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Keller MS, Guevara N, Guerrero JA, Mays AM, McCleskey SG, Reyes CE, Sarkisian CA. Experiences managing behavioral symptoms among Latino caregivers of Latino older adults with dementia and memory problems: a qualitative study. BMC Geriatr 2024; 24:725. [PMID: 39217285 PMCID: PMC11365257 DOI: 10.1186/s12877-024-05323-4] [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: 02/13/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Latinos are more likely than non-Latino Whites to develop dementia and be prescribed antipsychotics for dementia-related behavioral symptoms. Antipsychotics have significant risks yet are often overprescribed. Our understanding of how Latino caregivers of Latino older adults living with dementia perceive and address behavioral issues is limited, impeding our ability to address the root causes of antipsychotic overprescribing. METHODS We interviewed Latino older adults' caregivers and community-based organization workers serving older adults with cognitive impairment (key informants), focusing on the management of behavioral symptoms and experiences with health services. RESULTS We interviewed 8 caregivers and 2 key informants. Caregivers were the spouses, children, or grandchildren of the older adult living with cognitive impairment; their ages ranged from 30 to 95. We identified three categories of how caregivers learned about, managed, and coped with behavioral symptoms: caregivers often faced shortcomings with dementia care in the medical system, receiving limited guidance and support; caregivers found community organizations and senior day centers to be lifelines, as they received relevant, timely advice and support, caregivers often devised their own creative strategies to manage behavioral symptoms. CONCLUSION In-depth interviews suggest that the healthcare system is failing to provide support for behavioral symptoms from dementia; caregivers of Latino older adults rely on community organizations instead.
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Affiliation(s)
- Michelle S Keller
- USC Leonard Davis School of Gerontology, 3715 McClintock Avenue , Los Angeles, CA, 90089, USA.
- Department of Health Policy and Management, Fielding School of Public Health, University of California-Los Angeles, Los Angeles, CA, USA.
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
| | - Nathalie Guevara
- Section of Geriatric Medicine, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Allison M Mays
- Section of Geriatric Medicine, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Carmen E Reyes
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Catherine A Sarkisian
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Geriatric Research Education Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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Moore HL, Cassidy S, Rodgers J. Exploring the mediating effect of camouflaging and the moderating effect of autistic identity on the relationship between autistic traits and mental wellbeing. Autism Res 2024; 17:1391-1406. [PMID: 38108621 DOI: 10.1002/aur.3073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Abstract
Mental health difficulties are prevalent among autistic adults. Camouflaging (behaving differently to fit in) may be a mechanism by which autistic traits and mental health difficulties relate to each other, but little research has considered the role of different facets of camouflaging. Additionally, autistic identity might buffer against camouflaging and mental health difficulties. This research aims to explore the mediating effects of camouflaging behaviours on the relationship between autistic traits and both positive and negative mental wellbeing, as well as how autistic identity might moderate the relationship between autistic traits and camouflaging, and also mental health. Data were available for 627 autistic adults, recruited through volunteer databases and social media. Participants completed measures of autistic traits, anxiety, depression, positive wellbeing, camouflaging behaviours (compensating for difficulties, masking, and assimilating/putting on an act) and autistic identity. Mediation and moderated mediation models were tested, applying 95% bootstrapped CIs (10,000 resamples) and including age, gender and diagnosis as covariates. There were no significant direct effects between autistic traits and mental wellbeing. Assimilation was a significant mediator of all mental wellbeing measures, and compensation was a significant mediator of positive wellbeing only. Autistic identity was not a significant moderator. Assimilation and compensation should be considered when offering psychological interventions to support mental wellbeing of autistic people. Additional research into external drivers of camouflaging (e.g. stigma) and mechanisms by which camouflaging impacts mental wellbeing, such as autonomy, authenticity, skill mastery and community, may identify other areas of support. Concurrently, societal change is necessary to reduce the need to camouflage.
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Affiliation(s)
| | - Sarah Cassidy
- School of Psychology, University of Nottingham, University Park, Nottingham, UK
| | - Jacqui Rodgers
- Population Health Sciences Institute, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle Upon Tyne, UK
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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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Harding E, Sullivan MP, Camic PM, Yong KXX, Stott J, Crutch SJ. Exploring experiential differences in everyday activities - A focused ethnographic study in the homes of people living with memory-led Alzheimer's disease and posterior cortical atrophy. J Aging Stud 2024; 69:101226. [PMID: 38834246 DOI: 10.1016/j.jaging.2024.101226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 03/15/2024] [Accepted: 03/24/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Supporting ageing in place, quality of life and activity engagement are public health priorities for people living with dementia, but little is known about the needs and experiences of community-dwelling people with rarer forms of dementia with lesser known symptoms. Posterior cortical atrophy (PCA) is a rare form of dementia usually caused by Alzheimer's disease but which is characterised by diminished visual processing (rather than a dominant memory problem), which poses challenges for maintaining independence and accessing appropriate support. METHODS This study used a comparative qualitative design and focussed ethnographic methods to explore experiential differences in activity engagement for 10 people with the most common, memory-led presentation of Alzheimer's disease and 10 people with posterior cortical atrophy within their everyday home environments. RESULTS While the data collection revealed much rich variation in individual and contextual factors, some tentative high-level differences in the experiences of everyday activities could be drawn out, seemingly attributable to the different diagnoses' differing dominant symptoms. These included people with posterior cortical atrophy being less likely to use environmental cues to initiate activities, and more likely to withhold from asking for support because of preserved insight into the impact of this on carers. This lack of initiation of activities could be misinterpreted as apathy. People with posterior cortical atrophy also were discouraged from engaging in activities by disorientation within the home, and difficulties localising, identifying and manipulating objects. People with the more common, memory-led presentation of Alzheimer's disease exhibited more memory-based difficulties with engaging with activities such as forgetting planned activities, where to locate the items required for an activity and the steps involved. Despite these distinct symptom-led challenges, all participants and their family members demonstrated resourcefulness and resilience in making creative adaptations to support continued engagement in everyday activities, supporting the widely reported management strategies of people with dementia of the Alzheimer's type more generally. CONCLUSIONS These findings offer helpful insights into some the differing impacts dementia related visual and memory impairments can have on everyday activity engagement, which will be helpful for others navigating these challenges and the health and social care practitioners working with people affected by these conditions. The findings also highlight the vast individual variation in the multitude of individual and contextual factors involved in everyday activity engagement, and suggest important areas for future work utilising methods which are similarly high in ecological validity and accessibility as the home-based focussed ethnographic methods utilised here.
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Affiliation(s)
- Emma Harding
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK.
| | - Mary Pat Sullivan
- School of Social Work, Faculty of Education and Professional Studies, Nipissing University, Nipissing, ON, Canada
| | - Paul M Camic
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Keir X X Yong
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Joshua Stott
- Research Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
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Harding E, Sullivan MP, Camic PM, Yong KXX, Stott J, Crutch SJ. "I Want to Do Something" - Exploring What Makes Activities Meaningful for Community-Dwelling People Living With Dementia: A Focused Ethnographic Study. QUALITATIVE HEALTH RESEARCH 2024:10497323241239487. [PMID: 38648467 DOI: 10.1177/10497323241239487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Supporting ageing in place, quality of life, and activity engagement are public health priorities for people with dementia. The importance of maintaining opportunities for meaningful activities has been widely acknowledged for those with dementia in long-term care, but little is known about what makes activities meaningful for, and how they are experienced by, people with different types of dementia in their own homes. This study used focussed ethnographic methods to explore the motivations and meanings of everyday activity engagement within the homes of 10 people with memory-led Alzheimer's disease and 10 people with posterior cortical atrophy. While participants' interactions with their everyday environments were challenged by their diagnoses, they were all finding ways to continue meaning-making via various activities. The main findings are encapsulated in three themes: (1) The fun and the function of activities; (2) Reciprocities of care, and (3) The constitution and continuity of (a changing) self. Ongoing engagement with both fun and functional activities offered participants living with different dementias opportunities to connect with others, to offer care and support (as well as receive it), and to maintain a sense of self and identity. Implications are discussed regarding the development and delivery of tailored interventions and support to enable continued engagement in meaningful activities for people with different types of dementia living in the community.
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Affiliation(s)
- Emma Harding
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Mary Pat Sullivan
- School of Social Work, Faculty of Education and Professional Studies, Nipissing University, Nipissing, ON, Canada
| | - Paul M Camic
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Keir X X Yong
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Joshua Stott
- UCL Division of Psychology and Language Sciences, Department of Clinical, Educational, and Health Psychology, UCL, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, UCL, London, UK
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Chun S, Lee S, Heo J, Ryu J, Lee KH. Leisure Activity, Leisure Satisfaction, and Hedonic and Eudaimonic Well-Being Among Older Adults With Cancer Experience. Psychol Rep 2024; 127:489-512. [PMID: 35993312 DOI: 10.1177/00332941221123236] [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: 11/17/2022]
Abstract
Older adults with cancer experience are more likely to encounter a notable reduction of participation in physical and social leisure activities, which may threaten their overall well-being. The purpose of this study was to explore how specific types of leisure activities and leisure satisfaction were linked to hedonic and eudaimonic well-being among older adults who had experienced cancer. A nationally representative sample of 2,934 older adults with lifetime cancer experience was retained from the Health and Retirement Study. The results of regression analysis revealed that walking for 20 minutes was reported as the only type of leisure activity related to hedonic well-being for the oldest-old (85+ years old). The current study also found that TV watching was significantly, but negatively associated with eudaimonic well-being for the young-old (50-74 years of age). In contrast, using a computer was positively linked to hedonic and eudaimonic well-being among the young-old and old-old (75-84 years of age). The current study made a significant contribution to build the body of knowledge that the different age groups of older adults who had experienced cancer can enhance eudaimonic and hedonic well-being by participating in different types of leisure activities. Implications for further research are discussed.
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Affiliation(s)
- Sanghee Chun
- Department of Recreation and Leisure Studies, Brock University, Saint Catharines, ON, Canada
| | - Sunwoo Lee
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Jinmoo Heo
- Department of Sport Industry Studies, Yonsei University, Seoul, Korea
| | - Jungsu Ryu
- Department of Sport, Tourism and Hospitality Management, Marshall University, Huntington, WV, USA
| | - Kyung Hee Lee
- Department of Recreation, Parks, and Leisure Services Administration, Central Michigan University, Mount Pleasant, MI, USA
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Levinger P, Goh AMY, Dunn J, Katite J, Paudel R, Onofrio A, Batchelor F, Panisset MG, Hill KD. Exercise interveNtion outdoor proJect in the cOmmunitY - results from the ENJOY program for independence in dementia: a feasibility pilot randomised controlled trial. BMC Geriatr 2023; 23:426. [PMID: 37438710 DOI: 10.1186/s12877-023-04132-5] [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: 02/24/2023] [Accepted: 06/25/2023] [Indexed: 07/14/2023] Open
Abstract
The Seniors Exercise Park program is an evidence-based outdoor physical and social activity program designed originally for older people with no cognitive impairment. This study aimed to pilot this program for people living with dementia in residential aged care. We examined the feasibility of delivering the program, evaluating its structure, safety, and supervision needs. In addition, physical, social, health and cognitive benefits of participation were examined. Method This was a feasibility pilot randomised controlled design. Adults aged ≥ 60 years with symptoms of dementia and/or diagnoses of dementia were recruited from an aged care facility in Australia. Participants allocated to the intervention underwent a 12-week structured supervised physical activity program using the outdoor Seniors Exercise Park equipment followed by a 12-week maintenance phase, while the controls received usual care programs. Assessments occurred at baseline, 12 and 24-weeks. Feasibility evaluation included recruitment rate, retention, attendance, overall adherence, dropout rate, adverse events, program delivery modifications and supervision requirements. A suite of cognitive and health-related questionnaires and physical function measures were also collected. Results Sixteen participants were recruited (recruitment rate: 58.6%), eight for the intervention (83.3 ± 7.5 years, 87.5% women) and eight for the control (age 87.5 ± 3.0 years, 87.5% women). Eighty-eight percent completed the 12-week structured program, with 75% retention at 24-weeks. Across the 24-week period, 84.3% participation adherence was reported. No falls or adverse events occurred. Modifications of the program mainly related to method of communication, cueing and adjustments to suit individual personality and characteristics. A ratio of one trainer to two participants was practical and safe. There were no significant changes over time between groups in any of the secondary outcomes. High level of engagement, enjoyment and mood was reported throughout the exercise program. Conclusion The Seniors Exercise Park physical activity program was safe and feasible for people living with dementia in residential care, with high levels of enjoyment, positive attitude, and engagement reported in the intervention group. Individualised communication during program delivery was needed to facilitate motivation and participation. Further research is needed to assess the program effectiveness on physical and cognitive function on a larger scale. Trial registration This trial is registered with the Australian New Zealand Clinical Trials Registry-Registry Number ACTRN12620000733976 . Registered on the 13/07/2020.
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Affiliation(s)
- Pazit Levinger
- National Ageing Research Institute, Royal Melbourne Hospital, PO Box 2127, Melbourne, Victoria, 3050, Australia.
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne, Australia.
| | - Anita M Y Goh
- National Ageing Research Institute, Royal Melbourne Hospital, PO Box 2127, Melbourne, Victoria, 3050, Australia
- The University of Melbourne, Melbourne, Australia
| | - Jeremy Dunn
- National Ageing Research Institute, Royal Melbourne Hospital, PO Box 2127, Melbourne, Victoria, 3050, Australia
| | | | | | | | - Frances Batchelor
- National Ageing Research Institute, Royal Melbourne Hospital, PO Box 2127, Melbourne, Victoria, 3050, Australia
| | | | - Keith D Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne, Australia
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Chen H, Wang Y, Zhang M, Wang N, Hao X, Xue Z, Fang K, Liu Y. Translation and psychometric validation of the Chinese version of the meaningful and enjoyable activities scale for mild dementia. Front Psychiatry 2023; 14:1148838. [PMID: 36993922 PMCID: PMC10040571 DOI: 10.3389/fpsyt.2023.1148838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/22/2023] [Indexed: 03/18/2023] Open
Abstract
ObjectivesTo translate 20-item Meaningful and Enjoyable Activities Scale into Chinese and evaluate its psychometric properties amongst Chinese with mild dementia.MethodsA cross-sectional study of 450 people with mild dementia recruited from a memory disorders clinic was conducted with the C-MEAS. Raw data were randomly divided into two parts for exploratory factor analysis and confirmatory factor analysis, to evaluate the construct validity. Content validity and reliability were tested by content validity index and Cronbach’s α coefficients, respectively.ResultsAdaptation results showed that the Chinese version of the scale is adequate for linguistic and content validation. Confirmatory factor analysis indicated a significantly good fit for a three-factor model. Cronbach’s alpha coefficient was 0.84 for the overall scale.ConclusionThe C-MEAS for people with mild dementia is a reliable and valid instrument with satisfactory psychometric properties. Future studies should recruit a more representative sample of people with mild dementia in China to verify the applicability of the scale.
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Affiliation(s)
- Hongyu Chen
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
| | - Yuanyuan Wang
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Minyi Zhang
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Ning Wang
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
| | - Xixi Hao
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
| | - Zhihan Xue
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
| | - Kui Fang
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
- *Correspondence: Kui Fang,
| | - Yan Liu
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
- Yan Liu,
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Ervasti K, Kotkas T, Issakainen M, Teiska M, Mäki-Petäjä-Leinonen A. In the Shadow of COVID-19: The Well-Being and Rights of People Living with Dementia in Finland During the Pandemic. J Alzheimers Dis 2023; 92:1473-1485. [PMID: 36911938 DOI: 10.3233/jad-221096] [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: 03/12/2023]
Abstract
BACKGROUND Exceptional circumstances such as the COVID-19 pandemic increase the risk for vulnerability among people living with dementia. OBJECTIVE This article discusses the well-being and rights of people living with dementia in Finland during the pandemic and analyses the legal framework covering the restrictions of their rights during that period. METHODS The empirical research comprises a survey of persons with dementia (n = 31) and their family members (n = 168). The participants completed a total of 13 survey items involving questions about their well-being during the pandemic, restrictions on freedom, access to services, information on pandemic regulations and guidelines as well as possible problems with authorities. The survey included both multiple choice and open-ended questions. RESULTS According to people with dementia and their family members, by spring 2021, the pandemic had reduced meaningful activities available to people living with dementia in Finland and decreased the number of meetings between them and other people. Many reported a decline in their physical and/or mental well-being or greater difficulty or delays in accessing social and health services. Over a third of respondents found that the right to meet people was restricted among people with dementia, and almost half of the respondents took the view that their freedom of movement was restricted. There were also major shortcomings in terms of information on restrictions. CONCLUSION The results highlight the importance of bearing in mind the negative effects that restrictions on mobility, meeting other people and meaningful activities can have on the well-being of people living with dementia. This should be considered, for example, when reforming legislation.
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Affiliation(s)
- Kaijus Ervasti
- Law School, University of Eastern Finland, Joensuu, Finland
| | - Toomas Kotkas
- Faculty of Law, University of Helsinki, Helsinki, Finland
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Tierney L, MacAndrew M, Doherty K, Fielding E, Beattie E. Characteristics and value of 'meaningful activity' for people living with dementia in residential aged care facilities: "You're still part of the world, not just existing". DEMENTIA 2023; 22:305-327. [PMID: 36473712 DOI: 10.1177/14713012221144488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Most residential aged care facilities support residents to participate in activities and the importance of activities that are suited to individual preferences and abilities is widely acknowledged. Participating in activities, including those considered to be 'meaningful' has the potential to improve residents' quality of life. However, what makes activities meaningful for people living with dementia in residential aged care facilities is unclear. The aim of this study was to understand the key characteristics of 'meaningful activity' in residential aged care facilities and the perceived value of residents participating in these activities. Using a qualitative study design, this study explored 'meaningful activities' from the perspectives of people living with dementia in residential aged care facilities, their family members and staff. Across four residential aged care facilities, residents (n = 19) and family members (n = 17) participated in individual interviews while staff (n = 15) participated in focus group interviews. Interviews were recorded, transcribed and analysed using a qualitative content analysis approach. Participant responses suggest that the meaning of an activity is subjective, varying over time and between individuals. Key characteristics of an activity that makes it meaningful include being enjoyable, social and engaging, aligning with the persons' interests, preferences, and abilities. To be considered meaningful, activities need to do more than occupy the person. The activity needs to be linked to a personally relevant goal and an aspect of the individuals' identity. Participating in 'meaningful activities' was perceived as valuable to encourage participation and socialising, provide a sense of normality for residents and improve their wellbeing. The findings of this study further our understanding of the concept of 'meaningful activity' for people living with dementia in residential aged care facilities. Understanding the key attributes of 'meaningful activity' can also provide practical guidance for those supporting people with dementia to participate in these types of activities.
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Affiliation(s)
- Laura Tierney
- Faculty of Health, School of Nursing, 1969Queensland University of Technology, Brisbane, QLD, Australia
| | - Margaret MacAndrew
- Faculty of Health, School of Nursing, 1969Queensland University of Technology, Brisbane, QLD, Australia
| | - Kathleen Doherty
- Wicking Dementia Research and Education Centre, 3925University of Tasmania, Hobart, TAS, Australia
| | - Elaine Fielding
- Faculty of Health, School of Nursing, 1969Queensland University of Technology, Brisbane, QLD, Australia
| | - Elizabeth Beattie
- Faculty of Health, School of Nursing, 1969Queensland University of Technology, Brisbane, QLD, Australia
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Brennan F, Chapman M, Gardiner MD, Narasimhan M, Cohen J. Our dementia challenge: arise palliative care. Intern Med J 2023; 53:186-193. [PMID: 36822608 DOI: 10.1111/imj.16011] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 12/13/2022] [Indexed: 02/25/2023]
Abstract
While many of the maladies of the 20th century are steadily coming under control, the march of neurodegenerative disorders continues largely unchecked. Dementias are an exemplar of such disorders; their incidence and prevalence continue to rise, in large part due to a steadily ageing population worldwide. They represent a group of chronic, progressive and, ultimately, fatal neurodegenerative diseases. Dementia has remained therapeutically recalcitrant. It is not a single disease, and because of that, we cannot expect a single panacea. While primary prevention rightly gains prominence, those with established disease currently require a shift in focus from curative intent towards improved quality of life. Enter palliative care. The sheer number and complexity of needs of patients with dementia, from the physical to the psychosocial and spiritual, necessitates the engagement of a wide range of medical disciplines, nursing and allied health professionals. One of those disciplines, as highlighted in the recent Australian Royal Commission into Aged Care Quality and Safety, is palliative care. This paper shall expand upon that role in the overall context of care for those with dementia.
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Affiliation(s)
- Frank Brennan
- Department of Palliative Care, Calvary Hospital, Kogarah, New South Wales, Australia.,Department of Palliative Care, The St George Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine, The University of NSW Sydney, Sydney, New South Wales, Australia
| | - Michael Chapman
- Department of Palliative Care, Canberra Hospital, ACT, Canberra, Australian Capital Territory, Australia.,Medical School, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Matthew D Gardiner
- Department of Palliative Care, Calvary Hospital, Kogarah, New South Wales, Australia.,Faculty of Medicine, The University of NSW Sydney, Sydney, New South Wales, Australia
| | - Manisha Narasimhan
- Department of Neurology, The Sutherland Hospital, Sydney, New South Wales, Australia.,Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Joshua Cohen
- Department of Palliative Care, Calvary Hospital, Kogarah, New South Wales, Australia
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Scott TL, Jao YL, Tulloch K, Yates E, Kenward O, Pachana NA. Well-Being Benefits of Horticulture-Based Activities for Community Dwelling People with Dementia: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10523. [PMID: 36078239 PMCID: PMC9517764 DOI: 10.3390/ijerph191710523] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/19/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
Most people living with dementia in the early-to-middle stages live in the community or in their own homes and engagement in enjoyable activities is fundamental to maintaining quality of life and autonomy. Horticulture-based activities are beneficial for the health and well-being for people living with dementia ("PLWD") in residential care settings, yet evidence within community settings, where the majority live, has not been comprehensively synthesized. A mixed studies systematic review protocol was registered and a systematic search conducted to June 2022 across MEDLINE, COCHRANE, Web of Science, Embase, Psycnet, CINAHL, PsycINFO databases, using terms relating to dementia and horticulture. Original studies examining group or individual horticulture-based programs for community-dwelling PLWD were included. Forty-five articles were selected for full review, eight met inclusion criteria and were retained for data extraction. Evidence from three mixed methods, two quantitative, two qualitative, and one case study design, involving a total of 178 community dwelling PLWD, was narratively summarized. Findings revealed that involvement in horticulture-based activities led to positive impacts on engagement, social interactions, and mental and physical well-being in PLWD. No conclusive evidence was found from included studies for improvement in cognitive function. As most studies to date have concentrated on PLWD in long-term care settings, future research should evaluate the effect of these types of activities in a more rigorous intervention design in community settings.
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Affiliation(s)
- Theresa L. Scott
- School of Psychology, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Ying-Ling Jao
- College of Nursing, The Pennsylvania State University, University Park, State College, PA 16802, USA
| | - Kristen Tulloch
- School of Psychology, The University of Queensland, St. Lucia, QLD 4072, Australia
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Moreton Bay, Petrie, QLD 4556, Australia
| | - Eloise Yates
- School of Psychology, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Oliver Kenward
- School of Psychology, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Nancy A. Pachana
- School of Psychology, The University of Queensland, St. Lucia, QLD 4072, Australia
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13
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Strandenaes MG, Lund A, Engedal K, Kirkevold Ø, Selbaek G, Benth JŠ, Rokstad AMM. Self-reported quality of life in people with dementia attending a day-care programme in Norway: A 24-month quasi-experimental study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1315-1324. [PMID: 34032347 DOI: 10.1111/hsc.13455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 04/14/2021] [Accepted: 05/04/2021] [Indexed: 06/12/2023]
Abstract
The objectives of the study were (a) to compare self-reported Quality of Life (QoL) in a 24-month follow-up of people with dementia attending day care designed for people with dementia (day-care group, DC) with people with dementia who did not attend day care (control group, CG) and (b) to explore factors associated with QoL. A quasi-experimental design with a 24-month follow-up period was used. The DC group included 181 participants recruited from 53 day-care services. The CG included 76 participants recruited from 19 municipalities with no available day care designed for people with dementia. The sample covered the four health regions of Norway and inclusion period lasted from December 2013 to July 2015. The Quality of Life in Alzheimer's Disease (QoL-AD) scale was used as the outcome measure. The differences in QoL between groups and the associations between participant characteristics and QoL, such as depressive symptoms and functional dependency, were examined using a linear mixed model. In the multiple model, the overall trend in QoL did not differ significantly between the DC and CG. However, the DC group exhibited significantly higher self-reported QoL than the CG at all time points (p < 0.001 at T0, p = 0.018 at T12, and p = 0.006 at T24). Participants with shallow or no awareness who attended day care had significantly higher scores on QoL-AD than persons with full awareness (p = 0.017). More depressive symptoms (p < 0.001) and higher functional dependency (p < 0.001) were associated with lower self-reported QoL. The study revealed higher scores of self-reported QoL among people attending day care compared with those who did not attend, showing that day care might have positive impact on the lives of people with dementia.
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Affiliation(s)
- Margit Gausdal Strandenaes
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Lund
- Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Øyvind Kirkevold
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
- Research Centre for Age Related Functional decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Health Services Research Unit, Research Centre, Akershus University Hospital, Lørenskog, Norway
| | - Anne Marie Mork Rokstad
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
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14
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Telenius EW, Tangen GG, Eriksen S, Rokstad AMM. Fun and a meaningful routine: the experience of physical activity in people with dementia. BMC Geriatr 2022; 22:500. [PMID: 35689197 PMCID: PMC9188090 DOI: 10.1186/s12877-022-03149-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 05/16/2022] [Indexed: 11/18/2022] Open
Abstract
Background Physical activity is important to health and wellbeing. People with dementia are less physically active than their cognitively healthy counterparts. Reasons for this are multifaceted, and are thought to be social, psychological, and physiological. People with dementia often use services such as home care, day care centres and nursing home, and according to the stage of disease they are less or more dependent on other people to take part in activities. To develop appropriate services to this patient group, their needs and preferences regarding physical activity must be recognized. The aim of the study was therefore to provide insight into experiences with physical activity in people with dementia. Methods The current study is part of a larger research project on needs in people with dementia. The main project included qualitative semi-structured interviews with 35 persons with dementia. 27 of the participants talked about their experience with physical activity. In the current study, the relevant findings on this theme were analysed separately. A phenomenological hermeneutic research design was applied. Results The analysis revealed three main categories regarding experiences with physical activity. To be physically active provided positive experiences such as feelings of mastering and post-exercise euphoria. To be physically active was meaningful. The daily walk was an important routine to many, and it gave meaningful content to the day. Keeping up with activities confirmed identity. Lastly, to be active was perceived as challenging. Participants described different barriers to being physically active such as a decline of physical function, lack of motivation and being dependent on others to go out. Conclusions Many of the participants expressed that being physically active was important to them. It is essential that informal and formal carers are aware of the role physical activity plays in the lives of many people with dementia, so that appropriate measures can be taken to assure continued active living in order to preserve health and quality of life. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03149-6.
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Affiliation(s)
- Elisabeth Wiken Telenius
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, PO Box 2136, 3103, Tønsberg, Norway. .,Faculty of Health Studies, VID Specialized University, Oslo, Norway.
| | - Gro Gujord Tangen
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, PO Box 2136, 3103, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Siren Eriksen
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, PO Box 2136, 3103, Tønsberg, Norway.,Lovisenberg Diaconal University College, Oslo, Norway
| | - Anne Marie Mork Rokstad
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, PO Box 2136, 3103, Tønsberg, Norway.,Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
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15
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Li G, Jin C, Zhao B, Wu B. Smartphone Use, Technology Affordance for Healthcare and Elders' Life Satisfaction. Front Public Health 2022; 10:861897. [PMID: 35480578 PMCID: PMC9035850 DOI: 10.3389/fpubh.2022.861897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/10/2022] [Indexed: 11/13/2022] Open
Abstract
Previous studies have examined how smartphones influence the life satisfaction of the elderly, but the existence of conflicting conclusions suggests the existence of a “black box”. In this study, using a survey from 941 elders, we examine whether smartphone use can improve life satisfaction of the elders by inducing emotional affordance offered by social networking Apps and functional affordance offered by healthcare system Apps. It is found that both emotional affordance and functional affordance acted as intermediating variables between the use of smartphone and elders' life satisfaction. In addition, it is founded that living arrangement with adult children moderates the positive impact of smartphone use on functional affordance, but there was no such moderating effect on emotional affordance. This study offers insights about how digital healthcare innovation will be applied to increase well-being of elders by applying framework of selective optimization with compensation.
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Affiliation(s)
- Geling Li
- China Institute for Small and Medium Enterprises, Zhejiang University of Technology, Hangzhou, China
| | - Chenfei Jin
- China Institute for Small and Medium Enterprises, Zhejiang University of Technology, Hangzhou, China
| | - Bin Zhao
- Department of Cooperation and Exchange, Zhejiang University of Technology, Hangzhou, China
- Bin Zhao
| | - Bao Wu
- School of Management, Zhejiang University of Technology, Hangzhou, China
- *Correspondence: Bao Wu
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16
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Translation and Cultural Adaptation into Spanish of the Engagement in Meaningful Activities Survey. Occup Ther Int 2022; 2022:4492582. [PMID: 35414804 PMCID: PMC8979729 DOI: 10.1155/2022/4492582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 02/10/2022] [Accepted: 02/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background Participation in meaningful activities contributes to individual well-being, so it is essential to have specific evaluation tools that can assess this complex construct Objectives To create a Spanish version (EDIAS) of the Engagement in Meaningful Activities Survey (EMAS) by following best practices in instrument translation. Methodology. The translation was made according to the Principles of Good Practice for the translation and cultural adaptation of patient-reported outcome measures. Results The adaptation process involved a meticulous analysis of item equivalence by the expert committee and an expert on the EMAS. Also, harmonization with other translated versions and a cognitive debriefing was carried to assess comprehensibility. Conclusion Following best practice, this study has developed the EDIAS, a tool for evaluating participation in meaningful activities adapted to the Spanish context.
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17
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‘Rekindling couplehood’ using a multisensory suitcase of memories: a pilot study of people living with moderate dementia and their partners. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x21001926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Creating individualised activities in partnership with people who have moderate dementia and their partners at home has rarely been achieved, as such interventions are usually pre-planned by researchers or professionals. The academic gap is in the activity design being led by the person who has dementia and their partner and how to engage them in a meaningful manner which rekindles positive joint memories and improves the quality of their current relationship. This article explores the meaning and significance of recalling shared holiday memories for people living with moderate dementia and their partners, using multisensory reminiscence. A sensory ethnography research methodology was employed which enhanced co-design of the activity over five home visits. The research culminated in the creation of a digital story, sharing of food and drink, and re-enactment through exploration of their holiday memorabilia: forming their suitcase of memories (SOM). The study extends the current academic debate of co-produced interventions and identifies the critical themes of ‘holidays as life’, ‘freedom’, ‘view seen, viewpoint heard’ and ‘strengthened self-identity with younger self’ which emerged from the research. Such areas of sensory reminiscence have supported positive recollections, discourse and, when combined, resulted in a beneficial impact on the partner's shared relationship. A significant research outcome was the transition from a negative life view dominated by dementia to rekindling their relationship positively as a result of the SOM intervention and sensory methodology. Future research to continue the work with new couples to see if similar results are achieved with more case studies is needed.
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18
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Morbach ACB, Pedroso JDS. Aspects of the development of older adults in the perspective of analytical psychology: a systematic review of qualitative findings. Aging Ment Health 2022; 26:1-12. [PMID: 33222503 DOI: 10.1080/13607863.2020.1849024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To synthesize evidence related to aspects of the development of older adults in qualitative studies that have analytical psychology as a reference. METHODS we conducted a systematic review of qualitative findings following a meta-aggregation approach. Bibliographic databases PsycINFO, Pubmed (Medline), Web of Science, Scopus and LILACS were searched. Original research articles that fitted our selection criteria were selected. Two reviewers independently appraised the quality of the included studies, extracted the data, and aggregated it into a set of synthesized findings. RESULTS five studies fulfilled the inclusion criteria. Our meta-aggregation identified six synthesized findings: i) accessing the unconscious of older people with dementia; ii) contacting past experiences and emotions; iii) working with dreams; iv) facing mortality; v) individuation process in old age and vi) particularities of psychotherapeutic work with older people. CONCLUSIONS older adults benefit from Jungian-based psychotherapeutic interventions. Those techniques may help them cope with the developmental challenges of aging and enhance their well-being. Jungian thinking may contribute to a positive understanding of aging among mental-health professionals.
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Affiliation(s)
| | - Janari da Silva Pedroso
- Laboratório de Pesquisa em Saúde, Faculdade de Psicologia, Universidade Federal do Pará, Belém, Brazil
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19
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Gebhard D, Mir E. What Moves People Living With Dementia? Exploring Barriers and Motivators for Physical Activity Perceived by People Living With Dementia in Care Homes. QUALITATIVE HEALTH RESEARCH 2021; 31:1319-1334. [PMID: 33825572 PMCID: PMC8182331 DOI: 10.1177/10497323211002822] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
There is a lack of intervention promoting physical activity targeted toward people living with dementia because their input has not been prioritized in the development of exercise programs. The aim of this study is to investigate motivators and barriers concerning physical activity in people living with dementia in care homes and to give recommendations for intervention development. Qualitative semi-structured interviews were conducted; transcripts were analyzed using qualitative content analysis. Following a tailored procedural model, inductive and deductive category development was applied. The value of Cohen's κ = .94 indicates the high intercoder reliability of the category system developed. Ten interviewees reported 24 different barriers and 12 motivators concerning physical activity in the context of the social-ecological model. The strong impact of intrapersonal factors and the living environment became apparent. Points of reference for how people living with dementia can overcome barriers and activate their motivators to achieve more physical activity are provided.
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Affiliation(s)
| | - Eva Mir
- Carinthia University of Applied
Sciences, Feldkirchen, Austria
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20
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Dasgupta M, Beker L, Schlegel K, Hillier LM, Joworski L, Crunican K, Coulter C. A Non-Pharmacologic Approach to Manage Behaviours in Confused Medically Ill Older Adults in Acute Care. Can Geriatr J 2021; 24:125-137. [PMID: 34079606 PMCID: PMC8137457 DOI: 10.5770/cgj.24.469] [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: 11/22/2022] Open
Abstract
Background Non-pharmacological interventions are recommended to manage challenging behaviours among cognitively impaired older adults, however few studies have enrolled patients in acute care. This study aimed to determine the feasibility of implementing non-pharmacological interventions to manage behaviours in hospitalized older adults. Method A self-identity approach was used to identify potentially engaging activities for 13 older medically ill adults admitted to acute hospital; these activities were trialed for a two-week period. Data were collected on frequency of intervention administration and assistance required, as well as frequency of behaviours and neuroleptic use in the seven days prior to and following the trial of activities. Results Per participant, 5–11 interventions were prescribed. Most frequently interventions were tried two or more times (46%); 9% were not tried at all. Staff or family assistance was not required for 27% of activities. The mean number of documented behaviours across participants was 4.8 ± 2.3 in the pre-intervention period and 2.1 ± 1.9 in the post-intervention period. Overall the interventions were feasible and did not result in increasing neuroleptic use Conclusion Non-pharmacologic interventions may be feasible to implement in acute care. More research in this area is justified.
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Affiliation(s)
- Monidipa Dasgupta
- Division of Geriatric Medicine, Shulich School of Medicine, Western University, London, ON.,Lawson Health Research Institute, London, ON
| | | | - Kim Schlegel
- London Health Sciences Centre, London, ON.,Fanshawe College, London, ON
| | - Loretta M Hillier
- GERAS Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON
| | | | | | - Corrine Coulter
- Department of Family Medicine, Shulich School of Medicine, Western University, London, ON
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21
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Lu LC, Lan SH, Hsieh YP, Lan SJ. Effectiveness of intergenerational participation on residents with dementia: A systematic review and meta-analysis. Nurs Open 2021; 9:920-931. [PMID: 34021969 PMCID: PMC8859040 DOI: 10.1002/nop2.919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 02/18/2021] [Accepted: 04/14/2021] [Indexed: 11/20/2022] Open
Abstract
Aim This meta‐analysis evaluated the effectiveness of intergenerational program participation for long‐term care institution residents with dementia. Design A systematic review and meta‐analysis. Methods Ten electronic databases were systematically searched until August 2020: CINAHL, the Cochrane Library, EBSCO, EMBASE, Ovid Medline, ProQuest, Psychology and Behavioral Sciences Collection, PubMed, Scopus, and Web of Science. The Joanna Briggs Institute tool (JBI tool) was used for the quality appraisal of the included publications, and Review Manager 5.3 was used for the meta‐analysis. Results Thirteen articles were identified (1993–2015). Intergenerational program participation could improve the pleasure level and significantly reduce disengagement behaviours of residents with dementia. The intergenerational program intervention caused no apparent improvement in their quality of life, depression levels, and engagement levels.
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Affiliation(s)
- Li-Chin Lu
- School of Management, Putian University, Putian, China
| | - Shao-Huan Lan
- School of Pharmaceutical Sciences and Medical Technology, Putian University, Putian, China
| | - Yen-Ping Hsieh
- Department of Long-term Care, National Quemoy University, Jinning Township, Taiwan
| | - Shou-Jen Lan
- School of Basic Medical Science, Putian University, Putian, China
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22
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Sass C, Surr C, Lozano-Sufrategui L. Expressions of masculine identity through sports-based reminiscence: An ethnographic study with community-dwelling men with dementia. DEMENTIA 2021; 20:2170-2187. [PMID: 33595350 DOI: 10.1177/1471301220987386] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Despite increasing numbers of men living in isolation with dementia in the community, uptake of supportive interventions remains low. This may be because of limited availability of activities suited to men's interests. One organisation reporting higher attendance from men is Sporting Memories, offering inclusive sports-based reminiscence and physical activities for men living with dementia. This study aimed to explore the impact of the Sporting Memories intervention on men living with dementia. METHOD This study was an ethnography employing techniques of participant observation, informal conversations and semi-structured interviews with group participants. Data were woven into a series of narratives using creative non-fiction, to bring life to the first-hand accounts of participants and experiences within a typical group setting. FINDINGS The groups provided an environment for men with dementia to explore, reflect upon and reinforce their masculine identities through the subject of sport. Physical activities further facilitated this embodied demonstration for some, although this was not a feature of all sessions. CONCLUSIONS The content of Sporting Memories group sessions provides a vehicle for men to retain an important aspect of personhood. They also hold the potential to present opportunities for men to feel a sense of value by contributing to sessions in varied ways. Facilitators and volunteers require support and training to ensure this benefit is maintained.
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Affiliation(s)
- Cara Sass
- Centre for Dementia Research, 4467Leeds Beckett University, Leeds, UK; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Claire Surr
- Centre for Dementia Research, 4467Leeds Beckett University, Leeds, UK
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23
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de Boer B, Bozdemir B, Jansen J, Hermans M, Hamers JPH, Verbeek H. The Homestead: Developing a Conceptual Framework through Co-Creation for Innovating Long-Term Dementia Care Environments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E57. [PMID: 33374761 PMCID: PMC7795205 DOI: 10.3390/ijerph18010057] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/17/2020] [Accepted: 12/19/2020] [Indexed: 12/22/2022]
Abstract
Alternative care environments for regular nursing homes are highly warranted to promote health and well-being of residents with dementia that are part of an age-friendly and dementia-friendly city and society. Insight is lacking on how to translate evidence-based knowledge from theory into a congruent conceptual model for innovation in current practice. This study reports on the co-creation of an alternative nursing home model in the Netherlands. A participatory research approach was used to co-create a conceptual framework with researchers, practitioners and older people following an iterative process. Results indicate that achieving positive outcomes for people with dementia, (in)formal caregivers, and the community is dependent on how well the physical, social and organizational environment are congruently designed. The theoretical underpinnings of the conceptual model have been translated into "the homestead," which is conceptualized around three main pillars: activation, freedom and relationships. The Homestead Care Model is an illustrative example of how residential care facilities can support the development of age-friendly communities that take into consideration the needs and requirements of older citizens. However, challenges remain to implement radical changes within residential care. More research is needed into the actual implementation of the Homestead Care Model.
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Affiliation(s)
- Bram de Boer
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6229 GT Maastricht, The Netherlands;
- Living Lab in Ageing and Long-Term Care, 6229 GT Maastricht, The Netherlands; (B.B.); (J.J.); (M.H.)
| | - Belkis Bozdemir
- Living Lab in Ageing and Long-Term Care, 6229 GT Maastricht, The Netherlands; (B.B.); (J.J.); (M.H.)
- MeanderGroep Zuid Limburg, 6372 PP Landgraaf, The Netherlands
| | - Jack Jansen
- Living Lab in Ageing and Long-Term Care, 6229 GT Maastricht, The Netherlands; (B.B.); (J.J.); (M.H.)
- MeanderGroep Zuid Limburg, 6372 PP Landgraaf, The Netherlands
| | - Monique Hermans
- Living Lab in Ageing and Long-Term Care, 6229 GT Maastricht, The Netherlands; (B.B.); (J.J.); (M.H.)
- MeanderGroep Zuid Limburg, 6372 PP Landgraaf, The Netherlands
| | - Jan P. H. Hamers
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6229 GT Maastricht, The Netherlands;
- Living Lab in Ageing and Long-Term Care, 6229 GT Maastricht, The Netherlands; (B.B.); (J.J.); (M.H.)
| | - Hilde Verbeek
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6229 GT Maastricht, The Netherlands;
- Living Lab in Ageing and Long-Term Care, 6229 GT Maastricht, The Netherlands; (B.B.); (J.J.); (M.H.)
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24
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Holden RJ, Cavalcanti L, Vemireddy S, Bateman DR, Sheetz NJ, Fowler NR, Parmar T, Karanam Y. Community-Based Service Providers' Experiences With Activities for Persons With Dementia. Int J Aging Hum Dev 2020; 93:881-903. [PMID: 33242974 DOI: 10.1177/0091415020974620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Persons with dementia (PWD) benefit from participating in meaningful activities. This study's objective was to learn the characteristics of successful meaningful activities from community-based service providers who work with PWD. Six group interviews were performed with 15 unique professionals from an adult day service or community-based coordinated care program. These were supplemented by 100 hr of researcher immersion through weekly volunteering. Data were analyzed by a team, using qualitative content analysis. Participants reported successful activity content incorporated personalization; continuity and incremental challenges; and social engagement. Successful delivery of activities required managing necessary resources; involving informal (family/friend) caregivers; having a backup plan; monitoring time of day and energy levels; facilitating a domino effect; and ensuring safety. Outcomes of successful activities were experiencing fulfillment and purpose; overcoming challenges; and unexpected triggers. Research and practice recommendations include testing innovative, dynamic, and technology-enabled approaches to providing such activities.
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Affiliation(s)
- Richard J Holden
- 12250 Department of Medicine, Indiana University School of Medicine, Indianapolis, USA.,Indiana University Center for Aging Research, Regenstrief Institute, Inc., Indianapolis, USA
| | - Luiz Cavalcanti
- 10668 Department of Human-Centered Computing, Indiana University-Purdue University Indianapolis, Indianapolis, USA
| | - Sravani Vemireddy
- Department of BioHealth Informatics, Indiana University-Purdue University Indianapolis, Indianapolis, USA
| | - Daniel R Bateman
- 10668 Department of Human-Centered Computing, Indiana University-Purdue University Indianapolis, Indianapolis, USA.,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, USA
| | | | - Nicole R Fowler
- 12250 Department of Medicine, Indiana University School of Medicine, Indianapolis, USA.,Indiana University Center for Aging Research, Regenstrief Institute, Inc., Indianapolis, USA
| | - Takshak Parmar
- 10668 Department of Human-Centered Computing, Indiana University-Purdue University Indianapolis, Indianapolis, USA
| | - Yamani Karanam
- 10668 Department of Human-Centered Computing, Indiana University-Purdue University Indianapolis, Indianapolis, USA
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25
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Acceptability and willingness to participate in the Tailored Activity Program: perceptions of people living with dementia, their care partners and health professionals. BRAIN IMPAIR 2020. [DOI: 10.1017/brimp.2020.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AbstractObjectives:The Tailored Activity Program (TAP) is an evidence-based occupational therapist-led intervention for people living with dementia and their care partners at home, developed in the USA. This study sought to understand its acceptability to people living with dementia, their care partners, and health professionals, and factors that might influence willingness to participate prior to its implementation in Australia.Methods:This study used qualitative descriptive methods. Semi-structured interviews were conducted with people living with dementia in the community (n = 4), their care partners (n = 13), and health professionals (n = 12). People living with dementia were asked about health professionals coming to their home to help them engage in activities they enjoy, whereas care partners’ and health professionals’ perspectives of TAP were sought, after it was described to them. Interviews were conducted face-to-face or via telephone. All interviews were recorded and transcribed. Framework analysis was used to identify key themes.Results:Analysis identified four key themes labelled: (i) TAP sounds like a good idea; (ii) the importance of enjoyable activities; (iii) benefits for care partners; and (iv) weighing things up. Findings suggest the broad, conditional acceptability of TAP from care partners and health professionals, who also recognised challenges to its use. People living with dementia expressed willingness to receive help to continue engaging in enjoyable activities, if offered.Discussion:While TAP appeared generally acceptable, a number of barriers were identified that must be considered prior to, and during its implementation. This study may inform implementation of non-pharmacological interventions more broadly.
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26
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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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Affiliation(s)
- Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
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Effects of non-facilitated meaningful activities for people with dementia in long-term care facilities: A systematic review. Geriatr Nurs 2020; 41:863-871. [PMID: 32571584 PMCID: PMC7305740 DOI: 10.1016/j.gerinurse.2020.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 01/01/2023]
Abstract
Most activity interventions for people with dementia in long-term care are facilitated. Non-facilitated meaningful activities included music/stimulated family presence, animal-like social robot, lifelike dolls. Some beneficial effects for agitation, emotional wellbeing, feelings of pleasure, engagement and sleep quality. Future research into the potential benefits of non-facilitated meaningful activities is needed in rigorously designed RCTs.
This systematic review sought to evaluate the effectiveness of non-facilitated meaningful activities for older people with dementia in long-term care facilities. Searches were conducted in PubMed; CINAHL; EMBASE; Web of science; PsycINFO; Cochrane; ProQuest; and ClinicalTrials.gov to identify articles published between January 2004 and October 2019. A total of six studies were included. Results implied that current randomised controlled trials or controlled trials about non-facilitated meaningful activities for people with living dementia in long-term care facilitates are limited, but those included in this review were of adequate methodological quality. Meaningful non-facilitated activities, such as music, stimulated family presence, animal-like social robot PARO/plush toy and lifelike dolls, may have beneficial effects on agitation, emotional well-being, feelings of pleasure, engagement, and sleep quality. However, there remains a lack of conclusive and robust evidence to support these psychological and physiological effects of non-facilitated meaningful activities for older people with dementia living in long-term care facilities by care staff.
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Michelet M, Lund A, Strand BH, Engedal K, Selbaek G, Bergh S. Characteristics of patients assessed for cognitive decline in primary healthcare, compared to patients assessed in specialist healthcare. Scand J Prim Health Care 2020; 38:107-116. [PMID: 32362213 PMCID: PMC8570739 DOI: 10.1080/02813432.2020.1753334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Objective: The aim of this study was to describe patients assessed for cognitive decline in primary healthcare, compared to patients assessed in specialist healthcare and to examine factors associated with depression.Design: This was an observational study.Setting: Fourteen outpatient clinics and 33 general practitioners and municipality memory teams across Norway.Subjects: A total of 226 patients assessed in primary healthcare and 1595 patients assessed in specialist healthcare outpatient clinics.Main outcome measures: Cornell scale for depression in dementia (CSDD), Mini-Mental Status Examination (MMSE), Clock drawing test, Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), Instrumental Activities of Daily Living, Personal Self-Maintenance Scale, Relatives' stress scale (RSS), and Neuropsychiatric Inventory Questionnaire (NPI-Q)Results: Patients assessed in primary healthcare were older (mean age 81.3 vs 73.0 years), less educated, had poorer cognition (MMSE median 22 vs 25), more limitations in activities of daily living (ADL), more behavioural and psychological symptoms of dementia (BPSD), more depressive symptoms (CSDD median 7 vs 5), more often lived alone (60% vs 41%) and were more often diagnosed with dementia (86% vs 47%) compared to patients diagnosed in specialist healthcare. Depression was associated with female gender, older age, more severe decline in cognitive functioning (IQCODE, OR 1.65), higher caregiver burden (RSS, OR 1.10) and with being assessed in primary healthcare (OR 1.53).Conclusion: Post-diagnostic support tailored to patients diagnosed with dementia in primary healthcare should consider their poor cognitive function and limitations in ADL and that these people often live alone, have BPSD and depression.Key pointsPeople diagnosed in Norwegian primary healthcare had more needs than people diagnosed in specialist healthcare. • They were older, less educated, had poorer cognitive functioning and activity limitations, more often lived alone, and had more BPSD and depression. • Depression was associated with being female, older, having cognitive decline, being assessed in primary care and the caregiver experiencing burden • Post diagnostic support for people with dementia should be tailored to the individual's symptoms and needs.
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Affiliation(s)
- Mona Michelet
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway;
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway;
- Faculty of Medicine, University of Oslo, Oslo, Norway;
- CONTACT Mona Michelet Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, PO Box 2136, Tønsberg3103, Norway
| | - Anne Lund
- Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, OsloMet – Oslo Metropolitan University, Oslo, Norway;
| | - Bjørn Heine Strand
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway;
- Norwegian Institute of Public Health, Oslo, Norway;
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway;
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway;
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway;
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway;
- Faculty of Medicine, University of Oslo, Oslo, Norway;
| | - Sverre Bergh
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway;
- Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
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Goodman-Casanova JM, Dura-Perez E, Guzman-Parra J, Cuesta-Vargas A, Mayoral-Cleries F. Telehealth Home Support During COVID-19 Confinement for Community-Dwelling Older Adults With Mild Cognitive Impairment or Mild Dementia: Survey Study. J Med Internet Res 2020; 22:e19434. [PMID: 32401215 PMCID: PMC7247465 DOI: 10.2196/19434] [Citation(s) in RCA: 182] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The public health emergency of coronavirus disease (COVID-19) is rapidly evolving worldwide; some countries, including Spain, have implemented restrictive measures. Populations that are vulnerable to this outbreak and its physical and mental health effects include community-dwelling older adults with mild cognitive impairment or mild dementia. Telehealth is a potential tool to deliver health care and decrease exposure risk. OBJECTIVE The aims of this study were to explore the impact of confinement on the health and well-being of community-dwelling older adults with mild cognitive impairment or mild dementia, to provide television-based and telephone-based health and social support, and to study the effects of a television-based assistive integrated technology, TV-AssistDem (TeleVision-based ASSistive Integrated Service to supporT European adults living with mild DEMentia or mild cognitive impairment). METHODS A telephone-based survey was administered in Spain to 93 participants in the TV-AssistDem clinical trial from March 25 to April 6, 2020. RESULTS Of the respondents, 60/93 (65%) were women. The mean age was 73.34 (SD 6.07), and 69/93 (74%) lived accompanied. Lockdown measures forced 17/93 respondents (18%) to change their living arrangements. Health status was found to be optimal in 89/93 respondents (96%), with no COVID-19 symptoms. Grocery and pharmacy outings were performed by family members of 68/93 participants (73%); 57 (61%) reported overall well-being, and 65 (70%) maintained their sleep quality. However, participants living alone reported greater negative feelings and more sleeping problems. Regarding leisure activities, 53/93 respondents (57%) took walks, 32 (35%) played memory games, 55 (60%) watched television, and 91 (98%) telephoned relatives. 58/93 (64%) respondents reported accessing moderate or too much COVID-19 information, 89 (97%) received it from television, and 56 (62%) stated that their understanding of the information was extreme. 39/93 (39%) respondents had contacted health and social services, while 29 (31%) requested information regarding these services during the telephone call. There were no significant differences in health and well-being between the intervention and control groups. Respondents with TV-AssistDem performed more memory exercises (24/93, 52% vs 8/93, 17.4%; P<.001) than control respondents. CONCLUSIONS Our findings suggest that during COVID-19 confinement, the physical and mental health and well-being was optimal for the majority of our vulnerable population. However, those living alone reported greater negative psychological effects and sleeping problems. Measures adopted to address the negative experiences of confinement included keeping informed about the situation, accessing health and social services, having a support network that prevents risk of exposure to COVID-19 and guarantees food and medical supplies, a daily routine with maintained sleeping habits and leisure activities, staying physically and mentally active with cognitive stimulation exercises, and ensuring social connectedness using technology. Television sets were preferred technological devices to access COVID-19 information, watch television as a recreational activity, and perform memory exercises as an intellectual activity. Television-based telehealth support using TV-AssistDem demonstrated potential for cognitive stimulation. TRIAL REGISTRATION ClinicalTrials.gov NCT03653234; https://clinicaltrials.gov/ct2/show/NCT03653234.
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Affiliation(s)
- Jessica Marian Goodman-Casanova
- Department of Mental Health, Regional University Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
| | - Elena Dura-Perez
- Department of Mental Health, Regional University Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
| | - Jose Guzman-Parra
- Department of Mental Health, Regional University Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
| | - Antonio Cuesta-Vargas
- Department of Physiotherapy, University of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
| | - Fermin Mayoral-Cleries
- Department of Mental Health, Regional University Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
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Kim S, Chee KH, Gerhart O. Generativity in Creative Storytelling: Evidence From a Dementia Care Community. Innov Aging 2020; 4:igaa002. [PMID: 32258435 PMCID: PMC7102510 DOI: 10.1093/geroni/igaa002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Indexed: 11/21/2022] Open
Abstract
Background and Objectives Creative group storytelling as utilized in TimeSlips is a social activity that focuses on communication, improvisation, and creativity among its participants with dementia. A collective narrative is a channel through which participants express themselves, and it thus signifies clues about their identities, values, and experiences. No study to date, however, has examined the contents of the stories. Using the generativity model as a theoretical underpinning for analysis, this paper examines the emergent themes of such collective stories. Research Design and Methods This study used the data collected in a memory care community where a research team recruited and engaged 21 out of approximately 80 residents with dementia in 6 weekly creative storytelling sessions; 4 small groups of 4 to 6 participants created a total of 24 collective stories. Three researchers analyzed these stories by open-coding emergent themes. Once coded manually, the narratives were managed and analyzed in NVivo. Results Consistent with the concept of generativity, a thematic analysis of collective narratives revealed various aspects of participants’ generative concerns. Three themes related to generativity: (1) caring and promoting the well-being of others, (2) family values, and (3) positivity. Discussion and Implications The narratives show that participants living with dementia continue to express their generative values and concerns. The findings reveal generative identities held by persons living with dementia, which help destigmatize dementia. The findings also shed light on why creative group storytelling may affect multiple positive outcomes for its participants.
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Affiliation(s)
- Seoyoun Kim
- Department of Sociology, Texas State University, San Marcos
| | - Kyong Hee Chee
- Department of Sociology, Texas State University, San Marcos
| | - Olga Gerhart
- Department of Philosophy, Texas State University, San Marcos
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Balouch S, Zaidi A, Farina N, Willis R. Dementia awareness, beliefs and barriers among family caregivers in Pakistan. DEMENTIA 2020; 20:899-918. [PMID: 32223333 DOI: 10.1177/1471301220915066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Dementia research and services in Pakistan are limited. The following was explored in experiences of family caregivers of people with dementia in Pakistan: (a) to determine whether culture and religion play a role in caregiving; (b) to draw insights on how family caregivers cope, what barriers they face and what help they would be willing to accept and (c) to determine how these findings could be used to raise awareness and influence public policies in improving the lives of families living with dementia. METHODS The experiences of family caregivers of people with dementia in Pakistan were explored via semi-structured interviews (10 in Lahore; 10 in Karachi). This was part of a larger qualitative study conducted about dementia in Pakistan. Caregivers interviewed were aged 35-80 (14 female). Most caregivers in the study were educated and affluent. Interviews were conducted in Urdu, translated into English and thematically analysed. RESULTS Five themes emerged: knowledge and awareness; stigma; importance of religion and duty to care; use of day care centres and home-help; and barriers. A lack of dementia awareness exists in Pakistan. The religious duty to care for family influenced caregiving decisions. Day care centres and home-help were accessed and viewed positively. The caregivers also wanted extracurricular activities for people with dementia, support groups for caregivers and better training for healthcare staff. Novel findings included that caregivers felt that dementia should not be stigmatised, and awareness should be raised in Pakistan via TV, radio and social media, but not inside mosques. DISCUSSION Additional research is necessary to determine if positive views of day care centres and home-help exist more widely. Attitudes and experiences regarding stigma may be different for caregivers of people with more advanced dementia. We recommend raising dementia awareness, allocating more funds to dementia services and an emphasis on home-based care.
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Affiliation(s)
| | - Asghar Zaidi
- Government College University, Lahore, Pakistan; Oxford Institute of Population Ageing, Oxford, UK
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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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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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Comparative efficacy of non-pharmacological interventions on agitation in people with dementia: A systematic review and Bayesian network meta-analysis. Int J Nurs Stud 2019; 102:103489. [PMID: 31862527 DOI: 10.1016/j.ijnurstu.2019.103489] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/17/2019] [Accepted: 11/18/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Agitation in people with dementia is common and distressing and can lead to increased caregiver burden. However, medications often have adverse reactions and limited effectiveness. Thus, non-pharmacological interventions are being increasingly implemented. OBJECTIVES To compare and rank the efficacy of different non-pharmacological interventions in the management of agitation in people with dementia. DESIGN Bayesian network meta-analysis. METHODS A comprehensive electronic literature search was performed in five English databases and three Chinese databases to identify relevant randomized controlled trials (RCTs) that were published up to January 2019. A random-effects model was selected to conduct traditional meta-analysis to directly examine the efficacy of different non-pharmacological interventions. The consistency model was selected to conduct a network meta-analysis to evaluate the relative effects and rank probability of different non-pharmacological interventions. RESULTS A total of 65 RCTs were included in this network meta-analysis involving 11 different non-pharmacological interventions. Network meta-analysis showed that massage therapy, animal-assisted intervention, and personally tailored intervention were associated with more substantial reductions in agitation compared with other interventions and controls. CONCLUSIONS Our study confirmed the effectiveness of non-pharmacological interventions for ameliorating agitation in people with dementia and recommended several interventions for clinical practice. Healthcare professionals should be encouraged to apply promising non-pharmacological interventions (e.g. massage therapy, animal-assisted intervention and personally tailored intervention) for people with dementia during routine care.
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Nyman SR, Ingram W, Sanders J, Thomas PW, Thomas S, Vassallo M, Raftery J, Bibi I, Barrado-Martín Y. Randomised Controlled Trial Of The Effect Of Tai Chi On Postural Balance Of People With Dementia. Clin Interv Aging 2019; 14:2017-2029. [PMID: 31819385 PMCID: PMC6875562 DOI: 10.2147/cia.s228931] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 09/26/2019] [Indexed: 02/04/2023] Open
Abstract
Purpose To investigate the effect of Tai Chi exercise on postural balance among people with dementia (PWD) and the feasibility of a definitive trial on falls prevention. Patients and methods Dyads, comprising community-dwelling PWD and their informal carer (N=85), were randomised to usual care (n=43) or usual care plus weekly Tai Chi classes and home practice for 20 weeks (n=42). The primary outcome was the timed up and go test. All outcomes for PWD and their carers were assessed six months post-baseline, except for falls, which were collected prospectively over the six-month follow-up period. Results For PWD, there was no significant difference at follow-up on the timed up and go test (mean difference [MD] = 0.82, 95% confidence interval [CI] = -2.17, 3.81). At follow-up, PWD in the Tai Chi group had significantly higher quality of life (MD = 0.051, 95% CI = 0.002, 0.100, standardised effect size [ES] = 0.51) and a significantly lower rate of falls (rate ratio = 0.35, 95% CI =0.15, 0.81), which was no longer significant when an outlier was removed. Carers in the Tai Chi group at follow-up were significantly worse on the timed up and go test (MD = 1.83, 95% CI = 0.12, 3.53, ES = 0.61). The remaining secondary outcomes were not significant. No serious adverse events were related to participation in Tai Chi. Conclusion With refinement, this Tai Chi intervention has potential to reduce the incidence of falls and improve quality of life among community-dwelling PWD [Trial registration: NCT02864056].
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Affiliation(s)
- Samuel R Nyman
- Department of Psychology and Ageing & Dementia Research Centre, Faculty of Science and Technology, Bournemouth University, Poole House, Talbot Campus, Poole, Dorset BH12 5BB, UK
| | - Wendy Ingram
- Peninsula Clinical Trials Unit, Peninsula Medical School, University of Plymouth, Plymouth, Devon PL4 8AA, UK
| | - Jeanette Sanders
- Peninsula Clinical Trials Unit, Peninsula Medical School, University of Plymouth, Plymouth, Devon PL4 8AA, UK
| | - Peter W Thomas
- Bournemouth University Clinical Research Unit, Faculty of Health and Social Sciences, Bournemouth University, Royal London House, Lansdowne Campus, Bournemouth, Dorset BH1 3LT, UK
| | - Sarah Thomas
- Bournemouth University Clinical Research Unit, Faculty of Health and Social Sciences, Bournemouth University, Royal London House, Lansdowne Campus, Bournemouth, Dorset BH1 3LT, UK
| | - Michael Vassallo
- Centre of Postgraduate Medical Research and Education, Faculty of Health and Social Sciences, Bournemouth University, Royal London House, Lansdowne Campus, Bournemouth, Dorset BH1 3LT, UK
| | - James Raftery
- Faculty of Medicine, University of Southampton, Highfield Campus, Southampton, SO17 1BJ, UK
| | - Iram Bibi
- Department of Psychology and Ageing & Dementia Research Centre, Faculty of Science and Technology, Bournemouth University, Poole House, Talbot Campus, Poole, Dorset BH12 5BB, UK
| | - Yolanda Barrado-Martín
- Department of Psychology and Ageing & Dementia Research Centre, Faculty of Science and Technology, Bournemouth University, Poole House, Talbot Campus, Poole, Dorset BH12 5BB, UK
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Which Behaviour Change Techniques are Effective in Promoting Physical Activity Among Older People With Dementia? A Call For Research Into Three Underexplored Avenues. J Aging Phys Act 2019; 27:441-445. [PMID: 30676205 DOI: 10.1123/japa.2018-0301] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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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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Lee L, Hillier LM, Lu SK, Martin SD, Pritchard S, Janzen J, Slonim K. Person-centered risk assessment framework: assessing and managing risk in older adults living with dementia. Neurodegener Dis Manag 2019; 9:47-57. [PMID: 30638423 DOI: 10.2217/nmt-2018-0031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
AIM This study pilot-tested the person-centered risk assessment framework (PCRAF), a framework for managing risk among persons living with dementia (PLWD) in primary care. METHODS Healthcare providers (N = 7) piloting the PCRAF completed a survey, rating their satisfaction with the tool, and an interview to gather their perceptions of the PCRAF. PLWD and care partners (N = 12) completed a survey, rating their satisfaction with safety planning. RESULTS Care providers were very satisfied with the tool; however, patient or care partner inability to perceive or understand safety risks was a challenge. Use of the PCRAF was perceived as an opportunity to empower self-management, gather PLWD and care partner perspectives, reduce burden for care partners and increase understanding of potential risks. Patients and care partners were very satisfied with the way in which they were included in the risk discussion. CONCLUSION The PCRAF is a promising new tool to reduce risks associated with dementia.
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Affiliation(s)
- Linda Lee
- Center for Family Medicine Family Health Team, McMaster University, 10 B Victoria Street South, Kitchener, Ontario N2G 1C5, Canada.,Faculty of Medicine, Department of Family Medicine, McMaster University, 10 B Victoria Street South, Kitchener, Ontario N2G 1C5, Canada
| | - Loretta M Hillier
- Geriatric Education & Research in Aging Sciences (GERAS) Centre, St Peter's Hospital, 88 Maplewood Ave, Hamilton, Ontario L8M 1W9, Canada
| | - Stephanie K Lu
- Center for Family Medicine Family Health Team, McMaster University, 10 B Victoria Street South, Kitchener, Ontario N2G 1C5, Canada
| | - Sharon Dillon Martin
- Center for Family Medicine Family Health Team, McMaster University, 10 B Victoria Street South, Kitchener, Ontario N2G 1C5, Canada
| | - Sarah Pritchard
- Center for Family Medicine Family Health Team, McMaster University, 10 B Victoria Street South, Kitchener, Ontario N2G 1C5, Canada
| | - Jennifer Janzen
- Center for Family Medicine Family Health Team, McMaster University, 10 B Victoria Street South, Kitchener, Ontario N2G 1C5, Canada
| | - Karen Slonim
- Center for Family Medicine Family Health Team, McMaster University, 10 B Victoria Street South, Kitchener, Ontario N2G 1C5, Canada
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Abstract
Palliative care is an approach to the care of patients, affected by serious illness, and their families that aims to reduce suffering through the management of medical symptoms, psychosocial issues, spiritual well-being, and setting goals of care. Patients and families affected by a neurodegenerative illness have significant palliative care needs beginning at the time of diagnosis and extending through end-of-life care and bereavement. We advocate an approach to addressing these needs where the patient's primary care provider or neurologist plays a central role. Key skills in providing effective palliative care to this population include providing the diagnosis with compassion, setting goals of care, anticipating safety concerns, caregiver assessment, advance care planning, addressing psychosocial concerns, and timely referral to a hospice. Managing distressing medical and psychiatric symptoms is critical to improving quality of life throughout the disease course as well as at end-of-life. Many symptoms are common across illnesses; however, there are issues that are specific to the most common classes of neurodegenerative illness, namely dementia, parkinsonism, and motor neuron disease. Incorporating a palliative approach to care, although challenging in many ways, empowers physicians to provide greater support and guidance to patients and families in making the difficult journey through a neurodegenerative illness.
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Camic PM, Crutch SJ, Murphy C, Firth NC, Harding E, Harrison CR, Howard S, Strohmaier S, Van Leewen J, West J, Windle G, Wray S, Zeilig H. Conceptualising and Understanding Artistic Creativity in the Dementias: Interdisciplinary Approaches to Research and Practise. Front Psychol 2018; 9:1842. [PMID: 30337898 PMCID: PMC6178924 DOI: 10.3389/fpsyg.2018.01842] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 09/10/2018] [Indexed: 12/20/2022] Open
Abstract
Creativity research has a substantial history in psychology and related disciplines; one component of this research tradition has specifically examined artistic creativity. Creativity theories have tended to concentrate, however, on creativity as an individual phenomenon that results in a novel production, and on cognitive aspects of creativity, often limiting its applicability to people with cognitive impairments, including those with a dementia. Despite growing indications that creativity is important for the wellbeing of people living with dementias, it is less well understood how creativity might be conceptualised, measured and recognised in this population, and how this understanding could influence research and practise. This paper begins by exploring prevailing concepts of creativity and assesses their relevance to dementia, followed by a critique of creativity and dementia research related to the arts. Perspectives from researchers, artists, formal and informal caregivers and those with a dementia are addressed. We then introduce several novel psychological and physiological approaches to better understand artistic-related creativity in this population and conclude with a conceptualisation of artistic creativity in the dementias to help guide future research and practise.
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Affiliation(s)
- Paul M. Camic
- Created Out of Mind, Wellcome Collection, London, United Kingdom
- Salomons Centre for Applied Psychology, Canterbury Christ Church University, Canterbury, United Kingdom
| | - Sebastian J. Crutch
- Created Out of Mind, Wellcome Collection, London, United Kingdom
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Charlie Murphy
- Created Out of Mind, Wellcome Collection, London, United Kingdom
| | - Nicholas C. Firth
- Created Out of Mind, Wellcome Collection, London, United Kingdom
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
| | - Emma Harding
- Created Out of Mind, Wellcome Collection, London, United Kingdom
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | | | - Susannah Howard
- Created Out of Mind, Wellcome Collection, London, United Kingdom
- Living Words, Folkestone, United Kingdom
| | - Sarah Strohmaier
- Created Out of Mind, Wellcome Collection, London, United Kingdom
- Salomons Centre for Applied Psychology, Canterbury Christ Church University, Canterbury, United Kingdom
| | - Janneke Van Leewen
- Created Out of Mind, Wellcome Collection, London, United Kingdom
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Julian West
- Created Out of Mind, Wellcome Collection, London, United Kingdom
- Royal Academy of Music, London, United Kingdom
| | - Gill Windle
- Created Out of Mind, Wellcome Collection, London, United Kingdom
- Dementia Services Development Centre, Bangor University, Bangor, United Kingdom
| | - Selina Wray
- Created Out of Mind, Wellcome Collection, London, United Kingdom
- UCL Institute of Neurology, University College London, London, United Kingdom
| | - Hannah Zeilig
- Created Out of Mind, Wellcome Collection, London, United Kingdom
- College of Fashion, University of the Arts London, London, United Kingdom
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Morse N, Chatterjee H. Museums, health and wellbeing research: co-developing a new observational method for people with dementia in hospital contexts. Perspect Public Health 2017; 138:152-159. [PMID: 29130813 DOI: 10.1177/1757913917737588] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS The aim of this article is to present a new observational tool for assessing the impacts of museum object handling for people with moderate-to-severe dementia in hospital settings, focusing on wellbeing, social interaction, level of engagement and agitation. This article presents a four-step approach to collaboration towards co-developing the tool, which involved a range of academics, museums professionals, and health and social care partners, and describes the process of integrating multiple perspectives towards common research methodologies. METHODS The research team organised a series of meetings and workshops with museum and healthcare partners to identify commonly used assessments and their perspectives on the objectives and possible outcomes of museum object handling activities. These were integrated with findings from a review of current conceptualisations of engagement in people with dementia (PWD) to produce a fit-for-purpose video evaluation method of the health and wellbeing impacts of the museum object handling programmes. RESULTS This article presents the Museum Engagement Observation Tool for use in hospital settings for people with moderate-to-severe dementia. CONCLUSION This article suggests that collaborative approaches can inform the development of future methods for creative health research and evaluation initiatives and to support this, it outlines the process of development of a new observational tool for people with dementia.
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Affiliation(s)
- Nuala Morse
- Research Associate, Whitworth Art Gallery, University of Manchester and Honorary Researcher, UCL Culture, University College London, London, UK
| | - Helen Chatterjee
- Professor of Biology, UCL Biosciences and Head of Research and Teaching, UCL Culture, University College London, Gower Street, London WC1E 6BT, UK
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Hitch D, Swan J, Pattison R, Stefaniak R. Use of touchscreen tablet technology by people with dementia in homes: A scoping review. J Rehabil Assist Technol Eng 2017; 4:2055668317733382. [PMID: 31186940 PMCID: PMC6453045 DOI: 10.1177/2055668317733382] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 09/04/2017] [Indexed: 12/03/2022] Open
Abstract
Background The aim of this scoping review was to identify the range, extent and nature
of research around the use of touchscreen tablets by people with dementia in
their home environment, particularly in regards to its use as a means of
supporting participation in meaningful and socially connected activity. Methods A review of both peer-reviewed and grey literature was undertaken across 61
databases, along with reference list checking for articles published between
2010 and 2016. Results Twelve articles were included in this review, predominantly from Western
European cultures and community-based home environments. The studies were
exploratory in nature, with the majority focusing on the development of
applications for people with dementia. Conclusions The study identified a range of exploratory research related to the use of
touchscreen tablets by people with dementia. However, there were significant
gaps within this evidence base, which provide opportunities for further
research using more robust methodologies. Given the ubiquitous nature of
touchscreen tablets in modern communities, further research could facilitate
their use as a minimally stigmatizing and culturally appropriate form of
support for people with dementia.
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Affiliation(s)
- Danielle Hitch
- North Western Mental Health, Melbourne Health, Melbourne, Australia
| | - Jodie Swan
- North Western Mental Health, Melbourne Health, Melbourne, Australia
| | - Ruth Pattison
- North Western Mental Health, Melbourne Health, Melbourne, Australia
| | - Rachel Stefaniak
- North Western Mental Health, Melbourne Health, Melbourne, Australia
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Nyman SR, Adamczewska N, Howlett N. Systematic review of behaviour change techniques to promote participation in physical activity among people with dementia. Br J Health Psychol 2017; 23:148-170. [PMID: 28980370 DOI: 10.1111/bjhp.12279] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 09/03/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE The objective of this study was to systematically review the evidence for the potential promise of behaviour change techniques (BCTs) to increase physical activity among people with dementia (PWD). METHODS PsychINFO, MEDLINE, CINAHL, and the Cochrane Central Register of Controlled Trials databases were searched 01/01/2000-01/12/2016. Randomized controlled/quasi-randomized trials were included if they recruited people diagnosed/suspected to have dementia, used at least one BCT in the intervention arm, and had at least one follow-up measure of physical activity/adherence. Studies were appraised using the Cochrane Collaboration Risk of Bias Tool, and BCTs were coded using Michie et al., 2013, Annals of Behavioral Medicine, 46, 81. taxonomy. Intervention findings were narratively synthesized as either 'very promising', 'quite promising', or 'non-promising', and BCTs were judged as having potential promise if they featured in at least twice as many very/quite promising than non-promising interventions (as per Gardner et al., 2016, Health Psychology Review, 10, 89). RESULTS Nineteen articles from nine trials reported physical activity findings on behavioural outcomes (two very promising, one quite promising, and two non-promising) or intervention adherence (one quite promising and four non-promising). Thirteen BCTs were used across the interventions. While no BCT had potential promise to increase intervention adherence, three BCTs had potential promise for improving physical activity behaviour outcomes: goal setting (behaviour), social support (unspecified), and using a credible source. CONCLUSIONS Three BCTs have potential promise for use in future interventions to increase physical activity among PWD. Statement of contribution What is already known on this subject? While physical activity is a key lifestyle factor to enhance and maintain health and wellbeing amongst the general population, adults rarely participate in sufficient levels to obtain these benefits. Systematic reviews suggest that specific behaviour change techniques can increase physical activity, although one review suggested that self-regulatory techniques may be counterproductive when promoting physical activity among older people. Until now, no systematic review has been conducted to assess which behaviour change techniques may be associated with greater participation in physical activity among people with dementia. What does this study add? Interventions showed mixed promise for increasing physical activity and little effect on participant adherence. Goal setting (behaviour), social support (unspecified), and using a credible source are promising approaches. No technique showed promise for increasing adherence to physical activity interventions among people with dementia.
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Affiliation(s)
- Samuel R Nyman
- Department of Psychology and Ageing & Dementia Research Centre, Faculty of Science and Technology, Bournemouth University, Poole, Dorset, UK
| | - Natalia Adamczewska
- Department of Psychology and Ageing & Dementia Research Centre, Faculty of Science and Technology, Bournemouth University, Poole, Dorset, UK
| | - Neil Howlett
- Department of Psychology, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK
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Abstract
PURPOSE OF REVIEW This review discusses the concept of 'dementia-friendly communities' and summarizes the latest research and practice around such communities. This review also highlights important topic areas to be considered to promote dementia friendliness in healthcare settings. RECENT FINDINGS Definitions of 'dementia-friendly communities' reflect the contemporary thinking of living with dementia (e.g., dementia as a disability, equal human rights, a sense of meaning). Existing research has covered a wide range of topic areas relevant to 'dementia-friendly communities'. However, these studies remain qualitative and exploratory by nature and do not evaluate how dementia-friendly communities impact health and quality of life of people living with dementia and their caregivers. In healthcare settings, being dementia friendly can mean the inclusion of people with dementia in treatment discussion and decision-making, as well as the provision of first, adequate and appropriate service to people with dementia at an equivalent standard of any patient, second, person-centered care, and third, a physical environment following dementia-friendly design guidelines. SUMMARY Research incorporating more robust study designs to evaluate dementia-friendly communities is needed. Being dementia-friendly in healthcare settings requires improvement in multiple areas - some may be achieved by environmental modifications while others may be improved by staff education.
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