Single-System Methodology: A Way Forward in Dementia Care?

1998 ◽  
Vol 61 (10) ◽  
pp. 448-452 ◽  
Author(s):  
Tessa Perrin
Keyword(s):  
Direct Observation ◽  
Dementia Care ◽  
Therapeutic Interventions ◽  
System Evaluation ◽  
Cognitive Disability ◽  
Group Comparison ◽  
Single System ◽  
People With Dementia ◽  
The Impact ◽  
System Methodology

Owing to the cognitive disability of people with dementia, the direct observation of behaviour is often the only means of evaluating the impact of therapeutic interventions. A number of standardised instruments of direct observation have been developed in recent years, but none offering the occupational therapist the flexibility with which to evaluate the diversity of physical, emotional, cognitive and behavioural variables encountered in dementia care. Conventional group-comparison methodology is inadequate in the clinical setting. Single-system evaluation is able to address the highly individualised needs of people with dementia. This paper describes how an evaluation may be custom-built to identify the specific changes elicited in a specific individual by a specific intervention under specific conditions.

Northern Ireland

2019 ◽  
pp. 203-210
Author(s):  
Emma Louise Cunningham ◽  
Stephen Todd ◽  
Conor Barton ◽  
Peter Passmore
Keyword(s):  
Northern Ireland ◽  
Dementia Care ◽  
Mental Capacity ◽  
Therapeutic Interventions ◽  
Coordination Of Care ◽  
Strategic Issues ◽  
Code Of Practice ◽  
People With Dementia ◽  
Mental Capacity Act ◽  
Successful Production

The Northern Ireland (NI) Dementia Strategy was launched in November 2011, with similar strategic issues and priorities to those identified in the English, Welsh, and Scottish documents. There are a number of aspects of dementia care in NI of which the province can be proud, several of which are outlined. One of the major achievements has been the successful production of the Mental Capacity Act, which awaits implementation and publication of a code of practice for clinicians. Other challenges include the coordination of care for people with dementia across the healthcare spectrum and the anticipation and incorporation into practice of evolving diagnostic and therapeutic interventions.

scholarly journals What factors affect paramedics’ involvement of people with dementia in decisions about their care? A qualitative study

2021 ◽  
Vol 5 (4) ◽  
pp. 1-8
Author(s):  
Esme Choonara ◽  
Julia Williams
Keyword(s):  
Best Practice ◽  
Dementia Care ◽  
Research Approach ◽  
Best Interest ◽  
Individual Interviews ◽  
Ethical Frameworks ◽  
Lack Of Information ◽  
People With Dementia ◽  
Generic Qualitative ◽  
The Impact

<sec id="s1">Background: Paramedics are frequently called to people with dementia, but decision making can be challenging due to lack of information or difficulties in assessment. Best-practice dementia care should be holistic and involve people with dementia in decisions as far as possible. </sec> <sec id="s2">Aims: To explore how paramedics make decisions when attending people with dementia, with a particular focus on factors that impact on how, and to what degree, paramedics involve people with dementia in these decisions. </sec> <sec id="s3">Methods: A generic qualitative research approach was used. Data were collected through semi-structured individual interviews with seven paramedics. The interviews were recorded and transcribed verbatim and subsequently analysed using thematic analysis. </sec> <sec id="s4">Results: Four themes were identified that all touched on challenges to delivering person-centred care. Themes identified were: 1) paramedics’ differing approaches to assessing capacity and making best interest decisions; 2) communication and developing a rapport; 3) interconnections with others important to the person with dementia; and 4) the impact of paramedics’ values and attitudes. </sec> <sec id="s5">Conclusion: The involvement of people with dementia is sometimes limited by medical, social or clinician-dependent factors. This study highlights how paramedics’ values and communication skills influence their interactions with people with dementia. As the paramedic role evolves, there is an opportunity to embed person-centred care in practice and to ensure that education equips paramedics with the skills and ethical frameworks needed to deliver high quality dementia care. </sec>

scholarly journals 29 Adapting Dementia and Delirium Awareness Training to a Rehabilitation Setting

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Emma O'Brien ◽  
Monica Devine ◽  
Sarah Maxwell ◽  
Catherine McDonnell ◽  
Stuart Lee
Keyword(s):  
Cognitive Impairment ◽  
Occupational Therapy ◽  
Dementia Care ◽  
Awareness Training ◽  
Likert Scales ◽  
Staff Members ◽  
Patient Profile ◽  
People With Dementia ◽  
Adult Rehabilitation ◽  
The Impact

Abstract Background The patient profile in a Dublin rehabilitation hospital has changed in recent years to include older adult rehabilitation alongside orthopaedic rehabilitation. A snapshot audit completed by the occupational therapy department on one day in 2018 demonstrated that 64% of patients had an assessment score indicative of a cognitive impairment. A subjective gap in knowledge regarding dementia care and a misunderstanding of the ability of people with dementia to engage in rehabilitation was identified. It was imperative that dementia awareness training was provided with a particular focus on modifying rehabilitation techniques to cater for these patients. Methods A dementia care committee was established with an Educational Development subgroup responsible for addressing dementia and delirium awareness training. Educational material was received from the field of occupational therapy, nursing, medicine, pharmacy and dietetics. The programme was accredited by the Nursing and Midwifery Board of Ireland. A focus group was completed pre/post formulation of the presentation with various departmental representatives. Feedback provided was used to inform and finalise the training content. Results Sessions are completed once monthly. One hundred and seven participants to date have attended. Ten-point Likert scales are completed pre and post training. Data from the Likert scales were analysed revealing on average a 24.4 % increase in knowledge of dementia, a 27.6% increase in awareness of the impact of dementia on function and a 23.3% increase in confidence in caring for a patient with dementia. Highest contingent of staff members trained were household and catering staff (19%) nursing staff (18%), and health care attendants (13%). Conclusion This essential training is ongoing with thirty per cent of staff trained to date. The objective is for all staff to complete this training for enhanced care and rehabilitation for all patients with dementia. It will also aim to review treatment for all patients with cognitive impairment so unique rehabilitation programmes can be tailored.

scholarly journals A Pilot Study of the Impact of NHS Patient Transportation on Older People with Dementia

2010 ◽  
Vol 2010 ◽  
pp. 1-9 ◽  
Author(s):  
Nicola Roberts ◽  
Stephen Curran ◽  
Virginia Minogue ◽  
Jane Shewan ◽  
Rebecca Spencer ◽  
...  
Keyword(s):  
Pilot Study ◽  
Older People ◽  
Dementia Care ◽  
Formal Care ◽  
Transport Service ◽  
Patient Transport ◽  
People With Dementia ◽  
Care Mapping ◽  
The Impact ◽  
Dementia Care Mapping

Background. A pilot study using a mixed methodology was used to evaluate the effects of travelling on NHS Patient Transport Service ambulances on the experience of patients with dementia. The study assessed the feasibility of using Dementia Care Mapping in this setting and looked at the effects of the presence of designated staff teams on journeys, compared to journeys without such designated staff.Method. Dementia Care Mapping was used to observe and record participants' behaviour, mood, and engagement during their outward and return journeys to NHS hospital sites. Observations were analysed for themes relating to the effects of travelling on PTS across the two groups.Results and Conclusions. Participant's observed mood scores did not differ significantly across the two groups but the range of behaviours recorded on the escorted group journeys did and were reflective of formal care environments. The findings from this study highlight the importance of trained escorts on NHS PTS ambulances for people with dementia and provide important information regarding further research in this area.

scholarly journals ‘Getting to Know Me’: The second phase roll-out of a staff training programme for supporting people with dementia in general hospitals

Dementia ◽  
2016 ◽  
Vol 17 (1) ◽  
pp. 96-109 ◽  
Author(s):  
Ruth Elvish ◽  
Simon Burrow ◽  
Rosanne Cawley ◽  
Kathryn Harney ◽  
Mark Pilling ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Training Programme ◽  
Dementia Care ◽  
Second Phase ◽  
General Hospitals ◽  
People With Dementia ◽  
Point Increase ◽  
Care Training ◽  
The Impact ◽  
Roll Out

Objectives The aims were to evaluate a second phase roll-out of a dementia care training programme for general hospital staff and to further develop two outcome scales: the Confidence in Dementia scale for measuring confidence in working with people with dementia and the Knowledge in Dementia scale for measuring knowledge in dementia. Method Following a ‘training the trainers’ phase, the study involved the delivery of the ‘Getting to Know Me’ training programme to a large number of staff (n = 517) across three National Health Service (NHS) Trusts situated in North-West England. The impact of the programme was evaluated using a pre–post design which explored: (i) changes in confidence in dementia, (ii) changes in knowledge in dementia, and (iii) changes in beliefs about behaviours that challenge. Results Statistically significant change was identified between pre–post training on all outcome measures (Confidence in Dementia: eight point increase, p < 0.001; Knowledge in Dementia: two point increase p < 0.001; controllability beliefs scale: four point decrease, p < 0.001). Medium to large effect sizes were demonstrated on all outcome measures. The psychometric properties of the Confidence in Dementia and Knowledge in Dementia scales are reported. Conclusion Staff knowledge in dementia and confidence in working with people with dementia significantly increased following attendance at the training sessions. The findings are consistent with preliminary findings and strengthen current knowledge about the impact of dementia care training in general hospitals. The Confidence in Dementia and Knowledge in Dementia scales continue to demonstrate psychometrically sound properties and demonstrate utility in the field of dementia research.

scholarly journals Using touchscreen tablets to support social connections and reduce responsive behaviours among people with dementia in care settings: A scoping review

Dementia ◽  
2020 ◽  
pp. 147130122092274
Author(s):  
Lillian Hung ◽  
Bryan Chow ◽  
John Shadarevian ◽  
Ryan O’Neill ◽  
Annette Berndt ◽  
...  
Keyword(s):  
Scoping Review ◽  
Care Home ◽  
Dementia Care ◽  
Lessons Learned ◽  
Social Connections ◽  
Term Care ◽  
People With Dementia ◽  
Person With Dementia ◽  
The Impact

The use of touchscreen tablets, such as the iPad, offers potential to support the person with dementia staying in a care setting, ranging from a long-term care home to an adult day programme. Although electronic devices are used among people with dementia, a comprehensive review of studies focusing on their impact and how they may be used effectively in care settings is lacking. We conducted a scoping review to summarize existing knowledge about the impact of touchscreen tablets in supporting social connections and reducing responsive behaviours of people with dementia in care settings. Our research team consists of patient partners and family partners, physicians, nurses, a medical student and an academic professor. A total of 17 articles were included in the review. Our analysis identified three ways in which touchscreen tablets support dementia care: (1) increased the person’s engagement, (2) decreased responsive behaviours and (3) positive effect on enjoyment/quality of life for people with dementia. Lessons learned and barriers to the use of touchscreen tablets in the care of people with dementia are described. Overall, only a few studies delineated strategies that helped to overcome barriers to technology adoption in care settings. Knowledge translation studies are needed to identify effective processes and practical tips to overcome barriers and realize the potential of assistive technology in dementia care.

scholarly journals Exploring Dementia Care Systems Across the African Caribbean Diaspora: A Scoping Review and Consultation Exercise

2020 ◽  
Author(s):  
Reena Lasrado ◽  
Sophie Baker ◽  
Maria Zubair ◽  
Polly Kaiser ◽  
Veena Janith Lasrado ◽  
...  
Keyword(s):  
Health Care ◽  
United Kingdom ◽  
Scoping Review ◽  
Health Care Professionals ◽  
Meaning Making ◽  
Dementia Care ◽  
Caribbean Diaspora ◽  
People With Dementia ◽  
African Caribbean ◽  
The Impact

Abstract Background and Objectives Understanding the influences of marginalized cultural and social identities as experienced by the African Caribbean diaspora within the context of dementia care is essential to minimize the gaps in current practice and policy in the health care setting. This study explores the impact of marginalized identities upon the meaning-making process, access to services and experience of care provisions through a scoping review and consultancy exercises with key stakeholders. Research Design Fourteen databases were searched using key terms. Primary studies in English, any year, study design, and country of origin were eligible. Titles, abstracts, and full texts were screened for inclusion and data were extracted in stages. Thematic analysis was performed and the findings were discussed in a series of consultation meetings with people with dementia, carers, and health care professionals in Manchester (United Kingdom) and Jamaica. Results The scoping review retrieved n = 1,989 research articles. Nineteen were included, most were qualitative (n = 14), 3 quantitative, and 2 mixed-method. The findings revealed limited insight into cultural and multiple individual identities in explaining conceptualization and service access. Consultation meetings confirmed these findings and highlighted differences in health care services and systems in the United Kingdom and Jamaica. Discussion and Implications This study suggests there is a complex interaction of sociocultural processes that marginalize African Caribbean persons in and across various national settings within the context of dementia care. The study highlights the importance of acknowledging and addressing how prevalent racialized- and class-based divides and related marginalized social locations are reflected in inequities in access to and use of dementia services.

scholarly journals Museum activities in dementia care: Using visual analog scales to measure subjective wellbeing

Dementia ◽  
2015 ◽  
Vol 16 (5) ◽  
pp. 591-610 ◽  
Author(s):  
Joana Johnson ◽  
Alison Culverwell ◽  
Sabina Hulbert ◽  
Mitch Robertson ◽  
Paul M Camic
Keyword(s):  
Subjective Wellbeing ◽  
Social Activity ◽  
Dementia Care ◽  
Visual Analog Scales ◽  
People With Dementia ◽  
Care And Support ◽  
Community Based Programs ◽  
Museum Object ◽  
Quasi Experimental ◽  
The Impact

Introduction Previous research has shown that people with dementia and caregivers derive wellbeing-related benefits from viewing art in a group, and that facilitated museum object handling is effective in increasing subjective wellbeing for people with a range of health conditions. The present study quantitatively compared the impact of two museum-based activities and a social activity on the subjective wellbeing of people with dementia and their caregivers. Methods A quasi-experimental crossover design was used. People with early to middle stage dementia and caregivers ( N = 66) participated in museum object handling, a refreshment break, and art viewing in small groups. Visual analog scales were used to rate subjective wellbeing pre and post each activity. Results Mixed-design analysis of variances indicated wellbeing significantly increased during the session, irrespective of the order in which the activities were presented. Wellbeing significantly increased from object handling and art viewing for those with dementia and caregivers across pooled orders, but did not in the social activity of a refreshment break. An end-of-intervention questionnaire indicated that experiences of the session were positive. Conclusion Results provide a rationale for considering museum activities as part of a broader psychosocial, relational approach to dementia care and support the use of easy to administer visual analog scales as a quantitative outcome measure. Further partnership working is also supported between museums and healthcare professionals in the development of nonclinical, community-based programs for this population.

The impact of life story work on person-centred care for people with dementia living in long-stay care settings in Ireland

Dementia ◽  
2018 ◽  
Vol 18 (7-8) ◽  
pp. 2731-2746 ◽  
Author(s):  
Adeline Cooney ◽  
Eamon O’Shea
Keyword(s):  
Registered Nurses ◽  
Healthcare Professionals ◽  
Life Story ◽  
Dementia Care ◽  
People With Dementia ◽  
Constant Comparative ◽  
Story Work ◽  
Person With Dementia ◽  
The Impact ◽  
Depth Interviews

The potential of life story work to add quality to dementia care is widely acknowledged. Whether this potential is always realised in practice and under what circumstances is less clear. This paper explores whether knowing the person’s life story enhances healthcare professionals’ understanding of the person with dementia and whether this understanding impacts on the person’s care. In-depth interviews were conducted with 11 registered nurses and 12 healthcare assistants who had used life story work with people with dementia living in long-stay care settings. Data were analysed using the constant comparative technique. Engaging in life story work enabled staff to see the person behind the dementia. Understanding (as opposed to knowing) the person with dementia’s life story changed staff’s thinking on what is important when delivering care to people with dementia, with staff giving concrete examples of changes in how they delivered care to the person with dementia and what they considered important when delivering that care. It was concluded that life story work can facilitate a shift to person centred dementia care but how it is implemented matters if this outcome is to be achieved.

03  What factors affect paramedics’ involvement of people with dementia in decisions affecting their care? A qualitative study

2020 ◽  
Vol 37 (10) ◽  
pp. e3.1-e3
Author(s):  
Esme Choonara
Keyword(s):  
Decision Making ◽  
Social Constructivism ◽  
Best Practice ◽  
Dementia Care ◽  
Research Approach ◽  
Best Interest ◽  
Complex Needs ◽  
Ethical Frameworks ◽  
People With Dementia ◽  
The Impact

BackgroundParamedics are frequently called to people with dementia due to high rates of co-morbidities and complex needs, but decision making can be challenging due to lack of information or difficulties in assessment. Best-practice dementia care should be holistic and involve people with dementia in decisions as far as possible. A small number of qualitative studies have looked at paramedics’ decision-making in relation to dementia, but these studies have not specifically investigated the involvement of people with dementia in decisions. This study aimed to explore how paramedics make decisions when attending people with dementia, with a particular focus on understanding the factors that impact on whether, how, and to what degree paramedics involve people with dementia in decisions about their care.MethodsA generic qualitative research approach was used, informed by social constructivism and by the researcher’s commitment to the concept of ‘personhood’ in dementia care. Data were collected through semi-structured individual interviews with seven paramedics, each lasting between 40 and 80 minutes. The interviews were recorded and transcribed verbatim and subsequently analysed using thematic analysis.ResultsFour themes were identified that all touched on challenges to delivering person-centred care for people with dementia. Themes identified were: 1. Paramedics’ differing approaches to assessing capacity and making best interest decisions. 2. Communication and developing a rapport. 3. Interconnections with others important to the person with dementia. 4. The impact of paramedics’ values and attitudes.ConclusionThe involvement of people with dementia is sometimes limited by medical, social or clinician-dependent factors. This study highlights how paramedics’ values and communication skills influence their interactions with people with dementia. As the paramedic role evolves, there is an opportunity to embed person-centred care in practice and to ensure that education equips paramedics with the skills and ethical frameworks needed to deliver high quality dementia care.

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