A Tangled Web: Deception in Everyday Dementia Care

2021 ◽  
Vol 49 (2) ◽  
pp. 257-262 ◽  
Author(s):  
Rebecca Dresser

AbstractCare workers and families often engage in deception in everyday interactions with people affected by dementia. While benevolent deception can be justified, there are often more respectful and less risky ways to help people with dementia seeking to make sense of their lives.

Author(s):  
Yumi Shindo ◽  
Akira Homma

There are two strengths of dementia care services available in Japan. One strength is the creation of the Integrated Community Care System, which aims to provide various services that the elderly might need within their areas of residence. It is the responsibility of local governments to set up the ICCS, because each community has different social resources, as well as differences in the local population and the number of elderly individuals. The other strength lies in the various educational opportunities in dementia available to medical and long-term care professionals. In 2001, the national government introduced educational programmes for care workers in the field of dementia care. In addition, educational programmes for medical doctors, managers of facilities/service centres for people with dementia, medical professionals working in hospitals, pharmacists, and dentists are currently provided under the government’s policies.


2013 ◽  
Vol 25 (5) ◽  
pp. 765-774 ◽  
Author(s):  
Kate-Ellen J. Elliott ◽  
Christine M. Stirling ◽  
Angela J. Martin ◽  
Andrew L. Robinson ◽  
Jennifer L. Scott

ABSTRACTBackground: Community care workers’ experience of delivering support to people with dementia is less researched than that of residential workers. The purpose of the study is to explore community-based dementia care workers’ perspectives about their roles and the contextual variables that impact upon their work experiences.Method: A qualitative design was employed. Twenty-five community dementia care workers (average age 53 years, majority female and employed casually) participated in standardized semi-structured interviews about their job roles, training, employer agenda, organizational support, and intention to stay. A deductive approach to Interpretive Phenomenological Analysis was adopted to identify key themes.Results: Three themes highlighted workers’ experiences. Occupational communion described strong attachment to clients and a desire for greater connection with colleagues. Job demands described the challenges of work, which varied with intensity. Job resources ranged from positive (strong organizational commitment) to negative (poor pay and conditions). Occupational communion was identified as a concept that exists at the interface between social and organization psychology that was perceived to be essential for adaptive coping. Identifying themes informed a conceptual model for designing intervention components aimed at improving workers’ skills, capabilities, and employer supportive functions.Conclusion: Occupational communion may be particularly relevant for women's caring careers and future research is needed to explore the relevance of this concept for men. To determine reliable change associated with interventions that target occupational communion, further investigation is required in relation to measurement approaches.


2008 ◽  
Vol 28 (5) ◽  
pp. 629-651 ◽  
Author(s):  
RICHARD WARD ◽  
ANTONY A. VASS ◽  
NEERU AGGARWAL ◽  
CYDONIE GARFIELD ◽  
BEAU CYBYK

ABSTRACTThis article reports findings from a three-year project on ‘Communication patterns and their consequences for effective care’ that explored communication in dementia-care settings. As the proportion of people with dementia living in British care-homes continues to grow, there is a need to understand better their care. Using a range of qualitative methods, the project set out to identify the constituent elements of dementia-care practice and the patterns that characterise day-to-day relations in care homes. The tightly prescribed and standardised nature of the interactions between staff and residents is described: it raises questions about the capacity for dementia care to be truly person-centred. The project found that people with dementia are both capable of communication, and invest much effort in seeking to engage those around them, but are excluded from the monitoring, planning and provision of care in ways that we argue are discriminatory. The case is made for promoting and supporting communication as key skills and competencies for care workers. The value of measuring the level and quality of communication as a means to evaluate care is demonstrated. The authors question the priorities that currently guide care practice and argue that we need to listen to people with dementia and rethink what lies at the heart of dementia care.


2020 ◽  
Vol 19 (4) ◽  
pp. 321-326
Author(s):  
Rhonda Riachi ◽  
Sally Markwell

Purpose This paper aims to highlight the results and emerging themes from a study concerning the effect of communication techniques that were tailored to each client in relation to the extent of their dementia. Dementia was viewed by the care workers primarily as a memory disability. Design/methodology/approach A short qualitative study of the communication techniques of care workers in England, who had received training in dementia care and some training in the SPECAL® method (Specialised Early Care for Alzheimer’s),was conducted through semi-structured interviews. Resulting data were analysed using a constructivist grounded theory approach. Findings Continued application of the SPECAL techniques appeared to reinforced clients’ sense of well-being and produced benefits for care workers’ own well-being. Research limitations/implications This small qualitative study suggests there can be beneficial effects for both clients and the care team when care workers tailor their communication behaviour to the needs of people with dementia. Further research on communication techniques in dementia care is needed and how these benefits might be translated into institutional settings. Originality/value Few research studies have been made of the SPECAL dementia care method, and this study was the first to look explicitly at the communication techniques that the care workers used with clients. Public health professionals are less likely to be aware of the SPECAL method.


2017 ◽  
Vol 29 (10) ◽  
pp. 1609-1618 ◽  
Author(s):  
Ana Barbosa ◽  
Kathryn Lord ◽  
Alan Blighe ◽  
Gail Mountain

ABSTRACTBackground:This systematic review identifies and reports the extent and nature of evidence to support the use of Dementia Care Mapping as an intervention in care settings.Methods:The review was limited to studies that used Dementia Care Mapping as an intervention and included outcomes involving either care workers and/or people living with dementia. Searches were conducted in PubMed, Web of Knowledge, CINAHL, PsychINFO, EBSCO, and Scopus and manually from identified articles reference lists. Studies published up to January 2017 were included. Initial screening of identified papers was based on abstracts read by one author; full-text papers were further evaluated by a second author. The quality of the identified papers was assessed independently by two authors using the Cochrane Risk of Bias Tool. A narrative synthesis of quantitative findings was conducted.Results:We identified six papers fulfilling predefined criteria. Studies consist of recent, large scale, good quality trials that had some positive impacts upon care workers’ stress and burnout and benefit people with dementia in terms of agitated behaviors, neuropsychiatric symptoms, falls, and quality of life.Conclusion:Available research provides preliminary evidence that Dementia Care Mapping may benefit care workers and people living with dementia in care settings. Future research should build on the successful studies to date and use other outcomes to better understand the benefits of this intervention.


2009 ◽  
Vol 21 (S1) ◽  
pp. S53-S57 ◽  
Author(s):  
Richard Fleming ◽  
Diana FitzGerald

ABSTRACTDementia has been identified as a national health priority in Australia. National programs in the areas of research, education and training have been established. The Dementia Care Skills for Aged Care Workers program is a three-year project that commenced in 2006. It has the goal of providing training in the essentials of dementia care to 17,000 staff of aged care services across Australia. Successful completion of the training results in the award of a nationally recognized qualification. Although the delivery of the training has been difficult in some areas – because of the long distances to be covered by trainers and trainees, a wide range of cultural backgrounds, and difficulties in finding staff to cover for people attending the training – the seven training organizations providing this training are on target to meet the goal. The project is being evaluated independently. The anecdotal reports available to date strongly suggest that the training is being well received and is making a difference to practice.A surprisingly large proportion of attendees (9%) have been registered nurses, which demonstrates the need among this group of staff for training in the care of people with dementia.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Anita M. Y. Goh ◽  
Meg Polacsek ◽  
Sue Malta ◽  
Colleen Doyle ◽  
Brendan Hallam ◽  
...  

Abstract Background Our objective was to explore what people receiving and providing care consider to be ‘good’ in-home care for people living with dementia. Methods We conducted 36 in-depth interviews and two focus groups with key stakeholders in Australia in the first quarter of 2018. Participants included those receiving care (4 people living with dementia, 15 family carers) or providing care (9 case managers, 5 service managers, 10 home care workers). Qualitative thematic analysis was guided by Braun and Clarke’s six-step approach. Results Consensus was reached across all groups on five themes considered as important for good in-home dementia care: 1) Home care workers’ understanding of dementia and its impact; 2) Home care workers’ demonstrating person-centred care and empathy in their care relationship with their client; 3) Good relationships and communication between care worker, person with dementia and family carers; 4) Home care workers’ knowing positive practical strategies for changed behaviours; 5) Effective workplace policies and workforce culture. The results contributed to the co-design of a dementia specific training program for home care workers. Conclusions It is crucial to consider the views and opinions of each stakeholder group involved in providing/receiving dementia care from home care workers, to inform workforce training, education program design and service design. Results can be used to inform and empower home care providers, policy, and related decision makers to guide the delivery of improved home care services. Trial registration ACTRN 12619000251123.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julian Hirt ◽  
Melanie Karrer ◽  
Laura Adlbrecht ◽  
Susi Saxer ◽  
Adelheid Zeller

Abstract Background To support the implementation of nurse-led interventions in long-term dementia care, in-depth knowledge of specific supporting factors and barriers is required. Conditions and structures of caring for people with dementia differ widely, depending on the country and the care context. Our study aimed to describe the experiences and opinions of nursing experts and managers with regard to facilitators and barriers to the implementation of nurse-led interventions in long-term dementia care. Methods We conducted a qualitative descriptive study using individual interviews based on qualitative vignettes as a useful stimulus to generate narrations allowing to study peoples’ perceptions and beliefs. The study took place in nursing homes in the German-speaking part of Switzerland and in the Principality of Liechtenstein using purposive sampling. We intended to conduct the interviews face-to-face in a quiet room according to the participant’s choice. However, due to the lockdown of nursing homes during the COVID-19 pandemic in spring 2020, we performed interviews face-to-face and by video. We analysed data thematically following Braun and Clarke to achieve a detailed, nuanced description. To verify our interpretation and to ensure congruence with participants’ perspectives, we conducted member checks. The Standards for Reporting Qualitative Research (SRQR) served to structure our manuscript. Results Six dyads of nursing home managers and nursing experts from six nursing homes took part in our study (n = 12). Our thematic analysis yielded seven themes reflecting facilitators and barriers to implementing nurse-led interventions in long-term dementia care: «A common attitude and cohesion within the organization», «Commitment on several levels», «A needs-oriented implementation», «The effect and the public perception of the intervention», «A structured and guided implementation process», «Supporting knowledge and competencies», as well as «Resources for implementing the intervention». Conclusions To support the implementation of nurse-led interventions in long-term dementia care, active commitment-building seems essential. It is necessary that the value of the intervention is perceptible.Commitment-building is the precondition to reach the persons involved, such as nursing home managers, nursing staff, residents and relatives. Furthermore, nurses should precisely inform about the intervention. It is necessary that the value of the intervention is perceptible. In addition, nurses should adjust the interventions to the situational needs of people with dementia, thus. Therefore, it is important to support dementia-specific competencies in long-term care. Findings indicate that the barrier is determined by the intervention and its implementation – and not by the behaviour of the person with dementia.


2015 ◽  
Vol 28 (2) ◽  
pp. 211-219 ◽  
Author(s):  
Mei Zhao ◽  
Xiaozhen Lv ◽  
Maimaitirexiati Tuerxun ◽  
Jincai He ◽  
Benyan Luo ◽  
...  

ABSTRACTBackground:The prevalence and factors associated with delays in help seeking for people with dementia in China are unknown.Methods:Within 1,010 consecutively registered participants in the Clinical Pathway for Alzheimer's Disease in China (CPAD) study (NCT01779310), 576 persons with dementia (PWDs) and their informants reported the estimated time from symptom onset to first medical visit seeking diagnosis. Univariate analysis of general linear model was used to examine the potential factors associated with the delayed diagnosis seeking.Results:The median duration from the first noticeable symptom to the first visit seeking diagnosis or treatment was 1.77 years. Individuals with a positive family history of dementia had longer duration (p= 0.05). Compared with other types of dementia, people with vascular dementia (VaD) were referred for diagnosis earliest, and the sequence for such delays was: VaD < Alzheimer's disease (AD) < frontotemporal dementia (FTD) (p< 0.001). Subtypes of dementia (p< 0.001), family history (p= 0.01), and education level (p= 0.03) were associated with the increased delay in help seeking.Conclusions:In China, seeking diagnosis for PWDs is delayed for approximately 2 years, even in well-established memory clinics. Clinical features, family history, and less education may impede help seeking in dementia care.


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