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Blackwell J, Ray M. Exploring the Lived Experiences of Physical Activity in Community-Dwelling Adults Living With Dementia and Their Carers. J Aging Phys Act 2024:1-8. [PMID: 38849122 DOI: 10.1123/japa.2023-0195] [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: 06/12/2023] [Revised: 03/22/2024] [Accepted: 03/28/2024] [Indexed: 06/09/2024]
Abstract
People living with dementia have the same right to well-being as anyone else, including physical activity. Yet, physical activity levels among people with dementia are lower than in the general population, and while the physical activity health benefits are well established, little is known about how people living with dementia experience physical activity. To explore these physical activity experiences, we visited six community settings in one English county and conducted informal interviews with 18 people who were either living with dementia and community dwelling (n = 4), caring for or who had cared for someone with dementia (n = 10), or providing a support service for people living with dementia and their carers (n = 4). Findings highlight both the challenges and facilitators presented by organized groups, service provider skills and qualities, and environmental factors. Additionally, these factors were influential in shaping the physical activity experience of people living with dementia. The findings may be relevant for people providing or planning support services, commissioners, policymakers, and researchers.
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Affiliation(s)
- Joanna Blackwell
- School of Health and Social Care, College of Health and Science, University of Lincoln, Lincoln, United Kingdom
| | - Mo Ray
- School of Health and Social Care, College of Health and Science, University of Lincoln, Lincoln, United Kingdom
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Mahomed A, Pretorius C. Giving voice to the voiceless: Understanding the perceived needs of dementia family carers in Soweto, a South African township. DEMENTIA 2024; 23:622-642. [PMID: 38354041 PMCID: PMC11059838 DOI: 10.1177/14713012241234155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
This qualitative study aimed to provide family caregivers with an independent platform to reflect on and identify their needs in the role of dementia caregiver. Thirty caregivers were interviewed using a semi-structured approach, and data analysis followed a reflective thematic analysis method. The study revealed that Black African caregivers in townships require sufficient information and orientation to dementia-specific services, psychoeducation on dementia as a disease and its behavioural manifestations, as well as practical skills to manage the disease process. Caregivers expressed the need for in-depth, accessible education to boost their confidence and resilience in handling the challenges of dementia caregiving. They also proposed community initiatives to raise awareness, promote knowledge, and facilitate early detection and diagnosis of dementia. Additional needs included informational and educational workshops, resources like transportation services and helplines, day care facilities, media campaigns, and collaboration with the government for funding and policy change. New caregivers were advised to seek comprehensive education, support, and services while preserving the dignity of their family members with dementia. Remarkably, the identified needs and community initiatives aligned with the priority areas outlined by ADI for a National Dementia Plan, which South Africa currently lacks. The study highlights the importance of developing a National Dementia Plan in South Africa through collaboration among stakeholders, including communities, policy-makers, and multidisciplinary healthcare teams, while ensuring that individuals and families affected by dementia have a voice.
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Affiliation(s)
- Aqeela Mahomed
- Department of Psychology, Stellenbosch University, South Africa
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Nam S, Eakman AM, Bae S, Hong I. Item-Level Psychometrics of the Meaningful Activity Participation Assessment (MAPA) Scale. Int J Aging Hum Dev 2023; 97:496-512. [PMID: 36560911 DOI: 10.1177/00914150221143956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study investigates the psychometric properties of the Meaningful Activity Participation Assessment-Meaning (MAPA-M) scale using the Rasch measurement model. For the psychometric properties of MAPA-M, principal component analysis, Rasch analysis, and differential item functioning analysis were conducted. Participants in this study were 480 older adults from the USC Well Elderly 2 study, recruited from 21 locations in the Los Angeles metropolitan area. There were eight items with DIF, but they were accepted because they assumed unidimensionality and showed good person invariance. The 25 items assuming unidimensionality of MAPA-M had values between 0.6 and 1.4 in infit and Outfit MnSq, and all ZSTD values were less than 2.0. The 25 items demonstrated a conceptual item-difficulty hierarchy. The person strata value was 2.68, which is equivalent to a reliability index value of .76. The findings indicate that the revised scale can accurately and reliably measure meaningful activities by older adults.
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Affiliation(s)
- Sanghun Nam
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju-si, Gangwon-do, Republic of Korea
| | - Aaron M Eakman
- Department of Occupational Therapy, Colorado State University, Fort Collins, Colorado, USA
| | - Suyeong Bae
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju-si, Gangwon-do, Republic of Korea
| | - Ickpyo Hong
- Department of Occupational Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju-si, Gangwon-do, Republic of Korea
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Gibson C, Yates M, Moore KJ. Lessons learnt from a community-driven digital social connection pilot program for people living with dementia: A qualitative interview study with key stakeholders. Aust J Rural Health 2023; 31:1229-1239. [PMID: 37837265 DOI: 10.1111/ajr.13052] [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: 11/09/2022] [Revised: 08/06/2023] [Accepted: 09/30/2023] [Indexed: 10/15/2023] Open
Abstract
INTRODUCTION In response to COVID-19 and mandated physical distancing, a new digital social connection program was developed and implemented by the local community in a large regional town in western Victoria, Australia. This pilot program, the Digital Inclusion-Social Connections (DI-SC) program, aimed to support people living with dementia to use a digital device to access social connection activities. OBJECTIVE The objective of this study is to inform the local community implementing the DI-SC program of key stakeholder experience of DI-SC process and outcomes to support future development and potential translation of digital social connections programs for people living with dementia. DESIGN Three semi-structured focus groups and two interviews were conducted with a total of fifteen participants. Data was transcribed verbatim and thematically analysed. FINDINGS Three main themes were identified describing factors as influencing the process and outcomes of the DI-SC program: understanding dementia; personal choice and control; and service planning and coordination. Six sub-themes were identified: matching capability; establishing a relationship; creating opportunities for different interactions; ownership of the device, program coordination and defining the volunteer digital mentor role. CONCLUSION Key stakeholders perceived the DI-SC program as an acceptable way of supporting people living with dementia to engage in activities they found enjoyable promoting social connection with care partners and others. DI-SC program outcomes were impacted by inappropriate training and a lack of program coordination. The findings of this study may inform future development and implementation of digital social connection programs for vulnerable populations at risk of social isolation.
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Affiliation(s)
- Caroline Gibson
- Grampians Health, Ballarat, Victoria, Australia
- University of Newcastle, Callaghan, New South Wales, Australia
| | - Mark Yates
- Grampians Health, Ballarat, Victoria, Australia
- Deakin University, Burwood, Victoria, Australia
| | - Kirsten J Moore
- Melbourne Ageing Research Collaboration, National Ageing Research Institute, Parkville, Victoria, Australia
- Medicine - Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
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Middleton LE, Pelletier CA, Koch M, Norman R, Dupuis S, Astell A, Giangregorio LM, Hart F, Heibein W, Hughes C, Johannesson C, Pearce B, Regan K, Rossignoli C, Andrew M, Pettersen JA, Freeman S. The dementia-inclusive choices in exercise project: Using participatory action research to improve physical activity supports for persons with dementia. DEMENTIA 2023; 22:1651-1676. [PMID: 37715689 DOI: 10.1177/14713012231197144] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Abstract
Persons with dementia have the right to equal inclusion in rehabilitation, including physical activity. However, the perspectives of persons with dementia are rarely integrated into decision-making related to physical activity programming, services, and supports. Here, we describe the participatory action research (PAR) approach used to develop the Dementia-Inclusive Choices for Exercise (DICE) toolkit, which aims to increase the quality and number of physical activity opportunities available to persons with dementia. The DICE Research Team included persons with dementia, a family care partner, exercise professionals, community and dementia service providers, health care professionals, and researchers who worked to: 1) Engage/maintain the Research Team; 2) Set/navigate ways of engagement; 3) Understand barriers to physical activity; 4) Prioritize the audience and actions; 5) Develop the toolkit; 6) Conduct usability testing; and 7) Implement and evaluate. Guided by the Behaviour Change Wheel, and informed by interviews, focus groups, and existing research, our PAR Team chose to prioritize training exercise providers; exercise providers can enable exercise for persons with dementia if they understand common changes with dementia and how to support persons with dementia in exercise. The content and format of the toolkit was co-developed: drafted by our Research Team, adapted through a stakeholder workshop, and refined through iterative development and usability testing. The product of our PAR process, the DICE toolkit, includes videos meant to destigmatize dementia, training modules and a training manual for exercise providers, a physical activity handout for persons with dementia, and wallet cards to help persons with dementia communicate their abilities, needs, and preferences. Our usability study indicated that the toolkit could be used by exercise providers and may improve attitudes about dementia. Our vision is that our co-developed DICE toolkit will empower exercise providers to improve physical activity opportunities and support for persons with dementia.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Kayla Regan
- University of Waterloo, Waterloo, ON, Canada
| | | | | | | | - Shannon Freeman
- University of Northern British Columbia, Prince George, BC, Canada
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Kemp CL, Bender AA, Morgan JC, Burgess EO, Epps FR, Hill AM, Perkins MM. Understanding Capacity and Optimizing Meaningful Engagement among Persons Living with Dementia. DEMENTIA 2023; 22:854-874. [PMID: 36913646 PMCID: PMC10789114 DOI: 10.1177/14713012231162713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
Meaningful engagement is a key dimension of quality of life among persons living with dementia, yet little is known about how to best to promote it. Guided by grounded theory methods, we present analysis of data collected over a 1-year period in four diverse assisted living (AL) communities as part of the study, "Meaningful Engagement and Quality of Life among Assisted Living Residents with Dementia." Our aims are to: (a) learn how meaningful engagement is negotiated among AL residents with dementia and their care partners; and (b) identify how to create these positive encounters. Researchers followed 33 residents and 100 care partners (formal and informal) and used participant observation, resident record review, and semi-structured interviews. Data analysis identified "engagement capacity" as central to the negotiation of meaningful engagement. We conclude that understanding and optimizing the engagement capacities of residents, care partners, care convoys, and settings, are essential to creating and enhancing meaningful engagement among persons living with dementia.
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Affiliation(s)
- Candace L. Kemp
- The Gerontology Institute, Georgia State University, Atlanta, GA
- Department of Sociology, Georgia State University, Atlanta, GA
| | - Alexis A. Bender
- Division of Geriatric & Gerontology, Emory School of Medicine, Atlanta, GA
| | - Jennifer Craft Morgan
- The Gerontology Institute, Georgia State University, Atlanta, GA
- Department of Sociology, Georgia State University, Atlanta, GA
- Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University, Atlanta, GA
| | - Elisabeth O. Burgess
- The Gerontology Institute, Georgia State University, Atlanta, GA
- Department of Sociology, Georgia State University, Atlanta, GA
| | - Fayron R. Epps
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA
| | | | - Molly M. Perkins
- Division of Geriatric & Gerontology, Emory School of Medicine, Atlanta, GA
- Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center (GRECC)
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Yous ML, Boamah SA, Hunter PV, Coker E, Hadjistavropoulos T, Sussman T, Kaasalainen S. Exploring the factors influencing meaningful engagement of persons living with advanced dementia through the Namaste Care Program: a qualitative descriptive study. Palliat Care Soc Pract 2023; 17:26323524231165319. [PMID: 37025503 PMCID: PMC10071147 DOI: 10.1177/26323524231165319] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 03/07/2023] [Indexed: 04/04/2023] Open
Abstract
Background: Meaningful engagement has been described as active participation based on a person’s interests, preferences, personhood, or perceived value. It has many benefits for persons living with dementia in long-term care (LTC) homes, including improvement in physical and cognitive function, and mental health. People with advanced dementia continue to need and benefit from inclusion and social contact in LTC, yet there is not a well-developed understanding of how to support this. A tailored intervention called Namaste Care has been shown to be an effective approach to meaningfully engage residents in LTC, decrease behavioral symptoms, and improve their comfort and quality of life. There is a need to consider how best to deliver this intervention. Objective: The aim of this study was to describe environmental, social, and sensory factors influencing meaningful engagement of persons with advanced dementia during Namaste Care implementation in LTC. Methods: In this qualitative descriptive study, focus groups and interviews were conducted with families, volunteers, staff, and managers at two LTC homes. Directed content analysis was conducted. The Comprehensive Process Model of Engagement was used as a coding framework. Results: With respect to environmental attributes, participants emphasized that a designated quiet space and a small group format were helpful for engagement. In terms of social attributes, participants emphasized Namaste Care staff capacity to deliver individualized care. Regarding sensorial factors, familiarity with the activities delivered in the program was emphasized. Conclusion: Findings reveal the need to offer small group programs that include adapted recreational and stimulating activities, such as Namaste Care, for residents at the end of life in LTC. Such programs facilitate meaningful engagement for persons with dementia as they focus on individual preferences, comfort, and inclusion while recognizing changing needs and abilities of residents.
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Affiliation(s)
- Marie-Lee Yous
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - Sheila A. Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Paulette V. Hunter
- Department of Psychology, St. Thomas More College, University of Saskatchewan, Saskatoon, SK, Canada
| | - Esther Coker
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- St. Peter’s Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Thomas Hadjistavropoulos
- Department of Psychology and Centre on Aging and Health, University of Regina, Regina, SK, Canada
| | - Tamara Sussman
- School of Social Work, McGill University, Montreal, QC, Canada
| | - Sharon Kaasalainen
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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Yous ML, Ploeg J, Kaasalainen S, McAiney C. Experiences of caregivers of community-dwelling older persons with moderate to advanced dementia in adapting the Namaste Care program: a qualitative descriptive study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:61. [PMID: 36371288 PMCID: PMC9655803 DOI: 10.1186/s40900-022-00401-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Globally many older persons with dementia are living at home to maintain independence within the community. As older persons with dementia transition from early to moderate or advanced stages of dementia they require more support from family members and friends to complete their daily activities. Family and friend caregivers, however, often report a lack of preparation for their caregiving role. There are few psychosocial programs that can be delivered by caregivers of community-dwelling older persons with moderate to advanced dementia. Namaste Care is a psychosocial intervention, predominantly used in long-term care, to improve the quality of life of persons with advanced dementia. Namaste Care provides multisensory stimulation for persons with dementia through meaningful activities such as music, massage, aromatherapy, and nutrition. There have been limited attempts at adapting Namaste Care for use by caregivers in the community.There is a need to involve caregivers in adapting programs and understanding their experiences in research involvement so that strategies can be put in place for a positive experience. The purpose of this study is to explore the experiences of caregivers who participated in workshop sessions to adapt Namaste Care for community-dwelling older persons with moderate to advanced dementia. METHODS A qualitative descriptive design was used. Six caregivers residing in Ontario, Canada attended virtual workshop sessions (i.e., by phone or videoconference) that were guided by the Strategy for Patient-Oriented Research (SPOR) Patient Engagement Framework. Caregivers completed individual post-workshop interviews. Experiential thematic analysis was used to analyze interviews and post-interview researcher notes. RESULTS Key findings were that caregivers had a positive experience in adapting Namaste Care by learning how to improve their caregiving skills and being supported to engage in research through multiple facilitators such as flexible scheduling and an inclusive and respectful environment. Having designated time for discussions between caregivers was perceived as important to forming partnerships within the group to support co-creation of knowledge. CONCLUSION Findings support the need to improve caregiver research engagement processes by ensuring that caregivers can benefit through learning opportunities and discussions and empowering caregivers to value their contributions in adapting interventions.
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Affiliation(s)
- Marie-Lee Yous
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Jenny Ploeg
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Sharon Kaasalainen
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Carrie McAiney
- Schlegel-UW Research Institute for Aging, School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada
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Sun W, Bartfay E, Smye V, Biswas S, Newton D, Pepin M, Ashtarieh B. Living well with dementia: The role volunteer-based social recreational programs in promoting social connectedness of people with dementia and their caregivers. Aging Ment Health 2022; 26:1949-1962. [PMID: 34353187 DOI: 10.1080/13607863.2021.1950614] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objectives: This evaluation study was designed to examine the factors that contribute the promotion of social connectedness among people with dementia and their caregivers through social recreational programs; develop an understanding of volunteer's impact on program success; and identify the barriers and facilitators to improve the volunteer-based programs to promote social connectedness.Method: A qualitative descriptive research design was used to explore the study participants' lived experiences of social recreational programs from Alzheimer's Society of Durham Region (ASDR) in Ontario, Canada. A final sample of 31 participants was recruited including people with dementia, informal caregivers, and community volunteers. Qualitative data was collected through face-to-face semi-structured interviews. Emerging themes were derived from the qualitative descriptive data using thematic analysis.Results: The qualitative interviews highlighted the impact of social recreational programs on people with dementia, caregivers and volunteers in the promotion of social connectedness, as well as the examination of barriers and facilitators to identify opportunities for the future improvement of ASDR programs that would benefit the dementia populations. The study findings revealed that the project 'Living Well with Dementia' has been able to successfully foster social connectedness through its volunteer-led social recreational programs by promoting the physical and mental well-being of people with dementia and their caregivers.Conclusion: Our study findings underscored the critical roles of volunteers who contributed to the success of community-based programs. Future research is needed to identify the opportunities to address current gaps in services and to strengthen the social recreational programs using evidence-based practices and client-centered approaches.Supplemental data for this article can be accessed online at http://doi.org/10.1080/13607863.2021.1950614.
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Affiliation(s)
- Winnie Sun
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Emma Bartfay
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Victoria Smye
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, Canada
| | - Srija Biswas
- Master of Science in Community, Public and Population Health, Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | | | | | - Bahar Ashtarieh
- Bachelor of Science in Nursing, Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
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Measurement of Social Strain in People with Dementia: A Preliminary Study of the Reliability and Validity of the Negative Relationship Quality Questionnaire in Indonesia. Geriatrics (Basel) 2022; 7:geriatrics7050099. [PMID: 36136808 PMCID: PMC9498758 DOI: 10.3390/geriatrics7050099] [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: 08/04/2022] [Revised: 09/14/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
People with dementia (PWD) may exhibit symptoms that negatively affect their relationships with their families or friends which could cause social strain. The Negative Relationship Quality (NRQ) questionnaire can be used to measure social strain in PWD. There has never been an Indonesian adaptation of the NRQ. This preliminary study aimed to measure the validity and reliability of the NRQ among PWD in Indonesia (NRQ-INA). This study used a cross-sectional design. Forward−backward translation methods were conducted first. Pearson’s correlation and factor analysis were employed for the validity test. Cronbach’s alpha and test−retest were used to determine reliability. The NRQ-INA has four parallel items related to social strain that are divided into three subscales and asked to spouse/partner, family members, and friends, leading to a total of 12 questions. The results of validity testing from 60 respondents showed that all items in the NRQ-INA were strongly valid with correlation coefficients (r) of >0.8 (p < 0.01). Factor analysis showed a convergence with the variance explained of more than 50% for all items in each subscale, which also indicated that NRQ-INA had acceptable construct validity to measure social strain. Cronbach’s alpha values (α) were 0.926, 0.942, and 0.938 for the subscales of spouse, friends, and family members, respectively. The correlations of test−retest reliability for all items were >0.7 (p < 0.01), demonstrating a reliable NRQ-INA measurement. In conclusion, NRQ-INA had a good validity and reliability to measure social strain in PWD. Further study of the concurrent validity among PWD is still needed.
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Wang AH, Newman K, Martin LS, Lapum J. Beyond instrumental support: Mobile application use by family caregivers of persons living with dementia. DEMENTIA 2022; 21:1488-1510. [PMID: 35414298 PMCID: PMC9237854 DOI: 10.1177/14713012211073440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
In recent years, there has been a rapid increase in technology use in dementia caregiving, particularly the use of mobile applications (apps) which are highly accessible, cost-effective and intuitive. Yet, little is known about the experiences of family caregivers of persons living with dementia who use apps to support caregiving activities. This is of particular concern given that limited understandings of the user experience in designing technology have often led to end-users experiencing barriers in technology adoption and use. Using a qualitative descriptive approach, the purpose of the study was to explore the experiences of family caregivers of persons living with dementia on using apps in their caregiving roles. A purposive sample of five family caregivers in Ontario, Canada participated in two interviews each, with the second interview informed by photo-elicitation methods. Thematic analysis of the collected data revealed a central overarching theme, Connecting to support through apps in my, your and our lives, which explicated how apps played an important role in the lives of the caregiver, the care recipient and both together as a dyad. Three core themes also emerged: Adapting apps to meet individual needs of the dyad, Minimising the impact of the condition on the person and the family and Determining the effectiveness of apps. The findings highlighted that the value of apps extends beyond their mere functionality and their ability to help with care provision as they are also able to promote richer interpersonal connections, enhance personhood and sustain family routines. This research advances our understanding of the impact of app use in caregiving and provides direction for future research, policy, education, practice and app development.
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Affiliation(s)
- Angel H Wang
- Daphne Cockwell School of Nursing, 7984Ryerson University, Toronto, Ontario M5B 2K3, Canada
| | - Kristine Newman
- Daphne Cockwell School of Nursing, 7984Ryerson University, Toronto, Ontario M5B 2K3, Canada
| | - Lori Schindel Martin
- Daphne Cockwell School of Nursing, 7984Ryerson University, Toronto, Ontario M5B 2K3, Canada
| | - Jennifer Lapum
- Daphne Cockwell School of Nursing, 7984Ryerson University, Toronto, Ontario M5B 2K3, Canada
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12
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Motealleh P, Moyle W, Jones C, Dupre K. The Impact of a Dementia-Friendly Garden Design on People With Dementia in a Residential Aged Care Facility: A Case Study. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 15:196-218. [PMID: 34911368 DOI: 10.1177/19375867211063489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is a paucity of evidence on the efficacy of garden design based on dementia-friendly environment (DFE) characteristics on the level of agitation, apathy, and engagement of people with dementia in residential aged care facilities (RACFs). OBJECTIVE To investigate the effect of a garden improved according to DFE characteristics on agitation, apathy, and engagement of people with dementia in one RACF. METHODS A case study design with a mixed-method approach was used. RESULTS There was no significant improvement in the level of participants' agitation following visits to the improved garden, χ2(2) = 5.167, p = .076. A high level of engagement was found in participants during the intervention (Week 1-1, p < .01; Week 1-2, p < .01; Week 2, p < .01; Week 3, p < .05; and Week 4, p < .05) when compared to before intervention (Week 0). A higher level of apathy was found in participants at Week 0 when compared to during the intervention (Week 1-1, p < .05; Week 1-2, p < .01; Week 2, p < .05; Week 3, p < .01; and Week 4, p < .01). Five themes emerged from participant interviews: the presence of sensory-provoking elements in the garden, meaningful engagement in the garden, accessibility of the garden, garden impacts, and garden experiences that demonstrated the effectiveness of the garden. CONCLUSIONS The garden promoted engagement and decreased apathy of people with dementia living in the RACF with the researcher's partial facilitation of the intervention sessions. The qualitative findings indicated the effectiveness of the garden in reducing agitation.
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Affiliation(s)
- Parinaz Motealleh
- School of Nursing and Midwifery, Griffith University, Nathan Campus, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Wendy Moyle
- School of Nursing and Midwifery, Griffith University, Nathan Campus, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Cindy Jones
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.,Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Karine Dupre
- School of Engineering and Built Environment, Griffith Architecture and Design, Gold Coast Campus, Queensland, Australia
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Yang Y, Kwan RYC, Zhai HM, Xu XY, Huang CX, Liang SJ, Liu J. The association among apathy, leisure activity participation, and severity of dementia in nursing home residents with Alzheimer's disease: A cross-sectional study. Geriatr Nurs 2021; 42:1373-1378. [PMID: 34583236 DOI: 10.1016/j.gerinurse.2021.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to examine 1) the relationship between apathy and leisure activity participation in nursing home residents with Alzheimer disease (AD) and 2) the moderator effect of the severity of dementia on this relationship. Data were collected from 290 residents with AD using the Apathy Evaluation Scale-informant version (AES-I), Leisure Activities Questionnaire (LAQ), and Clinical Dementia Rating scale (CDR). The multiple linear regression model showed that leisure activity participation (β=-0.452, p<0.001) was negatively associated with apathy, while the severity of dementia (β=0.515, p<0.001) was positively associated with apathy. The severity of dementia moderated the effect of leisure activity participation on apathy (β=-0.108, p=0.015). The results indicate that the effects of leisure activity participation on apathy diminish with the aggravation of AD. The severity of dementia should be considered when designing and delivering leisure activity interventions to manage apathy in nursing home residents with AD.
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Affiliation(s)
- Yi Yang
- Department of Nursing, Medical School, Taizhou University, Taizhou, Zhejiang, China
| | - Rick Y C Kwan
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hui-Min Zhai
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China;.
| | - Xin-Yi Xu
- School of Nursing, Hebei Medical University, China
| | - Chuang-Xia Huang
- Obstetrics Department, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Si-Jing Liang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Juan Liu
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
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14
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Electronic interventions aimed at increasing self-worth in mild dementia may not be feasible. J Am Assoc Nurse Pract 2021; 33:5-10. [PMID: 31453826 DOI: 10.1097/jxx.0000000000000280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 06/13/2019] [Indexed: 11/26/2022]
Abstract
ABSTRACT Alzheimer disease (AD) is a devastating diagnosis. Milieu therapy and memory activities have been shown to improve self-worth and improve mood in AD patients, but adherence to these activities is challenging. This prospective randomized pilot study examined adherence to memory recall activities using positive reinforcement and explored the impact on self-worth and depression. Pretest-posttest scores and data abstraction were used to measure protocol adherence, self-worth (Rosenberg Self-Esteem Scale), cognitive decline (Mini-Mental Status Examination), and symptoms of depression (Geriatric Depression Scale). Among 22 mild AD participants, there were no statistically significant differences in pretest versus posttest scores for all measures. The results suggest that the intervention of memory recall did not enhance self-worth, improve the status of memory recall, or lower symptoms of depression. Additionally, positive reinforcement did not play a role in adherence to accessing the tasks.
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15
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Quail Z, Bolton L, Massey K. Digital delivery of non-pharmacological intervention programmes for people living with dementia during the COVID-19 pandemic. BMJ Case Rep 2021; 14:e242550. [PMID: 34140328 PMCID: PMC8212172 DOI: 10.1136/bcr-2021-242550] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 01/10/2023] Open
Abstract
The COVID-19 pandemic significantly impeded face-to-face health and social care delivery for people living with dementia and their carers. Interruption of meaningful activity engagement along with increased social isolation is known to be associated with loss of skills, increased loneliness, physical deterioration and decline in cognition and mood in people with dementia. To ensure continuity of care for people living with dementia, for whom multimodal, non-pharmacological intervention programmes were being provided, there was an urgent need to adopt a remote delivery model. Guidance on digitally delivered assessment and care specific to non-pharmacological interventions for dementia is lacking. Adoption of technology-enabled care for people with dementia requires overcoming barriers to technology use, adaptation of therapeutic guidelines, adaptation of communication methods and carer support. Despite these challenges, therapists successfully transitioned from in-person to digital delivery of therapeutic interventions with associated benefits of continued meaningful activity engagement discussed.
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Affiliation(s)
- Zara Quail
- Care Visions Healthy Ageing, Care Visions Limited, Stirling, UK
| | - Laura Bolton
- Care Visions Healthy Ageing, Care Visions Limited, Stirling, UK
| | - Karina Massey
- Care Visions Healthy Ageing, Care Visions Limited, Stirling, UK
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16
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Strick K, Abbott R, Thompson Coon J, Garside R. Meta-ethnography of the purpose of meaningful occupation for people living with dementia. Int J Older People Nurs 2021; 16:e12391. [PMID: 34075707 DOI: 10.1111/opn.12391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Guidance on provision of care for people with dementia states that occupation people find meaningful is essential for well-being; however, definitions of 'meaningful occupation' are often broad, with intrinsic meaning coming from within the person rather than the activity, leading to an inconsistent understanding of its purpose. OBJECTIVES This study aimed to create a conceptual framework depicting the types of meaning that are seen as stemming from occupation. METHOD Six electronic databases were searched (CINAHL, PubMed Central, PsycINFO, Embase, AMED, ASSIA) using a pre-specified search strategy to identify qualitative studies relating to meaningful occupation for people living with dementia. From 114 eligible full-text articles, six qualitative studies were identified as sufficiently rich, topically relevant and explicit in their definition of meaningful activity. A further 14 were purposefully sampled for their ability to refute or advance the emerging conceptual framework. The synthesis is based on meta-ethnography and is reported following eMERGe guidance. RESULTS We found the fundamental purpose of occupation is to support the person living with dementia to feel they are living a meaningful and fulfilling life. Three overlapping concepts were identified: (i) catalytic environment, (ii) meaningful life and (iii) occupation as a tool. CONCLUSION The framework proposes how occupation could support meaning in multiple ways and considers how these forms of meaning were influenced by the worldviews and values of the individual, and context in which they were experienced. IMPLICATIONS FOR PRACTICE The conceptual framework offers a consistent theoretical grounding with which to measure effectiveness of meaningful occupation for people living with dementia.
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Affiliation(s)
- Katherine Strick
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Rebecca Abbott
- Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and Health, University of Exeter, Exeter, UK
| | - Jo Thompson Coon
- Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and Health, University of Exeter, Exeter, UK
| | - Ruth Garside
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Exeter, UK
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17
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Bechard LE, McDougall A, Mitchell C, Regan K, Bergelt M, Dupuis S, Giangregorio L, Freeman S, Middleton LE. Dementia- and mild cognitive impairment-inclusive exercise: Perceptions, experiences, and needs of community exercise providers. PLoS One 2020; 15:e0238187. [PMID: 32898193 PMCID: PMC7478809 DOI: 10.1371/journal.pone.0238187] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/11/2020] [Indexed: 01/05/2023] Open
Abstract
PURPOSE For persons who are at risk for, or living with, dementia exercise is recommended, yet many become or remain inactive. Exercise providers play a vital role in promoting and facilitating exercise in these groups by recognizing and being responsive to the needs of persons with mild cognitive impairment (MCI) or dementia in exercise programming. The objective of this study was to explore the experiences, perceptions, and needs of community exercise providers regarding dementia. MATERIALS & METHODS Five focus groups were held with community exercise providers (n = 30) who deliver exercise to older adults (≥55 years) in municipal, non-profit, for profit, or academic settings. RESULTS Three themes were developed: (1) Unique experiences and diverse perceptions: suggests unique personal experiences with MCI and dementia inform distinct perceptions of dementia; (2) Dementia-Inclusive Practices: learning as you go and adapting for the individual: reflects exercise providers' approaches to recognizing and accommodating individuals' unique abilities and preferences; (3) Training and Best Practices, with Flexibility: identifies exercise providers' desires for MCI- and dementia-specific knowledge and training strategies, which need to recognize dementia heterogeneity between and within persons over time. CONCLUSIONS These findings highlight a willingness of exercise providers to support dementia-inclusive exercise, but recognize they have minimal training and lack educational resources to do so. Formal training resources may enhance exercise accessibility and participation for persons with MCI or dementia.
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Affiliation(s)
- Lauren E. Bechard
- Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Waterloo, Ontario, Canada
- * E-mail:
| | - Aidan McDougall
- Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Waterloo, Ontario, Canada
| | - Cheyenne Mitchell
- Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Waterloo, Ontario, Canada
| | - Kayla Regan
- Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Waterloo, Ontario, Canada
| | - Maximillian Bergelt
- Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Waterloo, Ontario, Canada
| | - Sherry Dupuis
- Department of Recreation and Leisure Studies, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Waterloo, Ontario, Canada
| | - Lora Giangregorio
- Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Waterloo, Ontario, Canada
| | - Shannon Freeman
- University of Northern British Columbia School of Nursing, Prince George, British Columbia, Canada
| | - Laura E. Middleton
- Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Waterloo, Ontario, Canada
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18
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Kielsgaard K, Horghagen S, Nielsen D, Kristensen HK. Approaches to engaging people with dementia in meaningful occupations in institutional settings: A scoping review. Scand J Occup Ther 2020; 28:329-347. [PMID: 32776817 DOI: 10.1080/11038128.2020.1791952] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND People with dementia in institutional settings lack engagement in meaningful occupations, which may cause decreased quality of life. Although many researchers and professionals have proposed approaches to engage people with dementia in these occupations, an overview seems to be missing. AIM This scoping review provides an overview by categorizing and describing the characteristics of the approaches. MATERIAL AND METHOD A thorough literature search in nine databases identified the studies on approaches. We included 54 studies, and extracted bibliometric data. A content analysis revealed the characteristics of the approaches. RESULTS Four categories of approaches were uncovered. First, the literature defined the concept of meaningful occupation in various ways. Second, a category of approaches provided theoretical knowledge of meaningful occupations. The third category focussed on specific themes, such as certain methods. The final described comprehensive multilevel approaches. CONCLUSION This review contributes to knowledge of the diversity of approaches to engage people with dementia in meaningful occupation within institutional settings. SIGNIFICANCE We suggest that occupational therapy researchers and practitioners consider how the concept of meaningful occupation is embedded in the theoretical landscape. Furthermore, activity programming requires reflexive decision-making at the policy and practice level, as engagement in meaningful occupations is complex.
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Affiliation(s)
- Kamilla Kielsgaard
- Unit of Rehabilitation, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Nursing and Occupational Therapy, UCL University College, Odense, Denmark
| | - Sissel Horghagen
- Unit of Rehabilitation, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Occupational Therapy, NTNU, Faculty of Medicine and Health Science, Trondheim, Norway
| | - Dorthe Nielsen
- Center for Global Health, University of Southern Denmark, Odense, Denmark.,Health Sciences Research Centre, UCL University College, Odense, Denmark.,Migrant Health Clinic, Odense University Hospital, Odense, Denmark
| | - Hanne Kaae Kristensen
- Unit of Rehabilitation, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Health Sciences Research Centre, UCL University College, Odense, Denmark
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19
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Wang J, Corazzini KN, McConnell ES, Ding D, Xu H, Wei S, Wu B. Living With Cognitive Impairment in China: Exploring Dyadic Experiences Through a Person-Centered Care Lens. Res Aging 2020; 43:177-187. [PMID: 32677553 DOI: 10.1177/0164027520935597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
China has experienced a substantial increase in the number of older adults with dementia and milder forms of cognitive impairment. Being spouses of Persons with cognitive impairment (PWCI) and living with them for several decades does not necessarily mean that it is easier for them to provide person-centered care and maintain a valued and healthy relationship. The current study explored how elements of PCC, as operationalized by the Senses Framework, operate or fail to operate in the dyadic experiences of PWCI and their spousal care partners within the socio-cultural context of China. Our findings suggest that PWCI and their spouses experience the six senses through the person-centeredness in their daily interactions with each other. It also indicated successes and challenges to being person-centered early in the disease and identified their unmet needs as well as barriers and facilitators to improve their well-being.
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Affiliation(s)
- Jing Wang
- 3065Fudan University, China.,3065Duke University School of Nursing, USA
| | | | - Eleanor S McConnell
- 3065Duke University School of Nursing, USA.,Department of Veterans Affairs, Geriatric Research, Education and Clinical Center (GRECC), Durham, North Carolina, USA
| | - Ding Ding
- Institute of Neurology, 159397Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Hanzhang Xu
- 3065Duke University School of Nursing, USA.,Department of Family Medicine and Community Health, Duke University School of Medicine, North Carolina, USA
| | - Sijia Wei
- 3065Duke University School of Nursing, USA
| | - Bei Wu
- Rory Meyers College of Nursing, 5894New York University, NY, USA.,NYU Aging Incubator, New York, NY, USA
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20
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Tierney L, Beattie E. Enjoyable, engaging and individualised: A concept analysis of meaningful activity for older adults with dementia. Int J Older People Nurs 2020; 15:e12306. [PMID: 32022414 DOI: 10.1111/opn.12306] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 11/22/2019] [Accepted: 01/03/2020] [Indexed: 11/28/2022]
Abstract
AIM The term "meaningful activity" is widely used in policy, practice and the research literature. However, definition and use of the term is unclear and inconsistent. A concept analysis was conducted to explore the fundamental attributes that make an activity meaningful for older adults with dementia and propose a conceptual model for understanding "meaningful activity" in this population. METHODS This study followed Walker and Avant's method of concept analysis. Searches were conducted in the Scopus, MEDLINE, CINAHL, PubMed, Academic Search Elite and Web of Science databases for literature using the term "meaningful activity." Papers published before 1996 were excluded. RESULTS Twenty-nine papers concerned with "meaningful activity" were analysed. This analysis identified five attributes that make activities meaningful for people with dementia: (a) enjoyable; (b) suited to the individual's skills, abilities and preferences; (c) related to personally relevant goals; (d) engaging; and (e) related to an aspect of identity. The conceptual model illustrates how individual and opportunity factors influence participation in "meaningful activity" and the consequences of this participation as discussed in the existing literature. CONCLUSION The findings of this concept analysis provide insight into what characteristics make an activity meaningful. Specific activities that are meaningful are different for each person and participation in personally 'meaningful activities' has the potential to positively impact the lives of people with dementia. IMPLICATIONS FOR PRACTICE This understanding of 'meaningful activity' can be used by those involved in research, planning or delivery of services and care for people with dementia to encourage and support participation in activities that are meaningful to individuals.
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Affiliation(s)
- Laura Tierney
- Queensland University of Technology, Brisbane, Qld, Australia
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21
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Birt L, Griffiths R, Charlesworth G, Higgs P, Orrell M, Leung P, Poland F. Maintaining Social Connections in Dementia: A Qualitative Synthesis. QUALITATIVE HEALTH RESEARCH 2020; 30:23-42. [PMID: 31550999 DOI: 10.1177/1049732319874782] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The clinical symptoms of dementia include difficulty with speech, poor short-term memory, and changes in behavior. These symptoms can affect how the person with dementia understands and performs in social interactions. This qualitative review investigated how people with mild to moderate dementia managed social connections. A systematic search of social science databases retrieved 13 articles; data were synthesized using thematic analysis. Results established the work undertaken by people with dementia to maintain and present a social persona seen as socially acceptable. Interpretations are contextualized within Goffman and Sabat's theories on "self." People with dementia were agentic in impression management: undertaking work to maintain recognized social roles, while being aware of when their illness led to others discrediting them. Wider recognition of strategies used to maintain a social self could inform interventions designed to increase capability and confidence in co-managing social connections following dementia diagnosis.
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Affiliation(s)
- Linda Birt
- University of East Anglia, Norwich, United Kingdom
| | | | - Georgina Charlesworth
- University College London, London, United Kingdom
- North East London NHS Foundation Trust, London, United Kingdom
| | - Paul Higgs
- University College London, London, United Kingdom
| | - Martin Orrell
- University of Nottingham, Nottingham, United Kingdom
| | - Phuong Leung
- University College London, London, United Kingdom
| | - Fiona Poland
- University of East Anglia, Norwich, United Kingdom
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22
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A Community Respite Ministry/University Partnership Creates Meaningful Elder-Care Experiences. J Christ Nurs 2020; 37:E4-E8. [DOI: 10.1097/cnj.0000000000000690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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23
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Han Y, Jia J, Li X, Lv Y, Sun X, Wang S, Wang Y, Wang Z, Zhang J, Zhou J, Zhou Y. Expert Consensus on the Care and Management of Patients with Cognitive Impairment in China. Neurosci Bull 2019; 36:307-320. [PMID: 31792911 DOI: 10.1007/s12264-019-00444-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 07/25/2019] [Indexed: 12/14/2022] Open
Abstract
The cognitive disease consensus was prepared by panels of health and public representatives based on actual clinical practice in Geriatric Departments in Chinese hospitals and a systematic literature review. This consensus reflects the medical knowledge accumulated by those experts and provides information about professional medical care and advice. A multidisciplinary panel of specialists (neurologists, psychiatrists, and nursing specialists) reports an expert consensus on the medical knowledge accumulated from those experts and provides information about professional medical care and advice. The recommendations focus on the care and management of older adults with mild cognitive impairment, the objectives and methods of maintaining cognition and training, the assessments and measures of daily care for patients at different stages of dementia, the assessments and coping strategies for the behavioral and psychological symptoms of dementia, principles and suggestions for an appropriate living environment, arrangements for recreational activities, the care and management of patients with end-stage dementia, and suggestions for addressing stress in caregivers.
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Affiliation(s)
| | - Yuliang Han
- The 305 Hospital of People's Liberation Army, Beijing, 100017, China
| | - Jianjun Jia
- The Second Medical Center, People's Liberation Army (PLA) General Hospital, Beijing, 100853, China.
| | - Xia Li
- Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai, 200030, China
| | - Yang Lv
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, 630014, China
| | - Xuan Sun
- The Second Medical Center, PLA General Hospital, Beijing, 100853, China
| | - Shanshan Wang
- The Second Medical Center, PLA General Hospital, Beijing, 100853, China
| | - Yongjun Wang
- Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen, 518020, China
| | - Zhiwen Wang
- Peking University School of Nursing, Beijing, 100191, China
| | - Jintao Zhang
- The 960th Hospital of People's Liberation Army, Taian, 271000, China
| | - Jiong Zhou
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Yuying Zhou
- HuanHu Hospital of Nankai University, Tianjin, 300350, China
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24
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Polenick CA, Sherman CW, Birditt KS, Zarit SH, Kales HC. Purpose in Life Among Family Care Partners Managing Dementia: Links to Caregiving Gains. THE GERONTOLOGIST 2019; 59:e424-e432. [PMID: 29873736 PMCID: PMC6857691 DOI: 10.1093/geront/gny063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Purpose in life is associated with better health and has been found to minimize caregiving stress. Greater purpose may also promote caregiving gains (i.e., rewards or uplifts from providing care), yet the implications of purpose for positive aspects of the care role are largely unknown. The present study determined how perceptions of purpose in life among persons with dementia (PWDs) and their family caregivers are linked to caregiving gains. RESEARCH DESIGN AND METHODS This cross-sectional study examined 153 co-resident family caregivers drawn from the 2011 National Health and Aging Trends Study and National Study of Caregiving. Linear regressions were estimated to evaluate associations between caregivers' and PWDs' reports of their own purpose in life and caregivers' perceived caregiving gains, along with whether these associations vary by caregiver gender. Models controlled for caregivers' sociodemographic characteristics, relationship to the PWD, care tasks, role overload, negative caregiving relationship quality, and both care partners' chronic health conditions. RESULTS Caregivers' higher purpose in life was significantly linked to greater caregiving gains. Beyond this association, PWDs' higher purpose in life was significantly associated with greater caregiving gains for women but not for men. DISCUSSION AND IMPLICATIONS Purpose in life is a psychological resource that contributes to positive caregiving outcomes. Interventions to improve caregiver well-being could benefit from strategies that strengthen and maintain feelings of purpose among caregivers and PWDs.
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Affiliation(s)
- Courtney A Polenick
- Department of Psychiatry, University of Michigan, Ann Arbor
- Program for Positive Aging, University of Michigan, Ann Arbor
| | | | - Kira S Birditt
- Institute for Social Research, University of Michigan, Ann Arbor
| | - Steven H Zarit
- Department of Human Development and Family Studies, Pennsylvania State University, University Park
| | - Helen C Kales
- Department of Psychiatry, University of Michigan, Ann Arbor
- Program for Positive Aging, University of Michigan, Ann Arbor
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
- HSR&D Center for Clinical Management Research (CCMR), Department of Veterans Affairs, Ann Arbor, Michigan
- Geriatric Research, Education and Clinical Center (GRECC), VA Ann Arbor Healthcare System, Michigan
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25
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Exploring the ‘active mechanisms’ for engaging rural-dwelling older men with dementia in a community technological initiative. AGEING & SOCIETY 2019. [DOI: 10.1017/s0144686x19000357] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractResearch has suggested ecopsychosocial initiatives can promote a sense of wellbeing and inclusion in people with dementia. However, few studies have elucidated the ‘active mechanisms’ whereby such initiatives can achieve these outcomes, so hindering their generalisability. This is particularly pertinent when seeking to support community-dwelling older men with dementia who are reluctant to engage with traditional health and social care initiatives. This paper reports on a study that drew from the principles of Participatory Action Research to explore the ‘active mechanisms’ of a technological initiative for older men (65+ years) with dementia in rural England. An individually tailored, male-only initiative, using off-the-shelf computer game technology (e.g. iPad, Nintendo Wii and Microsoft Kinect) was delivered over a nine-week period. Multiple qualitative methods were employed, including: focus groups, open interviews and extensive reflective field notes, to gather data from the perspective of 22 men, 15 care partners and five community volunteers. The data were analysed thematically and interpreted using a masculinity lens. Three mechanisms contributed to the initiative's success: the use of the technology, the male-only environment and the empowering approach adopted. The paper argues that initiatives aimed at community-dwelling older men with dementia would be advised to consider these gendered experiences and ensure participants can maximise their masculine capital when participating in them, by providing enabling activities, non-threatening environments and empowering approaches of delivery.
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26
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Skinner MW, Herron RV, Bar RJ, Kontos P, Menec V. Improving social inclusion for people with dementia and carers through sharing dance: a qualitative sequential continuum of care pilot study protocol. BMJ Open 2018; 8:e026912. [PMID: 30498050 PMCID: PMC6278785 DOI: 10.1136/bmjopen-2018-026912] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION This study examines the potential of dance to improve social inclusion for people living with dementia and carers. Research suggests that arts-based programmes can improve the health of people living with dementia and carers; however, little is known about how these programmes might address barriers to social inclusion. Addressing barriers requires the development and evaluation of accessible, non-stigmatising and affordable programmes that facilitate social inclusion across the continuum of institutional, community and household care settings. METHODS AND ANALYSIS The study involves a qualitative sequential pilot study of the innovative Baycrest NBS Sharing Dance Seniors programme underway in non-metropolitan regions of two Canadian provinces. It focuses on the remotely instructed delivery of the programme in care facilities, community centres and households. The study involves five phases of observations, diaries, focus groups and interviews with programme participants (people living with dementia), carers, coordinators, instructors and volunteers as well as critical reflections among research investigators and knowledge users. NVivo-based thematic and narrative analyses of the qualitative data will produce new knowledge about the experiences, effectiveness and challenges of the dance programme that will inform understanding of whether and in what ways it increases social inclusion and quality of life for older people living with dementia and carers. The findings will identify opportunities for programme expansion and support the further development of arts-based approaches. ETHICS AND DISSEMINATION The study is approved by the Research Ethics Boards at Trent University and Brandon University, and by participating organisations according to their governance procedures. The perspectives of people living with dementia and carers are incorporated throughout the study (from design to dissemination) and the study adheres to the ethical considerations when including people with dementia. A series of publicly available reports, seminars and symposia will be undertaken in collaboration with knowledge user and collaborating organisation partners.
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Affiliation(s)
- Mark W Skinner
- Trent School of the Environment, Trent University, Peterborough, Ontario, Canada
| | - Rachel V Herron
- Department of Geography, Brandon University, Brandon, Manitoba, Canada
| | - Rachel J Bar
- Canada's National Ballet School and Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Pia Kontos
- Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada
| | - Verena Menec
- Community Health Sciences, University of Manitoba, Winnipeg, Winnipeg, Canada
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27
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A mismatch between supply and demand of social support in dementia care: a qualitative study on the perspectives of spousal caregivers and their social network members. Int Psychogeriatr 2018; 30:881-892. [PMID: 28606195 DOI: 10.1017/s1041610217000898] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED ABSTRACTBackground:Access to social support contributes to feelings of independence and better social health. This qualitative study aims to investigate multi-informant perspectives on informal social support in dementia care networks. METHODS Ten spousal caregivers of people with dementia (PwD) completed an ecogram, a social network card and a semi-structured interview. The ecogram aimed to trigger subjective experiences regarding social support. Subsequently, 17 network members were interviewed. The qualitative analyses identified codes, categories, and themes. RESULTS Sixth themes emerged: (1) barriers to ask for support; (2) facilitators to ask for support; (3) barriers to offer support; (4) facilitators to offer support; (5) a mismatch between supply and demand of social support; and (6) openness in communication to repair the imbalance. DISCUSSION Integrating social network perspectives resulted in a novel model identifying a mismatch between the supply and demand of social support, strengthened by a cognitive bias: caregivers reported to think for other social network members and vice versa. Openness in communication in formal and informal care systems might repair this mismatch.
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28
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Juang C, Knight BG, Carlson M, Schepens Niemiec SL, Vigen C, Clark F. Understanding the Mechanisms of Change in a Lifestyle Intervention for Older Adults. THE GERONTOLOGIST 2018; 58:353-361. [PMID: 28329863 DOI: 10.1093/geront/gnw152] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 08/19/2016] [Indexed: 11/12/2022] Open
Abstract
Purpose of the Study This study investigated the mechanisms of change underlying an activity-based lifestyle intervention, an occupational therapy program aimed at promoting healthy habits, and routines in older adults. We examined two activity-relevant factors as potential mediators linking the intervention to reduced symptoms of depression: activity frequency and global perceptions of activity significance. Social connections and perceived control were assessed to understand how activity-related factors relate to reduced symptoms of depression. Design and Methods The sample consisted of 460 multiethnic community-dwelling older adults aged 60-95 years. Participants were randomly assigned to a 6-month lifestyle redesign intervention (n = 232) or a no-treatment control (n = 228) condition. After the 6-month period, 360 individuals completed post-testing. Latent change score models were used to represent changes from baseline over the experimental interval. Structural equation models were applied to examine the indirect effects of the intervention on reduced depressive symptoms. Results The results demonstrated significant indirect effects from intervention receipt to decreased depressive symptoms via increased activity frequency and activity significance. Higher activity frequency was linked to fewer depressive symptoms via heightened social connections, whereas increased activity significance was associated with fewer depressive symptoms via enhanced perceived control. Implications The results support basic principles of occupational therapy by highlighting important mediating roles of activity frequency and activity significance in reducing depressive symptoms. Understanding of these change mechanisms can help optimize activity-centered interventions to reduce depressive symptoms.
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Affiliation(s)
- Christine Juang
- Department of Psychology, University of Southern California, Los Angeles
| | - Bob G Knight
- School of Psychology and Counseling, University of Southern Queensland, Toowoomba, Australia
| | - Mike Carlson
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Stacey L Schepens Niemiec
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Cheryl Vigen
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Florence Clark
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
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Leung P, Yates L, Orgeta V, Hamidi F, Orrell M. The experiences of people with dementia and their carers participating in individual cognitive stimulation therapy. Int J Geriatr Psychiatry 2017; 32:e34-e42. [PMID: 28217838 DOI: 10.1002/gps.4648] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 11/23/2016] [Accepted: 11/24/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND The carer-delivered individual cognitive stimulation therapy (iCST) was developed to improve cognition and quality of life of people with dementia. This study aims to explore people with dementia and family carers' concepts of mental stimulation and experiences of participating in the iCST intervention. METHODS A sub-sample of 23 dyads of people with dementia and their family carers who completed the iCST intervention took part in semi-structured in-depth interviews. Data were analysed using framework analysis. RESULTS Three main themes emerged, 'Concepts of mental stimulation', 'Experiencing changes in everyday life as a result of participating in iCST' and 'Carer adherence to the intervention' along with 10 sub-themes. The overall experience of participating in iCST was described as having opportunities to engage in enjoyable mentally stimulating activities, motivation to stay active and bringing people with dementia and their carers 'together'. Family carers mentioned that finding time to do the sessions and their relatives being reluctant to engage in the activities could hinder their participation in the intervention. CONCLUSIONS People with dementia and their family carers found iCST stimulating and enjoyable, but many had difficulty delivering all the sessions as planned. Family carers suggested that providing extra support by involving other people in delivering the intervention may help to improve adherence to the intervention. iCST may be a useful tool to encourage people with dementia and their carers to communicate. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Phuong Leung
- Division of Psychiatry, University College London, London, UK
| | - Lauren Yates
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London, UK
| | - Fara Hamidi
- Department of Primary Care and Public Health Sciences, King's College London, London, UK
| | - Martin Orrell
- Institute of Mental Health, University of Nottingham, Nottingham, UK
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Regier NG, Hodgson NA, Gitlin LN. Characteristics of Activities for Persons With Dementia at the Mild, Moderate, and Severe Stages. THE GERONTOLOGIST 2017; 57:987-997. [PMID: 27986794 PMCID: PMC5881689 DOI: 10.1093/geront/gnw133] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 06/13/2016] [Indexed: 11/14/2022] Open
Abstract
Purpose To understand activity in dementia care, we examine relationships of disease stage with types and characteristics of meaningful activities (cueing needs, help with initiation, and recommended engagement time) provided in a home-based intervention trial designed to reduce behavioral symptoms. Design and Methods Data involved 158 activity prescriptions or written documents detailing prescribed activities, cueing needs, and engagement goals designed by occupational therapists for 56 families. Activities were categorized as arts and crafts, exercise/physical, cognitive, music/entertainment, manipulation/sensory/sorting, family/social/ reminiscence, and domestic/homemaking. Bivariate correlations examined relationships of activity categories and characteristics with disease stage (mild, moderate, or severe). Kruskal-Wallis H tests examined differences among disease stages and frequency of type of activities prescribed, recommended cues, and engagement time. For significant Kruskal-Wallis tests, pairwise comparisons utilized the Mann-Whitney U test. Results Activity categories and instructions for set up were significantly related to cognitive and functional levels. Persons with mild dementia were most often prescribed complex arts and crafts and cognitive activities. Persons with moderate dementia were most often prescribed music/entertainment. Persons with severe dementia were most often prescribed simple physical exercises and manipulation/sensory/sorting activities. Average time prescribed for activities was less for those in severe (15min) versus moderate (24min) and mild (28min) stages. The severe group required more assistance with activity initiation and cueing/redirection. Implications Type of activity, recommended cueing, and engagement time differed by dementia stage. Findings provide guidance as to how to use and set up activities across the dementia trajectory.
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Affiliation(s)
- Natalie G Regier
- Center for Innovative Care in Aging, Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Nancy A Hodgson
- Center for Innovative Care in Aging, Johns Hopkins University School of Nursing, Baltimore, Maryland
- University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania
| | - Laura N Gitlin
- Center for Innovative Care in Aging, Johns Hopkins University School of Nursing, Baltimore, Maryland
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Murray CM, Gilbert-Hunt S, Berndt A, de la Perrelle L. Promoting participation and engagement for people with dementia through a cognitive stimulation therapy programme delivered by students: A descriptive qualitative study. Br J Occup Ther 2016. [DOI: 10.1177/0308022616653972] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Dementia can affect participation and engagement due to deprivation of cognitive, social and sensory stimulation. To meet this need, educators and a service provider collaborated for occupational therapy students to provide cognitive stimulation therapy for people with dementia. Method We used a published, evidence-based cognitive stimulation therapy programme called ‘Making a Difference’. However, due to student availability, we adapted the programme to be conducted once weekly for 12 weeks by students in pairs. These services occurred in both community and residential settings. Following completion of the programme in 2012, perspectives of staff ( n = 8), family carers ( n = 5) and three people with dementia were sought about their involvement. Semi-structured interviews were recorded, transcribed and analysed using thematic analysis. Findings We found three themes of ‘something to talk about’, ‘it was a new relationship’ and ‘wanting to have a go’. Despite some initial concerns about people with dementia becoming stressed, the programme promoted social interactions, participation and engagement. The students adopted a relationship-centred approach with empathy and deliberate planning of sessions being important. Conclusion Through provision of the adapted Making a Difference programme, occupational therapy students were able to fulfil an unmet need while learning from their experience.
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Affiliation(s)
- Carolyn M Murray
- PhD Candidate and Lecturer, University of South Australia, Adelaide, Australia
| | | | - Angela Berndt
- Lecturer, University of South Australia, Adelaide Australia
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Vizzachi BA, Daspett C, Cruz MGDS, Horta ALDM. [Family dynamics in face of Alzheimer's in one of its member]. Rev Esc Enferm USP 2016; 49:933-8. [PMID: 27419676 DOI: 10.1590/s0080-623420150000600008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 08/29/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To understand the family dynamics when there is a member in the residence with Alzheimer's disease. METHOD A study of qualitative approach, using the creative sensitive method (CSM), and with participation of two families who had a member with Alzheimer's disease at home. RESULTS Three categories emerged: Effects of Alzheimer's disease and the family dynamics; Development process of Alzheimer's disease and Coping strategies in face of the disease. CONCLUSION It was possible to know the manifestations and consequences of Alzheimer's disease in the family, such as mutual help, the mobilization of resources to activate memories of the past, spirituality and faith. There was also understanding of the structure of family dynamics.
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Affiliation(s)
| | - Celina Daspett
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brazil
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Le Galès C, Bungener M. The family accompaniment of persons with dementia seen through the lens of the capability approach. DEMENTIA 2016; 18:55-79. [PMID: 27390172 DOI: 10.1177/1471301216657476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Using the capability approach initially developed by A Sen as a theoretical framework, this paper analyses both what people with dementia and their families do in response to difficulties in their daily life brought about by the disease, and the reasons they give for acting as they do. Individual and collective interviews and ethnographic observations with 15 persons with dementia and one or more of their family members were conducted. Follow-up interviews were possible for nine families. Results highlight a great diversity in ways of doing things and in accompaniment by family members. Daily adjustments are often hidden or minimized, at least at the onset of the dementia. Later, they become more frequent, repetitive and indispensable but remain influenced by the social and gender roles that existed prior to the illness. The inventiveness of families, in a context marked by various kinds of constraints, is primarily motivated by their desire to maintain the apparently intact abilities of the person with dementia but especially to preserve forms of liberty and what counted for the person, what that person valued before the disease. There are some ways of living with dementia, even when accompanied, which may long remain preferable to others, which better answer to the past and present aspirations of persons with dementia and the purposes of the accompanying persons. It is thus essential that health professionals, as well as society in general, recognize and address this issue.
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Affiliation(s)
- Catherine Le Galès
- CERMES3, INSERM U 988, CNRS UMR 8211, EHESS, Paris Descartes University, France
| | - Martine Bungener
- CERMES3, INSERM U 988, CNRS UMR 8211, EHESS, Paris Descartes University, France
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Lu YYF, Ellis J, Yang Z, Weaver MT, Bakas T, Austrom MG, Haase JE. Satisfaction With a Family-Focused Intervention for Mild Cognitive Impairment Dyads. J Nurs Scholarsh 2016; 48:334-44. [PMID: 27121662 DOI: 10.1111/jnu.12214] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE This article describes satisfaction that persons with mild cognitive impairment (PwMCI) and their caregivers had with the Daily Enhancement of Meaningful Activity (DEMA) intervention. METHODS This randomized controlled pilot study compared satisfaction (usefulness, ease of use, and acceptability) with DEMA (n = 17 dyads) to an information support (IS) control group (n = 19 dyads). Six biweekly sessions (two in person and four by telephone) were delivered by trained nurses. Data analysis included descriptive statistics, independent-sample t tests, and content analysis. FINDINGS PwMCI receiving DEMA rated their satisfaction significantly higher (p = .033) than did the control group; there was no difference in satisfaction between caregivers across groups. Qualitative interview data supported the usefulness, ease of use, and acceptability of DEMA for both PwMCI and caregivers. CONCLUSIONS Results documented PwMCI's satisfaction with DEMA as implemented by nurses to support PwMCI-caregiver dyads' engagement in meaningful activity. DEMA may need revision to increase satisfaction for caregivers. CLINICAL RELEVANCE The DEMA intervention was evaluated as useful, easy to use, and acceptable to PwMCI and their caregivers based on positive mean ratings. The study findings provide preliminary support of DEMA as a means to improve quality of life by helping to support patient and caregiver engagement in meaningful activities and problem solving.
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Affiliation(s)
- Yvonne Yueh-Feng Lu
- Associate Professor, Department Science of Nursing Care, Indiana University School of Nursing, Indianapolis, IN, USA
| | - Jennifer Ellis
- Indiana University School of Health and Rehabilitation, Indianapolis, IN, USA
| | - Ziyi Yang
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Michael T Weaver
- Professor & Associate Dean for Research & Scholarship, College of Nursing, University of Florida, Gainesville, FL, USA
| | - Tamilyn Bakas
- Professor Emeritus, Indiana University School of Nursing, Indianapolis, IN, and Professor and Jane E. Procter Endowed Chair, College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Mary Guerriero Austrom
- Wesley P Martin Professor of Alzheimer's Disease Education, Department of Psychiatry, Associate Dean for Diversity Affairs, Indiana University School of Medicine, and Director, Outreach, Recruitment and Education Core, Indiana Alzheimer Disease Center (IADC), Indianapolis, IN, USA
| | - Joan E Haase
- Holmquist Professor of Pediatric Oncology Nursing, Department Science of Nursing Care, Indiana University School of Nursing, Indianapolis, IN, USA
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Lu YYF, Bakas T, Yang Z, Weaver MT, Austrom MG, Haase JE. Feasibility and Effect Sizes of the Revised Daily Engagement of Meaningful Activities Intervention for Individuals With Mild Cognitive Impairment and Their Caregivers. J Gerontol Nurs 2016; 42:45-58. [PMID: 26934973 PMCID: PMC4819326 DOI: 10.3928/00989134-20160212-08] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 01/07/2016] [Indexed: 11/20/2022]
Abstract
A nurse-led intervention, Daily Engagement of Meaningful Activities (DEMA), was evaluated for feasibility and effect sizes in a two-group randomized pilot study with 36 patient-caregiver dyads (17 DEMA and 19 attention control). Effect sizes were estimated on 10 outcomes: dyad functional ability awareness congruence; patients' meaningful activity performance and satisfaction, confidence, depressive symptoms, communication satisfaction, physical function, and life satisfaction; and caregivers' depressive symptoms and life changes. High feasibility of DEMA was supported by the following indicators: consent (97.7%), session completion (91.7%), and Time 3 measure completion (97.2%). Compared to the attention control group, the DEMA group had higher dyad congruence in functional ability awareness and life satisfaction 3 months post-intervention and improved physical function at 2 weeks post-intervention. Although DEMA showed high feasibility and benefits on some health-related outcomes, further testing of DEMA in a larger randomized controlled clinical trial is needed.
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