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Kloos N, Bielderman A, Gerritsen DL. Learning From People With Dementia What Works Well for Well-Being: Interviews and Focus Groups. THE GERONTOLOGIST 2024; 64:gnae077. [PMID: 38953169 PMCID: PMC11308173 DOI: 10.1093/geront/gnae077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Previous research has tended to prioritize the condition of dementia when investigating positive lived experiences, while there is no evidence that well-being becomes fundamentally different when living with dementia. The current exploratory qualitative study examined how people living with dementia describe how they realize their well-being, without treating dementia as a central concern, and specifically addressed people who are successful in maintaining their well-being. RESEARCH DESIGN AND METHODS Semistructured face-to-face interviews (n = 16) and 2 focus groups (n = 13) were conducted with community-dwelling older people living with dementia, aged 65-93 years (68% male). Conversations covered contributors to experienced life satisfaction, and life enjoyment, and were analyzed using inductive thematic analysis. RESULTS Two main themes described how people realize well-being. (1) To live a fulfilling life, participants engaged in activities in order to feel useful and relaxed, and they engaged with others, by interacting and sharing with others, and relying on others. (2) To have a positive attitude toward life, participants appreciated the good things in their current life, their lived life, and about their own person, and positively coped with difficulties by accepting them as part of life, not dwelling on the negative, and actively addressing difficulties. DISCUSSION AND IMPLICATIONS The results appear to reflect universal ways of realizing well-being, justifying the use of universal models of well-being for people living with dementia. We can learn from people living with dementia that living a fulfilling life and having a positive attitude toward life are key to realizing their well-being.
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Affiliation(s)
- Noortje Kloos
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud Alzheimer Center, University Knowledge Network for Older Adult Care Nijmegen (UKON), Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands
- Centre for eHealth and Well-Being Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Overijssel, The Netherlands
| | - Annemiek Bielderman
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud Alzheimer Center, University Knowledge Network for Older Adult Care Nijmegen (UKON), Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands
| | - Debby L Gerritsen
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud Alzheimer Center, University Knowledge Network for Older Adult Care Nijmegen (UKON), Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands
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Mroz EL, Collette T, Keefe K, Gil H, Monin J, Sharma S. Trajectories of Purpose in Life Across Diagnosis of Alzheimer's Disease or Related Dementias in Older Adulthood. J Aging Health 2024:8982643241257559. [PMID: 38816276 DOI: 10.1177/08982643241257559] [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: 06/01/2024]
Abstract
Objectives: Sense of purpose serves as a psychological resource for late-life health. Limited research has examined how purpose changes across chronic illness diagnoses, including a diagnosis of Alzheimer's disease and related dementias (ADRD).Method: This study leverages data from the National Health and Aging Trends Study (NHATS; N = 831) to establish trajectories of purpose across ADRD diagnosis using three-year (pre-diagnosis, year of diagnosis, post-diagnosis) timespans and two comparison groups (heart disease diagnosis, no diagnosis). Results: We observed a longitudinal decrease in purpose in the ADRD diagnosis group, t = 3.85, p = .003, d = -0.258. This contrasts with heart disease diagnosis and no diagnosis groups, where purpose did not change over time. Discussion: Older adults who receive an ADRD diagnosis may be vulnerable to a decreasing sense of purpose across their diagnosis experience. We consider social, psychological, and clinical antecedents for this trend.
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Affiliation(s)
- Emily L Mroz
- Section of Geriatrics, Yale School of Medicine, New Haven, CT, USA
| | - Tyler Collette
- Department of Psychological Science, Kennesaw State University, Kennesaw, GA, USA
| | - Kate Keefe
- Live Well Institute, Southington, CT, USA
| | - Heidi Gil
- Live Well Institute, Southington, CT, USA
| | - Joan Monin
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Shubam Sharma
- Department of Psychological Science, Kennesaw State University, Kennesaw, GA, USA
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3
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Hockley A, Moll D, Littlejohns J, Collett Z, Henshall C. Do communication interventions affect the quality-of-life of people with dementia and their families? A systematic review. Aging Ment Health 2023; 27:1666-1675. [PMID: 37079782 DOI: 10.1080/13607863.2023.2202635] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/03/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVES Speech, language and communication difficulties are prevalent in all dementia subtypes and are likely to considerably impact the quality-of-life of people with dementia and their families. Communication interventions provided by trained professionals are recommended for this population, but little is known about their quality-of-life outcomes. This review aims to explore the quality-of-life outcomes of communication-related interventions for people with dementia and their families. METHODS Seven databases were systematically searched. Reference lists from included studies and relevant systematic reviews were also hand-searched. Primary research with quantitative quality-of-life outcomes were included. Narrative analysis was utilised to identify key intervention features and to describe quality-of-life outcomes. RESULTS 1,174 studies were identified. Twelve studies were eligible for inclusion. Studies were heterogeneous in location, participant group, methodologies, interventions and outcome measures. Four studies reported increased quality-of-life for people with dementia following intervention. No studies reported increased quality-of-life for family members. CONCLUSION Further research is needed in this area. The studies which reported improved quality-of-life involved multi-disciplinary approaches to intervention, involvement of family caregivers, and functional communication intervention. However, data is limited so results should be interpreted with caution. The standardised use of a communication-focused quality-of-life outcome measure would improve sensitivity and comparability of future studies.
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Affiliation(s)
- Anna Hockley
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Deborah Moll
- Research and Development, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Jemima Littlejohns
- Research and Development, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Zoe Collett
- Research and Development, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Catherine Henshall
- Research and Development, Oxford Health NHS Foundation Trust, Oxford, UK
- Oxford Institute for Nursing, Midwifery and Allied Health Research, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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A caring and living environment that supports the spirituality of older people with dementia: A hermeneutic phenomenological study. Int J Nurs Stud 2023; 138:104414. [PMID: 36549146 DOI: 10.1016/j.ijnurstu.2022.104414] [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: 04/26/2022] [Revised: 11/11/2022] [Accepted: 11/24/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Meeting spiritual needs is an important part of the quality of nursing for older people living with dementia. The spirituality-supportive caring and living environment has rarely been studied, even though the environment plays an important role in supporting the well-being of older people with dementia. AIM To further understanding about the spirituality-supportive elements of a caring and living environment from the perspective of older people with dementia and their family members. DESIGN, SETTING AND PARTICIPANTS We adapted hermeneutic phenomenology as a philosophical background and methodological approach in this study. After receiving the approval of the researcher's University Ethics Committee, a purposive sample of ten older people with dementia and their nine family members, in home care and long-term care settings in Southern Finland were recruited for interviews. METHODS An interview-based study was conducted using photography to collect the data. The in-depth interviews were conducted in dyads between September 2017 and March 2020 and transcribed verbatim. Thematic analysis was used to interpret the data. RESULTS Spirituality was seen as a continuum within human life, manifested through the environment even if older people with dementia were unable to express themselves. The spirituality experiences of the participants within the caring and living environment were summarized into three themes: "Where do I belong?", "What remains of me in the world?" and "Where am I going?" The older people, their family members and other people involved in their care provided a caring and living environment that supported spirituality with opportunities to seek answers to these questions through to the meaning of their life. DISCUSSION AND CONCLUSIONS This hermeneutic phenomenological study provides a new insight into the environment that supports the spirituality of older people with dementia. The elements of caring and living environment can remind older people with dementia of what supports their own way of thinking about spirituality and brings meaning to their life. Therefore, spirituality is worth of considering when planning a caring and living environment that supports what is important to the personhood of older people with dementia. TWEETABLE ABSTRACT Spirituality is worth of considering when planning a caring and living environment that supports what is important to the personhood of older people with dementia.
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van der Velde-van Buuringen M, Hendriks-van der Sar R, Verbeek H, Achterberg WP, Caljouw MAA. The effect of garden use on quality of life and behavioral and psychological symptoms of dementia in people living with dementia in nursing homes: a systematic review. Front Psychiatry 2023; 14:1044271. [PMID: 37124273 PMCID: PMC10130442 DOI: 10.3389/fpsyt.2023.1044271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
Objectives Considering the importance of going outside in a natural environment for people in general, and people living with dementia in particular, we want to unravel the aspects by which garden use affects quality of life (QoL) and behavioral and psychological symptoms of dementia (BPSD) in people living with dementia in nursing homes. Design Systematic review. Setting and participants People living with dementia in nursing homes. Methods This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight electronic bibliographic databases were searched (May 2022). Quantitative, qualitative and mixed-methods studies describing the effect of garden use on QoL, BPSD, or other outcomes related to QoL or BPSD in people living with dementia in nursing homes were included. The methodological quality of individual studies was assessed with the Mixed Methods Appraisal Tool (MMAT) and a narrative synthesis of the results was performed. Results After screening title and abstract (N = 498), and full-text assessment (N = 67), 19 publications were included. These described 17 studies and three types of interventions: (1) interventions regarding the evaluation of effects of specifically designed nursing home gardens, (2) participation of the people living with dementia in outside activities, and (3) other interventions, for example, garden visits and different seasons. Conclusions and implications Overall, first studies appear to suggest positive effects of garden use on QoL, BPSD, or other outcomes related to QoL or BPSD (stress, sleep, and mood) in people living with dementia in nursing homes. However, consensus regarding measurements and key outcomes, taking into account the physical, social, and organizational aspects when designing the garden use intervention, is necessary for the reliable evaluation of these interventions. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=283267, identifier: CRD42021283267.
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Affiliation(s)
- Melanie van der Velde-van Buuringen
- University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- Zorginstellingen Pieter van Foreest, Delft, Netherlands
- *Correspondence: Melanie van der Velde-van Buuringen
| | | | - Hilde Verbeek
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht University, Maastricht, Netherlands
| | - Wilco P. Achterberg
- University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Monique A. A. Caljouw
- University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
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Salai AM, Kirton A, Cook G, Holmquist LE. Views and experiences on the use of voice assistants by family and professionals supporting people with cognitive impairments. FRONTIERS IN DEMENTIA 2022; 1:1049464. [PMID: 39081473 PMCID: PMC11285577 DOI: 10.3389/frdem.2022.1049464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 10/18/2022] [Indexed: 08/02/2024]
Abstract
The use of voice assistants (e.g., Amazon Alexa, Google Home) is being widely advocated as part of supporting people living with dementia at home. The development of this technology is largely driven by industry, and there is little research to determine how family carers and professionals use voice assistants with people with dementia. This paper presents the findings from further analysis of data from two studies: Study 1-a qualitative study that aimed to explore the views and expectations of family carers and professionals who use voice assistants to support people with a cognitive impairment at home, and Study 2-a qualitative enquiry aiming to identify the views and barriers on using voice assistants by family carers of people with dementia and professionals, together with a pilot case study evaluating a prototype that addresses barriers identified during the enquiry, entitled IntraVox. Based on processing of smart home sensor data, IntraVox uses a personalised human voice to send prompts and reminders to end-users to conduct daily life activities and to activate smart home processes using voice assistants. The results of the qualitative studies indicate that family carers and professionals use voice assistants in their caring role for home automation, skills maintenance and development, prompts and reminders, behaviour and environment monitoring, and for leisure and social interaction support. The findings also show that family carers and professionals have specific challenges that need to be overcome for them to realise the benefits that may be gained through the use of voice assistants within technology enabled care. The pilot case study also provided a useful demonstration that interoperability can be achieved to enable exchanges between IntraVox and voice assistants, with the aim of providing customised and personalised technological solutions that address some of the barriers that people with dementia and their carers face in the use of this technology.
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Affiliation(s)
- Ana-Maria Salai
- Health and Life Sciences Faculty, Nursing, Midwifery & Health Department, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Alexandra Kirton
- Health and Life Sciences Faculty, Nursing, Midwifery & Health Department, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Glenda Cook
- Health and Life Sciences Faculty, Nursing, Midwifery & Health Department, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Lars Erik Holmquist
- School of Design, Northumbria University, Newcastle upon Tyne, United Kingdom
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Buhr E, Schweda M. Der Wert des Privaten für Menschen mit Demenz. Ethik Med 2022. [DOI: 10.1007/s00481-022-00723-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
ZusammenfassungDer Begriff der Privatheit markiert eine erstaunliche Leerstelle in der Diskussion um die Pflege von Menschen mit Demenz (MmD). Der sonst intensiv geführte pflegeethische Diskurs über Fragen der Privatheit scheint hier nahezu vollständig zu verstummen, so als verlören MmD im Verlauf ihrer Erkrankung jedes nachvollziehbare Interesse an einer Privatsphäre und verfügten über keinerlei privaten Bereich mehr, den man bei ihrer pflegerischen Versorgung beachten oder schützen müsste. Eine solche Vorstellung widerspricht allerdings nicht nur verbreiteten moralischen Intuitionen, sondern auch den Auffassungen und Bedürfnissen der Betroffenen selbst. Vor diesem Hintergrund gehen wir der Frage nach, inwieweit sich die Bedeutung von Privatheit für MmD ethisch verständlich und plausibel machen lässt. Zu diesem Zweck werden zunächst die Herkunft und die verschiedenen Bedeutungsdimensionen des Privatheitsbegriffs selbst umrissen, um anschließend seine Schwierigkeiten und Grenzen im Kontext demenzieller Erkrankungen aufzuzeigen. Wie sich dabei herausstellt, kann insbesondere der ausgeprägte Autonomiebezug vorherrschender liberaler Privatheitskonzepte ein erhebliches Hindernis für eine angemessene Konzeptualisierung der Bedeutung der Privatheit für MmD darstellen. Aus diesem Grund loten wir im Anschluss unterschiedliche Möglichkeiten aus, wie sich der „Wert des Privaten“ im Kontext demenzieller Erkrankungen auch losgelöst vom Recht auf individuelle Selbstbestimmung konzeptualisieren ließe. Während autonomiebasierte Konzepte von Privatheit in frühen Stadien noch tragen mögen, wird mit Blick auf den weiteren Krankheitsverlauf daher auch der Relevanz von erkennbaren persönlichen Präferenzen sowie objektiven Bedingungen von Würde und Wohlergehen nachgegangen. Auf diesem Weg lässt sich differenziert aufzeigen, inwiefern Privatheit auch für MmD von Bedeutung sein und im pflegerischen Umgang mit ihnen angemessen berücksichtigt werden kann.
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Rosteius K, de Boer B, Staudacher S, Schols J, Verbeek H. How the interrelated physical, social and organizational environment impacts daily life of residents with dementia on a Green Care Farm. Front Public Health 2022; 10:946962. [PMID: 36106159 PMCID: PMC9467523 DOI: 10.3389/fpubh.2022.946962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/11/2022] [Indexed: 01/21/2023] Open
Abstract
Green Care Farms (GCF) are innovative long-term care environments and an alternative to regular nursing homes in the Netherlands. Following a culture change movement, GCFs have radically altered the care environment. Research suggests positive effects on residents. However, knowledge is limited regarding their physical, social and organizational environment. This article explores the care environment of 24-h GCFs for people with dementia and its impact on residents and their daily life. An ethnographic study using mixed methods was carried out at a GCF in the Netherlands between June and October 2021. Researchers lived on the GCF and completed 28 days of participatory observations in three groups. During the day, informal conversations were held with residents (n = 48), staff and family members. Twenty four semi-structured interviews were conducted with residents, their family members, staff and the managers, complemented by a focus group with staff. The physical environment was additionally assessed with the OAZIS-dementia tool. Data collection methods informed each other. Qualitative data was thematically analyzed, quantitative data descriptively. Four themes were identified as crucial during daily life on the GCF: stimulating the senses, engaging in purposeful activities, sharing responsibilities and creating a community in a new home. Realizing these topics in practice, physical, social and organizational environmental components were highly interrelated. The physical environment encouraged and facilitated meaningful in-/outdoor activities and social encounters. The organizational environment supported the use of the physical environment by aligning processes and transporting the vision. The social environment focused on collaboration and creating a home-like atmosphere by including residents in household- and farm chores. This community-building led to more meaningful activities and social interaction. In conclusion, this study revealed the central influence of the management in paving the way for a new form of care delivery. As leaders shape the three environments, the organization influences the design of the physical environment and the actions taking place within it. By creating a community, the care home benefits residents, their families and staff equally. The conscious interrelation and harmonization of the physical, social and organizational components of a long-term care environment has the potential to improve the daily life of residents.
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Affiliation(s)
- Katharina Rosteius
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands,Living Lab in Ageing and Long Term Care, Maastricht, Netherlands,*Correspondence: Katharina Rosteius
| | - Bram de Boer
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands,Living Lab in Ageing and Long Term Care, Maastricht, Netherlands
| | - Sandra Staudacher
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands,Department of Public Health, Faculty of Medicine, Institute of Nursing Science, University of Basel, Basel, Switzerland
| | - Jos Schols
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands,Living Lab in Ageing and Long Term Care, Maastricht, Netherlands
| | - Hilde Verbeek
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands,Living Lab in Ageing and Long Term Care, Maastricht, Netherlands
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Strandenaes MG, Lund A, Engedal K, Kirkevold Ø, Selbaek G, Benth JŠ, Rokstad AMM. Self-reported quality of life in people with dementia attending a day-care programme in Norway: A 24-month quasi-experimental study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1315-1324. [PMID: 34032347 DOI: 10.1111/hsc.13455] [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: 10/22/2020] [Revised: 04/14/2021] [Accepted: 05/04/2021] [Indexed: 06/12/2023]
Abstract
The objectives of the study were (a) to compare self-reported Quality of Life (QoL) in a 24-month follow-up of people with dementia attending day care designed for people with dementia (day-care group, DC) with people with dementia who did not attend day care (control group, CG) and (b) to explore factors associated with QoL. A quasi-experimental design with a 24-month follow-up period was used. The DC group included 181 participants recruited from 53 day-care services. The CG included 76 participants recruited from 19 municipalities with no available day care designed for people with dementia. The sample covered the four health regions of Norway and inclusion period lasted from December 2013 to July 2015. The Quality of Life in Alzheimer's Disease (QoL-AD) scale was used as the outcome measure. The differences in QoL between groups and the associations between participant characteristics and QoL, such as depressive symptoms and functional dependency, were examined using a linear mixed model. In the multiple model, the overall trend in QoL did not differ significantly between the DC and CG. However, the DC group exhibited significantly higher self-reported QoL than the CG at all time points (p < 0.001 at T0, p = 0.018 at T12, and p = 0.006 at T24). Participants with shallow or no awareness who attended day care had significantly higher scores on QoL-AD than persons with full awareness (p = 0.017). More depressive symptoms (p < 0.001) and higher functional dependency (p < 0.001) were associated with lower self-reported QoL. The study revealed higher scores of self-reported QoL among people attending day care compared with those who did not attend, showing that day care might have positive impact on the lives of people with dementia.
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Affiliation(s)
- Margit Gausdal Strandenaes
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Lund
- Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Øyvind Kirkevold
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
- Research Centre for Age Related Functional decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Health Services Research Unit, Research Centre, Akershus University Hospital, Lørenskog, Norway
| | - Anne Marie Mork Rokstad
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
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10
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Tan JRO, Boersma P, Ettema TP, Aëgerter L, Gobbens R, Stek ML, Dröes RM. Known in the nursing home: development and evaluation of a digital person-centered artistic photo-activity intervention to promote social interaction between residents with dementia, and their formal and informal carers. BMC Geriatr 2022; 22:25. [PMID: 34991472 PMCID: PMC8733433 DOI: 10.1186/s12877-021-02632-w] [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] [Received: 09/14/2021] [Accepted: 11/15/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND To address the lack of social interaction and meaningful activities for persons with dementia (PWD) in nursing homes an artistic Photo-Activity was designed. The present study aims to develop a digital version of the Photo-Activity and to investigate its implementation and impact on nursing home residents with advanced dementia, and their (in)formal carers. METHODS First, within a user-participatory design, a digital-app version of the Photo-Activity will be developed and pilot-tested, in co-creation with (in)formal carers and PWD. Next, the feasibility and effectiveness of the Photo-Activity versus a control activity will be explored in a randomized controlled trial with nursing home residents (N=90), and their (in)formal carers. Residents will be offered the Photo-Activity or the control activity by (in)formal carers during one month. Measurements will be conducted by independent assessors at baseline (T0), after one month (T1) and at follow up, two weeks after T1 (T2). Qualitative and quantitative methods will be used to investigate the effects of the intervention on mood, social interaction and quality of life of the PWD, sense of competence of informal carers, empathy and personal attitude of the formal carers, and quality of the relationship between the PWD, and their (in)formal carers. In addition, a process evaluation will be carried out by means of semi-structured interviews with the participating residents and (in)formal carers. Finally, an implementation package based on the process evaluation will be developed, allowing the scaling up of the intervention to other care institutions. DISCUSSION Results of the trial will be available for dissemination by Spring 2023. The digital Photo-Activity is expected to promote meaningful connections between the resident with dementia, and their (in)formal carers through the facilitation of person-centered conversations. TRIAL REGISTRATION Netherlands Trial Register: NL9219 ; registered (21 January 2021); NTR (trialregister.nl).
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Affiliation(s)
- Josephine Rose Orejana Tan
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc /Amsterdam Public Health Research institute, Amsterdam, The Netherlands.
| | - Petra Boersma
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, The Netherlands
| | - Teake P Ettema
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc /Amsterdam Public Health Research institute, Amsterdam, The Netherlands
| | | | - Robbert Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, The Netherlands.,Zonnehuisgroep Amstelland, Amstelveen, The Netherlands.,Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Max L Stek
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc /Amsterdam Public Health Research institute, Amsterdam, The Netherlands.,Department of Old Age Psychiatry, Regional Mental Health organization GGZ inGeest, Amsterdam, Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc /Amsterdam Public Health Research institute, Amsterdam, The Netherlands
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Siette J, Knaggs GT, Zurynski Y, Ratcliffe J, Dodds L, Westbrook J. Systematic review of 29 self-report instruments for assessing quality of life in older adults receiving aged care services. BMJ Open 2021; 11:e050892. [PMID: 34794991 PMCID: PMC8603300 DOI: 10.1136/bmjopen-2021-050892] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Quality of life (QoL) outcomes are used to monitor quality of care for older adults accessing aged care services, yet it remains unclear which QoL instruments best meet older adults', providers' and policymakers' needs. This review aimed to (1) identify QoL instruments used in aged care and describe them in terms of QoL domains measured and logistical details; (2) summarise in which aged care settings the instruments have been used and (3) discuss factors to consider in deciding on the suitability of QoL instruments for use in aged care services. DESIGN Systematic review. DATA SOURCES MEDLINE, EMBASE, PsycINFO, Cochrane Library and CINAHL from inception to 2021. ELIGIBILITY CRITERIA Instruments were included if they were designed for adults (>18 years), available in English, been applied in a peer-reviewed research study examining QoL outcomes in adults >65 years accessing aged care (including home/social care, residential/long-term care) and had reported psychometrics. DATA EXTRACTION AND SYNTHESIS Two researchers independently reviewed the measures and extracted the data. Data synthesis was performed via narrative review of eligible instruments. RESULTS 292 articles reporting on 29 QoL instruments were included. Eight domains of QoL were addressed: physical health, mental health, emotional state, social connection, environment, autonomy and overall QoL. The period between 1990 and 2000 produced the greatest number of newly developed instruments. The EuroQoL-5 Dimensions (EQ-5D) and Short Form-series were used across multiple aged care contexts including home and residential care. More recent instruments (eg, ICEpop CAPability measure for Older people (ICECAP-O) and Adult Social Care Outcomes Toolkit (ASCOT)) tend to capture emotional sentiment towards personal circumstances and higher order care needs, in comparison with more established instruments (eg, EQ-5D) which are largely focused on health status. CONCLUSIONS A comprehensive list of QoL instruments and their characteristics is provided to inform instrument choice for use in research or for care quality assurance in aged care settings, depending on needs and interests of users.
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Affiliation(s)
- Joyce Siette
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- Centre for Ageing, Cognition and Wellbeing, Macquarie University, Sydney, New South Wales, Australia
| | - Gilbert Thomas Knaggs
- NHMRC Partnership Centre for Health Systems Sustainability, Macquarie University, Sydney, New South Wales, Australia
| | - Yvonne Zurynski
- NHMRC Partnership Centre for Health Systems Sustainability, Macquarie University, Sydney, New South Wales, Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Laura Dodds
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Johanna Westbrook
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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The Added Value of Art for the Well-Being of Older People with Chronic Psychiatric Illnesses and Dementia Living in Long-Term Care Facilities, and on the Collaboration between Their Caregivers and Artists. Healthcare (Basel) 2021; 9:healthcare9111489. [PMID: 34828535 PMCID: PMC8622552 DOI: 10.3390/healthcare9111489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/24/2021] [Accepted: 10/27/2021] [Indexed: 11/16/2022] Open
Abstract
This study sought to provide insight into how art activities influence the well-being of long-term care residents, and how artists and caregivers collaborate in offering these activities. In two long-term care facilities for people with dementia and one for older people with chronic psychiatric disorders, an uncontrolled pre- and post-test study was conducted using a mixed-method design. Forty-six residents participated in the study. Three art activities—(a) dance, (b) music and movement, and (c) visual arts—were studied and co-created with the residents and executed by artists and caregivers together in eight to ten weeks. The Face expression scale (FACE) was used to examine the extent to which participating in the art activity influenced resident mood. Qualitative data were collected via group discussions with artists, caregivers, residents, and an informal caregiver. The results indicated that participating in an art activity positively influenced resident mood (p < 0.000). p-values for the three art activities were: p < 0.000 for dance, p = 0.048 for music and movement, and p = 0.023 for visual arts. The qualitative data revealed that joining an art activity provided a positive effect, increased social relationships, and improved self-esteem for residents. The collaboration between artists and caregivers stimulated creativity, beauty, and learning from each other, as well as evoking emotions.
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13
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Roelofs TSM, Luijkx KG, Embregts PJCM. Love, Intimacy and Sexuality in Residential Dementia Care: A Client Perspective. Clin Gerontol 2021; 44:288-298. [PMID: 31522624 DOI: 10.1080/07317115.2019.1667468] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Residential care facility (RCF) residents with dementia are highly dependent on care. This can influence their experience of intimacy and sexuality. The perspective of residents and their spouses with regard to love, intimacy, and sexuality were explored and analyzed.Methods: The study was designed using the IPA methodology. Eight in-depth interviews were held with 12 participants: four couples and four individual residents with dementia.Results: Varied stories were shared; however, dementia had a great impact on all of them. Love, intimacy, and being together were considered fundamentally important by both couples and individual participants, although profound dilemmas were encountered. While only one couple experienced physical sexuality within the RCF, other participants reported that love and being intimate were the most important aspects of their current relationship. Regarding the possibility of fulfilling their needs within the RCF, a secure feeling of privacy was considered to be important, but was absent at the time of the survey.Conclusions: Although challenging to appropriately facilitate at RCFs, love, intimacy, and sexuality are still important aspects for residents with dementia and their spouses.Clinical implications: This study addresses these dilemmas and ads to the normalization of love, intimacy, and sexuality within RCF settings; the findings will hopefully improve the wellbeing of residents with dementia and that of their spouses.
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Affiliation(s)
- Tineke S M Roelofs
- Schakelring (department of Psychology), Waalwijk, the Netherlands.,School of Social and Behavioral Sciences, Department of Tranzo, Tilburg University, Tilburg, the Netherlands
| | - Katrien G Luijkx
- School of Social and Behavioral Sciences, Department of Tranzo, Tilburg University, Tilburg, the Netherlands
| | - Petri J C M Embregts
- School of Social and Behavioral Sciences, Department of Tranzo, Tilburg University, Tilburg, the Netherlands
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14
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Neal DP, Kerkhof YJF, Ettema TP, Muller M, Bosmans J, Finnema E, Graff M, Dijkstra K, Stek ML, Dröes RM. Evaluation of FindMyApps: protocol for a randomized controlled trial of the effectiveness and cost-effectiveness of a tablet-based intervention to improve self-management and social participation of community-dwelling people with mild dementia, compared to usual tablet use. BMC Geriatr 2021; 21:138. [PMID: 33627069 PMCID: PMC7903400 DOI: 10.1186/s12877-021-02038-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 01/19/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND For the rising number of people living with dementia, cost-effective community-based interventions to support psychosocial care are needed. The FindMyApps intervention has been developed with and for people with dementia and their caregivers, to help them use tablets to facilitate self-management and engagement in meaningful social activities. A feasibility study and exploratory pilot trial evaluating FindMyApps have been carried out. This definitive trial further evaluates the effectiveness of the intervention and, for the first time, the cost-effectiveness. METHODS A randomized controlled non-blinded single-center two-arm superiority trial will be conducted. Community-dwelling people with Mild Cognitive Impairment (MCI), or dementia with a Mini Mental-State Examination (MMSE) of > 17 and < 26, or Global Deterioration Scale 3 or 4, with an informal caregiver and access to a wireless internet connection will be included. In total, 150 patient-caregiver dyads will be randomly allocated to receive either usual care (control arm - tablet computer; n = 75 dyads) or usual care and the FindMyApps intervention (experimental arm - tablet computer and FindMyApps; n = 75 dyads). The primary outcomes are: for people with dementia, self-management and social participation; for caregivers, sense of competence. In addition to a main effect analysis, a cost-effectiveness analysis will be performed. In line with MRC guidance for evaluation of complex interventions a process evaluation will also be undertaken. DISCUSSION Results of the trial are expected to be available in 2023 and will be submitted for publication in international peer-reviewed scientific journals, in addition to conference presentations and reporting via the EU Marie Sklodowska-Curie DISTINCT ITN network. By providing evidence for or against the effectiveness and cost-effectiveness of the FindMyApps intervention, the results of the trial will influence national implementation of FindMyApps. We hope that the results of the trial will further stimulate research and development at the intersection of technology and psycho-social care in dementia. We hope to further demonstrate that the randomized controlled trial is a valuable and feasible means of evaluating new digital technologies, to stimulate further high-quality research in this growing field. TRIAL REGISTRATION NUMBER Netherlands Trial Register: NL8157 ; registered 15th November 2019.
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Affiliation(s)
- David Peter Neal
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc, Amsterdam, Netherlands
| | | | - Teake P Ettema
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc, Amsterdam, Netherlands
| | - Majon Muller
- Department of Internal Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Judith Bosmans
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Evelyn Finnema
- University Medical Centre Groningen, Groningen, Netherlands
| | - Maud Graff
- Radboud University Medical Centre, Nijmegen, Netherlands
| | - Karin Dijkstra
- Saxion University of Applied Sciences, Deventer, Netherlands
| | - Max L Stek
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc, Amsterdam, Netherlands
- Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc, Amsterdam, Netherlands.
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Koh WQ, Felding SA, Toomey E, Casey D. Barriers and facilitators to the implementation of social robots for older adults and people with dementia: a scoping review protocol. Syst Rev 2021; 10:49. [PMID: 33546772 PMCID: PMC7866756 DOI: 10.1186/s13643-021-01598-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 01/26/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Psychosocial health issues such as depression and social isolation are an important cause of morbidity and premature mortality for older adults and people with dementia. Social robots are promising technological innovations to deliver effective psychosocial interventions to promote psychosocial wellbeing. Studies have reported positive findings regarding this technology on the psychosocial health of older adults and people with dementia. However, despite positive findings of the effects of social robots for older adults and people with dementia, little is known about factors affecting their implementation in practice. METHODS This study follows Arksey and O'Malley's approach and methodological enhancement by Levac et al. Relevant articles will be identified by searching electronic databases: MEDLINE, Embase, PsycINFO, Scopus, Web of Science, Compendex and PubMed. A two-phase screening process will be undertaken by two independent reviewers to determine articles' inclusion. Findings will be summarised and reported thematically based on domains in the Consolidated Framework of Implementation Research (CFIR) and presented narratively. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) will guide the reporting of findings. DISCUSSION Reporting the protocol in advance of conducting the review will ensure that rigorous and transparent methodological approach is undertaken. The outcomes of the review include identifying variants in terminologies used to describe implementation, identifying the scope of the literature regarding the barriers and facilitators affecting the implementation of social robots and identifying research gaps to guide further empirical research in this field. This evidence synthesis constitutes part of a bigger project aimed to develop implementation guidelines for social robotics for older adults with dementia. Since the methodological process consists of reviewing and collecting data from publicly available data, this study does not require approval from a research ethics board. SCOPING REVIEW REGISTRATION Our protocol is registered with the Open Science Framework ( https://osf.io/2x3y9/ ) as an open access article, under the Creative Commons Attribution Non Commercial (CC BY-NC-4.0) license, which allows others to distribute, remix, adapt and build on this work on a non-commercial basis, and license their derivative work using different terms, on the basis that the original basis is properly cited and the use is non-commercial ( http://creativecommons.org/licenses/by-nc/4.0/ ).
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Affiliation(s)
- Wei Qi Koh
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.
| | | | - Elaine Toomey
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Dympna Casey
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
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16
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Neal D, van den Berg F, Planting C, Ettema T, Dijkstra K, Finnema E, Dröes RM. Can Use of Digital Technologies by People with Dementia Improve Self-Management and Social Participation? A Systematic Review of Effect Studies. J Clin Med 2021; 10:604. [PMID: 33562749 PMCID: PMC7915697 DOI: 10.3390/jcm10040604] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 12/22/2022] Open
Abstract
There is increasing interest in the use of technology to support social health in dementia. The primary objective of this systematic review was to synthesize evidence of effectiveness of digital technologies used by people with dementia to improve self-management and social participation. Records published from 1 January 2007 to 9 April 2020 were identified from Pubmed, PsycInfo, Web of Science, CINAHL, and the Cochrane Central Register of Controlled Trials. Controlled interventional studies evaluating interventions based on any digital technology were included if: primary users of the technology had dementia or mild cognitive impairment (MCI); and the study reported outcomes relevant to self-management or social participation. Studies were clustered by population, intervention, and outcomes, and narrative synthesis was undertaken. Of 1394 records identified, nine met the inclusion criteria: two were deemed to be of poor methodological quality, six of fair quality, and one of good quality. Three clusters of technologies were identified: virtual reality, wearables, and software applications. We identified weak evidence that digital technologies may provide less benefit to people with dementia than people with MCI. Future research should address the methodological limitations and narrow scope of existing work. In the absence of strong evidence, clinicians and caregivers must use their judgement to appraise available technologies on a case-by-case basis.
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Affiliation(s)
- David Neal
- Department of Psychiatry, Amsterdam University Medical Centre, Location VUMC, 1081 HJ Amsterdam, The Netherlands;
| | - Floor van den Berg
- Department of Linguistics and English as a Second Language, University of Groningen, 9712 EK Groningen, The Netherlands;
| | - Caroline Planting
- Department of Research and Innovation, GGZ inGeest, 1070 BB Amsterdam, The Netherlands;
| | - Teake Ettema
- Department of Psychiatry, Amsterdam University Medical Centre, Location VUMC, 1081 HJ Amsterdam, The Netherlands;
| | - Karin Dijkstra
- Research Group Nursing, Saxion University of Applied Sciences, 7417 DH Deventer, The Netherlands;
| | - Evelyn Finnema
- Health Sciences-Nursing Research, University Medical Centre Groningen, 9713 GZ Groningen, The Netherlands;
- Department of Healthcare, NHL Stenden University of Applied Sciences, 8917 DD Leeuwarden, The Netherlands
- School of Nursing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam University Medical Centre, Location VUMC, 1081 HJ Amsterdam, The Netherlands;
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Aarts E, Fleuren H, Sitskoorn M, Wilthagen T. Involve Residents to Ensure Person-Centered Nursing Home Care During Crises Like the COVID-19 Outbreak. THE NEW COMMON 2021. [PMCID: PMC7978698 DOI: 10.1007/978-3-030-65355-2_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Nursing homes aim to provide person-centered care and recognize residents as unique individuals with their own histories, life goals, and preferences. The life expectancy of nursing home residents is rather limited. Nursing homes have been hit hard by COVID-19 because of an increased risk of death and a total nursing home lockdown from March 19 until the end of May 2020. Although social relationships are a basic human need and the fulfillment of social needs is essential for both physical and mental health, nursing home residents were no longer allowed to meet their loved ones. This decision was taken without involving residents and their loved ones and without considering the psychosocial impact of such measures for residents and their loved ones. When visitors were again allowed in the nursing homes, this was valued highly. To enable decent decision-making, we call both the government and nursing homes to involve residents and their families in decision-making. It is essential to know how residents weigh the risk of a COVID-19 infection and the possible implication of them opposing social isolation. We have to adapt to a new common and need to stop talking about residents and their loved ones and start talking with them.
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Affiliation(s)
- Emile Aarts
- Tilburg University, Tilburg, The Netherlands
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Szcześniak D, Rymaszewska J, Saibene FL, Lion KM, D'arma A, Brooker D, Evans SB, Evans SC, Chattat R, Scorolli C, Meiland F, Hendriks I, Dröes RM, Farina E. Meeting centres support programme highly appreciated by people with dementia and carers: a European cross-country evaluation. Aging Ment Health 2021; 25:149-159. [PMID: 31684754 DOI: 10.1080/13607863.2019.1683814] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The Meeting Centres Support Programme (MCSP) offers a combined approach to providing practical, emotional and social support to people living with mild to moderately severe dementia and their family carers in the community. METHODS A mixed methods explanatory design was used. The evaluation took place within the framework of the international Joint Programme - Neurodegenerative Disease Research (JPND) - MEETINGDEM study in nine Meeting Centres in Italy, Poland and the United Kingdom. Eighty-seven people with dementia and 81 family carers completed a user evaluation survey after three months and 83 people with dementia and 84 carers after 6 months of participation in MCSP. Thirty-two people with dementia and 30 carers took part in focus groups after nine months. RESULTS The percentage of people with dementia who were very satisfied with the programme increased significantly over time (p = 0.05). The majority of carers reported that they felt less burdened after three months of participation in MCSP (48.1% much less; 35.4% a little less). After six months, this percentage increased significantly to 91% (p = 0.04, 57.7% much less; 33.3% little less). Focus group analysis showed that people with dementia and carers in all countries/centres improved their ability to maintain emotional balance. CONCLUSIONS The MCSP is highly appreciated by people with dementia and carers in all countries and it confirms the results of previous research into MCSP in the Netherlands. Our findings indicate that MCSP is a model that can help its users to increase their capacity to deal with the challenges caused by dementia and can promote emotional balance.
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Affiliation(s)
- Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | | | | | | | | | - Dawn Brooker
- Association for Dementia Studies, University of Worcester, United Kingdom
| | - Shirley B Evans
- Association for Dementia Studies, University of Worcester, United Kingdom
| | - Simon C Evans
- Association for Dementia Studies, University of Worcester, United Kingdom
| | - Rabih Chattat
- Department of Philosophy and Communication Studies, University of Bologna, Bologna, Italy
| | - Claudia Scorolli
- Department of Philosophy and Communication Studies, University of Bologna, Bologna, Italy
| | - Franka Meiland
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Iris Hendriks
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands
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Wehrmann H, Michalowsky B, Lepper S, Mohr W, Raedke A, Hoffmann W. Priorities and Preferences of People Living with Dementia or Cognitive Impairment - A Systematic Review. Patient Prefer Adherence 2021; 15:2793-2807. [PMID: 34934309 PMCID: PMC8684431 DOI: 10.2147/ppa.s333923] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/01/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Knowledge about the priorities and preferences of people living with dementia (PwD) might help to individualize treatment, care, and support, which could improve patient-related outcomes. This study aimed to summarize preferences of PwD or people with mild cognitive impairment (MCI), considering all relevant aspects of health care and everyday life. METHODS We conducted a systematic literature review and included studies about patient preferences published in English between January 1, 1990 and October 28, 2019. The inclusion criteria were that preferences were elicited directly by PwD or patients with MCI. We used the International Consortium for Health Outcomes Management value set for dementia to categorize the preferences into the following topics: a) clinical status, b) symptoms, functioning, and quality of life, and c) sustainability of care. RESULTS Of 578 initially identified studies, 45 met the inclusion criteria. Patients preferred to be informed about the diagnosis as early as possible, especially for anticipatory care planning. They ranked caregiver quality of life as their highest priority. They preferred not to be a burden to others more than their caregivers' mood, their own functional status, or their own distressing behaviors. Furthermore, PwD are eager to participate in medical decisions, especially in those about creating an everyday life routine. PwD preferred their own quality of life, self-efficacy, and emotional well-being. Institutionalized PwD preferred individualized and person-centered care. According to the sustainability of care, PwD preferred to maintain close bonds with their family at the end of their life and wanted to be treated with empathy. CONCLUSION This systematic review provides essential insights into cognitively impaired patients' preferences, which are rarely considered in treatment, care, and support services. Further studies should evaluate whether considering preferences in treatment and care or daily living can improve patient-reported outcomes.
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Affiliation(s)
- Hannah Wehrmann
- Translational Health Care Research, German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Greifswald, Germany
| | - Bernhard Michalowsky
- Translational Health Care Research, German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Greifswald, Germany
- Correspondence: Bernhard Michalowsky Tel +49 3834 86 75 07 Email
| | - Simon Lepper
- Translational Health Care Research, German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Greifswald, Germany
| | - Wiebke Mohr
- Translational Health Care Research, German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Greifswald, Germany
| | - Anika Raedke
- Translational Health Care Research, German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- Translational Health Care Research, German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Greifswald, Germany
- Epidemiology of Health Care and Community Health, Institute for Community Medicine & University Medicine Greifswald (UMG), Greifswald, Germany
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Hendriks I, Demetrio R, Meiland FJM, Chattat R, Szcześniak D, Rymaszewska J, Ettema TP, Evans SB, Brooker D, Evans SC, Atkinson T, Farina E, Saibene FL, Gerritsen DL, Dröes RM. Value of Personalized Dementia-Specific Quality of Life Scales: An Explorative Study in 3 European Countries. Am J Alzheimers Dis Other Demen 2021; 36:15333175211033721. [PMID: 34424058 PMCID: PMC10581102 DOI: 10.1177/15333175211033721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Measuring Quality of Life (QOL) can be difficult due to its individual character. To explore the value of personalized QOL measurement for people with dementia, personalized versions of two dementia-specific QOL scales (Dementia quality of Life (DQoL) and Quaility of Life in Alzheimer's Disease (QoL-AD)) were constructed. This study investigated whether the personalized measures are more valid to detect variations in QOL than their standard versions for people with mild to moderate dementia, with sufficient internal consistency. Moreover, the relationship between the personalized QOL measures and severity of dementia was investigated. Finally, the study explored the differences between countries regarding the personalized overall QOL and differences in the importance of QOL domains. This explorative one-group design study used baseline data from the MEETINGDEM study into the implementation of the Meeting Centres Support Programme in Italy, Poland and the UK. The personalized versions of the DQoL and QoL-AD were reliable, but not more valid than their standard versions. No relationship between severity of dementia and personalized QOL was found. While no differences were found between countries for the overall QOL score, some QOL domains were valued differently: people with dementia from the UK rated self-esteem, mood, physical health, energy level and the ability to do chores around the house significantly less important than people from Italy and Poland. The personalized versions of the DQoL and QoL-AD may offer dementia care practice important insights into what domains contribute most to an individual's QOL.
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Affiliation(s)
- Iris Hendriks
- Department of Psychiatry, Amsterdam UMC, Location VUmc GGZ-inGeest Dienst Onderzoek en Innovatie, Amsterdam, The Netherlands
| | - Raquel Demetrio
- Department of Psychology, University of Leiden, Wassenaarseweg, The Netherlands
| | - Franka J. M. Meiland
- Department of Psychiatry, Amsterdam UMC, Location VUmc GGZ-inGeest Dienst Onderzoek en Innovatie, Amsterdam, The Netherlands
| | - Rabih Chattat
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | | | - Teake P. Ettema
- Department of Psychiatry, Amsterdam UMC, Location VUmc GGZ-inGeest Dienst Onderzoek en Innovatie, Amsterdam, The Netherlands
| | - Shirley B. Evans
- Association for Dementia Studies, John’s Campus, University of Worcester, Worcester, UK
| | - Dawn Brooker
- Association for Dementia Studies, John’s Campus, University of Worcester, Worcester, UK
| | - Simon C. Evans
- Association for Dementia Studies, John’s Campus, University of Worcester, Worcester, UK
| | - Teresa Atkinson
- Association for Dementia Studies, John’s Campus, University of Worcester, Worcester, UK
| | | | | | - Debby L. Gerritsen
- Department of Primary and Community Care, Nijmegen Medical Centre, Radboud Alzheimer Centre, Radboud University, Nijmegen, The Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam UMC, Location VUmc GGZ-inGeest Dienst Onderzoek en Innovatie, Amsterdam, The Netherlands
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21
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Lee K, Dabelko-Schoeny H, Richardson VE. Volunteering Served as a Transitional Role That Enhances the Well-Being and Cognitive Health Among Older Adults With Cognitive Impairments. J Appl Gerontol 2020; 40:1568-1578. [PMID: 33356785 DOI: 10.1177/0733464820982731] [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: 11/17/2022] Open
Abstract
OBJECTIVES We examined whether volunteering among older adults with cognitive impairments serves as a transitional role that can enhance these older persons' well-being and cognitive health. METHODS Using data from the Health and Retirement Study, we selected older adults with cognitive impairments (N = 472) and developed linear mixed models to assess associations between volunteering and health outcomes. RESULTS Volunteers in our sample were mostly females, non-Hispanic whites, those with higher income, and those with a high-school diploma. Volunteering was associated with higher levels of self-rated health, and consistent participation in volunteer work was related to stronger feelings of purpose in life. Cognitive health slightly improved over time only among those who volunteered. DISCUSSION We demonstrate that cognitive impaired older adults' participation in the volunteer role can benefit cognitive health while strengthening their late life resilience.
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Affiliation(s)
- Kathy Lee
- The University of Texas at Arlington, USA
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Luijkx K, van Boekel L, Janssen M, Verbiest M, Stoop A. The Academic Collaborative Center Older Adults: A Description of Co-Creation between Science, Care Practice and Education with the Aim to Contribute to Person-Centered Care for Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239014. [PMID: 33287307 PMCID: PMC7730904 DOI: 10.3390/ijerph17239014] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 11/23/2022]
Abstract
Long-term care for older adults is in transition. Organizations offering long-term care for older adults are expected to provide person-centered care (PCC) in a complex context, with older adults aging in place and participating in society for as long as possible, staff shortages and the slow adoption of technological solutions. To address these challenges, these organizations increasingly use scientific knowledge to evaluate and innovate long-term care. This paper describes how co-creation, in the sense of close, intensive, and equivalent collaboration between science, care practice, and education, is a key factor in the success of improving long-term care for older adults. Such co-creation is central in the Academic Collaborative Center (ACC) Older Adults of Tilburg University. In this ACC, Tilburg University has joined forces with ten organizations that provide care for older adults and CZ zorgkantoor to create both scientific knowledge and societal impact in order to improve the quality of person-centered care for older adults. In the Netherlands, a “zorgkantoor” arranges long-term (residential) care on behalf of the national government. A zorgkantoor makes agreements on cost and quality with care providers and helps people that are in need of care to decide what the best possible option in their situation is. The CZ zorgkantoor arranges the long-term (residential) care in the south and southwest of the Netherlands. This paper describes how we create scientific knowledge to contribute to the knowledge base of PCC for older adults by conducting social scientific research in which the perspectives of older adults are central. Subsequently, we show how we create societal impact by facilitating and stimulating the use of our scientific knowledge in daily care practice. In the closing section, our ambitions for the future are discussed.
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Shiells K, Pivodic L, Holmerová I, Van den Block L. Self-reported needs and experiences of people with dementia living in nursing homes: a scoping review. Aging Ment Health 2020; 24:1553-1568. [PMID: 31163987 DOI: 10.1080/13607863.2019.1625303] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: With rates of dementia continuing to rise, the impetus on improving care for people with dementia is growing. Unmet needs of people with dementia living in nursing homes have been linked with worsening neuropsychiatric symptoms, higher levels of depression, and reduced quality of life. Furthermore, proxy accounts exploring the needs of people with dementia have frequently been shown to be unreliable. Therefore, this literature review aims to explore the self-reported needs and experiences of people with dementia in nursing homes.Method: A scoping review of the literature was carried out using the databases PubMed and PsycINFO to search for relevant articles according to PRISMA guidelines. Search terms were designed to include both quantitative and qualitative study designs. Thematic synthesis was used to categorise findings into themes related to self-reported needs and experiences.Results: A total of 41 articles met the eligibility criteria. An analysis of study characteristics revealed more than half of studies used a qualitative design. Thematic synthesis resulted in eight themes: activities, maintaining previous roles, reminiscence, freedom and choice, appropriate environment, meaningful relationships, support with grief and loss, end-of-life care.Conclusion: Whilst the voice of people with dementia has previously been neglected in research, this review has shown that people with dementia in nursing homes are able to describe their experiences and communicate their needs. The findings in this review have provided a contribution towards guiding evidence-based practice that is tailored to the needs of nursing home residents with dementia.
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Affiliation(s)
- Kate Shiells
- Centre of Expertise in Longevity and Long-term Care, Faculty of Humanities, Charles University, Prague, Czech Republic
| | - Lara Pivodic
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
| | - Iva Holmerová
- Centre of Expertise in Longevity and Long-term Care, Faculty of Humanities, Charles University, Prague, Czech Republic
| | - Lieve Van den Block
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
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24
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Morris P, McCloskey R, Keeping-Burke L, Manley A. Nurses' provisions for self-determination when caring for clients with cognitive impairment who live in a residential aged care facility: a scoping review protocol. JBI Evid Synth 2020; 19:484-490. [PMID: 32813411 DOI: 10.11124/jbisrir-d-19-00358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this scoping review is to examine and map knowledge of nursing provisions for self-determination while providing care to clients with cognitive impairment in residential aged care facilities. INTRODUCTION Maintaining the ability to have choices and to make decisions about daily activities is important for older adults. In residential aged care facilities, nurses' can be challenged to preserve clients' self-determination in favor of ritualistic care routines and a perceived duty to care. Moreover, nurses may perceive that their professional responsibilities to protect clients requires them to guard against decisions that are considered unwise or pose a risk to clients' health or safety. Insight into how nurses negotiate choice with clients with cognitive impairment who are living in a residential care facility will provide an in-depth understanding of the role self-determination plays in clients' lives. INCLUSION CRITERIA The scoping review will consider research and narrative reports on nursing provisions for self-determination in clients with cognitive impairment who are living in a residential aged care facility. The concepts of interest are self-determination and nursing provisions. Self-determination is defined as client choice and nursing provisions are the intentional reactions to clients' expressed choices. METHODS This scoping review will aim to locate published and unpublished literature employing a three-step search strategy. Only papers published in English from 1995 onward will be included. Data extracted from included papers will outline details on the participants, context, strategy, activity, and outcomes. Extracted data will be reported in a tabular form and presented narratively to address the review objective.
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Affiliation(s)
- Patricia Morris
- Horizon Health Network, Ridgewood Veterans Hospital, Saint John, NB, Canada.,Faculty of Nursing, University of New Brunswick, Fredericton, NB, Canada
| | - Rose McCloskey
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, NB, Canada.,The University of New Brunswick (UNB) Saint John Collaboration for Evidence-Informed Healthcare: A JBI Centre of Excellence, Saint John, NB, Canada
| | - Lisa Keeping-Burke
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, NB, Canada.,The University of New Brunswick (UNB) Saint John Collaboration for Evidence-Informed Healthcare: A JBI Centre of Excellence, Saint John, NB, Canada
| | - Allison Manley
- Horizon Health Network, Health Sciences Librarian, Miramichi, NB, Canada
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25
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Engel L, Bucholc J, Mihalopoulos C, Mulhern B, Ratcliffe J, Yates M, Hanna L. A qualitative exploration of the content and face validity of preference-based measures within the context of dementia. Health Qual Life Outcomes 2020; 18:178. [PMID: 32527264 PMCID: PMC7291594 DOI: 10.1186/s12955-020-01425-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 05/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Assessing the cost-effectiveness of interventions for people with dementia, based on cost per quality-adjusted life years (QALYs) gained, requires that the measures used to derive QALYs are preference-based whilst also being valid, feasible to use, comprehensible and acceptable for people with dementia. The aim of this study was to assess the content and face validity of six preference-based measures (PBMs) within the context of dementia. METHODS Qualitative focus groups and interviews were conducted with community-dwelling individuals with mild dementia and carers of people with dementia. After exploring participants' understanding of 'quality of life' (QoL), six PBMs were assessed for content and face validity: two measures assessing health-related QoL (EQ-5D-5L and AQoL-8D); two covering broader aspects of capability wellbeing and social care-related QoL (ICECAP-O and ASCOT); and two dementia-specific QoL measures (DEMQOL-U and AD-5D). A random mix of one health-related QoL measure, one wellbeing measure, and one dementia-specific measure was explored in each session. All sessions were audiotaped and transcribed verbatim. Data were analysed thematically. RESULTS Nine individuals with mild dementia and 17 carers of people with dementia participated across 4 focus groups and 10 interviews. Participants perceived 9 broad QoL domains as relevant to them: Activity, Autonomy, Cognition, Communication, Coping, Emotions, End-of-Life, Physical Functioning, and Relationships. These domains had limited overlap with the content of the six PBMs. Assessment of face validity was summarized into eight themes: (1) ambiguous questions, (2) double -barrelled questions, (3) difficult/abstract questions, (4) judgemental/confronting questions, (5) lack of relevance and comprehensiveness, (6) response options, (7) layout/format and (8) proxy-response. There was no clear preference for one of the six measures explored; participants identified advantages and disadvantages across all measures. Although particularly designed for individuals with dementia, dementia-specific QoL measures were not always favoured over non-specific measures. CONCLUSION Given the shortcomings of PBMs identified in this study, further empirical comparative analyses are necessary to guide the selection of PBMs for future dementia research.
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Affiliation(s)
- Lidia Engel
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia.
| | - Jessica Bucholc
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Cathrine Mihalopoulos
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Mark Yates
- Ballarat Health Services, Ballarat, Victoria, Australia
| | - Lisa Hanna
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
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26
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Lion KM, Szcześniak D, Bulińska K, Evans SB, Evans SC, Saibene FL, d'Arma A, Farina E, Brooker DJ, Chattat R, Meiland FJM, Dröes RM, Rymaszewska J. Do people with dementia and mild cognitive impairments experience stigma? A cross-cultural investigation between Italy, Poland and the UK. Aging Ment Health 2020; 24:947-955. [PMID: 30789028 DOI: 10.1080/13607863.2019.1577799] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Until now little research has been done to answer the question of whether people with dementia experience stigma. No previous studies investigated possible differences between countries and cultures. Therefore, the aims of this study were to compare the experience of stigma (with social isolation, social rejection and internalised shame as components) among people with dementia and mild cognitive impairment (MCI) (n = 180) in Italy (n = 79), Poland (n = 47) and the United Kingdom (UK) (n = 54); and to investigate possible relationships with demographical and clinical outcomes.Methods: A one group multinational cross-sectional design was used. Stigma was measured with the Stigma Impact Scale (SIS), quality of life aspects with Dementia Quality of Life scale (DQOL) and Quality of Life Alzheimer's Disease scale (QOL-AD), social support with Duke Social Support Index (DSSI), cognitive functioning with Global Deterioration Scale (GDS).Results: The level of stigmatisation (SIS) among study participants varied from 2 to 65 (median = 33.5; Q1 = 27; Q3 = 41). People with dementia in the UK experienced a higher level of stigmatisation than people in Italy and Poland. The experienced stigmatisation negatively correlated with social support (DSSI; rho = -0.42, p = 0.000) and quality of life (QOL-AD; rho = -0.39, p = 0.000). People who experienced a higher level of stigmatisation scored higher in negative mood DQOL subscale (rho = 0.28, p = 0.0002).Conclusion: There is a strong need for research into the individual experience of people with dementia across the world. This could help in providing support and care services that match their experience, needs, preferences; and in designing well informed awareness campaigns based on their voice.
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Affiliation(s)
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Katarzyna Bulińska
- Department of Rehabilitation in Internal Diseases, Wroclaw University School of Physical Education, Wroclaw, Poland
| | | | - Simon C Evans
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | | | | | | | - Dawn June Brooker
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Rabih Chattat
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Franka J M Meiland
- Department of Psychiatry, VU University Medical Center & Department of Research and Innovation, GGZ inGeest, Amsterdam, The Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, VU University Medical Center & Department of Research and Innovation, GGZ inGeest, Amsterdam, The Netherlands
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Remembering the past, enhancing the present and sharing the future: a qualitative study of the impact of film screenings in care home communities. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20000501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractMany care home residents lack opportunities for meaningful activity and social connection, resulting in poor physical and emotional wellbeing. Providing residents with varied activities and social opportunities can improve their quality of life. In this paper, we examine the potential for film to provide a meaningful, social activity. The limited existing research on film in care homes has predominantly examined the use of film clips and materials in stimulating reminiscence for people with dementia. In this paper, we adopt a broader, trans-disciplinary perspective of film, drawing on evidence from Film Studies that shared spectatorship has social and emotional benefits for the viewer. We offer the first qualitative study of care home residents’ social, emotional and embodied engagement with feature-length film and identify the key benefits of film in this setting. We ran social film screenings in two Scottish care homes over six weeks. Underpinned by psycho-cinematic theory, we collected and analysed observational data alongside interviews with care home staff and discussion groups with residents. Our findings identified three ways in which film screenings benefit residents and supports social connection: prompting reminiscence; enhancing residents’ experiences in the present; and creating a shared future and intergenerational connections. The paper offers useful insights into the rich potential for film to enhance the care home community, facilitate social connectivity and promote resident wellbeing.
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28
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Ibsen TL, Kirkevold Ø, Patil GG, Eriksen S. People with dementia attending farm-based day care in Norway - Individual and farm characteristics associated with participants' quality of life. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1038-1048. [PMID: 31884707 DOI: 10.1111/hsc.12937] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/29/2019] [Accepted: 12/10/2019] [Indexed: 06/10/2023]
Abstract
Farm-based day care for people with dementia is supposed to improve the participants quality of life by using activities and resources of the farm environment to promote mental and physical health. In this paper, we describe the characteristics of those attending farm-based day care services in Norway and explore the association between individual and farm characteristics and the quality of life. A sample of 94 people with dementia who attended farm-based day care was recruited from 25 farms between January 2017 and January 2018. The data collection was performed using standardized instruments. Information about the farms was retrieved from a former study. The association between the participants' quality of life and their individual and/or farm characteristics was examined with a linear multilevel regression model. The participants had a mean age of 76 years, 62% were men, and 68% had additional education after primary school. Most of them had mild (54.3%) or questionable dementia (18.3%). A few participants used antipsychotics (3.7%), tranquilizers (9.9%) and painkillers (13.6%), while a higher number used antidepressants (30.9%). Quality of life was associated with the experience of having social support (p = .023), a low score on depressive symptoms (p < .001), and spending time outdoors at the farm (p < .001). The variation between the farm-based day care services in the participants' reported quality of life was related to time spent outdoors at the farm. In light of the present study, it seems as farm-based day care is addressing people with dementia in an early stage, dominated by men, with quite good physical and medical condition. The strong association between quality of life and spending time outdoors underscores that facilitation for outdoor activity should be prioritized in all types of dementia care.
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Affiliation(s)
- Tanja L Ibsen
- Norwegian National Advisory Unit on Aging and Health (Aging and Health), Vestfold Hospital Trust, Tønsberg, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Øyvind Kirkevold
- Norwegian National Advisory Unit on Aging and Health (Aging and Health), Vestfold Hospital Trust, Tønsberg, Norway
- Department of Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
- Centre of Old Age Psychiatry Research, Innlandet Hospital Trust, Gjøvik, Norway
| | - Grete G Patil
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | - Siren Eriksen
- Norwegian National Advisory Unit on Aging and Health (Aging and Health), Vestfold Hospital Trust, Tønsberg, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
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29
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Hvidsten L, Engedal K, Selbæk G, Wyller TB, Benth JŠ, Kersten H. Quality of Life in People with Young-Onset Dementia: A Nordic Two-Year Observational Multicenter Study. J Alzheimers Dis 2020; 67:197-210. [PMID: 30530973 DOI: 10.3233/jad-180479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Cross-sectional studies of quality of life (QOL) of people with young-onset dementia show diverging results. OBJECTIVE To identify factors associated with QOL in people with young-onset Alzheimer's (AD) and frontotemporal dementia (FTD) and explore development in QOL over a two-year period, including differences between the two subtypes. METHODS A two-year cohort study of 88 community-dwelling people with young-onset AD and FTD recruited from Nordic memory clinics. QOL was assessed using the proxy version of the Quality of Life - Alzheimer's Disease questionnaire, dementia severity was rated with the Clinical Dementia Rating scale, depressive symptoms by the Cornell Scale for Depression in Dementia, awareness with the Reed anosognosia scale, and needs using the Camberwell Assessment of Needs in the Elderly questionnaire. Factors associated with QOL and development in QOL over time were explored with growth mixture model trajectories and mixed model analyses. RESULTS We identified two groups of people following trajectories with better (n = 35) versus poorer (n = 53) QOL. People with more depressive symptoms at baseline had higher odds of belonging to poorer QOL group, OR 1.2 (CI 1.1; 1.5, p = 0.011). Having Alzheimer's disease was associated with significantly better QOL (p = 0.047 at baseline, p = 0.009 at T1 and p = 0.033 at T2). Increasing number of unmet needs was significantly associated with poorer QOL at baseline (p = 0.007), but not later in follow-up. CONCLUSION Early assessment and treatment based on dementia subtype, depression, and individual needs may enhance quality of life in young-onset dementia.
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Affiliation(s)
- Lara Hvidsten
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Division for Mental Health and Addiction, Vestfold Hospital Trust, Tønsberg, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Vestfold Hospital Trust, Tønsberg, Norway.,Oslo University Hospital, Department of Geriatric Medicine, Oslo, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,The Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Torgeir Bruun Wyller
- Oslo University Hospital, Department of Geriatric Medicine, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Hege Kersten
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Pharmaceutical Bioscience, School of Pharmacy, University of Oslo, Oslo, Norway.,Department of Research and Development, Telemark Hospital, Skien, Norway
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30
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Blok M, van Ingen E, de Boer AH, Slootman M. The use of information and communication technologies by older people with cognitive impairments: from barriers to benefits. COMPUTERS IN HUMAN BEHAVIOR 2020. [DOI: 10.1016/j.chb.2019.106173] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rapaport P, Burton A, Leverton M, Herat-Gunaratne R, Beresford-Dent J, Lord K, Downs M, Boex S, Horsley R, Giebel C, Cooper C. "I just keep thinking that I don't want to rely on people." a qualitative study of how people living with dementia achieve and maintain independence at home: stakeholder perspectives. BMC Geriatr 2020; 20:5. [PMID: 31900113 PMCID: PMC6942277 DOI: 10.1186/s12877-019-1406-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 12/22/2019] [Indexed: 11/18/2022] Open
Abstract
Background Most people living with dementia want to remain in their own homes, supported by family and paid carers. Care at home often breaks down, necessitating transition to a care home and existing interventions are limited. To inform the development of psychosocial interventions to enable people with dementia to live well for longer at home, we qualitatively explored the views of people living with dementia, family carers and health and social care professionals, on how to achieve and maintain independence at home and what impedes this. Methods We conducted an inductive thematic analysis of qualitative interviews with 11 people living with dementia, 19 professionals and 22 family carers in England. Results We identified four overarching themes: being in a safe and familiar environment, enabling not disabling care, maintaining relationships and community connectedness, and getting the right support. For people living with dementia, the realities of staying active were complex: there was a tension between accepting support that enabled independence and a feeling that in doing so they were accepting dependency. Their and professionals’ accounts prioritised autonomy and ‘living well with dementia’, while family carers prioritised avoiding harm. Professionals promoted positive risk-taking and facilitating independence, whereas family carers often felt they were left holding this risk. Discussion Psychosocial interventions must accommodate tensions between positive risk-taking and avoiding harm, facilitating autonomy and providing support. They should be adaptive and collaborative, combining self-management with flexible support. Compassionate implementation of rights-based dementia care must consider the emotional burden for family carers of supporting someone to live positively with risk.
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Affiliation(s)
- Penny Rapaport
- University College London, London, UK. .,UCL Division of Psychiatry, 6th Floor Wing A, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | | | | | | | | | | | | | | | | | - Clarissa Giebel
- NIHR ARC NWC and Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
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‘When it faded in her … it faded in me’: a qualitative study exploring the impact of care-giving on the experience of spousal intimacy for older male care-givers. AGEING & SOCIETY 2019. [DOI: 10.1017/s0144686x19000850] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractOlder male care-givers play an increasingly important role in informal care-giving, yet they have received little attention in the literature. The aim of this study was to explore the impact of care-giving on the experience of spousal intimacy for older male care-givers. Twenty-four older male care-givers, drawn from a region of the United Kingdom, participated in one-to-one interviews about their care-giving role. Thematic analysis was used to analyse data, and the study was underpinned by theories of masculinity. Three main themes were identified: (a) ‘Impact of care-giving on the experience of sexual intimacy’; (b) ‘Impact of care-giving on the experience of emotional intimacy’; and (c) ‘Not up for discussion’. When sexual intimacy declined, some older male care-givers prioritised emotional intimacy; some struggled with the decline; and some were reluctant to discuss the issue. Additionally, some care-givers reported that they had not received support from external support providers for declining sexual or emotional intimacy. Intimacy has been highlighted as important for care-givers given its link with care-giver wellbeing and quality of life. Results of this study suggest that sexual and emotional intimacy was an issue for older male care-givers, and that this issue should be considered by external support providers as part of a holistic assessment of need in order to tailor effective support.
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33
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Kaushal N, Desjardins-Crépeau L, Langlois F, Bherer L. The Effects of Multi-Component Exercise Training on Cognitive Functioning and Health-Related Quality of Life in Older Adults. Int J Behav Med 2019; 25:617-625. [PMID: 29926316 DOI: 10.1007/s12529-018-9733-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE Exercise has been shown to have various proximal and distal benefits among older adults such as improving physical fitness, cognitive functioning, and health-related quality of life (HR-QOL). Despite this evidence, limited research has investigated pathway change of these outcomes. The primary purpose of this study was to test if older adults who improved in physical fitness measures from engaging in multicomponent exercise training for 12 weeks predicted change in proximal (cognitive functioning) and distal (HR-QOL) outcomes, respectively. METHODS Participants (n = 110) were healthy, older adults (M = 72, SD = 7.24) that comprised an exercise-intervention and control group. The intervention consisted of exercising in a supervised laboratory setting for 12 weeks. RESULTS Structural equation modeling revealed group type to predict change in physical performance and the maximum walking test with comparable effect sizes. Physical performance in turn predicted improvement in processing speed (β = 0.23, p = 0.013) executive functioning (β = 0.26, p = 0.006), and HR-QOL (β = 0.13, p = 0.031). However, only executive functioning was found to significantly predict HR-QOL (β = 0.49, p < 0.001) over processing speed (p > 0.05). CONCLUSIONS Between two fitness measures, the physical performance test demonstrated better predictive validity in proximal and distal health outcomes. In addition to physical fitness, older adults who engage in multi-component exercise sessions regularly can improve their executive functioning, which in turn enhances their HR-QOL.
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Affiliation(s)
- Navin Kaushal
- Department of Medicine, University of Montreal, Montréal, Québec, Canada.
- Montreal Heart Institute, Montréal, Québec, Canada.
| | - Laurence Desjardins-Crépeau
- Department of Medicine, University of Montreal, Montréal, Québec, Canada
- Montreal Heart Institute, Montréal, Québec, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Francis Langlois
- CSSS de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke, Montréal, Québec, Canada
| | - Louis Bherer
- Department of Medicine, University of Montreal, Montréal, Québec, Canada
- Montreal Heart Institute, Montréal, Québec, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
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The (cost-) effectiveness of exergaming in people living with dementia and their informal caregivers: protocol for a randomized controlled trial. BMC Geriatr 2019; 19:50. [PMID: 30782127 PMCID: PMC6381728 DOI: 10.1186/s12877-019-1062-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 02/12/2019] [Indexed: 01/30/2023] Open
Abstract
Background Physical activity is linked to benefits such as increased physical fitness, cognition, emotional and social functioning, general health and well-being in older people. Some evidence suggests that this also applies to people living with dementia. However, it can be harder for them to perform physical activities, due to several barriers, such as issues with orientation and balance problems. A relatively new type of physical activity called exergaming may help them overcome these barriers. Exergaming is “physical exercise interactively combined with cognitive stimulation in a gaming environment”. The aim of our study is to evaluate the effectiveness and cost-effectiveness of exergaming compared to regular activities in people living with dementia, who attend day-care centres. Additionally, we want to investigate whether the exergaming activity for the person living with dementia, also (indirectly) affects the informal caregiver, as well as which facilitators and barriers to implementation of exergames for this target group exist. Methods A cluster Randomized Controlled Trial (RCT), with economic and process evaluations alongside will be carried out. In the Netherlands, 24 day-care centres are randomized in the experimental or control group. The study group will consist of 224 dyads (community-dwelling participants with dementia and their informal caregivers), who are interviewed at baseline, and at 3 and 6 months of follow-up. The participant with dementia has to visit the day-care centre for at least two days per week, have a diagnosis of mild to moderate dementia and have an informal caregiver present, who is willing to participate. Societal cost data will be collected during interviews, using healthcare utilization diaries, and from day-care centres. The process evaluation will only involve the experimental group, and will include an online survey, qualitative interviews and focus groups. Discussion This study will contribute to the evidence base that more effective exercise among people with dementia will result in positive effects on their wellbeing and quality of life. This will motivate people with dementia to be physically active. We also envision that there might be a positive effect on the burden of care experienced by their informal caregivers. Trial registration This trial was registered at the Netherlands Trial Register (NTR) on December 10, 2015 (number: NTR5537), this publication is based on protocol amendment number 01, issue date 28 December 2018. This includes all items from the World Health Organization Trial Registration Data Set [see Additional file 1]. Electronic supplementary material The online version of this article (10.1186/s12877-019-1062-x) contains supplementary material, which is available to authorized users.
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Mak W, Sörensen S. Are Humor Styles of People With Dementia Linked to Greater Purpose in Life? THE GERONTOLOGIST 2018; 58:835-842. [PMID: 29385452 PMCID: PMC6137350 DOI: 10.1093/geront/gnx207] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Indexed: 11/12/2022] Open
Abstract
Objectives Little is known about humor and purpose in life in people with dementia. Although having a sense of humor is typically associated with positive psychological outcomes, recent evidence suggests that outcomes may vary depending on whether the humor being used is adaptive versus maladaptive. The goal of this study was to determine whether humor styles are predictive of purpose in life in people with dementia. Methods Questionnaires were verbally administered to people with mild-to-moderate dementia to measure humor styles and purpose in life. Results Adaptive humor styles were associated with purpose in life whereas maladaptive humor styles were not. Discussion Having a sense of humor in dementia may be associated with a stronger sense of purpose in life, but it depends on the type of humor used. Results are discussed in the context of understanding the role of humor in the daily lives of people with dementia and implications for care.
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Affiliation(s)
- Wingyun Mak
- Department of Psychology, Lehman College, Bronx, New York
| | - Silvia Sörensen
- Warner School of Education, University of Rochester, Rochester, New York
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Küçükgüçlü Ö, Akpınar Söylemez B, Yener G, Işık AT. The effects of support groups on dementia caregivers: A mixed method study. Geriatr Nurs 2018; 39:151-156. [DOI: 10.1016/j.gerinurse.2017.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 07/20/2017] [Accepted: 07/24/2017] [Indexed: 10/19/2022]
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Beerens HC, Zwakhalen SMG, Verbeek H, E S Tan F, Jolani S, Downs M, de Boer B, Ruwaard D, Hamers JPH. The relation between mood, activity, and interaction in long-term dementia care. Aging Ment Health 2018; 22:26-32. [PMID: 27624397 DOI: 10.1080/13607863.2016.1227766] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of the study is to identify the degree of association between mood, activity engagement, activity location, and social interaction during everyday life of people with dementia (PwD) living in long-term care facilities. METHOD An observational study using momentary assessments was conducted. For all 115 participants, 84 momentary assessments of mood, engagement in activity, location during activity, and social interaction were carried out by a researcher using the tablet-based Maastricht Electronic Daily Life Observation-tool. RESULTS A total of 9660 momentary assessments were completed. The mean age of the 115 participants was 84 and most (75%) were women. A negative, neutral, or positive mood was recorded during 2%, 25%, and 73% of the observations, respectively. Positive mood was associated with engagement in activities, doing activities outside, and social interaction. The type of activity was less important for mood than the fact that PwD were engaged in an activity. Low mood was evident when PwD attempted to have social interaction but received no response. CONCLUSION Fulfilling PwD's need for occupation and social interaction is consistent with a person-centred dementia care focus and should have priority in dementia care.
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Affiliation(s)
- Hanneke C Beerens
- a Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - Sandra M G Zwakhalen
- a Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - Hilde Verbeek
- a Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - Frans E S Tan
- b Department of Methodology & Statistics, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences , Maastricht University, Maastricht , The Netherlands
| | - Shahab Jolani
- b Department of Methodology & Statistics, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences , Maastricht University, Maastricht , The Netherlands
| | - Murna Downs
- c School of Dementia Studies, Faculty of Health Studies , University of Bradford , Bradford , United Kingdom
| | - Bram de Boer
- a Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - Dirk Ruwaard
- a Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - Jan P H Hamers
- a Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
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Gjernes T. Knitters in a Day Center: The Significance of Social Participation for People With Mild to Moderate Dementia. QUALITATIVE HEALTH RESEARCH 2017; 27:2233-2243. [PMID: 28835145 DOI: 10.1177/1049732317723890] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This article explores how people with dementia interact and solve problems while participating in social activities. The present article highlights social participation and interaction among elderly women with mild dementia who engaged in knitting as their main activity. The data were collected through participant observation at a day center in a Norwegian city, and the analysis revealed that the social activity of knitting facilitated conversations about different topics, required various forms of memory and problem solving, and involved different participant statuses. Being part of the knitting group appeared to help the participants maintain their skills and facilitated sociability.
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de Boer B, Hamers JPH, Zwakhalen SMG, Tan FES, Verbeek H. Quality of care and quality of life of people with dementia living at green care farms: a cross-sectional study. BMC Geriatr 2017; 17:155. [PMID: 28724358 PMCID: PMC5518159 DOI: 10.1186/s12877-017-0550-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 07/13/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Many countries are introducing smaller, more home-like care facilities that represent a radically new approach to nursing home care for people with dementia. The green care farm is a new type of nursing home developed in the Netherlands. The goal of this study was to compare quality of care, quality of life and related outcomes in green care farms, regular small-scale living facilities and traditional nursing homes for people with dementia. METHODS A cross-sectional design was used. Three types of nursing homes were included: (1) green care farms; (2) regular small-scale living facilities; (3) traditional nursing homes. All participating nursing homes were non-profit, collectively funded nursing homes in the south of the Netherlands. One hundred and fifteen residents with a formal diagnosis of dementia were included in the study. Data on quality of care was gathered and consisted of outcome indicators (e.g. falling incidents, pressure ulcers), structure indicators (e.g. hours per resident per day), and process indicators (e.g. presence, accessibility and content of protocols on care delivery). Furthermore, questionnaires on cognition, dependence in activities of daily living, quality of life, social engagement, neuropsychiatric symptoms, agitation, and depression were used. RESULTS Data showed that quality of care was comparable across settings. No large differences were found on clinical outcome measures, hours per resident per day, or process indicators. Higher quality of life scores were reported for residents of green care farms in comparison with residents of traditional nursing homes. They scored significantly higher on the Quality of Life - Alzheimer's disease Scale (p < 0.05, ES = 0.8) indicating a better quality of life. In addition, residents of green care farms scored higher on three quality of life domains of the Qualidem: positive affect, social relations and having something to do (p < 0.05, ES > 0.7). No differences with regular small-scale living facilities were found. CONCLUSIONS Green care farms seem to be a valuable alternative to existing nursing homes. This is important as people with dementia are a heterogeneous group with varying needs. In order to provide tailored care there also is a need for a variety of living environments.
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Affiliation(s)
- Bram de Boer
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Duboisdomein 30, 6229 GT, Maastricht, The Netherlands.
| | - Jan P H Hamers
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Duboisdomein 30, 6229 GT, Maastricht, The Netherlands
| | - Sandra M G Zwakhalen
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Duboisdomein 30, 6229 GT, Maastricht, The Netherlands
| | - Frans E S Tan
- Department of Methodology and Statistics, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Hilde Verbeek
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Duboisdomein 30, 6229 GT, Maastricht, The Netherlands
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Boersma P, Van Weert JCM, van Meijel B, van de Ven PM, Dröes RM. Study protocol Implementation of the Veder contact method (VCM) in daily nursing home care for people with dementia: an evaluation based on the RE-AIM framework. Aging Ment Health 2017; 21:730-741. [PMID: 26930177 DOI: 10.1080/13607863.2016.1154015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVES People with dementia in nursing homes benefit from person-centred care methods. Studies examining the effect of these methods often fail to report about the implementation of these methods. The present study aims to describe the implementation of the Veder contact method (VCM) in daily nursing home care. METHOD A process analysis will be conducted based on qualitative data from focus groups with caregivers and interviews with key figures. To investigate whether the implementation of VCM is reflected in the attitude and behaviour of caregivers and in the behaviour and quality of life of people with dementia, a controlled observational cohort study will be conducted. Six nursing home wards implementing VCM will be compared with six control wards providing Care As Usual. Quantitative data from caregivers and residents will be collected before (T0), and 9-12 months after the implementation (T1). Qualitative analysis and multilevel analyses will be carried out on the collected data and structured based on the constructs of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). CONCLUSION By using the RE-AIM framework this study introduces a structured and comprehensive way of investigating the implementation process and implementation effectiveness of person-centred care methods in daily dementia care.
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Affiliation(s)
- Petra Boersma
- a Research Group Mental Health Nursing , Inholland University of Applied Sciences , Diemen , The Netherlands
| | - Julia C M Van Weert
- b Amsterdam School of Communication Research/ASCoR , University of Amsterdam , Amsterdam , The Netherlands
| | - Berno van Meijel
- a Research Group Mental Health Nursing , Inholland University of Applied Sciences , Diemen , The Netherlands.,c Department of Psychiatry , EMGO Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands.,d Parnassia Psychiatric Institute , The Hague , The Netherlands
| | - Peter M van de Ven
- e Department of Epidemiology and Biostatistics , VU University Medical Center , Amsterdam , Netherlands
| | - Rose-Marie Dröes
- c Department of Psychiatry , EMGO Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands
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The association between attending specialized day care centers and the quality of life of people with dementia. Int Psychogeriatr 2017; 29:627-636. [PMID: 27852334 DOI: 10.1017/s1041610216002015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Day care that is designed for people with dementia aims to increase the users' quality of life (QoL). The objective of the study was to compare the QoL of people with dementia attending day care with those not attending day care. METHODS The study is based on baseline data from a project using a quasi-experimental design, including a group of day care users (n = 183) and a comparison group not receiving day care (n = 78). Quality of Life-Alzheimer's Disease (QoL-AD) was used as the primary outcome, to collect both self-reported and proxy-based information from family carers on the users' QoL. A linear mixed model was used to examine the differences between groups. RESULTS Attending day care was significantly associated with higher mean scores of self-reported QoL. There was no difference between the groups in proxy-reported QoL. Analyses of the interaction between group belonging and awareness of memory loss revealed that the participants with shallow or no awareness who attended day care had significant higher mean scores of QoL-AD compared to those not attending day care. CONCLUSIONS Higher self-reported QoL was found among people attending day care designed for people with dementia compared to the comparison group. The difference in QoL ratings was found in the group of day care users with shallow or no awareness of their memory loss. Hence, day care designed for people with dementia might have the potential to increase QoL as it is experienced by the users.
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Roelofs TSM, Luijkx KG, Embregts PJCM. Love, Intimacy and Sexuality in Residential Dementia Care: A Spousal Perspective. DEMENTIA 2017; 18:936-950. [DOI: 10.1177/1471301217697467] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Tineke SM Roelofs
- Schakelring, Waalwijk, the Netherlands; School of Social and Behavioral Sciences, Department of Tranzo, Tilburg University, Tilburg, the Netherlands
| | - Katrien G Luijkx
- School of Social and Behavioral Sciences, Department of Tranzo, Tilburg University, Tilburg, the Netherlands
| | - Petri JCM Embregts
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
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Boersma P, van Weert JCM, van Meijel B, Dröes RM. Implementation of the Veder contact method in daily nursing home care for people with dementia: a process analysis according to the RE-AIM framework. J Clin Nurs 2016; 26:436-455. [DOI: 10.1111/jocn.13432] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Petra Boersma
- Research Group Mental Health Nursing; Inholland University of Applied Sciences; Diemen The Netherlands
| | - Julia C M van Weert
- Amsterdam School of Communication Research/ASCoR; University of Amsterdam; Amsterdam The Netherlands
| | - Berno van Meijel
- Research Group Mental Health Nursing; Inholland University of Applied Sciences; Diemen The Netherlands
- Department of Psychiatry; VU University Medical Center; EMGO Institute for Health and Care Research; Amsterdam The Netherlands
- Parnassia Psychiatric Institute; The Hague The Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry; VU University Medical Centre; Alzheimer Centre; EMGO Institute for Health and Care Research; Amsterdam The Netherlands
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Peeters MM, Harbers M, Neerincx MA. Designing a personal music assistant that enhances the social, cognitive, and affective experiences of people with dementia. COMPUTERS IN HUMAN BEHAVIOR 2016. [DOI: 10.1016/j.chb.2016.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Han A, Radel J. Spousal Caregiver Perspectives on a Person-Centered Social Program for Partners With Dementia. Am J Alzheimers Dis Other Demen 2016; 31:465-73. [PMID: 26705379 PMCID: PMC10852899 DOI: 10.1177/1533317515619036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
This qualitative study explored spousal caregiver perspectives on the experience and impact of a person-centered social program for partners with dementia. Interviews with 5 caregivers and the spouses with dementia were conducted 7 to 8 months after the program ended to explore the sustained impact of the program. Interpretative phenomenological analysis was used to support in-depth exploration of interviews. Three themes emerged including benefits of the program for caregivers, initial expectations and later perspectives of caregivers about the program, and conflicting values and perspectives between caregivers and the spouses. These findings suggest participation in a person-centered social program by people with dementia benefits their caregivers, by meeting the caregivers' desire for their spouses to increase social participation and engagement in meaningful activities. Participation in the program provided a sustained benefit to one couple in particular, by encouraging the caregiver to resume arranging activities the couple once enjoyed but now had difficulty pursuing.
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Affiliation(s)
- Areum Han
- School of Occupational Therapy, Texas Woman's University, Denton, TX, USA
| | - Jeff Radel
- Department of Occupational Therapy Education, University of Kansas Medical Center, Kansas City, KS, USA
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Abstract
BACKGROUND The aim of this study is to develop and try out an approach for personalized nature activities for people with dementia. METHODS A qualitative descriptive study using focus group interviews with people with dementia was conducted. Based on the results of the focus groups and the relevant literature, the approach was developed. In a qualitative descriptive pilot study with a one-group design, we tried out the approach regarding acceptability and experience of the intervention among people with dementia, and satisfaction with the approach among healthcare professionals. Additionally, we investigated the organizational feasibility. RESULTS From the focus groups, eight key aspects of experiencing nature were identified as being important for quality of life (e.g. relaxation, freedom), as well as six categories of preferred activities (e.g. active, passive, and social activities). Based on these themes and categories, an approach was developed to design nature activities according to the personal wishes, needs, and experiences of people with dementia. During the intervention, participants in the pilot study showed high levels of positive behaviors and low levels of negative behaviors. As regards, organizational feasibility, eight themes for successful implementation of nature activities were identified. CONCLUSIONS This exploratory study contributes to the knowledge regarding the development and implementation of person-centered nature activities for people with dementia. The implementation of the activities could be improved by training professionals in person-centered care. The effect of the person-centered nature activities approach should be investigated.
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Han A, Radel J, McDowd JM, Sabata D. The Benefits of Individualized Leisure and Social Activity Interventions for People with Dementia: A Systematic Review. ACTIVITIES ADAPTATION & AGING 2016. [DOI: 10.1080/01924788.2016.1199516] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Beerens HC, de Boer B, Zwakhalen SMG, Tan FES, Ruwaard D, Hamers JPH, Verbeek H. The association between aspects of daily life and quality of life of people with dementia living in long-term care facilities: a momentary assessment study. Int Psychogeriatr 2016; 28:1323-31. [PMID: 27068245 DOI: 10.1017/s1041610216000466] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND To improve the quality of life (QoL) of people with dementia (PwD) living in long-term care facilities, insight into the association between QoL and how people spend their daily lives is urgently needed. This study investigated which aspects of daily life are related to QoL in dementia. METHODS An observational study was conducted. Daily life was assessed with the tablet-based Maastricht Electronic Daily Life Observation-tool (MEDLO-tool). Aspects included activity, engagement in the activity, social interaction, physical effort, mood, and agitation. QoL was assessed by formal nursing caregivers using the Quality of Life-Alzheimer's Disease scale (QoL-AD). A total of 9,660 momentary assessments were conducted. RESULTS The mean age of the 115 participants was 84 years and most (75%) were women. Bivariate analyses showed that residents with a higher QoL carried out less passive/purposeless activities (25% vs. 38%), were more engaged in active, expressive, and social activities, (40% vs. 27%), had more social interaction (34% vs. 22%), and had better mood scores (scale 1-7, 5.0 vs. 4.8), compared with residents with a lower QoL (all p-values < 0.001). Multivariate analyses showed that having more social interaction and a positive mood are related to a higher QoL. CONCLUSIONS The results underline the importance of social interaction and a positive mood for a higher QoL. Future research should investigate the importance of engagement in activities in more detail.
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Affiliation(s)
- Hanneke C Beerens
- Department of Health Services Research,CAPHRI School for Public Health and Primary Care,Faculty of Health,Medicine and Life Sciences,Maastricht University,Maastricht,the Netherlands
| | - Bram de Boer
- Department of Health Services Research,CAPHRI School for Public Health and Primary Care,Faculty of Health,Medicine and Life Sciences,Maastricht University,Maastricht,the Netherlands
| | - Sandra M G Zwakhalen
- Department of Health Services Research,CAPHRI School for Public Health and Primary Care,Faculty of Health,Medicine and Life Sciences,Maastricht University,Maastricht,the Netherlands
| | - Frans E S Tan
- Department of Methodology & Statistics,CAPHRI School for Public Health and Primary Care,Faculty of Health,Medicine and Life Sciences,Maastricht University,Maastricht,the Netherlands
| | - Dirk Ruwaard
- Department of Health Services Research,CAPHRI School for Public Health and Primary Care,Faculty of Health,Medicine and Life Sciences,Maastricht University,Maastricht,the Netherlands
| | - Jan P H Hamers
- Department of Health Services Research,CAPHRI School for Public Health and Primary Care,Faculty of Health,Medicine and Life Sciences,Maastricht University,Maastricht,the Netherlands
| | - Hilde Verbeek
- Department of Health Services Research,CAPHRI School for Public Health and Primary Care,Faculty of Health,Medicine and Life Sciences,Maastricht University,Maastricht,the Netherlands
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McDonald T. Supporting the pillars of life quality in long-term care. JOURNAL OF RELIGION, SPIRITUALITY & AGING 2016. [DOI: 10.1080/15528030.2016.1143906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gerritsen DL, Oyebode J, Gove D. Ethical implications of the perception and portrayal of dementia. DEMENTIA 2016; 17:596-608. [PMID: 27288459 DOI: 10.1177/1471301216654036] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The way we perceive and portray dementia has implications for how we act towards people with dementia and how we address the issue of dementia within society. As a multi-disciplinary working group, established within the framework of the European Dementia Ethics Network of Alzheimer Europe, we aimed to describe the different ways that people with dementia are perceived and portrayed within society and to consider the moral implications of this. In the current paper, we address perceptions of dementia as reflected in explanatory models of its cause and nature, descriptions of characteristics of people with dementia, the use of language, media portrayals and the views of people living with dementia. Academics and professionals could use this exploration to reflect on their behaviour and their use of language regarding people with dementia.
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Affiliation(s)
- Debby L Gerritsen
- Department of Primary and Community Care, Radboud University Medical Centre Nijmegen; Radboudumc Alzheimer Centre; Joachim en Anna, centre for specialized geriatric care, Nijmegen, the Netherlands
| | - Jan Oyebode
- School of Dementia Studies, University of Bradford, Bradford, BD7 1DP, UK
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