Peer support for people living with rare or young onset dementia: An integrative review

Objectives

The aim of this integrative review was to identify and synthesize the literature on peer support interventions for people living with or caring for someone with a rare or young onset dementia.

Design

A literature search of articles was performed using the Nipissing University Primo search system, a central index that enables simultaneous searches across databases which included MEDLINE (PubMed), Web of Science, PsycINFO, CINAHL, Sociological Abstracts, Cochrane Library.

Results

The eleven papers that met the inclusion criteria spanned eighteen years and from five countries. Studies reported on peer support programs that were either hospital-based (n = 6) or community-based (n = 4), and were predominantly led by disciplines in the health sciences. Only one study did not involve delivering services. There was a range of methodological quality within the studies included in the review. Further analysis and synthesis led to the identification of three overarching peer support themes. These included: (1) peers as necessarily part of social support interventions; (2) a theoretical portmanteau; and (3) dementia spaces and relationality.

Conclusion

Consistent with a much larger body of work examining peer involvement in social interventions, this review reinforced the valuable contribution of peers. A full understanding of the mechanisms of change was not achieved. Notwithstanding, the issue of studies neglecting to sufficiently conceptualize and describe interventions is an important one – drawing attention to the need to continue to explore varied delivery, including co-produced models, and more effective evaluation strategies to inform the dementia care sector.

Conceptualizing citizenship in dementia: A scoping review of the literature

Citizenship has provided an important conceptual framework in dementia research and practice over the past fifteen years. To date, there has been no attempt to synthesize the multiple perspectives that have arisen in this literature. The purpose of this paper is to explore, reflect on, and contrast, the key concepts and trends in the citizenship discourse as it relates to people with dementia. Using a scoping review methodology, forty-nine articles were identified for review. Despite the use of different descriptors, thematic analysis revealed four core themes underpinning citizenship discourse: 1) the relationality of citizenship; 2) facilitated agency and autonomy; 3) attention to stigma, discrimination and exclusion; and 4) recognition of the possibilities of identity and growth. Overall, this scoping review found a major emphasis on expanding definitions of agency and autonomy to render citizenship unconditional and inclusive of the diverse life experiences of people living with dementia. Notably, there is recognition that a more intersectional lens for embedding the subjective experience within a broader socio-political context is needed. Whilst the adoption of a citizenship lens in dementia research and practice has had real-world implications for policy and research, its exploration and use continue to be led by academics, highlighting the importance that future research involve input form people with dementia.

'I am making a difference': Understanding advocacy as a citizenship practice among persons living with dementia

In recent years, persons living with dementia have started advocating to have a more active role in shaping policies and interventions that impact their quality of life. In order to meaningfully involve and engage persons living with dementia in decision-making processes, community partners, providers, planners, as well as researchers and healthcare practitioners need to have a better understanding of their experience of living with dementia. Focusing on the lived experiences of dementia and advocacy enables the understanding that persons living with dementia can be agents of change with purpose and intent and helps us think beyond common stereotypes associated with dementia. Despite the valuable efforts of advocates to create this paradigm shift, there is limited research documenting their experiences of advocacy. Using the citizenship perspective, this study explores the experience of advocacy through semi-structured interviews with three persons living with dementia in Vancouver, Canada, focusing specifically on their motivation to advocate and the challenges they have faced along the way. Findings suggest a number of ways through which advocates living with dementia position themselves as social citizens. Consistent with the dimensions of social citizenship, participants suggested that advocacy (i) gave them a sense of purpose; (ii) helped them express their solidarity with the wider community of people living with dementia; (iii) facilitated their fight for freedom against stigma and discrimination; and (iv) enabled them to grow and evolve over time. Supporting individuals' meaningful engagement and advocacy helps acknowledge the agency and autonomy of persons living with dementia and their identity as social citizens. Taking this approach is imperative to facilitate community partnerships with persons living with dementia and their engagement in the development of relevant policy and practices aimed at creating dementia-friendly communities.

Posicionamiento del investigador de enfermería en la utilización de la teoría fundamentada constructivista

Introducción: La teoría fundamentada ha tenido un fuerte auge en las ciencias de la salud, especialmente en la enfermería, producto de las ventajas que presenta para ser aplicada en problemas o situaciones de la disciplina y analizar diversos tópicos de interés en salud. Una de las vertientes más recientes, la teoría fundamentada constructivista, mantiene en la actualidad un amplio desarrollo por las características inherentes a este enfoque. Una de ellas, que la diferencia de las perspectivas predecesoras, es la posición del investigador en temáticas sociales aplicadas a grupos vulnerables como las personas mayores. Desarrollo: El presente trabajo reflexiona en torno a los usos de la teoría fundamentada constructivista, la posición que debe adquirir el investigador que utilice este enfoque en investigaciones en enfermería, y las herramientas metodológicas con las que puede contar para cumplir este propósito al estudiar grupos vulnerables, como las personas mayores en un contexto latinoamericano. Reflexiones finales. Uno de los aportes destacados de la TFC es posicionar al investigador en un rol clave en la co-construcción de la teoría, como partícipe del proceso de investigación en conjunto con sus participantes como sujeto de cambio social.

Court rulings involving individuals with dementia in Israel: A qualitative perspective

Background

Individuals with dementia may appear before the courts in different roles. Despite the growing interest in the rights of older persons with dementia, relatively little empirical data exist regarding their actual interactions and experiences in court.

Methods

This study used a qualitative, textual analysis methodology. A total of 281 Israeli legal court cases, which addressed issues relating to dementia, were analyzed.

Results

Four key themes were found in the legal texts: (1) The legal construction of dementia and its relationships to old age; (2) The importance of procedural justice; (3) The implications and outcomes of the legal process; and (4) The legal implications to the society as a whole.

Conclusions

The legal narratives, which surround legal cases that deal with dementia in Israel, reveal an internal tension between stigmatic and anti-stigmatic narratives. This complex reality raises the need for further research and for a clearer judicial policy.