, and Functional Capacity as Predictors of Workplace Disability in a Cohort With Manifest Huntington's Disease. J Neuropsychiatry Clin Neurosci 2021; 32:235-243. [PMID: 32102602 DOI: 10.1176/appi.neuropsych.19090199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Huntington's disease (HD) is an inherited neurodegenerative disease involving motor, cognitive, psychiatric, and behavioral impairments that eventually affect work-role functioning. There is limited research regarding predictors of workplace disability in HD. The authors examined predictors of work impairment and disability in a cross-sectional cohort of employed persons with symptomatic HD participating in the worldwide Enroll-HD study. METHODS The study sample (N=316) comprised individuals with manifest HD and a CAG repeat length range between 39 and 60 and were currently engaged in paid full- or part-time employment. Univariate and multivariate logistic regression analyses identified predictors and the effect of all predictors in a fully adjusted model. RESULTS Of the sample, 20.3% reported missing work due to HD, 60.1% reported experiencing impairment while working due to HD, 79.1% reported having work-related activity impairment due to HD, and 60.8% reported impairment in overall work productivity due to HD. Individuals had 25% higher odds of missing work time if they had a higher level of functional impairment (odds ratio=0.76, 95% CI=0.64, 0.91) and had three times greater odds of missing work if they were current alcohol drinkers, compared with nondrinkers (odds ratio=2.86, 95% CI=1.62, 5.03). Individuals with lower self-perceived mental health were also 5% more likely to experience impairment at work due to HD. Motor impairment was not a strong predictor of workplace disability. CONCLUSIONS These findings provide important new knowledge that can inform the development of strategies or targeted intervention trials to support persons with symptomatic HD to maintain their work roles.
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Affiliation(s)
- Anita M Y Goh
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - Emily You
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - Stephanie Perin
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - Nicola T Lautenschlager
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - Fiona J Clay
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - Samantha M Loi
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - Terence Chong
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - David Ames
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - Edmond Chiu
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - Kathryn A Ellis
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
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Talbot CV, Briggs P. 'Getting back to normality seems as big of a step as going into lockdown': the impact of the COVID-19 pandemic on people with early to middle stage dementia. Age Ageing 2021; 50:657-663. [PMID: 33481988 PMCID: PMC7929391 DOI: 10.1093/ageing/afab012] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Indexed: 01/10/2023] Open
Abstract
People with dementia can experience shrinkage of their social worlds, leading to a loss of independence, control and reduced well-being. We used 'the shrinking world' theory to examine how the COVID 19 pandemic has impacted the lives of people with early to middle stage dementia and what longer-term impacts may result. Interviews were conducted with 19 people with dementia and a thematic analysis generated five themes: the forgotten person with dementia, confusion over government guidance, deterioration of cognitive function, loss of meaning and social isolation, safety of the lockdown bubble. The findings suggest that the pandemic has accelerated the 'shrinking world' effect and created tension in how people with dementia perceive the outside world. Participants felt safe and secure in lockdown but also missed the social interaction, cognitive stimulation and meaningful activities that took place outdoors. As time in lockdown continued, these individuals experienced a loss of confidence and were anxious about their ability to re-engage in the everyday practises that allow them to participate in society. We recommend ways in which the government, communities and organisations might counteract some of the harms posed by this shrinking world.
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Affiliation(s)
- Catherine V Talbot
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
- Department of Psychology, Bournemouth University, Poole, UK
| | - Pam Briggs
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
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31
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Mayrhofer AM, Greenwood N, Smeeton N, Almack K, Buckingham L, Shora S, Goodman C. Understanding the financial impact of a diagnosis of young onset dementia on individuals and families in the United Kingdom: Results of an online survey. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:664-671. [PMID: 33745216 DOI: 10.1111/hsc.13334] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/07/2021] [Accepted: 02/09/2021] [Indexed: 06/12/2023]
Abstract
Although literature on postdiagnostic support for people affected by young onset dementia acknowledges financial concerns, this topic has remained underresearched. The aim of this study was to explore the financial impact of a diagnosis of young onset dementia on individuals and families. An online survey, comprising binary yes/no, multiple-response and open-ended questions, was codesigned with people living with young onset dementia. The survey was promoted via networks and online platforms. Data were collected from August to October 2019. Survey respondents across the United Kingdom (n = 55) who had received a diagnosis of young onset dementia were aged between 45 and 64, were at different stages of dementia and had been diagnosed with thirteen different types of dementia. Of the 55 respondents, 71% (n = 39) had received assistance from family members when completing the survey. The main financial impact of a diagnosis of young onset dementia resulted from premature loss of income and reduced and often deferred pension entitlements. In some cases, care-costs became unaffordable. Lack of clarity of processes and procedures around needs assessments, carers' assessments and financial assessments by different organisations resulted in some families having to ask for legal advice and, in some cases, involved lengthy appeal processes. Future research needs to involve Adult Social Care and Third Sector organisations to help codesign and test financial management interventions to support people affected by this progressive health condition.
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Affiliation(s)
- Andrea M Mayrhofer
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK
| | - Nan Greenwood
- Faculty of Health, Social Care and Education, St George's University of London and Kingston University, London, UK
| | - Nigel Smeeton
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK
| | - Kathryn Almack
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK
| | | | - Shaheen Shora
- Hertfordshire Partnership University NHS Foundation Trust, Hatfield, UK
| | - Claire Goodman
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK
- CRIPACC, Faculty of Health and Human Sciences, University of Hertfordshire, Hatfield, UK
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32
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Bolger E, Egdell V, Ritchie L. Dementia in the workplace: the implications for career development practice. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2021. [DOI: 10.1080/03069885.2021.1902471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Emma Bolger
- School of Education and Social Sciences, University of the West of Scotland, Paisley, UK
| | - Valerie Egdell
- Newcastle Business School, Northumbria University, Newcastle upon Tyne, UK
| | - Louise Ritchie
- School of Health and Life Sciences, University of the West of Scotland, Lanarkshire, UK
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Bannon SM, Grunberg VA, Reichman M, Popok PJ, Traeger L, Dickerson BC, Vranceanu AM. Thematic Analysis of Dyadic Coping in Couples With Young-Onset Dementia. JAMA Netw Open 2021; 4:e216111. [PMID: 33856476 PMCID: PMC8050740 DOI: 10.1001/jamanetworkopen.2021.6111] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 02/25/2021] [Indexed: 12/17/2022] Open
Abstract
Importance A diagnosis of young-onset dementia (YOD) is a life-altering event for both persons with dementia and their spousal caregivers. Dyadic coping (DC) theoretical models acknowledge that dyads cope with stressors as a unit, but these models have yet to be used in YOD. Objective To explore the lived experiences of couples managing YOD using an integrated DC model. Design, Setting, and Participants This qualitative study recruited couples from a single major medical setting and through social media. Eligibility criteria included cohabitation, 1 partner diagnosed with YOD and able to participate, and both partners willing to participate. Live online video interviews were conducted from March to June 2020. Exposures One semistructured interview, which was recorded and subsequently transcribed. Recruitment was stopped once thematic saturation was reached. Main Outcomes and Measures Five themes were deductively derived based on the integrated DC framework, including stress communication, positive individual DC, positive conjoint DC, negative individual DC, and negative conjoint DC. Within each theme, subthemes were inductively identified to further characterize couples' dyadic coping experiences with YOD. Results A total of 23 couples were interviewed, comprising persons with dementia (11 women [48%]; mean [SD] age, 61.3 [4.65] years; mean [SD] time from diagnosis, 3.11 [3.85]) years; and spousal caregivers (13 women [57%]; mean [SD] age, 60.5 [5.40] years). Data supported the 5 a priori DC themes and novel subthemes describing couples' experiences with YOD. Specifically, couples enacted positive conjoint DC by approaching challenges using a teamwork approach to problem solving and relying on collaborative communication. In contrast, couples engaged in negative conjoint DC through mutual avoidance, leading to increased negative communication and conflict. Couples described initially engaging in avoidance and withdrawal to navigate YOD-related stressors. While these strategies provided short-term relief from challenging emotions, they prevented engagement in adaptive coping (eg, acceptance and collaborative problem-solving) to promote long-term adjustment. Conclusions and Relevance This study used an evidence-based integrated DC approach to identify the positive and negative coping behaviors of couples managing YOD. To our knowledge, this is the first study to use a DC framework to guide qualitative analysis, and it provides valuable insights into DC strategies used by couples navigating YOD-related stressors. Findings can inform the development of dyadic psychosocial services for couples managing YOD and have implications for other progressive illnesses.
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Affiliation(s)
- Sarah M. Bannon
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Victoria A. Grunberg
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Mira Reichman
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Paula J. Popok
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Lara Traeger
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Bradford C. Dickerson
- Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
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Talbot CV, O'Dwyer ST, Clare L, Heaton J. The use of Twitter by people with young-onset dementia: A qualitative analysis of narratives and identity formation in the age of social media. DEMENTIA 2021; 20:2542-2557. [PMID: 33765848 PMCID: PMC8564236 DOI: 10.1177/14713012211002410] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A diagnosis of dementia in midlife can be challenging, causing losses or changes in a
person’s identity. Narrative provides a means of reconstructing identity and can be
communicated on social media. There has been initial evidence on the value of Twitter for
people with dementia, but researchers have not yet directly engaged with users’
perspectives. We employed a narrative model of identity to examine why people with
dementia use Twitter and what challenges they face. Interviews were conducted with 11
younger people with dementia and analysed thematically. Participants used Twitter to
counter a loss of identity through community membership and by regaining a sense of
purpose. They sought to redefine dementia identities by challenging stigma and campaigning
for social change. The character limit of tweets facilitated narrative through which
participants preserved their identities. These findings suggest that Twitter could be an
important source of post-diagnostic support for people with young-onset dementia. However,
there are some risks as Twitter was sometimes a hostile environment for individuals who
did not present in a ‘typical’ manner, or faced technical difficulties because of their
symptoms. In the future, platform developers could work with people with dementia to make
Twitter more accessible for this group.
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Affiliation(s)
| | | | - Linda Clare
- College of Medicine and Health, 171002University of Exeter, UK
| | - Janet Heaton
- Division of Rural Health and Wellbeing, 7709University of the Highlands and Islands, UK
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Stamou V, La Fontaine J, Gage H, Jones B, Williams P, O'Malley M, Parkes J, Carter J, Oyebode J. Services for people with young onset dementia: The 'Angela' project national UK survey of service use and satisfaction. Int J Geriatr Psychiatry 2021; 36:411-422. [PMID: 32979287 DOI: 10.1002/gps.5437] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/16/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Young onset dementia is associated with distinctive support needs but existing research on service provision has been largely small scale and qualitative. Our objective was to explore service use, cost and satisfaction across the UK. METHODS Information about socio-demographic characteristics, service use and satisfaction were gathered from people with young onset dementia (YOD) and/or a family member/supporter via a national survey. RESULTS Two hundred and thirty-three responses were analysed. Diagnosis was most commonly received through a Memory Clinic or Neurology. The type of service delivering diagnosis impacted on post-diagnostic care. Those diagnosed in specialist YOD services were more likely to receive support within the first 6 weeks and receive ongoing care in the service where they were diagnosed. Ongoing care management arrangements varied but generally care was lacking. Around 42% reported no follow-up during 6-weeks after diagnosis; over a third reported seeing no health professional within the previous 3 months; just over a third had a key worker and just under a third had a care plan. Satisfaction and quality of care were highest in specialist services. Almost 60% of family members spent over 5 h per day caring; median costs of health and social care, 3 months, 2018, were £394 (interquartile range £389 to 640). CONCLUSIONS Variation across diagnostic and post-diagnostic care pathways for YOD leads to disparate experiences, with specialist young onset services being associated with better continuity, quality and satisfaction. More specialist services are needed so all with YOD can access age-appropriate care.
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Affiliation(s)
- Vasileios Stamou
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford, UK.,Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Jenny La Fontaine
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Heather Gage
- Surrey Health Economics Centre, Department of Economics, University of Surrey, Guildford, UK
| | - Bridget Jones
- Surrey Health Economics Centre, Department of Economics, University of Surrey, Guildford, UK
| | - Peter Williams
- Department of Mathematics, University of Surrey, Guildford, UK
| | - Mary O'Malley
- Centre for Applied Mental Health Research, Faculty of Health and Society, University of Northampton, Northampton, UK.,School of Biomedical Sciences, University of West London, London, UK
| | - Jacqueline Parkes
- Centre for Applied Mental Health Research, Faculty of Health and Society, University of Northampton, Northampton, UK
| | - Janet Carter
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Jan Oyebode
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford, UK
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Cartwright AV, Stoner CR, Pione RD, Spector A. The experiences of those affected by parental young onset dementia: A qualitative systematic literature review. DEMENTIA 2021; 20:2618-2639. [PMID: 33517771 PMCID: PMC8564265 DOI: 10.1177/1471301220988231] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM To develop understanding of the lived experiences of children of people living with young onset dementia, defined as individuals both under and over the age of 18 years whose parent was diagnosed with dementia before the age of 65 years. METHOD A critical appraisal and thematic synthesis of the available qualitative literature regarding the lived experience of individuals whose parent has a diagnosis of young onset dementia. A three-stage approach for conducing thematic synthesis was followed. RESULTS 15 articles were included in the review. Four analytical themes and 11 subthemes were found. The analytical themes were 'making sense of dementia', 'impact of dementia', 'coping' and 'support'. CONCLUSIONS The experiences of those affected by parental young onset dementia vary widely. There is a lack of knowledge and understanding of young onset dementia by professionals and the public, and a scarcity of appropriate support. This has clinical implications for professionals working with families affected by young onset dementia, in particular with regards to service design and delivery.
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Affiliation(s)
- Anna V Cartwright
- Department of Clinical, Educational and Health Psychology, 4919University College London (UCL), UK
| | - Charlotte R Stoner
- Department of Clinical, Educational and Health Psychology, 4919University College London (UCL), UK
| | - Richard D Pione
- Department of Clinical, Educational and Health Psychology, 4919University College London (UCL), UK
| | - Aimee Spector
- Department of Clinical, Educational and Health Psychology, 4919University College London (UCL), UK
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Egdell V, Cook M, Stavert J, Ritchie L, Tolson D, Danson M. Dementia in the workplace: are employers supporting employees living with dementia? Aging Ment Health 2021; 25:134-141. [PMID: 31549517 DOI: 10.1080/13607863.2019.1667299] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES As working lives extend and there is better recognition of early-onset dementias, employers need to consider dementia as a workplace concern. With suitable support, people living with dementia can continue employment - although, this is not appropriate for all. The requirement for employers to support employees living with dementia has human rights and legal foundations. This article considers whether employers consider dementia as a workplace concern; and the policies and/or practices available to support employees living with dementia. Thus, it develops understanding of whether employers are meeting their human rights/legislative obligations. METHOD A sequential mixed-methods approach was employed, with data collection undertaken in Scotland (United Kingdom). An online survey was sent to employers across Scotland, with 331 participating. Thirty employer interviews were conducted, with the survey results informing the interview approach. RESULTS The survey and interview data were analyzed separately and then combined and presented thematically. The themes identified were (1) Dementia as a workplace concern, (2) Support for employees living with dementia and (3) Employer policy development and awareness raising. The findings demonstrate dementia awareness, but this knowledge is not applied to employment situations. There was little evidence suggesting that the rights of employees living with dementia are consistently upheld. CONCLUSION This research sends out strong messages about the rights and legal position of person living with dementia which cannot be ignored. The continuing potential of employees living with dementia and their legal rights are not consistently recognized. This highlights the need for robust training interventions for employers.
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Affiliation(s)
- Valerie Egdell
- Newcastle Business School, Northumbria University, Newcastle upon Tyne, UK
| | - Mandy Cook
- Centre for International Research on Care, Labour and Equalities, University of Sheffield, Sheffield, UK
| | - Jill Stavert
- Centre for Mental Health and Capacity Law, Edinburgh Napier University, Edinburgh, UK
| | - Louise Ritchie
- Alzheimer Scotland Centre for Policy and Practice, University of the West of Scotland, Lanarkshire, UK
| | - Debbie Tolson
- Alzheimer Scotland Centre for Policy and Practice, University of the West of Scotland, Lanarkshire, UK
| | - Michael Danson
- Business Management, Heriot-Watt University, Edinburgh, UK
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Roach P, Zwiers A, Cox E, Fischer K, Charlton A, Josephson CB, Patten SB, Seitz D, Ismail Z, Smith EE. Understanding the impact of the COVID-19 pandemic on well-being and virtual care for people living with dementia and care partners living in the community. DEMENTIA 2020; 20:2007-2023. [PMID: 33381996 PMCID: PMC7952494 DOI: 10.1177/1471301220977639] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The COVID-19 pandemic has necessitated public health measures that have impacted the provision of care for people living with dementia and their families. Additionally, the isolation that results from social distancing may be harming well-being for families as formal and informal supports become less accessible. For those living with dementia and experiencing agitation, social distancing may be even harder to maintain, or social distancing could potentially aggravate dementia-related neuropsychiatric symptoms. To understand the lived experience of social and physical distancing during the COVID-19 pandemic in Canada, we remotely interviewed 21 participants who normally attend a dementia specialty clinic in Calgary, Alberta, during a period where essential businesses were closed and health care had abruptly transitioned to telemedicine. A reflexive thematic analysis was used to analyze the interview and field note data. The impacts of the public health measures in response to the pandemic emerged through iterative analysis in three main categories of experience: (1) personal, (2) health services, and (3) health status (of both persons living with dementia and care partner). Isolation and mental health needs emerged as important impacts to family experiences. This in-depth understanding of the needs and experiences of the pandemic for people living with dementia suggests that innovative means are urgently needed to facilitate provision of remote medicine and also social interaction and integration.
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Affiliation(s)
- Pamela Roach
- Department of Family Medicine, University of Calgary; Department of Community Health Sciences, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada; O'Brien Institute of Public Health, University of Calgary, Canada
| | - Angela Zwiers
- Department of Clinical Neurosciences, University of Calgary, Canada
| | - Emily Cox
- Department of Clinical Neurosciences, University of Calgary, Canada
| | - Karyn Fischer
- Department of Clinical Neurosciences, University of Calgary, Canada
| | - Anna Charlton
- Department of Clinical Neurosciences, University of Calgary, Canada
| | - Colin B Josephson
- Department of Community Health Sciences, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada; O'Brien Institute of Public Health, University of Calgary, Canada; Department of Clinical Neurosciences, University of Calgary, Canada; Centre for Health Informatics, University of Calgary, Canada
| | - Scott B Patten
- Department of Community Health Sciences, University of Calgary, Canada; Cuthbertson & Fischer Chair in Pediatric Mental Health, University of Calgary, Canada
| | - Dallas Seitz
- Department of Community Health Sciences, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada; O'Brien Institute of Public Health, University of Calgary, Canada; Department of Psychiatry, University of Calgary, Canada
| | - Zahinoor Ismail
- Department of Community Health Sciences, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada; O'Brien Institute of Public Health, University of Calgary, Canada; Department of Clinical Neurosciences, University of Calgary, Canada; Department of Psychiatry, University of Calgary, Canada
| | - Eric E Smith
- Hotchkiss Brain Institute, University of Calgary, Canada; Department of Clinical Neurosciences, University of Calgary, Canada
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Pu L, Bakker C, Appelhof B, Zwijsen SA, Teerenstra S, Smalbrugge M, Verhey FRJ, de Vugt ME, Zuidema SU, Koopmans RTCM. The Course of Quality of Life and Its Predictors in Nursing Home Residents With Young-Onset Dementia. J Am Med Dir Assoc 2020; 22:1456-1464.e1. [PMID: 33221165 DOI: 10.1016/j.jamda.2020.09.040] [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] [Received: 07/10/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To explore the course of quality of life (QoL) and possible resident-related predictors associated with this course in institutionalized people with young-onset dementia (YOD). DESIGN An observational longitudinal study. SETTING AND PARTICIPANTS A total of 278 residents with YOD were recruited from 13 YOD special care units in the Netherlands. METHODS Secondary analyses were conducted with longitudinal data from the Behavior and Evolution in Young-ONset Dementia (BEYOND)-II study. QoL was assessed with proxy ratings, using the Quality of Life in Dementia (QUALIDEM) questionnaire at 4 assessment points over 18 months. Predictors included age, gender, dementia subtype, length of stay, dementia severity, neuropsychiatric symptoms, and psychotropic drug use at baseline. Multilevel modeling was used to adjust for the correlation of measurements within residents and clustering of residents within nursing homes. RESULTS The total QUALIDEM score (range: 0-111) decreased over 18 months with a small change of 0.65 (95% confidence interval -1.27, -0.04) points per 6 months. An increase in several domains of QoL regarding care relationship, positive self-image, and feeling at home was seen over time, whereas a decline was observed in the subscales positive affect, social relations, and having something to do. Residents with higher levels of QoL and more advanced dementia at baseline showed a more progressive decline in QoL over time. Sensitivity analyses indicated a more progressive decline in QoL for residents who died during the follow-up. CONCLUSION AND IMPLICATIONS This study shows that although overall QoL in nursing home residents with YOD was relatively stable over 18 months, there were multidirectional changes in the QoL subscales that could be clinically relevant. Higher levels of QoL and more advanced stages of dementia at baseline predicted a more progressive decline in QoL over time. More longitudinal studies are needed to verify factors influencing QoL in YOD.
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Affiliation(s)
- Lihui Pu
- Department of Primary and Community Care, Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Menzies Health Institute Queensland & School of Nursing and Midwifery, Griffith University, Queensland, Australia
| | - Christian Bakker
- Department of Primary and Community Care, Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Radboudumc Alzheimer Center, Nijmegen, the Netherlands; Groenhuysen, Center for Specialized Geriatric Care, Roosendaal, the Netherlands.
| | - Britt Appelhof
- Department of Primary and Community Care, Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Radboudumc Alzheimer Center, Nijmegen, the Netherlands; Archipel, Landrijt, Knowledge Center for Specialized Care, Eindhoven, the Netherlands
| | - Sandra A Zwijsen
- Department of General Practice and Elderly Care Medicine/EMGO + Institute for Health and Care Research, Amsterdam UMC, Amsterdam, the Netherlands
| | - Steven Teerenstra
- Section Biostatistics, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Martin Smalbrugge
- Department of General Practice and Elderly Care Medicine/EMGO + Institute for Health and Care Research, Amsterdam UMC, Amsterdam, the Netherlands
| | - Frans R J Verhey
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Marjolein E de Vugt
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Sytse U Zuidema
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Raymond T C M Koopmans
- Department of Primary and Community Care, Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Radboudumc Alzheimer Center, Nijmegen, the Netherlands; De Waalboog "Joachim en Anna," Center for Specialized Geriatric Care, Nijmegen, the Netherlands
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Busted LM, Nielsen DS, Birkelund R. " Sometimes it feels like thinking in syrup" - the experience of losing sense of self in those with young onset dementia. Int J Qual Stud Health Well-being 2020; 15:1734277. [PMID: 32111147 PMCID: PMC7067159 DOI: 10.1080/17482631.2020.1734277] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Purpose: To explore and describe the experience of people having young-onset dementia.Methods: This was a qualitative study that used semi-structured interviews to collect data from nine persons with young-onset dementia (aged 47-65; five men and four women). Data were collected in the spring of 2018. All interviews were conducted at the participants' choice and in their own homes by one interviewer. The collected data were analysed using the six-stage process of reflexive thematic analysis model.Results: The analysis revealed three themes: Dementia causing loss of control over oneself; becoming a burden to the family while sense of self disappears; and fearing a humiliating future.Conclusions: The experience of having and living with young onset dementia affected the persons' thoughts and memory and was experienced through the persons' loss of personality and sense of self. Thoughts about the future were associated with fear, and the risk of changing their personalities to something different from the one which they had experienced as humiliating throughout most of their lives.
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Affiliation(s)
- Laila Mohrsen Busted
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Health Sciences Research Center, UCL University College, Odense, Denmark
| | - Dorthe S Nielsen
- Health Sciences Research Center, UCL University College, Odense, Denmark.,Migrant Health Clinic, Odense University Hospital, Center for Global Health, University of Southern Denmark, Odense, Denmark
| | - Regner Birkelund
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,IRS, Lillebaelt Hospital, University Hospital of Southern Denmark, Denmark
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Eriksen S, Bartlett RL, Grov EK, Ibsen TL, Telenius EW, Mork Rokstad AM. The Experience of Lived Time in People with Dementia: A Systematic Meta-Synthesis. Dement Geriatr Cogn Disord 2020; 49:435-455. [PMID: 33176312 PMCID: PMC7949212 DOI: 10.1159/000511225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/27/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION For people with dementia, lived time is important to understand, as the condition affects memory, perceptions of time, and life expectancy. The aim of this study was to locate, interpret, and synthesize the experience of lived time for people with dementia. METHOD This article presents a qualitative systematic meta-synthesis. The theoretical framework of lifeworlds by van Manen provided the context for the study. The Critical Appraisal Skills Programme criteria for qualitative studies were used to appraise the studies. Sixty-one qualitative research studies based on interviews with people with dementia were included in the review. The analysis followed the principles of interpretive synthesis. RESULTS Four categories were revealed: (1) rooted in the past - "I am the same as before"; (2) focussing on the present - "Nobody has tomorrow"; (3) thinking about the future - "What is going to happen to me?"; and (4) changes in the experience of self over time - "I used to…." The latent overall meaning was expressed as "being engaged with the dimensions of time." DISCUSSION/CONCLUSION The experience of lived time is an active and important one, enabling people to manage the dementia journey. Future work involving people with dementia should foreground the experience of lived time.
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Affiliation(s)
- Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Lovisenberg Diaconal University College, Oslo, Norway
| | - Ruth Louise Bartlett
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Tanja Louise Ibsen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Elisabeth Wiken Telenius
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Anne Marie Mork Rokstad
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway,
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway,
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Awata S, Edahiro A, Arai T, Ikeda M, Ikeuchi T, Kawakatsu S, Konagaya Y, Miyanaga K, Ota H, Suzuki K, Tanimukai S, Utsumi K, Kakuma T. Prevalence and subtype distribution of early-onset dementia in Japan. Psychogeriatrics 2020; 20:817-823. [PMID: 32815229 DOI: 10.1111/psyg.12596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 07/19/2020] [Accepted: 07/20/2020] [Indexed: 01/28/2023]
Abstract
AIM People living with early-onset dementia (EOD) have specific social needs. Epidemiological studies are needed to obtain current information and provide appropriate service planning. This study aimed to clarify the current prevalence and subtype distribution of EOD, as well as the services frequently used by individuals with EOD. METHODS A multisite, population-based, two-step study was conducted. Questionnaires were sent to 26 416 candidate facilities in 12 areas with a target population of 11 630 322 to inquire whether any individuals with EOD had sought services or stayed during the last 12 months (step 1). When "yes" responses were received, additional questionnaires were sent to the facilities both to complete and to distribute to the target individuals with EOD to obtain more detailed information, including the dementia subtype (step 2). RESULTS In step 1, valid responses were obtained from 16 848 facilities (63.8%), and 4077 cases were identified. In step 2, detailed information was obtained for 1614 cases (39.6%) from the facilities and 530 cases (13.0%) from the individuals. The national EOD prevalence rate was estimated to be 50.9/100 000 population at risk (95% confidence interval: 43.9-57.9; age range, 18-64 years). The number of individuals with EOD was estimated to be 35 700 as of 2018. Alzheimer-type dementia (52.6%) was the most frequent subtype, followed by vascular dementia (17.1%), frontotemporal dementia (9.4%), dementia due to traumatic brain injury (4.2%), dementia with Lewy bodies/Parkinson's disease dementia (4.1%), and dementia due to alcohol-related disorders (2.8%). Individuals with EOD were most frequently identified at medical centers for dementia. CONCLUSION The prevalence rate estimated in this study was comparable to those in previous studies in Japan. However, the subtype distribution differed, with Alzheimer-type dementia being the most prominent. Based on the case identification frequencies, medical centers for dementia are expected to continue to function as the primary special health service by providing quality diagnosis and post-diagnostic support for individuals with EOD.
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Affiliation(s)
- Shuichi Awata
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Ayako Edahiro
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Division of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, Japan
| | - Shinobu Kawakatsu
- Department of Neuropsychiatry, Aizu Medical Center, Fukushima Medical University, Aizu, Japan
| | - Yoko Konagaya
- Division of Research, Obu Dementia Care and Training Center, Obu, Japan
| | | | - Hidetaka Ota
- Advanced Research Center for Geriatric and Gerontology, Akita University, Akita, Japan
| | - Kyoko Suzuki
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University School of Medicine, Sendai, Japan
| | - Satoshi Tanimukai
- Department of Comprehensive Community Care for Elderly, Nursing and Health Science, Graduate School of Medicine, Ehime University, Toon, Japan
| | - Kumiko Utsumi
- Department of Psychiatry, Sunagawa City Medical Center, Sunagawa, Japan
| | - Tatsuyuki Kakuma
- Biostatistics Center, Kurume University School of Medicine, Kurume, Japan
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Bannon S, Reichman M, Popok P, Wagner J, Gates M, Uppal S, LeFeber L, Wong B, Dickerson BC, Vranceanu AM. In It Together: A Qualitative Meta-Synthesis of Common and Unique Psychosocial Stressors and Adaptive Coping Strategies of Persons With Young-Onset Dementia and Their Caregivers. THE GERONTOLOGIST 2020; 62:e123-e139. [PMID: 33125490 DOI: 10.1093/geront/gnaa169] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The common and unique psychosocial stressors and adaptive coping strategies of people with young-onset dementia (PWDs) and their caregivers (CGs) are poorly understood. This meta-synthesis used the stress and coping framework to integrate and organize qualitative data on the common and unique psychosocial stressors and adaptive coping strategies employed by PWDs and CGs after a diagnosis of young-onset dementia (YOD). RESEARCH DESIGN AND METHODS Five electronic databases were searched for qualitative articles from inception to January 2020. Qualitative data were extracted from included articles and synthesized across articles using taxonomic analysis. RESULTS A total of 486 articles were obtained through the database and hand searches, and 322 articles were screened after the removal of duplicates. Sixty studies met eligibility criteria and are included in this meta-synthesis. Four themes emerged through meta-synthesis: 1) common psychosocial stressors experienced by both PWDs and CGs, 2) unique psychosocial stressors experienced by either PWDs or CGs, 3) common adaptive coping strategies employed by both PWDs and CGs, and 4) unique adaptive coping strategies employed by either PWDs or CGs. Within each meta-synthesis theme, subthemes pertaining to PWDs, CGs, and dyads (i.e., PWD and CG as a unit) emerged. DISCUSSION AND IMPLICATIONS The majority of stressors and adaptive coping strategies of PWDs and CGs were common, supporting the use of dyadic frameworks to understand the YOD experience. Findings directly inform the development of resiliency skills interventions to promote adaptive coping in the face of a YOD diagnosis for both PWDs and CGs.
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Affiliation(s)
- Sarah Bannon
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Mira Reichman
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Paula Popok
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Juliana Wagner
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Melissa Gates
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Simrit Uppal
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Lisa LeFeber
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Bonnie Wong
- Frontotemporal Disorders Unit, Departments of Neurology and Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Bradford C Dickerson
- Frontotemporal Disorders Unit, Departments of Neurology and Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Ana Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Kvello-Alme M, Bråthen G, White LR, Sando SB. The Prevalence and Subtypes of Young Onset Dementia in Central Norway: A Population-Based Study. J Alzheimers Dis 2020; 69:479-487. [PMID: 31006688 PMCID: PMC6598022 DOI: 10.3233/jad-181223] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background: Young onset dementia poses several challenges for the individual, health care, and society that are not normally relevant for late onset dementia, but is little researched. Objective: To determine the prevalence and subtypes of young onset dementia in a defined catchment area in central Norway. Methods: The main sources of patient identification were the databases at the Department of Neurology, University Hospital of Trondheim (St. Olav’s Hospital), and Department of Psychiatry, Levanger Hospital. Both departments are the main sites for referral of young onset dementia (onset before age 65 years) in the county, covering approximately 90% of the catchment area of the study. Other sources included key persons in the communities, collaborating hospital departments examining dementia, and review of hospital records of all three hospitals in the area. Included patients met the DSM-IV criteria for dementia. The prevalence of dementias was calculated by sex and age. Results: All patients identified with dementia and onset before 65 years on census date were included in the study (n = 390). Patients younger than 65 on census date were included in the calculation of prevalence, giving a result of 76.3 per 100 000 persons at risk in the age category of 30–65 years, and 163.1 per 100,000 for the category 45–64 years. Etiology was heterogeneous, but the main subtype of dementia was Alzheimer’s disease. Conclusions: Young onset dementia affects a significant number of people in central Norway. Prevalence figures are higher than previously reported from England and Japan, but are similar to a more recent study from Australia.
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Affiliation(s)
- Marte Kvello-Alme
- Department of Neuromedicine and Movement Science (INB), NTNU, Faculty of Medicine and Health Sciences, Trondheim, Norway.,Department of Psychiatry, Nord-Trøndelag Hospital Trust, Levanger Hospital, Levanger, Norway
| | - Geir Bråthen
- Department of Neuromedicine and Movement Science (INB), NTNU, Faculty of Medicine and Health Sciences, Trondheim, Norway.,University Hospital of Trondheim, Department of Neurology, Trondheim, Norway
| | - Linda R White
- Department of Neuromedicine and Movement Science (INB), NTNU, Faculty of Medicine and Health Sciences, Trondheim, Norway.,University Hospital of Trondheim, Department of Neurology, Trondheim, Norway
| | - Sigrid Botne Sando
- Department of Neuromedicine and Movement Science (INB), NTNU, Faculty of Medicine and Health Sciences, Trondheim, Norway.,University Hospital of Trondheim, Department of Neurology, Trondheim, Norway
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Telenius EW, Eriksen S, Rokstad AMM. I need to be who I am: a qualitative interview study exploring the needs of people with dementia in Norway. BMJ Open 2020; 10:e035886. [PMID: 32801195 PMCID: PMC7430453 DOI: 10.1136/bmjopen-2019-035886] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Many people with dementia receive community services. These services are often based on the needs of informal caregivers and professional caregivers' assessment. User involvement and participation are main objectives in the Norwegian National Dementia Plan 2020. To enhance user involvement and individual tailoring of healthcare services, more information is required about the needs of people with dementia. The aim of this study was to explore the experienced needs of people with dementia in order to facilitate user involvement in provided services. METHODS An explorative cross-sectional study design was used. We performed semistructured interviews with people with dementia who were recruited from all regions of Norway. The sample comprised 35 participants diagnosed with dementia. The interviews were audio-recorded and transcribed, and the data material was analysed using a qualitative content analysis. RESULTS Three main categories emerged from the interviews: (1) to stay connected; (2) to be active and participate; and (3) to live for the moment. The overarching theme was: the need to be who I am. CONCLUSIONS People with dementia participating in the study were heterogeneous regarding wants and requirements. Most of them expressed the need and wish to hold on to who they are. Close and robust relations with family and friends can give significant support to people with dementia. However, living with dementia might put considerable strain on relations. Services should provide support to enhance relationships, encourage existing networks to remain stable and facilitate participation in meaningful activities for people living with dementia.
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Affiliation(s)
- Elisabeth Wiken Telenius
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Lovisenberg Diaconal University College, Oslo, Norway
| | - Anne Marie Mork Rokstad
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Molde University College, Molde, Norway
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Read ST, Toye C, Wynaden D. A qualitative exploration of family carer's understandings of people with dementia's expectations for the future. DEMENTIA 2020; 20:1284-1299. [PMID: 32551874 DOI: 10.1177/1471301220929543] [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: 11/17/2022]
Abstract
BACKGROUND There is little evidence that outlines how family carers understand the person with dementia's perspective, values and anticipated future needs. Whilst people with dementia should be consulted about their own quality of life and care values, carers - otherwise known as care partners - require such understandings to ensure that the support the person receives into the future upholds their quality of life and is consistent with what they desire. AIM This research aimed to explore and describe family carers' experience of supporting the person with dementia to maintain their quality of life by understanding how carers developed an awareness and understanding of the person with dementia's expectations for the future and what they believed was important for the person to whom they provided care. METHOD Using an application of the grounded theory method, data were collected from 21 carers during semi structured interviews and analysed using constant comparative analysis. FINDINGS Four categories emerged from the data: Knowing the person, Process of decision making, Maintaining normalcy and quality of life and Out of their control. DISCUSSION This study provides insights into how carers developed awareness of the expectations of people with dementia. Findings also illuminate carers' perspectives of the changing nature of decision making during the dementia trajectory. CONCLUSION Understanding the perspective of the person living with dementia is essential to facilitate advocacy and support that is 'person centred' now and into the future. Assisting carers to incorporate this perspective into caring has the potential to be better facilitated by health professionals and merits further investigation.
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Affiliation(s)
- Sheridan T Read
- School of Nursing, Midwifery and Paramedicine, Curtin University, Australia
| | - Christine Toye
- School of Nursing, Midwifery and Paramedicine, Curtin University, Australia
| | - Dianne Wynaden
- School of Nursing, Midwifery and Paramedicine, Curtin University, Australia
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Broadbent M, Gilbert S. The effect of a purpose-built memory support unit on the transition to high level dementia care; Perspectives of multiple participants. Collegian 2020. [DOI: 10.1016/j.colegn.2019.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Whilst the support requirements of people diagnosed with young onset dementia are well-documented, less is known about what needs to be in place to provide age-appropriate care. To understand priorities for service planning and commissioning and to inform the design of a future study of community-based service delivery models, we held two rounds of discussions with four groups of people affected by young onset dementia (n = 31) and interviewed memory services (n = 3) and non-profit service providers (n = 7) in two sites in England. Discussions confirmed published evidence on support requirements, but also reframed priorities for support and suggested new approaches to dementia care at the community level. This paper argues that involving people with young onset dementia in the assessment of research findings in terms of what is important to them, and inviting suggestions for solutions, provides a way for co-designing services that address the challenges of accessing support for people affected by young onset dementia.
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Affiliation(s)
- Andrea M Mayrhofer
- Andrea M Mayrhofer, Centre for Research in
Public Health and Community Care, University of Hertfordshire, College Lane,
Hatfield AL10 9AB, UK.
| | - Elspeth Mathie
- Centre for Research in Public Health and
Community Care, University of Hertfordshire, Hatfield, UK
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49
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Dixon E, Lazar A. Approach Matters: Linking Practitioner Approaches to Technology Design for People with Dementia. PROCEEDINGS OF THE SIGCHI CONFERENCE ON HUMAN FACTORS IN COMPUTING SYSTEMS. CHI CONFERENCE 2020; 2020:10.1145/3313831.3376432. [PMID: 32719832 PMCID: PMC7383934 DOI: 10.1145/3313831.3376432] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Technology design for dementia is an active and growing area. Though work to date has largely addressed functional needs, there is a growing recognition of the importance of supporting meaningful activities. However, technology for active, rather than passive, engagement is relatively novel beyond specific applications (e.g., music or reminiscence therapy). To better understand how to support active engagement of people with dementia in activities, we interviewed nineteen practitioners. Our findings reveal differing approaches to making sense of the actions of people with dementia, as well as to engaging them in activities. We discuss the importance of tracing epistemological understandings of dementia to different configurations of technology for people living with dementia and provide a practical guide to support designers to do so. Finally, we discuss considerations for the design of dementia technologies around facilitating self-actualization and managing emotional exposure for care-providers.
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Affiliation(s)
- Emma Dixon
- iSchool, Trace Center, HCIL, University of Maryland, College Park, MD, USA
| | - Amanda Lazar
- iSchool, Trace Center, HCIL, University of Maryland, College Park, MD, USA
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50
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Isherwood G, Taylor K, Burnside G, Fitzgerald R, Flannigan N. Teaching orthodontic emergencies using the "flipped classroom" method of teaching-A mixed methods RCT. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:53-62. [PMID: 31518475 DOI: 10.1111/eje.12467] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 08/26/2019] [Accepted: 09/09/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION In the United Kingdom, the General Dental Council requires newly graduated dentists to be competent in managing orthodontic emergencies. Undergraduate students typically receive limited exposure to orthodontics, with teaching primarily delivered via conventional lectures. Flipped teaching involves knowledge being acquired in students' own time, with class time focussing on construction of meaning. METHODS A total of 61 undergraduate dental students were randomised into either a flipped or a conventional group. The conventional group (n = 30) attended a lecture describing the management of six common emergencies. The flipped group (n = 31) were given access to six videos via a virtual learning environment and later completed practical tasks related to the material. Both groups completed a single best answer assessment. Perceptions of flipped classroom teaching were explored via focus groups. RESULTS For questions on orthodontic emergencies, the conventional group had a mean examination result of 70.5% (SD 8.0%) compared with the flipped group of 72.8% (SD 12.9%). There was no significant difference between the groups (P = .532). For regular orthodontic questions, the conventional group had a mean examination result of 64.8% (SD: 19.9%) compared with 78.3% (SD: 21.7%). There was no significant difference between the groups (P = .083). Thematic analysis identified the following themes: ways in which videos encourages more effective learning, improved engagement, awareness of learning needs and proposed teaching/curriculum changes. The overarching theoretical perspective was facilitating an experiential learning cycle using flipped classroom teaching. CONCLUSIONS In the context of this investigation, the flipped classroom method of teaching resulted in comparable examination performance and improved levels of satisfaction.
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Affiliation(s)
- Grant Isherwood
- Department of Orthodontics, Liverpool University Dental Hospital, Liverpool, UK
| | - Kathryn Taylor
- Department of Oral Surgery, Liverpool University Dental Hospital, Liverpool, UK
| | - Girvan Burnside
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | | | - Norah Flannigan
- Department of Orthodontics, Liverpool University Dental Hospital, Liverpool, UK
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