1
|
Burridge G, Amato C, Bye R, Basic D, Ní Chróinín D, Hill S, Howe K, Liu KPY. Strategies adopted by informal carers to enhance participation in daily activities for persons with dementia. Australas J Ageing 2024. [PMID: 38804160 DOI: 10.1111/ajag.13341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE Carers for people with dementia commonly experience difficulty assisting the care-recipients with their daily activities and may adopt specific strategies to decrease the difficulties experienced. The objective of this qualitative study was to explore and understand the strategies used by carers to assist with daily activities for persons living with dementia. METHODS Individual semi-structured interviews via face-to-face or telephone mode were conducted with 62 carers of persons living with dementia in Australia. Carers were asked about the strategies they have used previously, or are currently using, to assist with daily activity completion. Data were analysed via constant comparison and thematic analysis. RESULTS All carers reported the need for strategies to accommodate the varying behaviour and functioning of the care-recipients. Participants reported a total of 207 strategies that fell into four main categories: (i) engage; (ii) adapt; (iii) orientate; and (iv) sense. The most used strategies were reported as those aimed at adapting the activity by using equipment to facilitate completion. CONCLUSIONS Carers help persons living with dementia complete their daily activities by developing their own strategies based on the care-recipients' needs and personal preferences through a trial-and-error process. Carers can benefit if more advice is provided to them by health/social care professionals regarding what strategies may be helpful. Further studies are needed to develop these strategies into an educational package so that carers can be guided to use these strategies appropriately.
Collapse
Affiliation(s)
- Gemma Burridge
- Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Carmen Amato
- Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Rosalind Bye
- School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
| | - David Basic
- Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Danielle Ní Chróinín
- Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Susanna Hill
- School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
| | - Kaitlin Howe
- School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
| | - Karen P Y Liu
- School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
- Translation Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
- South Western Sydney Local Health District, Sydney, New South Wales, Australia
| |
Collapse
|
2
|
Arinaitwe I, Karungi CK, Gopez A, Wakida EK, Talib ZM, Mubangizi V, Obua C. Behavioral and psycho-social impairments among people living with dementia and their management by caregivers in South-Western Uganda: a qualitative study. Aging Ment Health 2023; 27:1938-1945. [PMID: 36369823 PMCID: PMC10432726 DOI: 10.1080/13607863.2022.2146053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 11/06/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVES This study aimed to explore the behavioral and social impairments among people living with dementia (PLWD) in rural southwestern Uganda. It also explored the burden of caregivers for people living with dementia. METHODS This was a qualitative study among people living with dementia and their caregivers. We consecutively enrolled 30 people living with dementia with their caregivers from their homes. We conducted in-depth interviews using a semi-structured interview guide. We did a thematic content analysis. RESULTS The themes under-reported behavioral impairment were; difficulty in personal care, physical inactivity, and impaired judgment. Under the social and cognitive impairment theme, there was the failure to be in social gatherings like church, community groups, and markets. Under the caregivers' role, their burden included managing behavioral, social, and cognitive impairments of PLWD. Although caregivers were committed to caring for PLWDs, this required sacrificing time at the expense of income-generating activities. CONCLUSIONS Dementia hinders the behavioral and social aspects of the affected people. Caregivers are highly burdened to care for PLWD. Strategies to minimize caregivers' burden while caring for people living with dementia are recommended.
Collapse
Affiliation(s)
- Innocent Arinaitwe
- Faculty of Medicine, Mbarara University of Science and technology, Mbarara, Mbarara, Uganda
| | - Christine K. Karungi
- Grants Administration and Management, Mbarara University of Science and technology, Mbarara, Uganda
| | - Abigail Gopez
- California University Science and Medicine, Colton, CA, USA
| | - Edith K. Wakida
- Grants Administration and Management, Mbarara University of Science and technology, Mbarara, Uganda
| | - Zohray M. Talib
- Department of Medical education, California University of Science and Medicine, Colton, California, USA
| | - Vincent Mubangizi
- Department of Family Medicine and Community Practice, Faculty of Medicine, Mbarara University of Science and technology, Mbarara, Mbarara, Uganda
| | - Celestino Obua
- Office of the Vice-Chancellor, Mbarara University of Science and technology, Mbarara, Uganda
| |
Collapse
|
3
|
Persson AC, Dahlberg L, Janeslätt G, Möller M, Löfgren M. Daily time management in dementia: qualitative interviews with persons with dementia and their significant others. BMC Geriatr 2023; 23:405. [PMID: 37400773 DOI: 10.1186/s12877-023-04032-8] [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: 01/24/2023] [Accepted: 05/10/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Persons with dementia encounter time-related problems and significant others often need to provide support in daily time management and use of time assistive technology (AT). Further research has been requested on how time AT for persons with dementia affects the situation of significant others. Moreover, there are a few previous qualitative studies on the experiences of time AT by persons with dementia. This study explores the experiences of persons with dementia and significant others in daily time management and their perceptions on how time AT affects everyday life. METHOD Semi-structured interviews with persons with mild to moderate dementia (n = 6) and significant others (n = 9) were conducted three months after receiving prescribed time AT. Interviews were analysed using qualitative content analysis. RESULTS A main category "Support by significant others is always part of daily time management", and three categories "Facing new challenges", "Using strategies to handle changes", and "Time assistive technology in daily life" illustrated that significant others provided support for daily time management in all phases of dementia. This support was often embedded in other kinds of support for emerging challenges. Support in time management was needed from an early stage in dementia, and responsibility for time management was gradually transferred to significant others. Time AT could support time orientation and were important for sharing the time management conducted by others but did not enable independent time management. CONCLUSIONS Time-related assessments and interventions should be offered at an early stage of dementia to increase the possibility of maintaining daily time management skills. Using time AT to communicate time might increase agency and participation in daily occupations for persons with dementia. Given the central role of significant others for daily time management, the society needs to adequately support persons with dementia lacking support from significant others.
Collapse
Affiliation(s)
- Ann-Christine Persson
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, 182 88, Stockholm, Sweden.
- Department of Rehabilitation Medicine, Danderyd University Hospital, Entrévägen 8, plan 2, 182 88, Stockholm, SE, Sweden.
| | - Lena Dahlberg
- School of Health and Welfare, Dalarna University, 791 88, Falun, Sweden
- Aging Research Center, Karolinska Institutet & Stockholm University, 18A, 171 65, Tomtebodavägen, Solna, Sweden
| | - Gunnel Janeslätt
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Center for Clinical Research in Dalarna, 791 29, Box 712, Falun, SE, Sweden
| | - Marika Möller
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, 182 88, Stockholm, Sweden
- Department of Rehabilitation Medicine, Danderyd University Hospital, Entrévägen 8, plan 2, 182 88, Stockholm, SE, Sweden
| | - Monika Löfgren
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, 182 88, Stockholm, Sweden
- Department of Rehabilitation Medicine, Danderyd University Hospital, Entrévägen 8, plan 2, 182 88, Stockholm, SE, Sweden
| |
Collapse
|
4
|
Persson A, Möller MC, Dahlberg L, Löfgren M, Janeslätt G. Assessing time processing ability and daily time management in persons with dementia: Psychometric properties of three instruments. Aust Occup Ther J 2023; 70:3-17. [PMID: 35769002 PMCID: PMC10084225 DOI: 10.1111/1440-1630.12827] [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: 12/14/2021] [Revised: 06/16/2022] [Accepted: 06/18/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Persons with dementia experience time-related problems, but there is a lack of instruments evaluating their time processing ability and daily time management. This study aimed to evaluate the psychometric properties of the instruments KaTid®-Senior measuring time processing ability, and Time-S© Senior and Time-Proxy© measuring daily time management for persons with dementia. METHODS Persons with dementia (n = 53) and their significant others (n = 49) participated in the study. Rasch analyses were used to evaluate the instruments' rating scale functioning; internal scale validity; person-response validity; unidimensionality; person-separation reliability; and internal consistency. Versions excluding items with poor fit to the Rasch model were also evaluated. RESULTS Overall, the Rasch analyses showed acceptable psychometric properties. All instruments met the criteria for unidimensionality and the reliability was good. More challenging items should be added in KaTid-Senior for better targeting of persons with mild dementia. Person-response validity issues in Time-S Senior need to be addressed. CONCLUSION The instruments can validly and reliably be used to assess time processing ability and daily time management in persons with dementia in clinical research and healthcare settings. In turn, this can contribute to the development of methods to compensate for impaired time processing ability and daily time management. The assessments can also increase the possibility of early detection of impaired time processing ability and daily time management, thereby facilitating adequate timing of interventions and enhanced occupational performance.
Collapse
Affiliation(s)
- Ann‐Christine Persson
- Department of Clinical Sciences, Danderyd HospitalKarolinska InstitutetStockholmSweden
- Department of Rehabilitation MedicineDanderyd University HospitalStockholmSweden
| | - Marika C. Möller
- Department of Clinical Sciences, Danderyd HospitalKarolinska InstitutetStockholmSweden
- Department of Rehabilitation MedicineDanderyd University HospitalStockholmSweden
| | - Lena Dahlberg
- School of Health and WelfareDalarna UniversityFalunSweden
- Aging Research CenterKarolinska Institutet & Stockholm UniversitySolnaSweden
| | - Monika Löfgren
- Department of Clinical Sciences, Danderyd HospitalKarolinska InstitutetStockholmSweden
- Department of Rehabilitation MedicineDanderyd University HospitalStockholmSweden
| | - Gunnel Janeslätt
- Department of Public Health and Caring SciencesDisability and Habilitation, Uppsala UniversityUppsalaSweden
- Center for Clinical Research in DalarnaFalunSweden
| |
Collapse
|
5
|
Persson AC, Janeslätt G, Dahlberg L, Löfgren M, Möller M. Associations between Time Processing Ability, Daily Time Management, and Dementia Severity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3928. [PMID: 35409618 PMCID: PMC8997539 DOI: 10.3390/ijerph19073928] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 12/04/2022]
Abstract
This study investigated associations between time processing ability (TPA), daily time management (DTM), and dementia severity. Persons with dementia (PwDs) (n = 53) and their significant others (n = 49) participated in this cross-sectional study. Bivariate analyses were used to investigate associations between TPA and DTM and the dementia severity. Linear regression models were used to further predict the contribution of the subtests in the Mini Mental State Examination (MMSE) for TPA results. The results showed significant correlations between TPA and dementia severity, where visuospatial functions were the most highly correlated. TPA also showed a significant correlation to proxy-rated DTM. In addition, proxy-rated DTM was significantly correlated with dementia severity and PwDs' own self-ratings of their DTM. Knowledge of the association between TPA, dementia severity, and visuospatial functions can enable early detection of TPA impairments. For a comprehensive assessment of TPA and DTM, objective measures should be used in combination with self-ratings and proxy-ratings. The findings can be used in clinical research and healthcare settings to develop methods to compensate for impaired TPA and support DTM in PwDs.
Collapse
Affiliation(s)
- Ann-Christine Persson
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, 18288 Stockholm, Sweden; (M.L.); (M.M.)
- Department of Rehabilitation Medicine, Danderyd University Hospital, 18288 Stockholm, Sweden
| | - Gunnel Janeslätt
- Department of Public Health and Caring Sciences, Uppsala University, 75105 Uppsala, Sweden; or
- Center for Clinical Research in Dalarna, Box 712, 79129 Falun, Sweden
| | - Lena Dahlberg
- School of Health and Welfare, Dalarna University, 79188 Falun, Sweden;
- Aging Research Center, Karolinska Institutet & Stockholm University, 17165 Solna, Sweden
| | - Monika Löfgren
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, 18288 Stockholm, Sweden; (M.L.); (M.M.)
- Department of Rehabilitation Medicine, Danderyd University Hospital, 18288 Stockholm, Sweden
| | - Marika Möller
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, 18288 Stockholm, Sweden; (M.L.); (M.M.)
- Department of Rehabilitation Medicine, Danderyd University Hospital, 18288 Stockholm, Sweden
| |
Collapse
|
6
|
Persson AC, Boman IL, Dahlberg L, Janeslätt G, Möller MC, Löfgren M. Lack of time and dependence on significant others: Occupational therapists´ experiences of prescribing time assistive technology for persons with dementia. Scand J Occup Ther 2020; 27:614-624. [PMID: 32356475 DOI: 10.1080/11038128.2020.1751875] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: There is lack of knowledge on how occupational therapists (OTs) assess daily time management (DTM) for persons with dementia (PwDs) and on which aspects affect prescription of time assistive technology (AT).Aim: To explore OTs' experiences of assessing the need for and prescribing time AT for PwDs.Material and methods: Focus group interviews with OTs that prescribe time AT for PwDs analyzed via qualitative content analysis.Results: A main category and four categories were identified. The categories illustrated a complex and time-consuming prescription process, which was facilitated if the PwD was supported by a significant other (SO). Support from a SO was especially important during implementation and follow-up. OTs had to take individual responsibility for staying informed about time AT. Organizational limitations and time constraints were barriers for OTs striving to work according to national prescription guidelines.Conclusions and significance: High demands are made on SO's participation during the prescription process. PwDs with no support from SOs are at risk not receiving or fully benefitting from time AT. To avoid inequalities, specific forms of support need to be developed and targeted at PwDs without SOs to ensure that they have sufficient opportunities to access and use time AT.
Collapse
Affiliation(s)
- Ann-Christine Persson
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Inga-Lill Boman
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Lena Dahlberg
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.,Aging Research Center, Karolinska Institutet, Stockholm University, Solna, Sweden
| | - Gunnel Janeslätt
- Department of Public Health and Caring Sciences, Disability and Habilitation, Uppsala University, Uppsala, Sweden.,Center for Clinical Research in Dalarna, Falun, Sweden
| | - Marika C Möller
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Monika Löfgren
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| |
Collapse
|
7
|
Sriram V, Jenkinson C, Peters M. Informal carers' experience of assistive technology use in dementia care at home: a systematic review. BMC Geriatr 2019; 19:160. [PMID: 31196003 PMCID: PMC6567448 DOI: 10.1186/s12877-019-1169-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/23/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Dementia is a health and care priority globally. Caring for persons with dementia is a challenge and can lead to negative psychological, physiological and financial consequences for informal carers. Advances in technology have the potential to assist persons with dementia and their carers, through assistive technology devices such as electronic medication dispensers, robotic devices trackers and motion detectors. However, little is known about carers' experience and the impact of these technologies on them. This review aims to investigate the outcomes and experience of carers of persons with dementia, who live at home and use assistive technology. METHODS A systematic search in seven databases and manual searches were carried out using pre-defined inclusion and exclusion criteria to identify studies on carers of persons with dementia involving the use of assistive technology. The search identified 56 publications with quantitative, qualitative and mixed-method designs. RESULTS The studies reported positive and negative findings and focused on a wide variety of assistive technology devices. There were large differences in the uses of assistive technology, outcome measures used and the quality of studies. Knowledge and acceptance, competence to use and ethical issues when using assistive technology were themes that emerged from the studies. Carers generally appreciated using assistive technology and their experience of use varied. CONCLUSIONS The intention of this systematic review is to list and classify the various types of assistive technology used by carers of persons with dementia and explores the positive and negative aspects, knowledge, acceptance and ethical issues in the use of assistive technology by carers of persons with dementia. We recommend the use of a standard and person-centred system of classifying and naming assistive technology devices and systems and for future research efforts in assistive technology to incorporate a family/carer centred model. SYSTEMATIC REVIEW REGISTRATION PROSPERO - CRD42017082268 .
Collapse
Affiliation(s)
- Vimal Sriram
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF UK
| | - Crispin Jenkinson
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF UK
| | - Michele Peters
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF UK
| |
Collapse
|