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White J, Falcioni D, Barker R, Bajic-Smith J, Krishnan C, Mansfield E, Hullick C. Understanding Dementia Carer Experiences Before Admission to a Residential Aged Care Facility: Implications for Integrated Care. J Appl Gerontol 2024:7334648241261454. [PMID: 39023911 DOI: 10.1177/07334648241261454] [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: 07/20/2024] Open
Abstract
In-depth understanding of dementia carer experience can assist clinicians by providing insight into dementia onset, symptoms and management, and help conceptualize and understand the pattern of dementia progress over time and what help is needed. We undertook a qualitative study to understand dementia carers experiences of providing care and reasons for admission to a residential aged care facility (RACF). Three themes were identified: (1) Challenges in the path to diagnosis and care, leading to delays accessing support; (2) Carer role impacted by living circumstances; and (3) Variation in decision support prior to admission to a RACF. Identifying dementia carer experiences, reinforces the need for more timely diagnosis, referral for support and interventions to promote better quality of life for a people living with dementia and their carer and to delay premature RACF placement.
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Affiliation(s)
- Jennifer White
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Dane Falcioni
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Roslyn Barker
- Hunter New England Local Health District, New Lambton Heights, NSW, Australia
| | | | - Chitra Krishnan
- Hunter New England Local Health District, New Lambton Heights, NSW, Australia
| | - Elise Mansfield
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Carolyn Hullick
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Hunter New England Local Health District, New Lambton Heights, NSW, Australia
- Australian Commission of Safety and Quality in Health Care, Sydney, NSW, Australia
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Giebel C. Do people with dementia and carers get what they need? Barriers in social care and carers needs assessments. DEMENTIA 2024; 23:550-566. [PMID: 38429248 PMCID: PMC11059843 DOI: 10.1177/14713012241237673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
BACKGROUND People with dementia and unpaid carers need to go through a social care or carers needs assessment to access and receive subsidised or fully-funded social care. With no previous evidence, this qualitative study aimed to provide insights into the access to, experiences of receiving and conducting social care or carers needs assessments, and access to social care. METHODS Unpaid carers of people with dementia and professionals conducting social care or carers needs assessment living or working in England were interviewed remotely about their experiences between April and August 2023. Topic guides were co-produced with two unpaid carers, and both were supported to code anonymised transcripts. Thematic analysis was used to analyse the data. FINDINGS Twenty-seven unpaid carers (n = 21) and professionals (n = 6) participated. Four themes were generated: (1) Issues with accessing needs assessments, not the process; (2) Knowledge of needs assessments and the health and social care system; (3) Expectations of unpaid carers; and (4) Post-assessment unmet needs. The most prominent barriers unpaid carers and their relatives with dementia encountered were awareness of and access to needs assessment. Unpaid carers were mostly unaware of the existence and entitlement to a needs assessment, and sometimes realised they had participated in one without their knowledge. Professionals described the pressures on their time and the lack of financial resources within services. CONCLUSIONS To facilitate improved access to dementia care and support for carers, the pathway to accessing needs assessments needs to be clearer, with better integration and communication between health and social care.
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Affiliation(s)
- Clarissa Giebel
- Clarissa Giebel, Institute of Psychology, Health and Society, University of Liverpool, Brownlow Street, Waterhouse Building, Liverpool L69 3GL, UK.
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Hevink M, Linden I, de Vugt M, Brodaty H, Low LF, Phillipson L, Jeon YH, Gresham M, Doucet S, Luke A, Vedel I, McAiney C, Szcześniak D, Błaszkiewicz M, Rymaszewska J, Verhey F, Wolfs C. Moving forward with dementia: an explorative cross-country qualitative study into post-diagnostic experiences. Aging Ment Health 2024:1-10. [PMID: 38656033 DOI: 10.1080/13607863.2024.2342968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVES This explorative cross-country qualitative study aims to describe experiences of receiving a dementia diagnosis and experiences of support following a diagnosis in Australia, Canada, the Netherlands and Poland. METHOD Qualitative study using projective techniques during online focus groups, online and telephone interviews with people with dementia and caregivers. RESULTS Twenty-three people with dementia and 53 caregivers participated. Qualitative content analysis revealed five themes; (1) 'Coming to terms with dementia' helped people deal with complex emotions to move forward. (3) 'The social network as a source of support' and (4) 'The challenges and realities of formal support' and impacted 'Coming to terms with dementia'. (2) 'Navigating life with dementia as a caregiver' highlights caregiver burden and was impacted by (4) 'The challenges and realities of formal support'. People were (5) 'Self-caring and preparing for tomorrow' as they focused on maintaining current health whilst planning the future. Despite differences in healthcare and post-diagnostic support systems, there were more similarities across countries than differences. CONCLUSION Across countries, formal support and support from friends and family are crucial for people with dementia and caregivers to come to terms with dementia and maintain carer wellbeing to ultimately live well with dementia.
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Affiliation(s)
- Maud Hevink
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Iris Linden
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Lee-Fay Low
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lyn Phillipson
- School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Yun-Hee Jeon
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Meredith Gresham
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Shelly Doucet
- Department of Nursing and Health Sciences, The Centre for Research in Integrated Care, University of New Brunswick, Saint John, Canada
| | - Alison Luke
- Department of Nursing and Health Sciences, The Centre for Research in Integrated Care, University of New Brunswick, Saint John, Canada
| | - Isabelle Vedel
- Department of Family Medicine, McGill University, Lady Davis Institute, Jewish General Hospital, Montreal, Canada
| | - Carrie McAiney
- School of Public Health Sciences, University of Waterloo and Schlegel-UW Research Institute for Aging, Waterloo, Canada
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | | | | | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Claire Wolfs
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
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Ozcan M, Akyar I. The effect of structured education and phone follow-up on moderate stage Alzheimer's disease caregiving: Outcomes for patient and caregivers. Jpn J Nurs Sci 2024; 21:e12574. [PMID: 38031663 DOI: 10.1111/jjns.12574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/02/2023] [Accepted: 10/14/2023] [Indexed: 12/01/2023]
Abstract
AIM To determine the effectiveness of a caregiver education (needs tailored) and telephone follow-up intervention for caregivers of people with moderate stage Alzheimer's disease on caregiver burden, caregiving impact on life, and patients' neuropsychiatric symptoms, dependence on activities of daily living. METHODS This quasi-experimental study sampled caregivers of people with moderate stage Alzheimer's. Caregivers in the intervention group received education and telephone follow-up over 12 weeks, while the control group received routine care. Caregivers were assessed for burden, changes in life, and patients for neuropsychiatric symptoms, and dependence on daily living activities. RESULTS The caregiver burden, life changes, distress, and patients' neuropsychiatric symptom scores showed apparent trend toward betterment, but no statistically significant differences were found in study outcomes between the two groups (P > .05). CONCLUSION The caregiver need-based, structured education and telephone follow-up intervention was not empirically effective. With the promising effect from this study, managing behavioral symptoms with need-based, structured, and skill-oriented training has the potential to alleviate the burden on caregivers.
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Affiliation(s)
- Munevver Ozcan
- Faculty of Health Sciences, Yozgat Bozok University, Yozgat, Turkey
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Berghout M, Waller A, Lachapelle N, Noble N, Nair BK, Sanson-Fisher R. Preferred type, timing and format of dementia information: A cross-sectional survey of carers of people living with dementia. Australas J Ageing 2024; 43:131-139. [PMID: 37877350 DOI: 10.1111/ajag.13251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 08/15/2023] [Accepted: 09/21/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVES To clarify the unmet information needs of carers of people living with dementia, including the stage of their care journey at which topics become relevant, and the preferred format and mode of delivery of information. METHODS A cross-sectional survey of carers of people living with dementia was conducted between April 2022 and October 2022. Carers were recruited through public and private geriatric hospital and community clinics, aged care providers, an online research register and community dementia services. Consenting carers completed a survey assessing sociodemographic characteristics, preferred type and timing of information about dementia, accessing services, changes in behaviour/personality, changes in physical/emotional health, managing own health/well-being and preferred information format and mode of delivery. RESULTS A total of 163 carers returned a survey (20% response rate). Most carers (75-98%) reported wanting information across a range of topics. Carers preferred general dementia information at diagnosis, information about accessing services at or within the first year of diagnosis, and information on managing symptoms as they emerged. Carers were most interested in receiving information in-person face-to-face (60% very interested), written information (51% very interested) or via face-to-face group information sessions (42% very interested). CONCLUSIONS Carers of people living with dementia expressed a desire for information on a wide range of topics, which changed as the dementia of the person they cared for progressed. Information needs to be made available in a variety of formats to cater for differing ways in which it is consumed.
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Affiliation(s)
- Mani Berghout
- John Hunter Hospital, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Amy Waller
- Health Behaviour Research Collaborative, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New South Wales, Newcastle, Australia
| | - Nicole Lachapelle
- Health Behaviour Research Collaborative, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New South Wales, Newcastle, Australia
| | - Natasha Noble
- Health Behaviour Research Collaborative, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New South Wales, Newcastle, Australia
| | - Balakrishnan Kichu Nair
- John Hunter Hospital, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New South Wales, Newcastle, Australia
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Bjørge H, Halvorsrud L, Goyal AR. Always on alert: How relatives of family members with dementia experience the transition from home to permanent nursing home placement. Nurs Open 2023; 10:6300-6308. [PMID: 37345273 PMCID: PMC10416068 DOI: 10.1002/nop2.1877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 05/05/2023] [Accepted: 05/29/2023] [Indexed: 06/23/2023] Open
Abstract
AIM Our aim was to gain insight into how the relatives of family members with dementia have experienced their family members' transition from home to permanent nursing home placement. DESIGN Our research was a qualitative case study. METHODS Inspired by Kvale and Brinkmann's phenomenological-hermeneutic approach, we performed the thematic analysis of semi-structured interviews describing how the relatives of family members with dementia have experienced the dementia trajectory. RESULTS Twelve relatives of family members with dementia living in nursing homes agreed to participate. The descriptions of relatives' experiences indicated four primary themes: mismatches between healthcare services and the family members' needs, witnessing the family members' cognitive decline, the effects of the experiences on the relatives' health and well-being and what matters to the relatives during their family members' transition to nursing home. Mismatches between available resources in the municipalities and the family members' healthcare needs were the most distressing experiences, along with the family members' gradual cognitive decline. In response, the relatives stressed individualized support, continuity in follow-up care and regular information-sharing between them and staff members caring for their family members. They also highlighted the importance of facilitating seamless transitions from home to nursing homes.
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Affiliation(s)
| | - Liv Halvorsrud
- Oslo Metropolitan UniversityOsloMetNorway
- Østfold University CollegeHaldenNorway
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Russell C. "We Can Do This!": The Role of Physical Activity in What Comes Next for Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6503. [PMID: 37569043 PMCID: PMC10418976 DOI: 10.3390/ijerph20156503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/06/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023]
Abstract
There is increasing interest in physical activity as a response to the harm caused by dementia. The focus has been upon interventions to prevent or delay symptoms or to support people living with the condition to reminisce. Whilst this is welcome, there are other features inherent to physical activity that remain unrecognised or underutilised and, consequently, its full potential for good is unrealised. Most prominent is the ability physical activity has to enable participants to claim and sustain a place in the world through what they do, crucial to a context where the impact of dementia tends to annihilate this for those living with the condition. The article addresses this gap. In doing so, it presents key findings. These include (1) highlighting the fundamental importance of features such as person-centred care, human rights and social citizenship to enabling people with dementia to live lives of quality and (2) identifying synergies with these features and what physical activity can offer; for example, emphasising the value of bringing these together to illustrate how physical activity can contribute to enabling people with dementia to live lives characterised by quality, and the maintenance of their place in the world. The article concludes by suggesting what must come next to ensure physical activity can play the fullest role possible.
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Affiliation(s)
- Christopher Russell
- Association for Dementia Studies, University of Worcester, Henwick Grove, Worcester WR2 6AJ, UK
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Britton A, Zimmermann M. Informal dementia care: The carer's lived experience at the divides between policy and practice. DEMENTIA 2022; 21:2117-2127. [PMID: 35838118 PMCID: PMC9483676 DOI: 10.1177/14713012221112234] [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: 11/15/2022]
Abstract
Support for informal dementia care at a local community level is not working for most carers today. Carers looking after a person with dementia have long lamented the absence of an empowered named support and an effectively actioned care plan. Drawing on literary writing and social research, we argue in this article that these challenges have existed since dementia emerged as a major condition in the West during the 1980s. Based on this historical context, we ask: Why has this issue persisted over the last four decades? How have healthcare politics and policy initiatives responded to these requests? And what can we learn from this for the current, COVID-19 exacerbated crisis of care? This article focuses on the English context, to discuss these ongoing challenges in the light of a series of policy papers, and to ask what is hampering the implementation of such policy initiatives. In England, local authorities are responsible for dementia support. This article focuses on the situation in a county in the Midlands where one of us (AB) has been lobbying local government for over a decade. The discussion contextualises the lived experience of dementia care within the situation exacerbated by the COVID-19 pandemic, ensuing politics of crises and persistent emphasis on cure over care. We find that the absence on two points centrally challenges care: a joined-up approach between health and social care and adequate information on available care support services, accessible through an empowered named contact. To enhance the lived experience of dementia care, consistent provision of individual named support and professional care support, as and when required, should become essential to local implementation of the care policy.
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Affiliation(s)
- Anthony Britton
- Founder Trustee, The Pam Britton Trust for Dementia, Leamington Spa, UK
| | - Martina Zimmermann
- UKRI Future Leaders Fellow and Lecturer, Health Humanities and Health Sciences, Department of English, 4616King's College London, London, UK
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Henriques MA, Loura DDS, Nogueira P, Melo G, Gomes I, Ferraz I, Viegas L, Costa A. Does Reality Overcome the Expected? Survey on Informal Caregivers' Profile: A Nurse-Led Study in Times of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11394. [PMID: 36141669 PMCID: PMC9517550 DOI: 10.3390/ijerph191811394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/01/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
The increasing overload of chronic conditions raises challenges for the health system. Informal caregivers have a major role in ensuring the quality of life of the cared-for person, despite the reported lack of working resources which can lead to unmet needs. This article reports on the first part of a nurse-led research project entitled ''Informal caregiver' profiles in Lisbon county: a health community approach.' We aimed to support decision-making by developing an informal caregiver profile to promote tailored interventions. A survey addressing the dyad was developed and submitted to a convenient, network-based, stratified sample of carers aged 18 years or above. More than thirty community partners supported the identification of caregivers. Data were submitted to univariate descriptive analysis. A profile of the cared-for person and the informal caregiver was uncovered by identifying 639 caregivers, of whom the majority lived with the cared-for person. Only four percent planned the transition to a caregiver role, and no more than 10% had access to support programs. Approximately half of the respondents found that COVID-19 negatively impacted their performance in the caregiver role. Developing a local and tailored strategy with collaboration between healthcare professionals, academics, and community partners is key to ensuring that meaningful support is provided to caregivers.
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Affiliation(s)
- Maria Adriana Henriques
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096 Lisbon, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - David de Sousa Loura
- Nursing School of Lisbon, 1600-096 Lisbon, Portugal
- Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, E.P.E., 1169-045 Lisbon, Portugal
| | - Paulo Nogueira
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096 Lisbon, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
- Laboratório de Biomatemática, Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Egas Moniz, 1649-028 Lisbon, Portugal
| | - Graça Melo
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096 Lisbon, Portugal
| | - Idalina Gomes
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096 Lisbon, Portugal
| | - Isabel Ferraz
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096 Lisbon, Portugal
| | - Laura Viegas
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096 Lisbon, Portugal
| | - Andreia Costa
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096 Lisbon, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
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Kinchin I, Edwards L, Adrion E, Chen Y, Ashour A, Leroi I, Brugulat‐Serrat A, Phillips J, Masterson F, Kochovska S. Care partner needs of people with neurodegenerative disorders: What are the needs, and how well do the current assessment tools capture these needs? A systematic meta-review. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5764. [PMID: 35665539 PMCID: PMC9328373 DOI: 10.1002/gps.5764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 05/12/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The burden on care partners, particularly once dementia emerges, is among the greatest of all caregiving groups. This meta-review aimed to (1) synthesis evidence on the self-reported needs of care partners supporting people living with neurodegenerative disorders; (2) compare the needs according to care partner and care recipient characteristics; and (3) determine the face validity of existing care partner needs assessment tools. METHODS We conducted a systematic review of reviews involving a thematic synthesis of care partner needs and differences in needs according to demographic and other characteristics. We then conducted a gap analysis by identifying the themes of needs from existing needs assessment tools specific to dementia and cross-matching them with the needs derived from the thematic synthesis. RESULTS Drawing on 17 published reviews, the identified range of needs fell into four key themes: (1) knowledge and information, (2) physical, social and emotional support, (3) care partner self-care, and (4) care recipient needs. Needs may differ according to disease trajectory, relationship to the care recipient, and the demographic characteristics of the care partner and recipient. The 'captured needs' range between 8% and 66% across all the included needs assessment tools. CONCLUSIONS Current tools do not fully or adequately capture the self-identified needs of care partners of people living with neurodegenerative disorders. Given the high burden on care partners, which has been further exacerbated by the COVID-19 (SARS CoV-2) pandemic, the needs assessment tools should align with the self-reported needs of care partners throughout the caregiving trajectory to better understand unmet needs and target supportive interventions.
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Affiliation(s)
- Irina Kinchin
- Centre for Health Policy and ManagementTrinity College DublinUniversity of DublinDublinIreland
- Global Brain Health InstituteUniversity of Dublin/University of California San FranciscoDublinIreland
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) CentreUniversity of Technology SydneyUltimoNew South WalesAustralia
| | - Layla Edwards
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) CentreUniversity of Technology SydneyUltimoNew South WalesAustralia
| | - Emily Adrion
- Global Brain Health InstituteUniversity of Dublin/University of California San FranciscoDublinIreland
- Global Health Policy Unit, Social PolicyUniversity of EdinburghEdinburghUK
| | - Yaohua Chen
- Global Brain Health InstituteUniversity of Dublin/University of California San FranciscoDublinIreland
- Univ.Lille, Inserm UMR‐S1172, Lille Neurosciences & Cognition, Degenerative and Vascular Cognitive DisordersDepartment of GeriatricsCHU Lille, LiCENDLilleFrance
| | - Aya Ashour
- Global Brain Health InstituteUniversity of Dublin/University of California San FranciscoDublinIreland
- Department of NeurologyAin Shams UniversityCairoEgypt
| | - Iracema Leroi
- Global Brain Health InstituteUniversity of Dublin/University of California San FranciscoDublinIreland
| | - Anna Brugulat‐Serrat
- Global Brain Health InstituteUniversity of Dublin/University of California San FranciscoDublinIreland
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Hospital del Mar Medical Research Institute (IMIM)BarcelonaSpain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES)MadridSpain
| | - Jane Phillips
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) CentreUniversity of Technology SydneyUltimoNew South WalesAustralia
- School of NursingQueensland University of TechnologyBrsibaneQueenslandAustralia
| | - Fiona Masterson
- Family Carers Ireland Research Advisory NetworkDublinIreland
| | - Slavica Kochovska
- Faculty of Science, Medicine and HealthUniversity of WollongongWollongongNew South WalesAustralia
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11
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Mansfield E, Cameron EC, Boyes AW, Carey ML, Nair B, Hall AE, Sanson-Fisher RW. Prevalence and type of unmet needs experienced by carers of people living with dementia. Aging Ment Health 2022; 27:904-910. [PMID: 35356837 DOI: 10.1080/13607863.2022.2053833] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Carers of people with dementia experience significant physical, emotional, and social burdens. Needs assessment can provide important information to assist services in providing support to carers to reduce these burdens. However, few studies have examined the prevalence of unmet needs experienced by carers of people with dementia using a quantitative instrument. This study aimed to examine the prevalence and type of unmet needs experienced by carers of people with dementia in Australia. METHODS This was a cross-sectional survey of carers providing support to community-dwelling individuals living with dementia. Carers were recruited through geriatric clinics, aged care providers, support services and community organisations. Consenting carers completed a survey including an 80-item study-specific unmet needs instrument for carers (UNI-C) and sociodemographic characteristics. Descriptive statistics were used to identify the most prevalent unmet needs reported by carers. RESULTS A total of 169 carers (response rate 47%) completed the survey. Most (87%) carers reported at least one unmet need. Carers reported a median of 16.0 (IQR = 24.0; max = 58) out of a possible 80 unmet needs. The most frequently endorsed unmet needs spanned a range of areas including emotional wellbeing, accessing health and aged care services, managing apathy, and finding information. CONCLUSION This study highlighted that a large proportion of carers experience unmet needs associated with caring for someone with dementia. Developing and rigorously testing interventions to meet carers' commonly reported unmet needs are warranted. UNLABELLED Supplemental data for this article is available online at https://doi.org/10.1080/13607863.2022.2053833 .
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Affiliation(s)
- Elise Mansfield
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Emilie C Cameron
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Allison W Boyes
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Mariko L Carey
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Balakrishnan Nair
- Hunter New England Local Health District, New Lambton Heights, John Hunter Hospital, NSW, Australia.,School of Medicine and Public Health (Medical Education and Professional Development), University of Newcastle, Callaghan, NSW, Australia
| | - Alix E Hall
- Hunter New England Local Health District, Hunter New England Population Health, Wallsend, NSW, Australia
| | - Rob W Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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12
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Giebel C, Robertson S, Beaulen A, Zwakhalen S, Allen D, Verbeek H. "Nobody Seems to Know Where to Even Turn To": Barriers in Accessing and Utilising Dementia Care Services in England and The Netherlands. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212233. [PMID: 34831989 PMCID: PMC8622725 DOI: 10.3390/ijerph182212233] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Accessing post-diagnostic care can be difficult for people with dementia and their informal carers. Little is known, however, about the determinants of barriers to access, and how these might vary between countries. The aim of this study was to explore potential inequalities in access to formal dementia care services between England and the Netherlands, specifically from more disadvantaged areas. METHODS This was a mixed-methods study, involving semi-structured qualitative interviews and a carer questionnaire. People with dementia and informal carers were recruited by clinicians. The postal survey was co-produced with people with dementia, informal carers, and health care professionals. The survey asked carers about their own and their relatives with dementia's, social support service usage and financing; as well as how they were made aware of services and whether they required more support. Qualitative transcripts were analysed by two researchers in each country using thematic analysis. RESULTS A total of 103 carer questionnaires were received by post and 13 interviews were conducted with people with dementia and family carers between January 2020 and April 2020. Many services were accessed via self-funding. Thematic analysis generated five core themes: Health literacy; Having faith and lack of faith; Service suitability; Structural issues surrounding service provision; and Financing care. One major difference between both country's systems of care were the case manager and network support which people with dementia and carers benefitted from in the Netherlands, which was rarely the case in the UK. CONCLUSIONS People with dementia and informal carers need to be supported better in accessing formal dementia care services in both the UK and the Netherlands, whilst some learning can be taken to improve access.
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Affiliation(s)
- Clarissa Giebel
- Institute of Population Health Sciences, University of Liverpool, Liverpool L69 3GL, UK
- NIHR ARC NWC, Liverpool L69 3GL, UK;
- Correspondence:
| | | | - Audrey Beaulen
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands; (A.B.); (S.Z.); (H.V.)
| | - Sandra Zwakhalen
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands; (A.B.); (S.Z.); (H.V.)
| | | | - Hilde Verbeek
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands; (A.B.); (S.Z.); (H.V.)
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