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Pullen D, Pillay BS, Krüger E. Tube feeding in advanced dementia: Insights from South African speech-language therapists. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2024; 71:e1-e11. [PMID: 38426734 PMCID: PMC10913100 DOI: 10.4102/sajcd.v71i1.970] [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: 03/09/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Speech-language therapists (SLTs) may recommend tube feeding even with minimal research evidence of its effectiveness, and an understanding of SLTs' perceived practices is warranted. OBJECTIVES To qualitatively describe a sample of South African SLTs' perceived practices regarding feeding tube placement in people with advanced dementia. METHOD Semi-structured online interviews were conducted via Microsoft Teams. Eight South African SLTs with a particular interest in advanced dementia, in public and private settings, were recruited. Data were analysed using inductive reflexive thematic analysis. RESULTS Three main themes were identified: (1) factors influencing SLTs' decisions for feeding tube placement in people with advanced dementia; (2) nature of clinical setting and SLTs' decision-making and (3) SLTs' considerations to improve management of people with advanced dementia. Existing local palliative care guidelines were not employed in decisions about tube feeding. Most participants did not recommend tube feeding during end-of-life care. Perceived burden of care influenced participants' decisions about tube feeding. CONCLUSION Speech-language therapists in South Africa likely have an increased reliance on clinical experience rather than recent research and guidelines for decisions about feeding tube placement. Findings accentuate the importance of clinical supervision, mentoring and continuous professional development in the workplace. The findings are an urgent call to action to improve SLTs' overall practices and ethical service delivery for people with advanced dementia and their families.Contribution: Factors and needs regarding SLTs' decision-making about feeding tubes in people with advanced dementia are highlighted.
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Affiliation(s)
- Danette Pullen
- Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria.
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Tsuda S, Matsumoto H, Takehara S, Yabuki T, Hotta S. Family caregiver's concerns and anxiety about unaccompanied out-of-home activities of persons with cognitive impairment. BMC Geriatr 2023; 23:396. [PMID: 37380962 DOI: 10.1186/s12877-023-04025-7] [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: 02/02/2023] [Accepted: 05/07/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Although people with cognitive impairment highly value social participation in out-of-home activities, their families typically perceive concerns and experience anxiety over such activities. This study aimed to elucidate the underlying concerns and factors associated with family caregivers' anxiety over the individual's unaccompanied out-of-home activities. METHODS In December 2021, we conducted a cross-sectional e-survey of family caregivers of individuals with early-stage cognitive impairment. Caregivers' concerns about ten common risks related to out-of-home activities were cross-tabulated by specific anxiety levels to examine trend associations. With the variables of caregivers and their individuals across the five domains, we ran logistic regression analyses to determine explanatory models for anxiety. RESULTS The study participants were 1,322 family caregivers of people whose cognitive function varied from intact to possible mild dementia according to the Dementia Assessment Sheet for Community-based Integrated Care System 8-item. Significant associations were found between the prevalence of concerns and the degree of anxiety, even without actual experience with the issues of concern. Among the five domains, individual dementia characteristics and social behaviors were the predominant factors attributed to caregiver anxiety. Caregivers' no anxiety state was significantly associated with: younger age (OR 4.43, 95% CI 1.81-10.81), no detectable cognitive decline (OR 3.34, 95% CI 1.97-5.64), free from long-term care (LTC) (OR 3.52, 95% CI 1.72-7.21), no manifestation of behavioral and psychological symptoms of dementia (BPSD) (OR 13.22, 95% CI 3.06-57.01), and not engaging in unaccompanied out-of-home activities (OR 3.15, 95% CI 1.87-5.31). Their severe anxiety was positively associated with being on LTC (OR 3.39, 95% CI 2.43-4.72) and minor BPSD (OR 1.43, 95% CI 1.05-1.95), and negatively associated with engagement in unaccompanied out-of-home activities (OR 0.31, 95% CI 0.23-0.43). CONCLUSIONS The study found that family caregivers' anxiety was associated with concerns about behavioral issues, regardless of actual experiences. There were two significant associations in opposite directions between caregivers' anxiety and the individual's engagement in out-of-home activities. In the early phase of cognitive impairment, caregivers may intuitively interpret the individual's behavior and feel anxious. Educational support may provide reassurance and enable caregivers to facilitate out-of-home activities.
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Affiliation(s)
- Shuji Tsuda
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho, Itabashi, Tokyo, 173-0015, Japan.
| | - Hiroshige Matsumoto
- Department of Community Health Nursing, School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-0033, Japan
| | - Shun Takehara
- Department of Occupational Therapy, Faculty of Rehabilitation, Gunma Paz University, 1-7-1 Tonya, Takasaki, Gunma, 370-0006, Japan
| | - Tomoyuki Yabuki
- University of Kochi, 2751-1 Ike, Kochi, Kochi, 781-8515, Japan
| | - Satoko Hotta
- Graduate School of Health Management, Keio University, Endo, Fujisawa, Kanagawa, 4411, 252-0883, Japan
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Yin G, Lin S, Chen L. Risk factors associated with home care safety for older people with dementia: family caregivers' perspectives. BMC Geriatr 2023; 23:224. [PMID: 37029350 PMCID: PMC10082513 DOI: 10.1186/s12877-023-03893-3] [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: 07/12/2022] [Accepted: 03/15/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND Many older people with dementia currently prefer home care; however, homes are neither professionally designed nor regulated like health care facilities, and home care is more prone to safety incidents. Many studies have examined home care safety for older people with dementia. However, factors contributing to safety incidents in home care have not been adequately considered. This study explored the risk factors for home care safety for older people with dementia based on the perspective of family caregivers. METHODS This study used a qualitative research approach; a total of 24 family caregivers were interviewed face-to-face and semi-structured from February 2022 to May 2022, and the Colaizzi seven-step phenomenological research method was used to analyze the data and refine the themes. RESULTS Safety risks in home care for older people with dementia stem from five areas: poor health of older people with dementia, dementia symptoms, unsafe home environment, the insufficient caring ability of family caregivers, and lack of safety awareness of family caregivers. CONCLUSION The risk factors for home care safety for older people with dementia are complex. And as the primary caregivers of older people with dementia, the caregiving ability and safety awareness of family caregivers primarily determine the safety of home care for older people with dementia. Therefore, when addressing home care safety for older people with dementia, the focus should be on providing targeted education programs and support services for family caregivers of older people with dementia.
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Affiliation(s)
- Guo Yin
- School of Nursing, Sanquan College of Xinxiang Medical University, Xinxiang City, Henan Province, China
| | - Siting Lin
- School of Nursing and Health, Nanfang College, Guangzhou, Guangzhou City, Guangdong, China
| | - Linghui Chen
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK.
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Atoyebi O, Beaudoin M, Routhier F, Auger C, Demers L, Wister A, Plante M, Mortenson WB. Potential assistive technology preferences of informal caregivers of people with disability. J Rehabil Assist Technol Eng 2023; 10:20556683231172671. [PMID: 37168036 PMCID: PMC10164850 DOI: 10.1177/20556683231172671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 04/13/2023] [Indexed: 05/13/2023] Open
Abstract
Background Preferences of informal caregivers of people with neurocognitive disorders for technological solutions are important in user- centered design approaches. It is crucial to take into consideration the needs and preferences of users when developing new technology to facilitate their uptake. Objectives The objective of this study was to determine caregiver preferences for potential technological solutions to help address their needs and compare technology preferences of caregivers who provide care to those with and without neurocognitive disorders (NCD). Methods This was a quantitative descriptive study. We surveyed informal caregivers of older adults with disability in Canada. Participants were asked to answer questions about their preferences for 10 potential technological solutions that could be developed to make caregiving easier. Results Data from 125 respondents (72 caregivers of people with NCD and 53 caregivers of people with non-NCD-related disabilities) were analyzed. Generally, caregivers preferred web-based solutions as these were among the first five choices for both groups combined. However, there were some differences in the order of preference of potential solutions in both groups. Conclusion Informal caregivers of people with NCD preferred web-based solutions to help address their needs.
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Affiliation(s)
- Oladele Atoyebi
- University of British Columbia, Vancouver, Canada
- GF Strong Rehabilitation Research Program, Vancouver, Canada
| | - Maude Beaudoin
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale, Québec City, Canada
- Université Laval, Québec City, Canada
| | - François Routhier
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale, Québec City, Canada
- Université Laval, Québec City, Canada
| | - Claudine Auger
- Université de Montréal, Montréal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montréal, Canada
| | - Louise Demers
- Université de Montréal, Montréal, Canada
- Centre de Recherche de L’Institut Universitaire de Gériatrie de Montréal, Montréal, Canada
| | - Andrew Wister
- Gerontology Research Centre, Vancouver, Canada
- Simon Fraser University, Vancouver, Canada
| | - Michelle Plante
- Centre de Recherche de L’Institut Universitaire de Gériatrie de Montréal, Montréal, Canada
| | - W Ben Mortenson
- University of British Columbia, Vancouver, Canada
- GF Strong Rehabilitation Research Program, Vancouver, Canada
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Tudor Car L, Teng YS, How JW, Nazri NNBM, Tan ALX, Quah J, Peckham S, Smith H. Priorities for family physician and general practitioner recruitment and retention in Singapore: a PRIORITIZE study. BMC FAMILY PRACTICE 2021; 22:229. [PMID: 34784892 PMCID: PMC8596925 DOI: 10.1186/s12875-021-01570-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 10/20/2021] [Indexed: 11/28/2022]
Abstract
Background A shortage of primary care physicians has been reported in many countries. Primary care systems are diverse and the challenges leading to a decline in workforce are at times context-specific and require tailored solutions. Inviting frontline clinicians to share their insights can help identify optimal strategies for a particular setting. To determine priorities for family physicians’ and general practitioners’ recruitment and retention in Singapore, we invited primary care physicians to rank pertinent strategies using PRIORITIZE, a transparent, systematic priority-setting approach. Methods The study advisory board, consisting of representatives of Singapore’s key primary care stakeholders, determined the criteria for prioritising of general practitioners (GPs) and family physicians (FPs) recruitment and retention strategies in Singapore. A comprehensive list of GPs and FPs recruitment and retention strategies was extracted from a recent systematic review of the relevant literature. A questionnaire listing the strategies and the scoring criteria was administered online to doctors practicing in public and private sector in Singapore. Respondents’ scores were combined to create a ranked list of locally most relevant strategies for improving GPs and FPs recruitment and retention. Results We recruited a diverse sample of 50 GPs and FPs practicing in a variety of primary care settings, many with a range of additional professional responsibilities. Around 60 and 66% of respondents thought that there was a problem with recruitment and retention of GPs and FPs in Singapore, respectively. Strategies focusing on promoting primary care by emphasizing the advantages and enhancing the status of the profession as well as training-related strategies, such as sub-specialisation and high-quality rotations were considered priorities for improving recruitment. For retention of GPs and FPs, improving working conditions by increasing GPs’ and FPs’ salary and recognition, as well as varying or reducing time commitment, were seen as the most important strategies. The ranking between physicians working in public and private sector was mostly similar, with nine out of the top ten recruitment and retention strategies being the same. Conclusion Primary care physicians’ ranking of recruitment and retention strategies for GPs and FPs in Singapore provide important insight into the challenges and the solutions as seen by the members of the profession themselves. This information can guide future policy and decision making in this area. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01570-1.
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Affiliation(s)
- Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, Singapore. .,Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK.
| | - Yee Sean Teng
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, Singapore
| | - Jin Wei How
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, Singapore
| | | | - Amy Li Xian Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, Singapore
| | - Joanne Quah
- SingHealth Polyclinics, Singapore, Singapore
| | - Stephen Peckham
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Helen Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, Singapore
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Curnow E, Rush R, Gorska S, Forsyth K. Differences in assistive technology installed for people with dementia living at home who have wandering and safety risks. BMC Geriatr 2021; 21:613. [PMID: 34717561 PMCID: PMC8556981 DOI: 10.1186/s12877-021-02546-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 10/12/2021] [Indexed: 02/04/2023] Open
Abstract
Background Assistive Technology for people with dementia living at home is not meeting their care needs. Reasons for this may be due to limited understanding of variation in multiple characteristics of people with dementia including their safety and wandering risks, and how these affect their assistive technology requirements. This study therefore aimed to explore the possibility of grouping people with dementia according to data describing multiple person characteristics. Then to investigate the relationships between these groupings and installed Assistive Technology interventions. Methods Partitioning Around Medoids cluster analysis was used to determine participant groupings based upon secondary data which described the person characteristics of 451 people with dementia with Assistive Technology needs. Relationships between installed Assistive Technology and participant groupings were then examined. Results Two robust clustering solutions were identified within the person characteristics data. Relationships between the clustering solutions and installed Assistive Technology data indicate the utility of this method for exploring the impact of multiple characteristics on Assistive technology installations. Living situation and caregiver support influence installation of assistive technology more strongly than level of risk or cognitive impairment. People with dementia living alone received different AT from those living with others. Conclusions Results suggest that caregiver support and the living situation of the person with dementia influence the type and frequency of installed Assistive Technology. Reasons for this include the needs of the caregiver themselves, the caregiver view of the participants’ needs, caregiver response to alerts, and the caregiver contribution to the assistive technology assessment and selection process. Selection processes should be refined to account for the needs and views of both caregivers and people with dementia. This will require additional assessor training, and the development of validated assessments for people with dementia who have additional impairments. Policies should support the development of services which provide a wider range of AT to facilitate interventions which are focused on the needs of the person with dementia.
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Affiliation(s)
- Eleanor Curnow
- School of Health Sciences, Queen Margaret University, Edinburgh, EH21 6UU, UK.
| | - Robert Rush
- School of Health Sciences, Queen Margaret University, Edinburgh, EH21 6UU, UK
| | - Sylwia Gorska
- School of Health Sciences, Queen Margaret University, Edinburgh, EH21 6UU, UK
| | - Kirsty Forsyth
- School of Health Sciences, Queen Margaret University, Edinburgh, EH21 6UU, UK
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Dalgarno EL, Gillan V, Roberts A, Tottie J, Britt D, Toole C, Clarkson P. Home care in dementia: The views of informal carers from a co-designed consultation. DEMENTIA 2021; 20:2261-2277. [PMID: 33530737 PMCID: PMC8564226 DOI: 10.1177/1471301221990504] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND In the United Kingdom, there is a current priority for high-quality dementia care provided at home. However, home care or domiciliary care is an area where problems have been reported, in terms of a lack of consistency, coordination and appropriate responses to the specific needs of those with dementia. The views of informal carers, who often must respond to these problems when supporting relatives, are crucial in shedding light on the issues and in seeking to promote solutions. METHODS This study explored the views of informal carers of those with dementia concerning home care, through a consultation using an electronic survey. The survey questions were designed by informal carers, through a public involvement group within an existing programme of dementia research. The survey elicited responses from 52 informal carers in 2017/18. The data were analysed qualitatively using framework analysis. FINDINGS Carers' views focused on the need for investment into meaningful personalisation, recognising the value of providing care and valuing formal carers, systemic failings of care coordination and provision and the importance of ongoing collaboration and care planning. CONCLUSION Based on a framework drawn from the views of informal carers themselves, this study articulated issues of concern for home care and its delivery for people with dementia. Attempts should be made to make dementia home care more consistently personalised, inclusive and collaborative with informal carers and key others involved. Further areas to explore include working conditions of formal carers and current models utilised in homecare provision.
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Affiliation(s)
| | - Vincent Gillan
- Social Care and Society, 5292University of Manchester, Manchester, UK
| | - Amy Roberts
- Social Care and Society, 5292University of Manchester, Manchester, UK
| | - Jean Tottie
- Family Carer, Together in Dementia, Liverpool, UK
| | | | | | - Paul Clarkson
- Social Care and Society, 5292University of Manchester, Manchester, UK
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Cunningham N. Understanding the training and education needs of homecare workers supporting people with dementia and cancer: A systematic review of reviews. DEMENTIA 2020; 19:2780-2803. [PMID: 31271044 PMCID: PMC7925442 DOI: 10.1177/1471301219859781] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Many people with dementia, supported by family carers, prefer to live at home and may rely on homecare support services. People with dementia are also often living with multimorbidities, including cancer. The main risk factor for both cancer and dementia is age and the number of people living with dementia and cancer likely to rise. Upskilling the social care workforce to facilitate more complex care is central to national workforce strategies and challenges. Training and education development must also respond to the key requirements of a homecare workforce experiencing financial, recruitment and retention difficulties. This systematic review of reviews provides an overview of dementia and cancer training and education accessible to the homecare workforce. Findings reveal there is a diverse range of training and education available, with mixed evidence of effectiveness. Key barriers and facilitators to effective training and education are identified in order to inform future training, education and learning development for the homecare workforce supporting people with dementia and cancer.
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Häikiö K, Sagbakken M, Rugkåsa J. Dementia and patient safety in the community: a qualitative study of family carers' protective practices and implications for services. BMC Health Serv Res 2019; 19:635. [PMID: 31488131 PMCID: PMC6728989 DOI: 10.1186/s12913-019-4478-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/28/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Dementia is a cause of disability and dependency associated with high demands for health services and expected to have a significant impact on resources. Care policies worldwide increasingly rely on family caregivers to contribute to service delivery for older people, and the general direction of health care policy internationally is to provide care in the community, meaning most people will receive services there. Patient safety in primary care is therefore important for future care, but not yet investigated sufficiently when services are carried out in patients' homes. In particular, we know little about how family carers experience patient safety of older people with dementia in the community. METHODS This was an explorative study, with qualitative in-depth interviews of 23 family carers of older people with suspected or diagnosed dementia. Family carers participated after receiving information primarily through health professionals working in dementia care. A semi-structured topic guide was used in a flexible way to capture participants' experiences. A four-step inductive analysis of the transcripts was informed by hermeneutic-phenomenological analysis. RESULTS The ways our participants sought to address risk and safety issues can be understood to constitute protective practices that aimed to prevent or reduce the risk of harm and/or alleviate damage from harm that occurs. The protective practices relate to four areas: physical harm, economic harm, emotional harm, and relational harm. The protective practices are interlinked, and family carers sometimes prioritize one over another, and as they form part of family practice, they are not always visible to service providers. As a result, the practices may complicate interactions with health professionals and even inadvertently conceal symptoms or care needs. CONCLUSIONS When family caregivers prevent harm and meet needs, some needs may be concealed or invisible to health professionals. To recognize all needs and provide effective, safe and person-centered care, health professionals need to recognize these preventive practices and seek to build a solid partnership with family carers.
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Affiliation(s)
- Kristin Häikiö
- HØKH - Health Services Research Unit, Akershus University Hospital, Postbox 1000, 1478, Lørenskog, Norway.
- Oslo Metropolitan University, Pilestredet 32, 0166, Oslo, Norway.
| | - Mette Sagbakken
- Oslo Metropolitan University, Pilestredet 32, 0166, Oslo, Norway
| | - Jorun Rugkåsa
- HØKH - Health Services Research Unit, Akershus University Hospital, Postbox 1000, 1478, Lørenskog, Norway
- Centre for Care Research, University of South-Eastern Norway, 3900, Porsgrunn, Norway
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Bächle M, Daurer S, Judt A, Mettler T. Assistive technology for independent living with dementia: Stylized facts and research gaps. HEALTH POLICY AND TECHNOLOGY 2018. [DOI: 10.1016/j.hlpt.2017.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Davis R, Ziomkowski MK, Veltkamp A. Everyday Decision Making in Individuals with Early-Stage Alzheimer's Disease: An Integrative Review of the Literature. Res Gerontol Nurs 2017; 10:240-247. [PMID: 28926672 DOI: 10.3928/19404921-20170831-05] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 05/24/2017] [Indexed: 11/20/2022]
Abstract
Individuals with Alzheimer's disease (AD) demonstrate fluctuation in cognitive abilities that can affect their ability to make decisions. Everyday decision making encompasses the types of decisions about typical daily activities, such as what to eat, what to do, and what to wear. Everyday decisions are encountered many times per day by individuals with AD/dementia and their caregivers. However, not much is known about the ability of individuals with AD/dementia to make these types of decisions. The purpose of the current literature review was to synthesize the evidence regarding everyday decision making in individuals with early-stage AD/dementia. Findings from the review indicate there is beginning evidence that individuals with early to moderate stages of AD/dementia desire to have input in daily decisions, have the ability to state their wishes consistently at times, and having input in decision making is important to their selfhood. The literature revealed few interventions to assist individuals with AD/dementia in everyday decision making. Findings from the review are discussed with implications for nursing practice and research. [Res Gerontol Nurs. 2017; 10(5):240-247.].
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