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Wang W, Roumell E, Xu C, Lu Z. Home Through Their Eyes: A Qualitative Exploration of the Meaning of Home for Persons With Dementia and Impact of Physical Environment During Meaning-Making. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae107. [PMID: 38863436 DOI: 10.1093/geronb/gbae107] [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: 01/03/2024] [Indexed: 06/13/2024] Open
Abstract
OBJECTIVES This study aimed to examine the meaning of home for persons with dementia and the role of the physical environment during their meaning-making process. In response to a growing number of persons with dementia, there has been a strong advocacy for prioritizing the development of dementia-friendly environments within design practice and research agendas, for which "home" has become one of the important loci. However, of the limited studies on the meaning of home from the perspective of those individuals who continue to live in their own homes after developing dementia, even fewer addressed this issue within the Chinese context. METHODS Five dyads, persons with dementia and their family caregivers, participated in the qualitative phenomenology study. Ten home visits-2 visits per dyad-were conducted, during which interview data, photographs, and field notes were collected. Phenomenological analysis was applied within and across the data sets. RESULTS Three key themes emerged-"Three Dimensions of Home" revealed that "home" goes beyond physical residence and immediate family connections, including meaningful objects and places, enduring relationships, self-identity, and lived experiences.; "The Impact of Physical Environment" and "The Impact of Cognitive Impairment" showed the complex interactions between the environment, cognitive impairment, and meaning-making. DISCUSSION An exploration of the essence of meaning of home within the Chinese context, in person-environment relationships with dementia progression, and implications for future research and practice on dementia-related environments and care were further discussed. This study contributes insights into enhancing the well-being of persons with dementia and benefiting their caregivers.
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Affiliation(s)
- Wenjin Wang
- Department of Landscape Architecture & Urban Planning, Texas A&M University, College Station, Texas, USA
| | - Elizabeth Roumell
- Department of Educational Administration & Human Resource Development, Texas A&M University, College Station, Texas, USA
| | - Chuanyue Xu
- Department of Architecture, Texas A&M University, College Station, Texas, USA
| | - Zhipeng Lu
- Department of Architecture, Texas A&M University, College Station, Texas, USA
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Thijssen M, Dauwerse L, Lemmers F, der Sanden MNV, Daniels R, Graff M, Kuijer-Siebelink W. 'Practice what you preach'. Perspectives on the involvement of people with dementia and carers in community-based dementia friendly initiatives, a qualitative study. Front Psychiatry 2024; 15:1387536. [PMID: 38818024 PMCID: PMC11137317 DOI: 10.3389/fpsyt.2024.1387536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 04/29/2024] [Indexed: 06/01/2024] Open
Abstract
Introduction People with dementia and their carers experience social stigma and often refrain from social participation. Significant improvement might be achieved by creating Dementia Friendly communities (DFCs) for which dementia friendly initiatives (DFIs) are needed. DFIs are developed by a variation of stakeholders. However, people with dementia and their carers are often unrepresented herein. This study aims to get insight into the perspectives of stakeholders (e.g., health- and social care professionals, volunteers, people with dementia and their carers) about the involvement of people with dementia and their carers during the development and sustainment of DFIs. Methods Descriptive qualitative study, using a co-research design with a carer as co-researcher. Nineteen semi-structured interviews with stakeholders, including people with dementia and their carers, were performed. Inductive content analysis took place using Atlas Ti. Results Four themes were found: 1) the involvement of people with dementia and their carers is important for both people with dementia and their carers and other stakeholders; 2) personal character traits, life histories, and associated emotions evoke the need for involvement; 3) involvement requires an open, responsive stance and building relationships; and 4) the estimation of one's own and others' capacities influences perspectives on involvement. As such, practice what you preach means actively adopting an open, responsive approach and acknowledging the unique abilities and backgrounds of people with dementia and their carers. It emphasizes the importance of actually living by the values you advocate for. Conclusion Central to perspectives on involving people with dementia and their carers is the emphasis on working relationally, differing from service-led and pre-structured patient and public involvement (PPI). Working relationally calls for organizational shifts aligned with a rights-based perspective to avoid tokenism, and promotion of user-led organizations with genuine partnerships. Creative methods, problem-solving, and communication skills are essential for the development and sustainment of inclusive, supportive, person-centered DFIs. Future studies should explore the long-term impact of the involvement and working relationally on the well-being of people with dementia and their carers.
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Affiliation(s)
- Marjolein Thijssen
- Radboudumc Research Institute, Scientific Center for Quality of Health (IQ health), Radboud University Medical Center, Nijmegen, Netherlands
- Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
- Department Occupational Therapy, School of Allied Health, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Linda Dauwerse
- Department of Primary and Community Care, Medical Centre, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Maria Nijhuis-van der Sanden
- Radboudumc Research Institute, Scientific Center for Quality of Health (IQ health), Radboud University Medical Center, Nijmegen, Netherlands
| | - Ramon Daniels
- Research Centre Assistive Technology in Care, Zuyd University of Applied Sciences, Heerlen, Netherlands
| | - Maud Graff
- Radboudumc Research Institute, Scientific Center for Quality of Health (IQ health), Radboud University Medical Center, Nijmegen, Netherlands
- Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
| | - Wietske Kuijer-Siebelink
- School of Education, HAN University of Applied Sciences, Nijmegen, Netherlands
- Radboudumc Health Academy, Research on Learning and Education, Radboud University Medical Center, Nijmegen, Netherlands
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Lee OE, Nah KO, Kim EM, Choi NG, Park DH. Exploring the Use of Socially Assistive Robot Among Socially Isolated Korean American Older Adults. J Appl Gerontol 2024:7334648241236081. [PMID: 38410030 DOI: 10.1177/07334648241236081] [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: 02/28/2024] Open
Abstract
This pilot study explored whether a socially assistive robot (SAR) would have positive effects on Korean American immigrant older adults' health behaviors and emotional well-being and whether the older adults would be receptive to the SAR. A total of 30 participants (age 65+) in a large metropolitan area participated in the study, and each participant was provided a SAR named Hyodol for 4 months and interacted with it in ways that they saw appropriate. We used one-group pre- and post-test design to assess changes between baseline and follow-up in medication adherence, depressive symptoms, loneliness, and disability. Additionally, we employed in-depth qualitative interviews to explore participants' perceptions about the SAR. At post-test, participants showed improved medication adherence, reduced depressive symptoms, and a slightly and statistically nonsignificant decrease in loneliness scores. Qualitative data suggested high adoptability of this particular SAR among the participants.
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Affiliation(s)
| | - Kwi Ok Nah
- Older Adult Center, Korean Community Services of Metropolitan New York, New York, NY, USA
| | - Eun Mi Kim
- Older Adult Center, Korean American Community Services of Metropolitan New York, New York, NY, USA
| | - Namkee G Choi
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Do-Hyung Park
- School of Business IT, Kookmin University, Seoul, Republic of Korea
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Naylor R, Spector A, Fisher E, Fucci F, Bertrand E, Marinho V, Bomilcar I, Coutinho B, Laks J, Mograbi DC. Experiences of cognitive stimulation therapy (CST) in Brazil: a qualitative study of people with dementia and their caregivers. Aging Ment Health 2024; 28:238-243. [PMID: 37458268 DOI: 10.1080/13607863.2023.2231376] [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: 04/25/2022] [Accepted: 06/17/2023] [Indexed: 02/02/2024]
Abstract
OBJECTIVES There is a lack of investment in psychosocial treatments for people with dementia in Brazil. Cognitive Stimulation Therapy (CST) is a group-based intervention that has shown to have benefits on activities of daily living and mood for people with dementia in Brazil. This study aims to explore the experiences and perceived changes following CST groups. METHODS Individual interviews were conducted with the participants of the group (n = 12) and their caregivers (n = 11). Framework analysis was used to inspect the data. RESULTS Two main themes have emerged: 'Personal benefits of being part of the group', containing two subthemes: 'Benefits for caregivers' and 'Benefits for person with dementia' and 'Day-to-day changes', containing seven subthemes; 'Memory', Sociability', 'Language', 'Mood', 'Orientation', 'Everyday activities' and 'Behavioural and psychological symptoms'. CONCLUSION Results suggest that CST groups led to perceived personal benefits for the people with dementia and caregivers and that there are perceived changes for the participants of the groups.
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Affiliation(s)
- Renata Naylor
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aimee Spector
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Emily Fisher
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Fernanda Fucci
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Valeska Marinho
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Iris Bomilcar
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruna Coutinho
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jerson Laks
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Translational Biomedicine Postgraduate Programme, Universidade do Grande Rio (Unigranrio), Duque de Caxias, Brazil
| | - Daniel C Mograbi
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Conway E. Use of adapted or modified methods with people with dementia in research: A scoping review. DEMENTIA 2023; 22:1994-2023. [PMID: 37871184 PMCID: PMC10644684 DOI: 10.1177/14713012231205610] [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] [Indexed: 10/25/2023]
Abstract
People with dementia are excluded from research due to methodological challenges, stigma, and discrimination. Including perspectives of people with dementia across a spectrum of abilities is essential to understanding their perspectives and experiences. Engaging people living with dementia in qualitative research can require adaptation of methods.Qualitative research is typically considered when researchers seek to understand the perspectives, lived experiences, or opinions of individuals' social reality. This scoping review explores current use of adapted methods with people with dementia in qualitative research, including methods used and impacts on the engagement as it relates to meeting accessibility needs. This review considered rationales for adaptations provided by authors, particularly whether authors identified a human rights or justice rationale for adapting methods to promote accessibility and engagement.This review began with a search of primary studies using qualitative research methods published in English in OECD countries from 2017 to 2022. Two reviewers screened titles and abstracts for inclusion. Full texts were reviewed, and data from included studies were extracted using a pre-determined chart. Content analysis of rationales was conducted and reviewed by all authors. Studies were assessed for findings related to impacts of adapted methods.Twenty-eight studies met inclusion criteria. Adaptations to qualitative research methods ranged from minor changes, such as maintaining a familiar interviewer, to more extensive novel methods such as photo-elicitation techniques. Twenty-seven studies provided a rationale for adapting their methods. No studies assessed impacts of their methodology on engagement or accessibility. Five studies observed that their methodology supported engagement.This review helps understand the breadth of adaptations that researchers have made to qualitative research methods to include people with dementia in research. Research is needed to explore adaptations and their impact on engagement of persons with dementia with a range of abilities and backgrounds.
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Affiliation(s)
- Emma Conway
- School of Public Health Sciences, University of Waterloo, Canada
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Gridley K. Standardised data collection from people with dementia over the telephone: A qualitative study of the experience of DETERMIND programme researchers in a pandemic. DEMENTIA 2023; 22:1718-1737. [PMID: 37495232 PMCID: PMC10372513 DOI: 10.1177/14713012231190585] [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: 07/28/2023]
Abstract
There is a notable lack of evidence on what constitutes good practice in remote quantitative data collection from research participants with dementia. During the COVID-19 pandemic face-to-face research became problematic, especially where participants were older and more at risk of infection. The DETERMIND-C19 study, a large cohort study of people with dementia, switched to telephone data collection over this period. This paper explores the experiences of researchers who collected quantitative data over the telephone from people with dementia during the first COVID-19 lockdowns in England. The aim was to learn from these experiences, share insights and inform future research practice across disciplines. Seven DETERMIND researchers were interviewed about the processes and challenges of collecting quantitative data from people with dementia over the telephone compared to face-to-face. Data were analysed using reflexive thematic analysis. Two themes were developed: first the telephone adds an extra layer of confusion to an already cognitively complex interaction. Second, researchers found it difficult to recognise subtle cues that signalled participants' rising emotion over the telephone in time to prevent distress. The researchers employed strategies to support participants which may not have conformed to the strict conventions of structured interviewing, but which were informed by person-oriented principles. Whilst in practice this may be a common approach to balancing the needs of participants and the requirements of quantitative research, it is rare for studies to openly discuss such trade-offs in the literature. Honest, reflective reporting is required if the practice of remote data collection from people with dementia is to progress ethically and with integrity.
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Affiliation(s)
- Kate Gridley
- Social Policy Research Unit, University of York, UK
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Fahsold A, Roes M, Holle B, Kuliga S. Methods for the involvement of people living with dementia in research focused on the built environment: a protocol for a scoping review. BMJ Open 2023; 13:e075350. [PMID: 37620266 PMCID: PMC10450054 DOI: 10.1136/bmjopen-2023-075350] [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: 05/05/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
INTRODUCTION The positive influence of a well-designed built environment in dementia-specific care has been known for several years. Many studies focusing on the built environment have captured the perspectives of people living with dementia. However, it remains unclear to what degree and with which methods these individuals have been actively involved in research especially when attempting to understand their perspective. The planned scoping review aims to (1) synthesise methods and results from research about the built environment according to active involvement of people living with dementia and (2) describe facilitators and barriers to this active involvement to capture their perspectives in research. METHODS AND ANALYSIS We will use four search strategies: (1) searches in academic databases MEDLINE via PubMed, CINAHL and APA PsycINFO via EBSCO, and Scopus; (2) grey literature searches via Google Scholar; (3) handsearches of non-academic environmental planning and design journals and (4) identifying other publications of key authors in the field. Additionally, backward and forward citation tracking will be performed via reference lists and Google Scholar, respectively. Relevant literature published between 2013 and 2023 will be identified for data extraction and synthesis. One researcher will perform each strategy. Title-abstract/full text-screening will be conducted using Covidence by two researchers. Results will be displayed in a table and through figures illustrating identified facilitators and barriers. ETHICS AND DISSEMINATION We raised no ethical concerns for the planned scoping review. We will prepare the findings including the identified barriers with long-term care practitioners from our network to identify how changes in practical application methods can be addressed. This dialogue can serve as a basis for including people living with dementia to discuss highlighted barriers when researching their perspectives on the built environment. The scoping review results will be reported in both academic and non-academic journals and at academic conferences.
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Affiliation(s)
- Anne Fahsold
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Standort Witten, Witten, Germany
- School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Martina Roes
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Standort Witten, Witten, Germany
- School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Bernhard Holle
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Standort Witten, Witten, Germany
- School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Saskia Kuliga
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Standort Witten, Witten, Germany
- Faculty of Health, Witten/Herdecke University, Witten, Germany
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Alb'ool B, Abu Khait A. The presence and severity of neuropsychiatric symptoms and their association with quality of life among patients with dementia. Cogn Neuropsychiatry 2023; 28:307-325. [PMID: 37665567 DOI: 10.1080/13546805.2023.2255342] [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: 11/14/2022] [Accepted: 07/10/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Neuropsychiatric symptoms are common manifestations of dementia. The presence and severity of these symptoms differ depending on different personal and contextual factors. PURPOSE This study aimed to investigate the presence and predictors of neuropsychiatric symptoms and the association between the severity of these symptoms and the quality of life in a sample of patients with dementia in Jordan. METHODS In this cross-sectional study, 112 patients with dementia residing in Jordanian nursing homes were recruited using the consecutive sampling method. RESULTS The mean severity of neuropsychiatric symptoms was 9.58. The most prevalent neuropsychiatric symptoms among patients were depression (61.6%), followed by irritability (55.4%), and a feeling of euphoria (54.5%). The regression analysis results indicated that gender, marital status, and dementia severity significantly predicted the neuropsychiatric symptoms severity score and explained 17.70% of the variance. A significant negative correlation between the severity of neuropsychiatric symptoms and quality of life was found. CONCLUSION The study's results indicate that our sample reported mild neuropsychiatric symptoms. These symptoms' high prevalence and persistence negatively impact patients' quality of life. The study's results can help mental health nurses determine the factors impacting effective treatment strategies to combat these symptoms. Future longitudinal studies are warranted to help explain the importance of early diagnosis and management of these symptoms in preventing dementia progression.
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Affiliation(s)
- Banan Alb'ool
- Department of Health Care, Vocational Training Corporation, Irbid, Jordan
| | - Abdallah Abu Khait
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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McMahon K, McFerran K, Clark IN, Odell-Miller H, Stensæth K, Tamplin J, Baker FA. Learning to use music as a resource: the experiences of people with dementia and their family care partners participating in a home-based skill-sharing music intervention: a HOMESIDE sub-study. Front Med (Lausanne) 2023; 10:1205784. [PMID: 37275362 PMCID: PMC10232877 DOI: 10.3389/fmed.2023.1205784] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/03/2023] [Indexed: 06/07/2023] Open
Abstract
An increasing number of people with dementia receive informal care from family members to help them remain living in the community. Music therapy is particularly beneficial for supporting the wellbeing of people living with dementia. However, little is known about how music therapy might support people with dementia and their family care partners as dyads. This study explored the experiences of six dyads participating in a 12-week home-based skill-sharing music intervention facilitated by a music therapist. We examined their experiences during the intervention period and in the 3-6 months following. This study was conducted within a larger randomised control trial, HOMESIDE. Data was collected through video-recorded music-based interviews, participant diaries, and a semi-structured interview. Data was analysed using an abductive and relational-centred research approach in consideration of the Contextual Connection Model of Health Musicking for People Living with Dementia and Their Family Care Partners. The study found fifteen themes that describe dyads' supported experiences of sharing music in their homes. These were organised into three global themes: (1) experiences were shaped by complex influences; (2) a connected musical ecosystem; and (3) music was a resource for wellbeing. This study highlighted the important role of personalised facilitation and the therapeutic relationship as dyads learned to use music as a resource through a process of trial and error. The implications for skill-sharing, indirect music therapy and direct music therapy practice are discussed.
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Affiliation(s)
- Kate McMahon
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Katrina McFerran
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Imogen N. Clark
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, United Kingdom
| | - Karette Stensæth
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Felicity A. Baker
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
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Lood Q, Hermansen Østby R, Hultqvist S, Edvardsson D, Dahlin-Ivanoff S. Uncovering hidden abilities for participation in research through photo-elicitation interviews: a view on participatory research with people living in residential care facilities. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:9. [PMID: 36934278 PMCID: PMC10024515 DOI: 10.1186/s40900-023-00422-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Participatory research has been described to improve the relevance of research findings for the society in terms of quality of healthcare services and other public benefits. Nevertheless, there is limited guidance on how to conduct participatory research, and especially in relation to persons living in residential care facilities. To make the voices of this group heard, we therefore take a stance in the democratic approach to participatory research, and we have applied the theoretical framework Model of Human Occupation (MoHO) on participation to evaluate photo-elicitation interviews as a participatory research method with this group. METHODS A total of 13 persons living in two residential care facilities were involved in the study and asked to take photographs of their everyday life over one week. They were then invited to an individual interview to narrate the meaning of the photographs and to describe how they experienced the photo-elicitation method. The interviews were analysed in the six steps of theoretically driven reflexive thematic analysis. RESULTS The findings are described in the theme 'Uncovering hidden abilities for participation in research' that describes how photo elicitation interviews facilitated the older persons' participation in research. This is illustrated by four sub-themes: 'Bridging the ageing body', 'Altering habituation to everyday life', 'Empowering storytelling', and 'Negotiating the institutional culture'. CONCLUSIONS Our study findings support further application and evaluation of photo-elicitation interviews as a method for participatory research in residential care facilities. The major finding is how photo-elicitation interviews were used to reduce the impact of the institutional culture on the older persons' participation in research. The method is, however, not without limitations and we encourage researchers to study the dynamic relationship between physical, social, and cultural aspects of residential care facilities in relation to the use of photo-elicitation interviews with the persons living there.
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Affiliation(s)
- Qarin Lood
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health –AgeCap, University of Gothenburg, Box 455, 40530 Gothenburg, Sweden
- School of Nursing and Midwifery, Faculty of Health Sciences, La Trobe University, GS Building, Office 327, Bundoora, 3083 Australia
| | - Roar Hermansen Østby
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health –AgeCap, University of Gothenburg, Box 455, 40530 Gothenburg, Sweden
| | - Sara Hultqvist
- Faculty of Social Science, Department of Social Work, Linnaeus University, 351 95 Växjö, Sweden
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
| | - David Edvardsson
- School of Nursing and Midwifery, Faculty of Health Sciences, La Trobe University, GS Building, Office 327, Bundoora, 3083 Australia
- Centre for Person‑Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Synneve Dahlin-Ivanoff
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, Vån 3 SU/Sahlgrenska, 413 45 Gothenburg, Sweden
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Fischer J, Roßmeier C, Hartmann J, Tensil M, Jox RJ, Diehl-Schmid J, Riedl L. Inappropriate Involvement? Presenting Empirical Insight into the Preparation Phase of Advance Directives of Persons Living with Dementia Under German Legislation. J Aging Soc Policy 2023:1-16. [PMID: 36814064 DOI: 10.1080/08959420.2023.2182565] [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: 02/24/2023]
Abstract
The scholarly debate on advance directives (ADs) in the context of dementia is mainly built around ethical arguments. Empirical studies that shed light into the realities of ADs of persons living with dementia are few and far between and too little is known about the effect of national AD legislation on such realities. This paper offers insight into the preparation phase of ADs according to German legislation in the context of dementia. It presents results from a document analysis of 100 ADs and from 25 episodic interviews with family members. Findings show that drafting an AD involves family members and different professionals in addition to the signatory, whose cognitive impairment differed considerably at the time of preparing the AD. The involvement of family members and professionals is at times problematic, which prompts the question of how much and what kind of involvement of others turns an AD of a person living with dementia into an AD about a person living with dementia. The results invite policy makers to critically review legislation on ADs from the perspective of cognitively impaired persons, who might find it difficult to protect themselves from inappropriate involvement when completing an AD.
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Affiliation(s)
- Julia Fischer
- School of Medicine, Department of Psychiatry and Psychotherapy, Centre for Cognitive Disorders, Technical University of Munich, Munich, Germany
| | - Carola Roßmeier
- School of Medicine, Department of Psychiatry and Psychotherapy, Centre for Cognitive Disorders, Technical University of Munich, Munich, Germany
| | - Julia Hartmann
- School of Medicine, Department of Psychiatry and Psychotherapy, Centre for Cognitive Disorders, Technical University of Munich, Munich, Germany
| | - Maria Tensil
- School of Medicine, Department of Psychiatry and Psychotherapy, Centre for Cognitive Disorders, Technical University of Munich, Munich, Germany
| | - Ralf J Jox
- Institute of Humanities in Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Janine Diehl-Schmid
- School of Medicine, Department of Psychiatry and Psychotherapy, Centre for Cognitive Disorders, Technical University of Munich, Munich, Germany
| | - Lina Riedl
- School of Medicine, Department of Psychiatry and Psychotherapy, Centre for Cognitive Disorders, Technical University of Munich, Munich, Germany
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Roberts MA, Abery BH. A person-centered approach to home and community-based services outcome measurement. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1056530. [PMID: 36817716 PMCID: PMC9929050 DOI: 10.3389/fresc.2023.1056530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/10/2023] [Indexed: 02/04/2023]
Abstract
In the United States, over 2.5 million people with disabilities are recipients of supports through the Center for Medicare and Medicaid Services (CMS) Home and Community-Based Services (HCBS) program. Recent decades have seen a growing focus on providing HCBS in a person-centered manner thereby supporting outcomes that are both important for and to the person. HCBS outcome measurement, however, has not kept pace with advancements in person-centered thinking as it relates to providing supports to people with disabilities. The concept of person-centered outcome measurement has been inadequately defined and is frequently misunderstood including by those in the measurement field. The authors first operationally define person-centered measurement and establish its importance within the context of HCBS and the recent CMS's Final Settings Rule. The important role that person-centered measurement has to play in quality improvement efforts in this area is then explored. A discussion is subsequently provided as to the challenges that are faced in person-centered measurement specific to the disability field. In addition to further conceptualizing and defining this form of measurement, recommendations are provided for moving the field forward.
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Toso F, Brankaert R, Hendriks N, Lenaerts L, Wilkinson A. Reflecting on Living Labs as Multi-Stakeholder Collaborative Networks to Evaluate Technological Products for People Living with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1673. [PMID: 36767050 PMCID: PMC9914846 DOI: 10.3390/ijerph20031673] [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: 11/29/2022] [Revised: 12/30/2022] [Accepted: 01/04/2023] [Indexed: 06/18/2023]
Abstract
Dementia is a growing societal challenge putting pressure on care systems across Europe. Providing supporting technology for people living with dementia, referring to both people with dementia and their caregivers, is an important strategy to alleviate pressure. In this paper, we present lessons learned from the Interreg NWE Project Certification-D, in which we evaluated technological products with people living with dementia, using a Living Lab approach. Living Labs were set up in five different countries to conduct field evaluations at the homes of people living with dementia. Via an open call products from small to medium enterprises across northwestern Europe were selected to be evaluated in the Living Labs. In this paper, we describe the setup of and reflection on Living Labs as multi-stakeholder collaboration networks to evaluate technological products in the context of dementia. We reflect on the experiences and insights from the Living Lab researchers to execute and operate the Living Labs in such a sensitive setting. Our findings show that Living Labs can be used to conduct field evaluations of products, that flexibility is required to adopt a Living Lab in various care settings with different stakeholder compositions and expertise, and that Living Lab researchers serve as both a linking pin and buffer between people living with dementia and companies and thereby support the adoption of technological products. We close the paper with a proposal of best practices to encourage inclusivity in, and scalability of, Living Labs in the context of dementia.
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Affiliation(s)
- Francesca Toso
- Human Centred Design (HCD) Group, Department of Design, Production and Management, Faculty of Engineering Technology (ET), University of Twente, Horst Complex, 7522 LV Enschede, The Netherlands
- Systemic Change Group, Department of Industrial Design, Eindhoven University of Technology, Atlas Building, 5612 AE Eindhoven, The Netherlands
| | - Rens Brankaert
- Systemic Change Group, Department of Industrial Design, Eindhoven University of Technology, Atlas Building, 5612 AE Eindhoven, The Netherlands
- Health Innovations & Technology, Fontys School of Allied Health Professions, Dominee Theodor Fliednerstraat 2, 5631 BN Eindhoven, The Netherlands
| | - Niels Hendriks
- Interactions Research Group, LUCA School of Arts, C-Mine 5, 3600 Genk, Belgium
| | - Lieke Lenaerts
- Interactions Research Group, LUCA School of Arts, C-Mine 5, 3600 Genk, Belgium
| | - Andrea Wilkinson
- Interactions Research Group, LUCA School of Arts, C-Mine 5, 3600 Genk, Belgium
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Anything Goes? Analyzing Varied Understandings of Assent. Camb Q Healthc Ethics 2023; 32:76-89. [PMID: 36468375 DOI: 10.1017/s0963180122000524] [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: 12/07/2022]
Abstract
Assent to medical research or treatment may be an intuitively attractive way to address the area between incapacity and capacity that might otherwise be subject to a best interests assessment. Assent has become a widely disseminated concept in law, research, and clinical ethics, but little conceptual work on assent has so far occurred. An exploration of use of assent in treatment and research in children and people with dementia suggests that at least five claims are made on behalf of assent. Since at least some of these may lead to tensions with others, assent requires firmer conceptual underpinning. Whether assent remains primarily a local approach to research in children in the United States, where it appears to fit with legal background conditions, or develops its promise to overturn the dominant, binary, approach to (in)capacity will depend on the strength of future philosophical work to improve the theoretical foundations to assent.
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Seetharaman K, Chaudhury H, Hung L, Phinney A, Freeman S, Groulx M, Hemingway D, Lanthier-Labonté S, Randa C, Rossnagel E. Protocol for A Mixed-Methods Study: Dementia-Inclusive Streets and Community Access, Participation, and Engagement (DemSCAPE). INTERNATIONAL JOURNAL OF QUALITATIVE METHODS 2023; 22:160940692311573. [DOI: 10.1177/16094069231157350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2023]
Abstract
Neighbourhoods are known to help maintain functional abilities and enable out-of-home activities and social participation for people living with dementia. Dementia friendly and inclusive communities (DFC) frameworks recognize the importance of developing supportive and empowering environments for people living with dementia and their families. Beyond the core objective of raising awareness and eliminating stigma associated with dementia, most DFC frameworks also focus on improving accessibility and navigability in the neighbourhood environment. Limited research on this topic points to the importance of evidence-based design of the neighbourhood built environment to promote mobility and wayfinding, legibility, familiarity, and safety for people living with dementia. Increased relevance of DFCs for policy and practice calls for expanding this body of knowledge. The proposed study, titled “Dementia-inclusive Spaces for Community Access, Participation, and Engagement (DemSCAPE),” focuses on identifying neighbourhood destinations considered important by people living with dementia, as well as neighbourhood built environmental features relevant for their outdoor mobility, engagement, and social participation. This study protocol paper offers key information on 1) the need for mixed methods research on this topic and its theoretical and methodological underpinnings, 2) study sampling and recruitment strategy, 3) data collection methods, which include a series of structured and semi-structured sit-down interviews and a walk-along interview, 4) procedure for data analysis, 5) ethical and methodological considerations, and 6) measures taken to enhance study rigour.
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Affiliation(s)
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Lillian Hung
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Alison Phinney
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Shannon Freeman
- School of Nursing, University of Northern British Columbia, Prince George, BC, Canada
| | - Mark Groulx
- School of Planning and Sustainability,University of Northern British Columbia, Prince George, BC, Canada
| | - Dawn Hemingway
- School of Social Work, University of Northern British Columbia, Prince George, BC, Canada
| | | | - Cari Randa
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Emma Rossnagel
- School of Nursing, University of Northern British Columbia, Prince George, BC, Canada
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Just and inclusive end-of-life decision-making for long-term care home residents with dementia: a qualitative study protocol. BMC Palliat Care 2022; 21:202. [PMID: 36419147 PMCID: PMC9684772 DOI: 10.1186/s12904-022-01097-x] [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: 05/17/2022] [Accepted: 11/04/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Many people living with dementia eventually require care services and spend the remainder of their lives in long-term care (LTC) homes. Yet, many residents with dementia do not receive coordinated, quality palliative care. The stigma associated with dementia leads to an assumption that people living in the advanced stages of dementia are unable to express their end-of-life needs. As a result, people with dementia have fewer choices and limited access to palliative care. The purpose of this paper is to describe the protocol for a qualitative study that explores end-of-life decision-making processes for LTC home residents with dementia. METHODS/DESIGN This study is informed by two theoretical concepts. First, it draws on a relational model of citizenship. The model recognizes the pre-reflective dimensions of agency as fundamental to being human (irrespective of cognitive impairment) and thereby necessitates that we cultivate an environment that supports these dimensions. This study also draws from Smith's critical feminist lens to foreground the influence of gender relations in decision-making processes towards palliative care goals for people with dementia and reveal the discursive mediums of power that legitimize and sanction social relations. This study employs a critical ethnographic methodology. Through data collection strategies of interview, observation, and document review, this study examines decision-making for LTC home residents with dementia and their paid (LTC home workers) and unpaid (family members) care partners. DISCUSSION This research will expose the embedded structures and organizational factors that shape relationships and interactions in decision-making. This study may reveal new ways to promote equitable decision-making towards palliative care goals for LTC home residents with dementia and their care partners and help to improve their access to palliative care.
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Smith G, Dixon C, Neiva Ganga R, Greenop D. How Do We Know Co-Created Solutions Work Effectively within the Real World of People Living with Dementia? Learning Methodological Lessons from a Co-Creation-to-Evaluation Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14317. [PMID: 36361197 PMCID: PMC9654242 DOI: 10.3390/ijerph192114317] [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: 08/31/2022] [Revised: 10/27/2022] [Accepted: 10/30/2022] [Indexed: 06/16/2023]
Abstract
Living Labs (LL) are a novel and potentially robust way of addressing real-life health challenges, especially within the dementia field. Generally, LLs focus on co-creating through implementing the quadruple helix partnership as a user-centric approach to co-creating. In the context of this paper, the users were people with dementia and their informal carers. LL are not necessarily environments that evaluate these co-created innovations within the real world. Considering this disconnect between co-creation and real-world evaluation, this paper, as a critical commentary, will reflect on the methodological lessons learnt during the development of an LL model aimed at addressing this discrepancy. The LL at Liverpool John Moores University (LJMU) was commissioned to co-create and then evaluate a new Dementia Reablement Service. The case study findings revealed that the Dementia Reablement Service had a positive impact on the quality of life of people with dementia, suggesting that the service is a catalyst for positive change. In addition, the critical learning from this case study highlights the potential role of LLs in seamlessly co-creating and then evaluating the co-created solution within the real world. A benefit of this way of working is that it provides opportunities for LLs to secure access to traditional research funding.
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Affiliation(s)
- Grahame Smith
- Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
| | - Chloe Dixon
- Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
| | - Rafaela Neiva Ganga
- Faculty of Business and Law, Liverpool John Moores University, Liverpool L3 5UG, UK
| | - Daz Greenop
- Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
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Thuesen J, Graff L. Ageing, dementia and the future - ambivalent futurework in rehabilitation-focused dementia care. DEMENTIA 2022; 21:2210-2230. [PMID: 35921632 PMCID: PMC9483685 DOI: 10.1177/14713012221117412] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Due to its goal-orientation, rehabilitation may be considered a future-oriented practice.
As rehabilitation is increasingly recognized as contributing to dementia care it is
important to explore how rehabilitation corresponds with the future orientation of older
people with dementia. The aim of this study was to explore the futurework of home-dwelling people with mild to
moderate dementia in the context of rehabilitation-focused municipal dementia care, that
is, their thinking and practices regarding their future and how these correspond with
institutionalized practices. The study was conducted as a case-study inspired by the methodology of Institutional
Ethnography (IE). The study setting was two Danish municipalities sampled as a
paradigmatic case. Eight older people living with early-stage dementia (mean age: 78
years, age range: 65–91) were strategically sampled and each interviewed recurringly
within a period of six through 15 months. In total, 29 interviews were completed. An
abductive analysis was subsequently conducted based on these interviews. Findings included three dimensions of futurework: Extending the present state into the
near future; avoiding being confronted with an anticipated future; and adjusting to
decline and preparing for future losses. Based on these findings, a notion of ‘ambivalent
futurework’ is suggested. The futurework of older people did not always correspond with
the institutional arrangements in a rehabilitation-focused dementia care. Findings show
that the institutional arrangements in dementia care may support as well as challenge the
futurework of the participants. Paying attention to the ambivalences of older people
living with dementia and recognizing the ambivalent futurework may be essential in
rehabilitation-focused dementia care.
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Affiliation(s)
- Jette Thuesen
- Department of Public Health, 6174University of Southern Denmark, Syddanmark, Denmark.,Centre for Nutrition and Rehabilitation, 165104Absalon University College, Sjælland, Denmark.,REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, 6174University of Southern Denmark, Syddanmark, Denmark
| | - Lea Graff
- The Danish Center for Social Science Research, 4298VIVE, Copenhagen, Denmark
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West J, Birt L, Wilson D, Mathie E, Poland F. A Case Study of Co-production Within a Mental Health Recovery College Dementia Course: Perspectives of A Person With Dementia, Their Family Supporter and Mental Health Staff. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:920496. [PMID: 36188994 PMCID: PMC9397742 DOI: 10.3389/fresc.2022.920496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/30/2022] [Indexed: 12/04/2022]
Abstract
Background Undertaking co-production as a power-sharing way to improve mental health dementia services remains uncommon, suggesting opportunities to apply knowledge from lived experience of people with dementia, may often be missed. One barrier is stigma, assuming people with progressive cognitive impairment cannot manage this level of participation, support peers nor offer a “valid” perspective. Purpose This paper shares knowledge gained from a service evaluation that explored various experiences of a person with dementia, their family supporter and mental health staff, involved in co-producing a course about “living well” with dementia, within a mental health Recovery College. Design A qualitative, case study approach used semi-structured interviewing and inductive thematic analysis. Findings Co-production activities generated a shared sense of positivity, pride and privilege, highlighting positive effects in breaking down the “them and us” barriers common in traditional healthcare professional-service user relationships. Each individual had both something to offer and something to gain during the process. Staff identified challenges in the co-production process; in that balancing all the voices during meetings could be complex at times, and the process overall required considerable time commitment. Conclusion Taking part in co-production at an appropriate level and with peer support is a relational activity seen to be valuable in powerfully, yet gently, challenging stigma and assumptions around dementia. Findings show that while the process of co-production requires time and dedication, there is overall value in involving people living with dementia both in co-production and in peer support. This provided a straightforward and beneficial means to inclusively improve post-diagnosis support and care quality within a memory service.
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Affiliation(s)
- Juniper West
- Research Development Programme, Research and Development Department, Older People's Services, Norfolk and Suffolk NHS Foundation Trust, Norwich, United Kingdom
- *Correspondence: Juniper West
| | - Linda Birt
- Faculty of Medicine and Health Sciences, School of Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Danielle Wilson
- Research Development Programme, Research and Development Department, Older People's Services, Norfolk and Suffolk NHS Foundation Trust, Norwich, United Kingdom
| | - Elspeth Mathie
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, United Kingdom
| | - Fiona Poland
- Faculty of Medicine and Health Sciences, School of Health Sciences, University of East Anglia, Norwich, United Kingdom
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20
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Stigma and its implications for dementia in South Africa: a multi-stakeholder exploratory study. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x2200040x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Stigma and discrimination in relation to dementia has a range of implications for people living with dementia and their families worldwide, including help-seeking, quality of life, social rejection and isolation. Few studies consider the perceptions and stigma towards dementia from multiple perspectives, such as people living with dementia, carers, general public and health-care workers. South Africa has limited evidence on the stigmatisation of people living with dementia, with responses to people living with dementia being driven by poor understanding of the condition, cultural beliefs about causes and social interaction problems associated with memory and cognitive impairment. This study explored the experiences of stigma among people living with dementia and their carers through understanding their own knowledge, attitudes and beliefs as well as those of the public and health-care workers. Qualitative data (N = 52) were collected across two provinces and in four languages (English, Afrikaans, Sesotho and isiZulu), with semi-structured interviews and focus groups with the following stakeholder groups: people living with dementia and their carers, the general public and health-care workers. Inductive thematic analysis generated themes across stakeholder groups. The study shows that people living with dementia and carers experienced high levels of internalised stigma, related to negative public attitudes, which were associated with high levels of isolation, health system unpreparedness and limited access to support. The study contributes to the evidence base needed in South Africa but also extends its relevance by contributing to a growing global evidence base on stigma and dementia in low- and middle-income contexts.
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21
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Hansen TE, Andresen M, Præstegaard J, Tjørnhøj-Thomsen T, Nørgaard B. Dementia-friendliness - Inclusion or exclusion: A critical discourse analysis. DEMENTIA 2022; 21:1933-1954. [PMID: 35562108 DOI: 10.1177/14713012221101240] [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: 11/16/2022]
Abstract
This article explores how individuals with dementia and their relatives discursively construct dementia-friendliness in a situation where different definitions of this term exists. Thirteen semi-structured interviews were conducted, including seven individual interviews with people living with dementia. The remaining six interviews consisted of three interviews with the relatives of a person with dementia and three with married couples of which one were diagnosed with dementia. Notes taken by the first author during 6 months of fieldwork at a day centre and a drop-in centre for people with dementia and their families were used to supplement the interviews. Critical discourse analysis provides an analytical tool for revealing the discourses constructing dementia-friendliness. The analysis revealed that people with dementia and their relatives draw on the three discourses of sameness, security and care and autonomy during their attempts to construct dementia-friendliness. The ensuing discursive battles over dementia-friendliness appear to constitute a tightrope walk between the inclusion and exclusion of people with dementia, which underscores the importance of including the voices of people living with dementia when dementia-friendly initiatives and communities are developed.
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Affiliation(s)
- Tania Ea Hansen
- Department of Public Health, 74340University of Southern Denmark, Odense, Denmark; Centre of Nutrition and Rehabilitation, 165104University College Absalon, Naestved, Denmark
| | - Mette Andresen
- Centre of Nutrition and Rehabilitation, 165104University College Absalon, Naestved, Denmark
| | - Jeanette Præstegaard
- Centre of Nutrition and Rehabilitation, 165104University College Absalon, Naestved, Denmark
| | - Tine Tjørnhøj-Thomsen
- National Institute of Public Health, 74340University of Southern Denmark, Odense, Denmark
| | - Birgitte Nørgaard
- Department of Public Health, 74340University of Southern Denmark, Odense, Denmark
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22
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Mansfield E, Cameron E, Carey M, Boyes A, Nair B, Hall A, Sanson-Fisher R. Prevalence and Type of Unmet Needs Experienced by People Living with Dementia. J Alzheimers Dis 2022; 87:833-842. [DOI: 10.3233/jad-215183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Accurately identifying the unmet needs of community-dwelling people with dementia allows targeted support to be provided to assist these individuals to stay at home. Objective: We developed a self-report instrument to identify the unmet needs of community-dwelling people with dementia and used this to explore the prevalence and type of unmet needs present in this population. Methods: This was a cross-sectional survey of people with dementia living in the community in Australia. Participants were recruited from geriatric clinics, respite centers, aged care providers, and carers attending support groups. Eligible people with dementia were provided with a study information pack and survey which included the self-report Unmet Needs Instrument for Dementia (UNI-D), sociodemographic characteristics and survey acceptability. Results: The UNI-D contained 26 items across 5 domains and demonstrated acceptable internal consistency, face and construct validity, and acceptability. Ninety-five eligible participants completed the survey (response rate 35%) with 85% identifying at least one unmet need (median = 4; IQR = 1–9). The items most frequently endorsed included needing more help with remembering things (64%), finding possible treatments for dementia (44%), understanding who to contact regarding a problem or concern related to dementia (36%), and to see friends and family more often (33%). Conclusion: The UNI-D is a promising tool to identify the self-reported needs of people with dementia. The development and rigorous testing of interventions targeting unmet needs related to health and wellbeing, dementia support, and meaningful activities appears warranted.
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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, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Emilie Cameron
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Mariko Carey
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Allison Boyes
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Balakrishnan Nair
- John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, New South Wales, Australia
- Medical Education and Professional Development, School of Medicine and Public Health, College of Health and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Alix Hall
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
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Ritchie K, Cramm H, Aiken A, Donnelly C, Goldie C. PTSD Symptoms and Dementia in Older Veterans Who are Living in Long-Term Care. QUALITATIVE HEALTH RESEARCH 2022; 32:504-519. [PMID: 34949122 DOI: 10.1177/10497323211061345] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Co-occurring posttraumatic stress disorder symptoms and dementia can result in increased symptoms, such as suspicion, aggression, and nightmares in Veterans that can be difficult to manage in long-term care environments. The objective of the study was to explore how the co-occurrence of posttraumatic stress disorder symptoms and dementia are understood in Canadian Veterans who are living in long-term care. A descriptive multiple case study was conducted in two Veteran long-term care facilities in Canada. Data collection consisted of semi-structured interviews with Veterans, their family caregivers, and health care providers, non-participant observation, and a chart audit. Three major themes emerged relating to symptom expression and care approach: a) symptoms are the same but different; b) differences in the complexity of care; and c) added dimensions involved in care. The results of this study contribute foundational information about co-occurring posttraumatic and dementia symptoms that can inform policy, care approaches, and potential interventions.
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Affiliation(s)
- Kim Ritchie
- 4257Queen's University, Kingston, ON, Canada
| | - Heidi Cramm
- 4257Queen's University, Kingston, ON, Canada
| | - Alice Aiken
- 3688Dalhousie University, Halifax, NS, Canada
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24
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Thompson Z, Baker FA, Tamplin J, Clark IN. How Singing can Help People With Dementia and Their Family Care-Partners: A Mixed Studies Systematic Review With Narrative Synthesis, Thematic Synthesis, and Meta-Integration. Front Psychol 2021; 12:764372. [PMID: 34707550 PMCID: PMC8542693 DOI: 10.3389/fpsyg.2021.764372] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/10/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Recent research on the efficacy of music-based interventions for people with dementia have focused on specific outcomes and methods, and singing has been noted as a particularly beneficial activity. However, due to heterogeneity of research methods, there is a need to synthesise the findings of both quantitative and qualitative research in order to better understand both the impact and potential mechanisms of singing for people in this population. Method: This systematic review included quantitative, qualitative and mixed-methods studies, and analysed these using a systematic mixed-studies synthesis (with a results-based convergent approach). Quantitative and qualitative data were initially synthesised using a narrative synthesis and thematic synthesis method, respectively, before a final meta-integration method was used to synthesise common themes across the two data forms. Results: Electronic and hand search strategies revealed 1,815 relevant studies, 40 of which met the full eligibility criteria. Narrative synthesis of quantitative data revealed six key outcome areas (quality of life; psychological well-being; cognition; engagement; activities of daily living; care-partner well-being), and thematic synthesis of qualitative data generated seven themes relating to the impact and mechanisms of singing (pragmatic elements; social benefits; mood; identity; memory; flow-on effects; and relationships). Meta-integration identified four key areas relating to the impact and mechanisms of singing for people with dementia and care-partners: psychological well-being, quality of life, cognition, and care-partner well-being. Conclusion: Results from the syntheses suggest that singing can positively impact the lives of people with dementia and their care-partners, although due to heterogeneity of study design and outcome measures, it is difficult to draw conclusions based on quantitative data alone. Qualitative data provides further context and insights from participant perspectives, and when integrated with quantitative data, contextual factors that may influence the benefits that participants experience from singing are revealed.
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Affiliation(s)
- Zara Thompson
- Faculty of Fine Arts and Music, University of Melbourne, Melbourne, VIC, Australia
| | - Felicity A Baker
- Faculty of Fine Arts and Music, University of Melbourne, Melbourne, VIC, Australia
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, University of Melbourne, Melbourne, VIC, Australia
| | - Imogen N Clark
- Faculty of Fine Arts and Music, University of Melbourne, Melbourne, VIC, Australia
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25
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Feasibility and Effectiveness of a Biography-Based Physical Activity Intervention in Institutionalized People With Dementia: Quantitative and Qualitative Results From a Randomized Controlled Trial. J Aging Phys Act 2021; 30:237-251. [PMID: 34426552 DOI: 10.1123/japa.2020-0343] [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: 08/12/2020] [Revised: 03/19/2021] [Accepted: 04/20/2021] [Indexed: 11/18/2022]
Abstract
The objective of this multicenter randomized controlled trial was to evaluate the feasibility and effectiveness of a physical activity intervention for institutionalized people with dementia, individualized by capacity and biography. The intervention group (n = 34; age: mean = 86.09 years; 79.40% female; mean Mini-Mental State Examination value = 18.59) participated in a multicomponent training program, which included daily activities, dancing, gardening, and sports/games, twice weekly for 3 months. The control group (n = 29; age: mean = 86.34 years; 75.90% female; mean Mini-Mental State Examination value = 19.90) received standard care. Feasibility was evaluated by means of focus groups and feedback questionnaires. Functional performance (Short Physical Performance Battery and Timed Up and Go Test), activities of daily living, and gait were outcomes for effectiveness. A high adherence rate (80.46%) and uniformly positive feedback indicate that the piloted training program is feasible. The results show preliminary effectiveness on functional performance (Short Physical Performance Battery mean t0 = 3.15; mean t1 = 4.50; p = .006) and gait (e.g., velocity mean t0 = 46.97; mean t1 = 58.04; p = .007).
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Daly Lynn J, Washbrook M, Ryan A, McCormack B, Martin S. Partnering with older people as peer researchers. Health Expect 2021; 24:1879-1889. [PMID: 34337838 PMCID: PMC8483193 DOI: 10.1111/hex.13331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 11/27/2022] Open
Abstract
Background The term peer researcher describes the role of a person who has similar characteristics and can identify with the participant group in a research study. This paper describes the methodological approach and experiences of older people who were peer researchers on a study that explored the lived experience of people with dementia who lived in technology‐enriched housing. Methods Nine people responded to a public recruitment campaign through nongovernment organisations using multiple methods such as seniors' forums, development officers and social media. Mandatory training across 2 days was provided and seven peer researchers successfully completed the training. A total of 22 interviews were undertaken by the seven peer researchers. The data collected from the training feedback proforma (N = 7), interview debrief forms (N = 22) and final evaluation forms (N = 5) were analysed using content analysis and triangulated. Results Five core themes emerged from the data using a content analysis approach to examine the peer researchers' experience: (1) skill development; (2) recognition of competencies; (3) connection; (4) supplementary information; and (5) the triad dynamic. Conclusions Considerations to enhance the peer researcher experience emerged including enhanced communication training, consideration of the optimum number of peer researchers to balance workload and identification of the characteristics that enable people to connect as peer researchers. Future research should consider the impact that experiential skill development has on the data collected. Public Contribution Older people conducted qualitative interviews as peer researchers with people living with dementia to cocreate knowledge.
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Affiliation(s)
- Jean Daly Lynn
- School of Health Sciences, Ulster University, Newtownabbey, Northern, Ireland.,Engage with Age, East Belfast, Northern, Ireland
| | - Margy Washbrook
- Peer Researcher, Member of the Public, Belfast, Northern Ireland
| | - Assumpta Ryan
- School of Nursing, Ulster University, Londonderry, Northern Ireland
| | | | - Suzanne Martin
- School of Health Sciences, Ulster University, Newtownabbey, Northern, Ireland
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Fox MT, Sidani S, Butler JI, Skinner MW, Macdonald M, Durocher E, Hunter KF, Wagg A, Weeks LE, MacLeod A, Dahlke S. Optimizing hospital-to-home transitions for older persons in rural communities: a participatory, multimethod study protocol. Implement Sci Commun 2021; 2:81. [PMID: 34294145 PMCID: PMC8295643 DOI: 10.1186/s43058-021-00179-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/27/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Transitional care involves time-limited interventions focusing on the continuity of care from hospital to home, to optimize patient functioning and management. Providing interventions, as part of transitional care, that optimize the functioning of older people with dementia is critical due to the small window of opportunity in which they can return to their baseline levels of functioning. Yet prior research on transitional care has not included interventions focused on functioning and did not target older people with dementia in rural communities, limiting the applicability of transitional care to this population. Accordingly, the goal of this study is to align hospital-to-home transitional care with the function-related needs of older people with dementia and their family-caregivers in rural communities. METHODS In this multimethod study, two phases of activities are planned in rural Ontario and Nova Scotia. In phase I, a purposive sample of 15-20 people with dementia and 15-20 family-caregivers in each province will rate the acceptability of six evidence-based interventions and participate in semi-structured interviews to explore the interventions' acceptability and, where relevant, how to improve their acceptability. Acceptable interventions will be further examined in phase II, in which a purposive sample of healthcare providers, stratified by employment location (hospital vs. homecare) and role (clinician vs. decision-maker), will (1) rate the acceptability of the interventions and (2) participate in semi-structured focus group discussions on the facilitators and barriers to delivering the interventions, and suggestions to enable their incorporation into rural transitional care. Two to three focus groups per stratum (8-10 healthcare providers per focus group) will be held for a total of 8-12 focus groups per province. Data analysis will involve qualitative content analysis of interview and focus group discussions and descriptive statistics of intervention acceptability ratings. DISCUSSION Findings will (1) include a set of acceptable interventions for rural transitional care that promote older patients' functioning and family-caregivers' ability to support patients' functioning, (2) identify resources needed to incorporate the interventions into rural transitional care, and (3) provide high-quality evidence to inform new transitional care practices and policies and guide future research.
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Affiliation(s)
- Mary T. Fox
- School of Nursing, Faculty of Health, York University Centre for Aging Research and Education, York University, HNES suite 343, 4700 Keele St, Toronto, Ontario M3J 1P3 Canada
| | - Souraya Sidani
- School of Nursing, Faculty of Community Services, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3 Canada
| | - Jeffrey I. Butler
- School of Nursing, York University Centre for Aging Research and Education, Faculty of Health, York University, HNES suite 343, 4700 Keele Street, Toronto, Ontario M3J 1P3 Canada
| | - Mark W. Skinner
- Trent School of the Environment, Trent University, 1600 West Bank Drive, Peterborough, Ontario K9L 0G2 Canada
| | - Marilyn Macdonald
- School of Nursing, Dalhousie University, Room 130, Forrest Bldg., PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia B3H 4R2 Canada
| | - Evelyne Durocher
- School of Rehabilitation Science, Institute of Applied Health Sciences, Faculty of Health Sciences, McMaster University, Room 428, 1400 Main St. W, Hamilton, Ontario L8S 1C7 Canada
| | - Kathleen F. Hunter
- Faculty of Nursing, University of Alberta, 5-293 Edmonton Clinic Health Academy 11405-87 Ave NW, Edmonton, Alberta T6G 1C9 Canada
| | - Adrian Wagg
- Department of Geriatric Medicine, University of Alberta, 1-198 Clinical Sciences Building, Edmonton, Canada
| | - Lori E. Weeks
- School of Nursing, Dalhousie University, Room G30, Forrest Bldg. PO Box 15000, Halifax, Nova Scotia B3H 4R2 Canada
| | - Ann MacLeod
- Trent/Fleming School of Nursing, Trent University, 1600 West Bank Drive, Peterborough, Ontario K9L 0G2 Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy 11405-87 Ave NW, Edmonton, Alberta T6G 1C9 Canada
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Gebhard D, Mir E. What Moves People Living With Dementia? Exploring Barriers and Motivators for Physical Activity Perceived by People Living With Dementia in Care Homes. QUALITATIVE HEALTH RESEARCH 2021; 31:1319-1334. [PMID: 33825572 PMCID: PMC8182331 DOI: 10.1177/10497323211002822] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
There is a lack of intervention promoting physical activity targeted toward people living with dementia because their input has not been prioritized in the development of exercise programs. The aim of this study is to investigate motivators and barriers concerning physical activity in people living with dementia in care homes and to give recommendations for intervention development. Qualitative semi-structured interviews were conducted; transcripts were analyzed using qualitative content analysis. Following a tailored procedural model, inductive and deductive category development was applied. The value of Cohen's κ = .94 indicates the high intercoder reliability of the category system developed. Ten interviewees reported 24 different barriers and 12 motivators concerning physical activity in the context of the social-ecological model. The strong impact of intrapersonal factors and the living environment became apparent. Points of reference for how people living with dementia can overcome barriers and activate their motivators to achieve more physical activity are provided.
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Affiliation(s)
| | - Eva Mir
- Carinthia University of Applied
Sciences, Feldkirchen, Austria
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29
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Aging in Place with Age-Related Cognitive Changes: The Impact of Caregiving Support and Finances. SOCIETIES 2021. [DOI: 10.3390/soc11020031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In the United States, aging in place is a common concept that refers to older adults’ desire to remain in their homes as they age. However, this ability to age in place is a complex process that is not only impacted by the home’s accessibility or individual functional abilities. This paper aims to examine different factors, such as home environment and home modification, caregivers, finances, and other supports present in the participants’ lives, that impact older adults with age-related cognitive changes (ARCC) (in)ability to age in place. Qualitative interviews with older adults with ARCC (n = 5) and their caregivers (n = 5) were conducted. The participants’ experiences while aging in place indicate that finances and caregiving support greatly impacted their lives at home and ability to age in place. Personal finances dictated where some of the participants could age and the support, they could afford from home health aides. Additionally, informal and formal caregivers were an important source of support that aided in the older adults’ ability to remain home. As researchers, we need to continue to address personal finances and the support that the individual has in their lives to most effectively promote aging in place and their life at home.
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Margot-Cattin I, Ludwig C, Kühne N, Eriksson G, Berchtold A, Nygard L, Kottorp A. Visiting Out-of-Home Places When Living With Dementia: A Cross-Sectional Observational Study: Visiter des lieux hors du domicile lorsque l'on vit avec une démence: étude transversale observationnelle. The Canadian Journal of Occupational Therapy 2021; 88:131-141. [PMID: 33745342 PMCID: PMC8240000 DOI: 10.1177/00084174211000595] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND. Persons living with dementia face a reduction of their life space outside home and disengagement from participation, linked to places visited. PURPOSE. This study explored stability and change in perceived participation in places visited outside home and its relationship with occupational gaps among older adults. METHOD. Older adults living with (n = 35) or without (n = 35) dementia were interviewed using the Participation in ACTivities and Places OUTside Home (ACT-OUT) questionnaire and the Occupational Gaps Questionnaire (OGQ). Data analysis used descriptive and inferential statistics. FINDINGS. The group of people living with dementia reported significantly fewer places (p < .001) visited than the comparison group and having abandoned more places visited (p < .001) than the comparison group. The number of occupational gaps was significantly different between groups (p < .001). IMPLICATIONS. Participation outside home is not influenced in a uniform and straightforward way for persons living with dementia; the shrinking world effect appears differently in relation to types of places.
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Affiliation(s)
- Isabel Margot-Cattin
- Isabel Margot-Cattin, Haute Ecole Specialisee de Suisse Occidentale (HES-SO), HETSL, ch.des Abeilles 14, 1010 Lausanne, Switzerland. E-mail:
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Chu CH, Biss RK, Cooper L, Quan AML, Matulis H. Exergaming Platform for Older Adults Residing in Long-Term Care Homes: User-Centered Design, Development, and Usability Study. JMIR Serious Games 2021; 9:e22370. [PMID: 33687337 PMCID: PMC7988392 DOI: 10.2196/22370] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 12/12/2020] [Accepted: 02/12/2021] [Indexed: 12/14/2022] Open
Abstract
Background Older adults (OAs) residing in long-term care (LTC) homes are often unable to engage in adequate amounts of physical activity because of multiple comorbidities, including frailty and severe cognitive impairments. This level of physical inactivity is associated with declines in cognitive and functional abilities and can be further compounded by social isolation. Exergaming, defined as a combination of exercise and gaming, has the potential to engage OAs in exercise and encourage social interaction. However, previously used systems such as the Nintendo Wii are no longer commercially available, and the physical design of other exergames is not suitable for OAs (ie, fall risks, accessibility issues, and games geared toward a younger population) with diverse physical and cognitive impairments. Objective This study aims to design and develop a novel, user-centered, evidence-based exergaming system for use among OAs in LTC homes. In addition, we aim to identify facilitators and barriers to the implementation of our exergaming intervention, the MouvMat, into LTC homes according to staff input. Methods This study used a user-centered design (UCD) process that consisted of 4 rounds of usability testing. The exergame was developed and finalized based on existing evidence, end user and stakeholder input, and user testing. Semistructured interviews and standardized and validated scales were used iteratively to evaluate the acceptability, usability, and physical activity enjoyment of the MouvMat. Results A total of 28 participants, 13 LTC residents, and 15 staff and family members participated in the UCD process for over 18 months to design and develop the novel exergaming intervention, the MouvMat. The iterative use of validated scales (System Usability Scale, 8-item Physical Activity Enjoyment Scale, and modified Treatment Evaluation Inventory) indicated an upward trend in the acceptability, usability, and enjoyment scores of MouvMat over 4 rounds of usability testing, suggesting that identified areas for refinement and improvement were appropriately addressed by the team. A qualitative analysis of semistructured interview data found that residents enjoyed engaging with the prototype and appreciated the opportunity to increase their PA. In addition, staff and stakeholders were drawn to MouvMat’s ability to increase residents’ autonomous PA. The intended and perceived benefits of MouvMat use, that is, improved physical and cognitive health, were the most common facilitators of its use identified by study participants. Conclusions This study was successful in applying UCD to collaborate with LTC residents, despite the high number of physical and sensory impairments that this population experiences. By following a UCD process, an exergaming intervention that meets diverse requirements (ie, hardware design features and motivation) and considers environmental barriers and residents’ physical and cognitive needs was developed. The effectiveness of MouvMat in improving physical and cognitive abilities should be explored in future multisite randomized controlled trials.
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Affiliation(s)
- Charlene H Chu
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Renée K Biss
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Lara Cooper
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Amanda My Linh Quan
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Henrique Matulis
- Department of Mechanical & Industrial Engineering, University of Toronto, Toronto, ON, Canada
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Nielsen KD, Boenink M. Ambivalent anticipation: How people with Alzheimer's disease value diagnosis in current and envisioned future practices. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:510-527. [PMID: 33635548 PMCID: PMC8248062 DOI: 10.1111/1467-9566.13238] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/24/2020] [Accepted: 12/10/2020] [Indexed: 06/12/2023]
Abstract
Emergent biomarkers for Alzheimer's disease (AD) are expected to provide earlier and more precise diagnoses. However, even if biomarkers live up to these expectations, it cannot be taken for granted that patients actually would value an earlier and more precise AD diagnosis. Based on an interview study, we aim to give more insight into the value of an AD diagnosis for patients, in existing as well as future practices, by describing how a diagnosis enables or may enable knowing, foreseeing, and acting in relation to one's illness. Our findings show that how people with AD value a diagnosis is not only characterised by great variety, as previous studies have shown, but also by profound ambivalence for the individual. With lack of treatment and poor prognostics as the status quo, this ambivalence and the way people deal with it are particularly linked to the far-from-straightforward capacity of an AD diagnosis to support anticipation of the future. We argue that in otherwise unchanged practices the envisioned future biomarker-based diagnostics are unlikely to reduce the ambivalence about receiving an AD diagnosis and, in particular, the challenges of anticipation that it entails. Rather, biomarker-based innovations may even reinforce some of the main issues involved.
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Affiliation(s)
- Karen Dam Nielsen
- Section Medical EthicsIQ Healthcare, Radboud UMCNijmegenThe Netherlands
| | - Marianne Boenink
- Section Medical EthicsIQ Healthcare, Radboud UMCNijmegenThe Netherlands
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33
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Kuske S, Borgmann SO, Wolf F, Bleck C. Emotional Safety in the Context of Dementia: A Multiperspective Qualitative Study. J Alzheimers Dis 2020; 79:355-375. [PMID: 33285639 PMCID: PMC7902974 DOI: 10.3233/jad-201110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background: Current research acknowledges the relevance of the emotional safety of people living with dementia. However, available evidence regarding this topic is limited. A comprehensive view of this topic that equally considers the perspectives of people living in an early stage of dementia, relatives, and public stakeholders is lacking. Objective: This study aimed to obtain a multiperspective view of emotional safety in the context of dementia in the living environment. Methods: A descriptive qualitative study was conducted based on data collected through semi-structured guided interviews (n = 14), focus groups (n = 3), guided feedback, and participatory approaches. People living in an early stage of dementia (N = 6), relatives of people living with dementia (N = 11), and public stakeholders (N = 15) were included. Results: Considering “social togetherness”, “personal condition”, “health”, “physical environment”, and “society” in the light of “living and learning in relations” are preconditions for understanding emotional safety in the context of dementia. “Living and learning in relations” refers to the interaction of people in the context of dementia and relations to the topic of dementia. The focus lies on the (collective) learning. The individuality of each person and his or her situation is central, related to dementia-related, psychosocial, biographical, physical, and economic factors. Conclusion: Our study highlights the relevance of research on emotional safety in the context of dementia. Approaches to improving the emotional safety of people living in an early stage of dementia should consider the complex situations of each target group in relation to each other at the micro, meso, and macro levels.
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Affiliation(s)
- Silke Kuske
- Fliedner Fachhochschule Düsseldorf, University of Applied Sciences, Düsseldorf, Germany
| | | | - Florian Wolf
- Fliedner Fachhochschule Düsseldorf, University of Applied Sciences, Düsseldorf, Germany
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Lee S, O'Neill D, Moss H. Promoting well-being among people with early-stage dementia and their family carers through community-based group singing: a phenomenological study. Arts Health 2020; 14:85-101. [PMID: 33119993 DOI: 10.1080/17533015.2020.1839776] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Dementia can negatively impact the well-being of people living with dementia and their family carers. Research suggests that music psychosocial interventions are effective, safe alternatives to pharmacological interventions for the promotion of well-being . However, evidence is limited, and research gaps remain. This study explores how a community-based group singing intervention impacts the well-being of people with early-stage dementia and their family carers. METHODS A phenomenological methodological approach was adopted. Participants engaged in a six-week group singing intervention facilitated by a music therapist in a community arts centre. Semi-structured interviews were conducted (n = 7). RESULTS Interpretative Phenomenological Analysis revealed four superordinate themes: (1) Social Connection; (2) Happiness and Rejuvenation; (3) Reconnection with the Self; and (4) Supporting the Carer-Cared-for Relationship. CONCLUSIONS Evidence of multidimensional enhancement of well-being, absence of adverse effects, and accessibility of this musical medium support the increased provision of community-based singing groups for these populations.
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Affiliation(s)
- Sophie Lee
- Health Research Institute, Ageing Research Centre, Irish World Academy of Music and Dance, University of Limerick, Limerick, Ireland
| | - Desmond O'Neill
- Centre for Ageing, Neurosciences and the Humanities, Trinity College Dublin, Dublin, Ireland.,Trinity Centre for Health Sciences, Tallaght University Hospital, Dublin, Ireland
| | - Hilary Moss
- Health Research Institute, Ageing Research Centre, Irish World Academy of Music and Dance, University of Limerick, Limerick, Ireland
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Jakobsson E, Nygård L, Kottorp A, Olsson CB, Malinowsky C. The use of everyday technology; a comparison of older persons with cognitive impairments’ self-reports and their proxies’ reports. Br J Occup Ther 2020. [DOI: 10.1177/0308022620954117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Older persons with cognitive impairment have often been disregarded in providing information on their own perceptions. This study explored the number of relevant everyday technologies and the ability to use everyday technologies as perceived by persons with cognitive impairment in comparison with their proxies’ estimates using the Short Everyday Technology Use Questionnaire. Method In this cross-sectional study, persons with cognitive impairment ( n = 21) and their proxies ( n = 21) were interviewed on separate occasions with the Short Everyday Technology Use Questionnaire, which measures the number of relevant everyday technologies and the ability to use everyday technologies. The data were analysed with t-tests, z-comparisons, and Fisher’s exact test. The level of significance was set at p < 0.05. Results At the group level, no significant differences were found between persons with cognitive impairments’ perceptions and their proxies’ estimates regarding the number of relevant everyday technologies or the ability to use everyday technologies. On the individual level, significant differences were found in the ability measures within four out of the 21 dyads. Conclusion The persons with cognitive impairment and their proxies verified each other’s responses, providing evidence that persons with cognitive impairment should be the primary source for information about their own everyday technology use.
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Affiliation(s)
- Elin Jakobsson
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Louise Nygård
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Anders Kottorp
- Faculty of Health and Society, Malmö University, Malmö, Sweden
| | | | - Camilla Malinowsky
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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Toubøl A, Moestrup L, Ryg J, Thomsen K, Nielsen DS. Stakeholder perspectives of the dementia-friendly hospital: A qualitative descriptive focus group study. DEMENTIA 2020; 20:1501-1517. [PMID: 32930603 DOI: 10.1177/1471301220947848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The term dementia-friendly hospital is increasingly used to describe a variety of initiatives and strategies that are implemented to meet the challenges faced by patients with dementia during hospitalization. However, no definition of the dementia-friendly hospital currently exists. This qualitative focus group study aimed to describe stakeholders' perspectives of the dementia-friendly hospital. Four stakeholder groups were included: people with dementia, relatives, hospital staff, and representatives from the Danish Alzheimer Association. The thematic analysis suggests that a person-centered approach is a key feature. This approach is described as a continuously reflexive awareness of how to see the person behind the dementia diagnosis. We discuss possible revision of the current dementia discourse and the implications of the findings for future practice and research.
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Affiliation(s)
- Annemarie Toubøl
- 138728Health Sciences Research Center, UCL University College, Denmark
| | - Lene Moestrup
- Health Sciences Research Center, 138728UCL University College, Denmark
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Denmark
| | - Katja Thomsen
- Department of Geriatric Medicine, Odense University Hospital, Denmark
| | - Dorthe S Nielsen
- Centre for Global Health, 6174University of Southern Denmark, Denmark
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Lee OE, Davis B. Adapting 'Sunshine,' A Socially Assistive Chat Robot for Older Adults with Cognitive Impairment: A Pilot Study. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2020; 63:696-698. [PMID: 32635827 DOI: 10.1080/01634372.2020.1789256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Affiliation(s)
| | - Boyd Davis
- The University of North Carolina , Charlotte, North Carolina, USA
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Johnston K, Preston R, Strivens E, Qaloewai S, Larkins S. Understandings of dementia in low and middle income countries and amongst indigenous peoples: a systematic review and qualitative meta-synthesis. Aging Ment Health 2020; 24:1183-1195. [PMID: 31074290 DOI: 10.1080/13607863.2019.1606891] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Dementia is a growing health priority, particularly in less resourced countries and amongst indigenous populations. Understanding cultural meanings ascribed to dementia is an important aspect of policy development and the provision of culturally congruent care and support for people with dementia, their families and the caring professions. This review investigates conceptualizations of dementia amongst indigenous peoples and populations living in low and middle income countries (LMIC), who experience limited diagnosis and formal care for dementia, and how these shape responses to dementia.Methods: A systematic search was conducted for qualitative studies, reported in English, that investigated the perceptions, attitudes or understandings of dementia in LMIC and amongst indigenous populations. A qualitative analysis and meta-synthesis was carried out.Findings: Nineteen articles were included in the review following quality assessment. Dementia was rarely conceptualized as a defined, pathological condition characterized by progressive cognitive decline. Rather, notions of dementia existed within conceptualizations of aging, mental illness, traditional cultural beliefs and the trauma of colonization. Responses to dementia were influenced and perpetuated by community and health providers, and cultural norms for caregiving.Conclusions: There is a need to understand conceptualizations of dementia from the perspective of all stakeholders within a setting, and the dynamic responses that exist between key stakeholders. Community knowledge systems could facilitate understanding about appropriate and acceptable health and community care responses to dementia, and approaches to stigma reduction. Inclusive discussions about dementia are essential if awareness campaigns are to improve the wellbeing of people with dementia and caregivers.
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Affiliation(s)
- Karen Johnston
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.,Anton Breinl Research Centre for Health Systems Strengthening, James Cook University, Townsville, Queensland, Australia
| | - Robyn Preston
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.,Anton Breinl Research Centre for Health Systems Strengthening, James Cook University, Townsville, Queensland, Australia
| | - Edward Strivens
- Sub-acute and Rehabilitation Services, Cairns and Hinterland Hospital Health Service, Cairns, Queensland, Australia
| | - Sefanaia Qaloewai
- College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | - Sarah Larkins
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.,Anton Breinl Research Centre for Health Systems Strengthening, James Cook University, Townsville, Queensland, Australia
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Portacolone E, Covinsky KE, Johnson JK, Halpern J. Expectations and Concerns of Older Adults With Cognitive Impairment About Their Relationship With Medical Providers: A Call for Therapeutic Alliances. QUALITATIVE HEALTH RESEARCH 2020; 30:1584-1595. [PMID: 32564681 PMCID: PMC7398607 DOI: 10.1177/1049732320925796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
We sought to understand the expectations and concerns of older adults with cognitive impairment with regard to their relationship with medical providers. In particular, we observed whether study participants were involved in therapeutic alliances. Medical providers and patients create therapeutic alliances when they agree on the goals of the treatment and share a personal bond. Whereas such alliances have been studied in cancer research, little is known about therapeutic alliances in dementia research. Data were gathered in a qualitative study of 27 older adults with cognitive impairment and analyzed with narrative analysis. We introduce four case studies that illustrate the effects of having or missing a therapeutic alliance. Whereas the participant in the first case benefited from a therapeutic alliance, the other cases are marked by different experiences of abandonment. Findings suggest that interventions should concentrate on ways to enhance the relationship between medical providers and patients with cognitive impairment.
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Affiliation(s)
- Elena Portacolone
- University of California San Francisco, San Francisco, California, USA
| | | | - Julene K. Johnson
- University of California San Francisco, San Francisco, California, USA
| | - Jodi Halpern
- University of California, Berkeley, Berkeley, California, USA
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Gruters AAA, Christie HL, Ramakers IHGB, Verhey FRJ, Kessels RPC, de Vugt ME. Neuropsychological assessment and diagnostic disclosure at a memory clinic: A qualitative study of the experiences of patients and their family members. Clin Neuropsychol 2020; 35:1398-1414. [PMID: 32301377 DOI: 10.1080/13854046.2020.1749936] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study was to gain insight into the experiences of patients and their family members regarding a neuropsychological assessment (NPA) and the diagnostic disclosure given by the medical specialist (psychiatrist, geriatrician, or their residents) at the memory clinic (MC). METHOD Patients with and without a cognitive impairment and their family members were recruited from three Dutch MCs. Four focus groups with 14 patients and 13 family members were analyzed using both inductive and deductive content analysis. RESULTS Three themes were identified: uncertainty, early diagnostic paradox, and knowledge utilization. High levels of uncertainty were experienced throughout the NPA and diagnostic disclosure. The early diagnostic paradox refers to the coexistence of negative emotions, feeling distressed due to undergoing an NPA that made them aware of their cognitive complaints, and the experience of relief due to insight given by the outcome of the NPA and medical diagnosis. Knowledge utilization refers to a low retention of medical information. CONCLUSION Clinicians can reduce uncertainty by using clear communication, limiting interruptions during an NPA, and paying attention to contextual factors. Low information retention could possibly be improved by involving a family member and using visual aids or written information during the diagnostic disclosure. Finally, participants also appreciated being provided with neuropsychological feedback on the strengths and weaknesses of their cognitive profiles and with guidance on how to manage this diagnosis in their daily lives.
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Affiliation(s)
- Angélique A A Gruters
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Hannah L Christie
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Inez H G B Ramakers
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.,Department of Medical Psychology & Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marjolein E de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
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Pu L, Moyle W, Jones C. How people with dementia perceive a therapeutic robot called PARO in relation to their pain and mood: A qualitative study. J Clin Nurs 2019; 29:437-446. [PMID: 31738463 DOI: 10.1111/jocn.15104] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/19/2019] [Accepted: 11/10/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Interacting with social robots, such as the robotic seal PARO, has been shown to improve mood and acute pain for people with dementia. Little attention has been paid to the effect of PARO on people with dementia and chronic pain. OBJECTIVE To explore how people with mild to moderate dementia and chronic pain perceive PARO as an alternative intervention to manage their pain and mood. DESIGN A descriptive qualitative approach nested within a pilot randomised controlled trial. METHODS Participants with dementia and chronic pain were recruited from three residential aged care facilities. They interacted with PARO for 30 min, 5 days a week over a 6-week period. A sample of 11 participants completed individual semi-structured interviews at the end of the intervention. Data were collected from January 2018-January 2019. Inductive thematic analysis was undertaken. Reporting of findings followed the COREQ checklist. RESULTS Four themes emerged from the data: (a) perceptions of PARO; (b) therapeutic effects of PARO; (c) limitations of PARO; and (d) programme improvement. Residents with dementia expressed positive attitudes towards the use of PARO and acknowledged the therapeutic benefits of PARO on mood improvement and relaxation for pain relief but also mentioned the limitations of its weight, voice and characteristics. Residents' responses could also fluctuate during the intervention process, and individual preferences need to be considered. CONCLUSIONS The PARO intervention is a promising intervention to improve positive emotion, and there is some anecdotal evidence that pain may be decreased from the perspectives of people living with chronic pain and dementia. RELEVANCE TO CLINICAL PRACTICE Long-term care staff may incorporate PARO therapy into daily dementia care. Understanding of individual's preferences may enhance the implementation of PARO for pain management in this group.
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Affiliation(s)
- Lihui Pu
- School of Nursing and Midwifery, Griffith University, Brisbane, Qld, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia
| | - Wendy Moyle
- School of Nursing and Midwifery, Griffith University, Brisbane, Qld, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia
| | - Cindy Jones
- Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia.,Faculty of Health Sciences & Medicine, Bond University, Robina, Qld, Australia
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Lazar A, Dixon E. Safe Enough to Share: Setting the Dementia Agenda Online. CSCW : PROCEEDINGS OF THE CONFERENCE ON COMPUTER-SUPPORTED COOPERATIVE WORK. CONFERENCE ON COMPUTER-SUPPORTED COOPERATIVE WORK 2019; 3:85. [PMID: 32601621 PMCID: PMC7323863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
CSCW research is increasingly interested in the ways that people use technology to discuss health and disability online. In addition to studying how people share information and seek and provide emotional support, a growing area of interest is health activism. In this paper, we analyze how a project centered around sharing "real and raw" experiences with dementia provides a safe platform for people to share their authentic experiences. These accounts counter predominant depictions of dementia and push back on tokenistic involvement of people with this condition. In a study involving observations and interviews with members of this project, we find that people with dementia must negotiate several goals which at times compete with each other: sharing a "real and raw" look at dementia, changing attitudes, showcasing a polished presentation, and inhabiting a safe space. The paper concludes with a discussion of future directions for CSCW on configuring a space for dialogue on sensitive topics, health activism, and sharing online with dementia.
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Affiliation(s)
| | - Emma Dixon
- University of Maryland, College Park, USA
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Young JA, Lind C, Orange JB. A qualitative systematic review of experiences of persons with dementia regarding transition to long-term care. DEMENTIA 2019; 20:5-27. [PMID: 31335168 DOI: 10.1177/1471301219862439] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The current qualitative systematic review identified and examined critically the literature on how persons with dementia experience transitions to long-term care. Results are intended to help develop guidelines for future care and research. METHOD A search was conducted of OvidSP, SCOPUS, Web of Science, ProQuest, PsycINFO, CINAHL, AgeLine and Informit databases. In total, 4705 articles were reviewed (published 1954-2018). A textual narrative approach was used to synthesise the findings of the included articles. RESULTS Seven articles met inclusion criteria (five using data collected from interviews with persons with dementia and two using reports from a proxy). Overall, the findings showed that transition to long-term care possesses varied meanings for persons with dementia, is often not the decision of the persons with dementia, and is a process throughout which social connections remain important. DISCUSSION Accounts of the experiences of persons with dementia regarding transitions from community to long-term care show that they and their families should be supported: with respect to their individual contexts, to share the positives and negatives of the transition experiences, to make decisions together, and to maintain old and establish new social connections.
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Affiliation(s)
- Jessica A Young
- College of Nursing and Health Sciences, Flinders University, Australia; Health and Rehabilitation Sciences Program, Faculty of Health Sciences, Western University, Canada
| | - Christopher Lind
- College of Nursing and Health Sciences, Flinders University, Australia
| | - J B Orange
- School of Communication Sciences and Disorders, Faculty of Health Sciences, Western University, Canada; Canadian Centre for Activity and Aging, Western University, Canada
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Larsson V, Holmbom-Larsen A, Torisson G, Strandberg EL, Londos E. Living with dementia with Lewy bodies: an interpretative phenomenological analysis. BMJ Open 2019; 9:e024983. [PMID: 30700486 PMCID: PMC6352787 DOI: 10.1136/bmjopen-2018-024983] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To explore the subjective experience of living with dementia with Lewy bodies (DLB). DESIGN A qualitative study of in-depth interviews using interpretative phenomenological analysis. SETTING A memory clinic in Malmö, southern Sweden. PARTICIPANTS A purposive sample of five male participants with DLB between the ages of 78 and 88 years and disease duration of 1.5-7 years. RESULTS Three themes were identified in relation to the participants' experiences of living with DLB: (1) disease impact, in terms of symptom experience and restricted participation and activities; (2) self-perception and coping strategies; (3) importance of others, such as healthcare, family and friends. CONCLUSIONS This study provides a broad insight into the first-hand experience of living with DLB and how it compares with other dementia types. Findings highlight factors characterising the disease experience and well-being, and how persons with DLB address challenges arising secondary to disease. These findings are important for both research and clinical practice, demonstrating the feasibility of direct involvement of DLB persons in identifying important aspects of care, which include improved healthcare services.
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Affiliation(s)
- Victoria Larsson
- Department of Clinical Sciences, Malmö, Clinical Memory Research Unit, Lund University, Malmö, Sweden
| | - Axel Holmbom-Larsen
- Department of Clinical Sciences, Malmö, Clinical Memory Research Unit, Lund University, Malmö, Sweden
| | - Gustav Torisson
- Department of Infectious Diseases, Skåne University Hospital, Malmö, Sweden
| | - Eva Lena Strandberg
- Department of Clinical Sciences, Malmö, Center for Primary Health Care Research, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Elisabet Londos
- Department of Clinical Sciences, Malmö, Clinical Memory Research Unit, Lund University, Malmö, Sweden
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Gray K, Evans SC, Griffiths A, Schneider J. Critical reflections on methodological challenge in arts and dementia evaluation and research. DEMENTIA 2017; 17:775-784. [PMID: 28980477 DOI: 10.1177/1471301217734478] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Methodological rigour, or its absence, is often a focus of concern for the emerging field of evaluation and research around arts and dementia. However, this paper suggests that critical attention should also be paid to the way in which individual perceptions, hidden assumptions and underlying social and political structures influence methodological work in the field. Such attention will be particularly important for addressing methodological challenges relating to contextual variability, ethics, value judgement and signification identified through a literature review on this topic. Understanding how, where and when evaluators and researchers experience such challenges may help to identify fruitful approaches for future evaluation.
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Affiliation(s)
- Karen Gray
- Association for Dementia Studies, University of Worcester, UK
| | | | - Amanda Griffiths
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, UK
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