scholarly journals Better Brain Health through Equity: Addressing Health and Economic Disparities in Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1002-1002
Author(s):  
Rajiv Ahuja ◽  
Cara Levy
Keyword(s):  
African Americans ◽  
Health Equity ◽  
Minority Groups ◽  
Treatment Options ◽  
Ethnically Diverse ◽  
Dementia Care ◽  
Brain Health ◽  
Term Care ◽  
Dementia Prevention

Abstract Dementia disproportionately impacts the health and financial security of women and certain minority groups. Long-standing inequities create distrust of the medical system, fewer treatment options, and reduced access to care. Research predicts that from 2020 to 2060, the number of African Americans and Latinx living with dementia will grow by nearly 200 percent and 440 percent, respectively, while prevalence among non-Hispanic Whites will increase by 69 percent. As the prevalence of dementia rises, so will the costs associated with dementia care. African Americans bear 1/3 of the costs associated with dementia. And the costs for Latinx living with Alzheimer’s disease are expected to exceed $100 billion by 2060. To mitigate these growing health and economic concerns, efforts to improve dementia care must put equity front and center. This presentation highlights five actionable recommendations to build health equity by reducing disparities in dementia prevention, detection, diagnosis, and care. These recommendations center around two overarching themes: (1) Strengthening the infrastructure among health-care, long-term care, and community-based organizations to achieve greater health equity for people living with dementia and their caregivers and (2) Expanding dementia-friendly networks and workplaces in racially and ethnically diverse communities. The recommendations discussed in this presentation will offer guidance for policymakers, health services researchers, businesses, health systems, and communities to reduce the inequitable impact of dementia on African Americans and Latinx, which is even more vital amid demographic trends showing a population growing older and more racially and ethnically diverse.

scholarly journals Facilitators and barriers to implement nurse-led interventions in long-term dementia care: a qualitative interview study with Swiss nursing experts and managers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julian Hirt ◽  
Melanie Karrer ◽  
Laura Adlbrecht ◽  
Susi Saxer ◽  
Adelheid Zeller
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Public Perception ◽  
Dementia Care ◽  
Term Care ◽  
Face To Face ◽  
People With Dementia ◽  
Qualitative Interview Study ◽  
Facilitators And Barriers

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.

scholarly journals The Effect of Long Term Care Resources on Burdens for Caregiving People Living with Dementia in Taiwan

2021 ◽  
Author(s):  
Yang-Hao Ou ◽  
Ming-Che Chang ◽  
Wen-Fu Wang ◽  
Kai-Ming Jhang
Keyword(s):  
Caregiver Burden ◽  
Long Term Care ◽  
Dementia Care ◽  
Care Team ◽  
Control Group ◽  
Term Care ◽  
People With Dementia ◽  
Home Based ◽  
Caregiver Group

Abstract Background: There is an increasing awareness of caregiver's burden, especially in those caring for people with dementia. The caregiver burden has been studied extensively in Western countries; however, the interpretation of the results and replication of the intervention may deem unfit in the Chinese culture. Therefore, this study identifies the change in caregiver burden by interventional methods under current Taiwan's long-term care Act 2.0.Method: A total of 2,598 newly diagnosed dementia outpatients was evaluated by the Changhua Christian Hospital dementia care team. Eighty patients utilize one of the three care resources, including community-based services (n = 33), home-based services (n = 19), or taking care by foreign caregivers (n = 28). Participants in the control group were selected by matching their global CDR score, gender, age, and caregivers' age with a 1:4 ratio. All caregivers completed the Zarit Burden Interview (ZBI) questionnaires before and six months after utilizing the care resources. Results: The home-based and the foreign caregiver groups have the highest baseline ZBI scores with 37.63±16.14 and 36.57±17.14, respectively. The second ZBI score was assessed about six months after the baseline showing that the home-based group remained the highest caregiver burden (ZBI = 31.74±12.23) and the foreign caregiver group showed the lowest burden (ZBI = 25.68±12.09). The mean difference in the ZBI score confirmed that the foreign caregiver group had the most improvement, averaging a decrease of 17.99±31.08 points (adjust observation time). A linear regression model showed that home-based care and foreign caregiver contributes the most reduction in caregiver burden (-11.83 and -19,07 ZBI scores, respectively).Conclusion: Caring for people with dementia includes caring for their caregivers. Dementia care team should provide proper social resources, which are crucial in the alleviation of caregiver burden.

A Collaborative Approach for Online Dementia Care Training

2008 ◽  
pp. 224-230
Author(s):  
Colla MacDonald ◽  
Emma J. Stodel ◽  
Lynn Casimiro ◽  
Lynda Weaver
Keyword(s):  
Training Program ◽  
Long Term Care ◽  
Dementia Care ◽  
Collaborative Approach ◽  
Term Care ◽  
Delicate Balance ◽  
Care Training ◽  
Large Committee ◽  
Community Team

There are obvious benefits to working in collaboration. However, real collaboration takes time; time to engage in meetings, complete accountability processes, and resolve problems. The delicate balance between democracy and efficiency can be compromised when you have to choose between equal participation and looming deadlines (Stoecker, 2003). Weaver and Cousins (2004) described this dilemma as assessing manageability or having to make a choice between achieving complete diversity on the researcher-community team and the unwieldiness of working with a large committee. Compromise is often necessary. This article describes our experiences using a collaborative approach involving university-based researchers and community professionals—in this case, long-term care (LTC) managers, administrators, and hospital-based educators and researchers—to create an online dementia care training program.

scholarly journals ENHANCING PERSON-CENTERED DEMENTIA CARE BY NURSING HOME STAFF USING MICROLEARNING: LITTLE MESSAGE WITH A BIG IMPACT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S3-S3
Author(s):  
Jenny Inker ◽  
Christine J Jensen ◽  
Sonya Barsness
Keyword(s):  
Job Satisfaction ◽  
Nursing Home ◽  
Focus Groups ◽  
Long Term Care ◽  
Dementia Care ◽  
Care Staff ◽  
Training Curriculum ◽  
Term Care ◽  
Online Platform

Abstract Effective training is critical to providing quality care in long-term care environments, where many residents have dementia. Training has been linked to positive resident care outcomes and improved job satisfaction of staff. The aim of this study was to develop, pilot, and evaluate a Microlearning training curriculum, using short (5-10 minute) “bursts” of training available through an online platform on demand (i.e. 24/7). The expected outcomes were to improve staff knowledge, attitudes, and skills regarding person-centered dementia care and to increase job satisfaction. Researchers translated the Centers for Medicare and Medicaid Hand-in-Hand training curriculum into 52 weekly Microlearning lessons delivered via an online platform (accessible by computer, IPad or smart phone) followed by a short quiz. Using pre- and post-tests, nine focus groups, and fourteen telephone interviews, the researchers engaged with a convenience sample of staff (N = 244) working at all levels from direct care to leadership in nine nursing homes in Virginia. Pre- and post-tests comprised items from the Dementia Attitudes Scale and the Nursing Home Nurse Aide Job Satisfaction Scale. Results from a between subjects t-test demonstrated significant improvements in attitudes to people with dementia. Focus groups and interviews revealed high satisfaction with the training with a significant majority agreeing it was a helpful way to learn and that they were able to apply what they had learned to caring for residents. This pilot demonstrates a promising new practice for training long-term care staff. Further research using a control group receiving usual training is indicated.

The securitisation of dementia: socialities of securitisation on secure dementia care units

2019 ◽  
pp. 1-17 ◽  
Author(s):  
Megan E. Graham
Keyword(s):  
Social Impact ◽  
Long Term Care ◽  
Dementia Care ◽  
Steady Increase ◽  
Security Threat ◽  
Security Issue ◽  
Security Technology ◽  
Term Care ◽  
Security Technologies

AbstractNearly 50 million people around the world live with dementia, with statistics predicting a steady increase in prevalence for the foreseeable future. There is a need for comprehensive and compassionate dementia care. Long-term care homes have built special care units for people living with middle- to late-stage dementia. Among other services, these care units often use innovative security technologies that monitor and curtail movement beyond unit exit doors. As care-givers and technology developers grapple with the ethical dilemma of autonomy and risk management, researchers are beginning to investigate the social impact of these security technologies. The present research contributes to this line of inquiry. Fieldwork was carried out on two secure long-term care units for people living with dementia. Ethnographic accounts will illustrate how security technology creates socialities of securitisation on a secure dementia unit. Using securitisation theory, I will argue that dementia has been redefined, shifting it from a health issue to a security issue. The discursive construction of dementia as a security issue will be considered in terms of the co-constructed notions of vulnerability, risk, security threat and security challenge with respect to people living with dementia. The paper investigates how securitisation influences the ethics of dementia care.

Long-term care, dementia care, and end-of-life care in China

2021 ◽  
pp. 38-63
Author(s):  
Sabrina Ching Yuen Luk ◽  
Hui Zhang ◽  
Peter P. Yuen
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Dementia Care ◽  
Life Care ◽  
Term Care

Attitudes of long-term care staff toward dementia and their related factors

2012 ◽  
Vol 25 (1) ◽  
pp. 140-147 ◽  
Author(s):  
Jenny Lee ◽  
Elsie Hui ◽  
Carolyn Kng ◽  
Tung Wai Auyeung
Keyword(s):  
Residential Care ◽  
Work Experience ◽  
Positive Attitude ◽  
Long Term Care ◽  
Demographic Data ◽  
Dementia Care ◽  
Care Staff ◽  
Further Training ◽  
Term Care

ABSTRACTBackground: Attitudes of residential care staff toward residents with dementia affect the quality of care. We examined the attitude of frontline residential care staff toward residents with dementia, and how the presence of specialized care units or programs may affect staff attitude.Methods: Staff working in nursing homes participated in a survey which covered demographic data, current state of dementia care in workplace, opinion regarding dementia care, and perceived importance of dementia behaviors.Results: 1,047 nurses and personal care workers participated. 78.8% respondents reported difficulties in managing dementia residents. Those who ranked positive symptoms as more important were 4.5 times more likely to report difficulties, independent of experience. Independent factors associated with positive attitudes toward further training were working in a non-profit home (OR 2.4, 95% CI 1.1, 5.0; p = 0.024) and having a dementia program or unit in the current workplace (OR 1.8, 95% CI 0.985, 3.302; p = 0.056). Only having a dementia program or unit in the current workplace was associated with a positive attitude toward commitment to stay in dementia care (OR 1.9, 95% CI 1.1, 3.2; p = 0.021), adjusted for gender, type of home, post, dementia prevalence in workplace, and work experience.Conclusion: The majority of long-term care staff felt dementia care difficult yet hold positive attitude toward further training and were committed to stay in dementia care. Having a specialized dementia care unit or program in the current workplace was associated with commitment to stay in dementia care and was marginally associated with positive attitude toward further training.

The Impact of a Shared Decision-Making Training Program on Dementia Care Planning in Long-Term Care

2018 ◽  
Vol 64 (4) ◽  
pp. 1123-1135 ◽  
Author(s):  
Elena Mariani ◽  
Rabih Chattat ◽  
Giovanni Ottoboni ◽  
Raymond Koopmans ◽  
Myrra Vernooij-Dassen ◽  
...  
Keyword(s):  
Decision Making ◽  
Training Program ◽  
Shared Decision Making ◽  
Long Term Care ◽  
Dementia Care ◽  
Care Planning ◽  
Shared Decision ◽  
Term Care ◽  
The Impact

scholarly journals Presence redefined: The reciprocal nature of engagement between elder-clowns and persons with dementia

Dementia ◽  
2016 ◽  
Vol 16 (1) ◽  
pp. 46-66 ◽  
Author(s):  
Pia Kontos ◽  
Karen-Lee Miller ◽  
Gail Joyce Mitchell ◽  
Jan Stirling-Twist
Keyword(s):  
Long Term Care ◽  
Qualitative Interviews ◽  
Dementia Care ◽  
Care Staff ◽  
Severe Dementia ◽  
Term Care ◽  
Recent Innovation ◽  
Care Relationships ◽  
Embodied Engagement

Elder-clowns are a recent innovation in arts-based approaches to person-centred dementia care. They use improvisation, humour, and empathy, as well as song, dance, and music. We examined elder-clown practice and techniques through a 12-week programme with 23 long-term care residents with moderate to severe dementia in Ontario, Canada. Analysis was based on qualitative interviews and ethnographic observations of video-recorded clown-resident interactions and practice reflections. Findings highlight the reciprocal nature of clown-resident engagement and the capacity of residents to initiate as well as respond to verbal and embodied engagement. Termed relational presence, this was achieved and experienced through affective relationality, reciprocal playfulness, and coconstructed imagination. These results highlight the often overlooked capacity of individuals living with dementia to be deliberately funny, playful, and imaginative. Relational presence offers an important perspective with which to rethink care relationships between individuals living with dementia and long-term care staff.

scholarly journals Identifying gaps in COVID-19 health equity data reporting in Canada using a scorecard approach

2020 ◽  
Author(s):  
Alexandra Blair ◽  
Kahiye Warsame ◽  
Harsh Naik ◽  
Walter Byrne ◽  
Abtin Parnia ◽  
...  
Keyword(s):  
Population Size ◽  
Health Equity ◽  
Long Term Care ◽  
Average Score ◽  
Immigration Status ◽  
Term Care ◽  
Data Reporting ◽  
Local Areas ◽  
Detention Facilities

Objective: To assess health equity-oriented COVID-19 data reporting across Canadian provinces and territories, using a scorecard approach. Method: A scan was performed of provincial and territorial reporting of five data elements (cumulative totals of tests, cases, hospitalizations, deaths and population size) across three units of aggregation (province or territory-level, health regions, and local areas) (15 "overall" indicators), and for two vulnerable settings (long term care and detention facilities) and six social markers (age, sex, immigration status, race/ethnicity, essential worker status, and income) (120 "equity-related" indicators). Per indicator, one point was awarded if case-delimited data were released, 0.7 points if only summary statistics were reported, and 0 if neither was provided. Results were presented using a scorecard approach. Results: Overall, information on cases and deaths was more complete than for tests, hospitalizations and population size denominators needed for rate estimation. Information provided on jurisdictions and their regions, overall, tended to be more available (average score of 53%, "B") than for equity-related indicators (average score of 21%, "D"). Only British Columbia and Alberta provided case-delimited data, and only Alberta provided information for local areas. No jurisdiction reported on outcomes according to patients' individual-level immigration status, race, or income. Only Ontario and Quebec provided detailed information for long-term care settings and detention facilities. Conclusion: Socially stratified reporting for COVID-19 outcomes is sparse in Canada. However, several best practices in health equity-oriented reporting were observed and set a relevant precedent for all jurisdictions to follow for this pandemic and future ones.

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