scholarly journals Explaining the effects of symptom attribution by carers on help-seeking for individuals living with dementia

Dementia ◽  
2016 ◽  
Vol 16 (3) ◽  
pp. 375-387 ◽  
Author(s):  
Lisa Feldman ◽  
Jane Wilcock ◽  
Ingela Thuné-Boyle ◽  
Steve Iliffe
Keyword(s):  
General Practice ◽  
Cognitive Decline ◽  
Life Events ◽  
Help Seeking ◽  
Public Awareness ◽  
Memory Loss ◽  
Behavioural Symptoms ◽  
People With Dementia ◽  
Help Seeking Behaviour ◽  
Symptom Attribution

This study investigated the effects of carer attributions on help-seeking behaviour for people with dementia using interviews with 84 carers recruited through general practice. Memory loss was the most commonly reported first symptom but psychological and behavioural symptoms were also common at onset. In over a third of individuals help-seeking was delayed for a mean of 25 months (range 6–69, SD 19.3). Help-seeking between those who attributed symptoms to dementia, or to unknown causes, and those who attributed symptoms to personality, ageing, life events or other illnesses was statistically significant ( p < 0.001). No statistically significant associations between help-seeking and patient or carer characteristics were found. There is a need to raise public awareness about the range of symptoms suggestive of dementia. Assumptions that age and other conditions may be the likely cause of an individual’s cognitive decline needs to be challenged by practitioners. Attribution of symptoms to characteristics other than dementia delays help-seeking.

Ethical issues in the care of people with dementia

2020 ◽  
Vol 13 (6) ◽  
pp. 374-381
Author(s):  
Joshua Parker
Keyword(s):  
Cognitive Decline ◽  
Functional Impairment ◽  
Ethical Issues ◽  
Memory Loss ◽  
Assistive Technologies ◽  
Best Interests ◽  
Truth Telling ◽  
People With Dementia

Dementia is a syndrome characterised by cognitive decline, memory loss and progressive functional impairment. It is increasingly common, and is largely managed in the community. The nature of dementia leads to many deep philosophical problems that bear on the various ethical issues that arise for clinicians caring for these patients. This article explores these ethical issues with a focus on promoting autonomy and making best interests decisions. Everyday ethical issues including truth telling, restraint and limitations of freedom, abuse and vulnerability are considered. Ethical issues generated by the use of assistive technologies and finally confidentiality are also, briefly, considered. Although this article cannot give specific ‘right answers’ to the myriad ethical issues confronting GPs working with people with dementia, it does aim to highlight productive lines of thought in navigating such issues.

scholarly journals What is the relationship between people with dementia and their caregiver’s illness perceptions post-diagnosis and the impact on help-seeking behaviour? A systematic review

Dementia ◽  
2021 ◽  
pp. 147130122199729
Author(s):  
Jane E Gregg ◽  
Jane Simpson ◽  
Ramin Nilforooshan ◽  
Guillermo Perez-Algorta
Keyword(s):  
Help Seeking ◽  
Illness Perceptions ◽  
Cultural Beliefs ◽  
People With Dementia ◽  
Help Seeking Behaviour ◽  
Major Factors ◽  
Person With Dementia ◽  
The Impact ◽  
The Relationship ◽  
System Threat

Background: As the number of people with dementia increases, more families will be affected by the daily challenges of providing effective support, given its current incurable status. Once individuals are diagnosed with dementia, the earlier they access support, the more effective the outcome. However, once people receive a diagnosis, how they make sense of their dementia can impact on their help-seeking intentions. Exploring the illness beliefs of people with dementia and their caregivers and this relationship to help seeking may identify how best to facilitate early support. Aims: To systematically obtain and critically review relevant studies on the relationship between illness perceptions and help seeking of people with dementia and their caregivers. Method: A systematic search was conducted and included both quantitative and qualitative studies. The initial search was conducted in October 2018, with an adjacent search conducted in April 2020. Findings: A total of 14 articles met the inclusion criteria. Conceptually, the studies examined the association of illness perceptions and help-seeking post-diagnosis and revealed that people living with dementia and their caregivers sought help when symptoms became severe. Components of illness perceptions revealed that lack of knowledge, cultural beliefs, complexity of the healthcare system, threat to independence and acceptance were identified as major factors for delaying help seeking. Conclusion: Although research interest in the area of illness perceptions and their impact on help seeking for dementia is increasing, further work is needed to understand this area, particularly regarding the influence of the relationship between the person with dementia and their caregiver.

Perceptions of Dementia among Asian Indian Americans

2008 ◽  
Vol 6 (2) ◽  
pp. 45-65 ◽  
Author(s):  
Poorni Otilingam ◽  
Margaret Gatz
Keyword(s):  
Asian Indian ◽  
Help Seeking ◽  
Memory Loss ◽  
Convenience Sample ◽  
Culturally Tailored ◽  
Willingness To Seek Help ◽  
Indian Americans ◽  
Education And Care ◽  
Dementia Education ◽  
Asian Indian Americans

We surveyed a convenience sample of 255 Asian Indian Americans (AIAs) aged 18-81 years assessing perceptions of dementia etiology, help-seeking, and treatment, and knowledge of symptoms of Alzheimer’s disease (AD). In response to a vignette describing the early stages of AD, participants indicated a substantial willingness to seek help. Most participants knew that memory loss was the key symptom of dementia, yet most knowledge items were correctly answered by fewer than half of the sample. Participants who had more knowledge of AD were more likely than those with less knowledge of AD to state that they would seek help for an elderly relative showing symptoms of dementia. Relative to other psychosocial factors, loneliness was highly rated as an etiological factor and keeping mentally active was highly rated as a treatment. This study is the first to document dementia beliefs among AIAs, illustrating the need for culturally-tailored dementia education and care for the AIA population.

Advance care planning: the future

2020 ◽  
pp. bmjspcare-2020-002304
Author(s):  
Judith Rietjens ◽  
Ida Korfage ◽  
Mark Taubert
Keyword(s):  
Advance Care Planning ◽  
Public Awareness ◽  
Care Planning ◽  
Decisional Capacity ◽  
Best Interest ◽  
Awareness Campaigns ◽  
People With Dementia ◽  
Future Care ◽  
Advance Care ◽  
Improve Patient

ObjectivesThere is increased global focus on advance care planning (ACP) with attention from policymakers, more education programmes, laws and public awareness campaigns.MethodsWe provide a summary of the evidence about what ACP is, and how it should be conducted. We also address its barriers and facilitators and discuss current and future models of ACP, including a wider look at how to best integrate those who have diminished decisional capacity.ResultsDifferent models are analysed, including new work in Wales (future care planning which includes best interest decision-making for those without decisional capacity), Asia and in people with dementia.ConclusionsACP practices are evolving. While ACP is a joint responsibility of patients, relatives and healthcare professionals, more clarity on how to apply best ACP practices to include people with diminished capacity will further improve patient-centred care.

scholarly journals The Role of Stressful Childhood Experiences in Shaping Later-Life Memory Loss Among Black and White U.S. Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 296-296
Author(s):  
Caroline Hartnett
Keyword(s):  
Cognitive Decline ◽  
Memory Loss ◽  
Later Life ◽  
Behavioral Risk ◽  
Black Adults ◽  
Childhood Experiences ◽  
White Children ◽  
Black And White ◽  
Stressful Experiences ◽  
White Adults

Abstract Cognitive decline common in the U.S. and greatly impacts quality of life, both for those who experience it and for those who care for them. Black Americans experience higher burdens of cognitive decline but the mechanisms underlying this disparity have not been fully elucidated. Stress experienced in early life is a promising explanatory factor, since stress and cognition are linked, childhood stressors been shown to have a range of negative implications later in life, and Black children experience more childhood stressors than White children, on average. In this paper, we use data from the Behavioral Risk Factor Surveillance System (BRFSS) to examine whether stressful experiences in childhood help explain Black-White disparities in memory loss. These data were available for 5 state-years between 2011 and 2017 (n=11,708). Preliminary results indicate that, while stressful childhood experiences are strongly associated with memory loss, stressful experiences do not mediate the association between race and memory loss. However, race does appear to moderate the association between stressful childhood experiences and memory loss. Specifically, stressful experiences are associated with a higher likelihood of memory loss for Black adults compared to White adults.In addition, there seem to be some noteworthy patterns across different types of experiences (i.e. parental drinking may predict later memory loss more strongly for Black adults than White adults, but parental hitting may predict memory loss more strongly for White adults than Black adults).

scholarly journals Correlates of Help-Seeking Behaviour in Adolescents Who Experience Bullying Victimisation

2021 ◽  
Author(s):  
Lori K. Matuschka ◽  
James G. Scott ◽  
Marilyn A. Campbell ◽  
David Lawrence ◽  
Stephen R. Zubrick ◽  
...  
Keyword(s):  
Help Seeking ◽  
Help Seeking Behaviour ◽  
Bullying Victimisation

scholarly journals Hearing Loss and Help-Seeking Behavior

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 797-797
Author(s):  
Nicholas Reed
Keyword(s):  
Health Care ◽  
Hearing Loss ◽  
Help Seeking ◽  
Health Care Quality ◽  
Medicare Beneficiary ◽  
Care Quality ◽  
The Past ◽  
Help Seeking Behaviour ◽  
Seeking Behavior ◽  
Future Work

Abstract Hearing Loss (HL) is common among older adults and is associated with poor health care quality outcomes include 30-day readmissions, length of stay, poorer satisfaction, and increased medical expenditures. These associations may manifest in changes in help-seeking behaviour. In the 2015 Current Medicare Beneficiary Study (MCBS) (n=10848; weighted sample=46.3 million), participants reported whether they knowingly had avoided seeking care in the past year and self-reported HL was measured as degree of trouble (none, a little, or a lot) hearing when using a hearing aid if applicable. In a model adjusted for demographic, socioeconomic, and health factors, those with a little trouble (OR= 1.612; 95% CI= 1.334-1.947; P&lt;0.001) and a lot of trouble hearing (OR= 2.011; 95% CI= 1.443-2.801; P&lt;0.001) had 61.2% and 101.1% higher odds of avoiding health care over the past year relative to participants with no trouble hearing. Future work should examine whether hearing care modifies this association.

scholarly journals Psychosocial influences on help-seeking behaviour for cancer in low-income and lower middle-income countries: a mixed-methods systematic review

2021 ◽  
Vol 6 (2) ◽  
pp. e004213
Author(s):  
Grace McCutchan ◽  
Bahr Weiss ◽  
Harriet Quinn-Scoggins ◽  
Anh Dao ◽  
Tom Downs ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Cancer Treatment ◽  
Help Seeking ◽  
Middle Income ◽  
Cancer Symptoms ◽  
Middle Income Countries ◽  
Help Seeking Behaviour ◽  
Psychosocial Influences

IntroductionStarting cancer treatment early can improve outcomes. Psychosocial factors influencing patients’ medical help-seeking decisions may be particularly important in low and lower middle-income countries (LMIC) where cancer outcomes are poor. Comprehensive review evidence is needed to understand the psychosocial influences on medical help-seeking for cancer symptoms, attendance for diagnosis and starting cancer treatment.MethodsMixed-methods systematic review registered on PROSPERO (CRD42018099057). Peer-reviewed databases were searched until April 2020 for studies assessing patient-related barriers and facilitators to medical help-seeking for cancer symptoms, diagnosis and treatment in adults (18+ years) living in LMICs. Quality of included studies was assessed using the Critical Appraisal Skills Programme tool. Data were synthesised using meta-analytic techniques, meta-ethnography or narrative synthesis as appropriate.ResultsOf 3963 studies identified, 64 were included. In quantitative studies, use of traditional, complementary and alternative medicine (TCAM) was associated with 3.60 higher odds of prolonged medical help-seeking (95% CI 2.06 to 5.14). Qualitative studies suggested that use of TCAM was a key barrier to medical help-seeking in LMICs, and was influenced by causal beliefs, cultural norms and a preference to avoid biomedical treatment. Women face particular barriers, such as needing family permission for help-seeking, and higher stigma for cancer treatment. Additional psychosocial barriers included: shame and stigma associated with cancer such as fear of social rejection (eg, divorce/disownment); limited knowledge of cancer and associated symptoms; and financial and access barriers associated with travel and appointments.ConclusionDue to variable quality of studies, future evaluations would benefit from using validated measures and robust study designs. The use of TCAM and gender influences appear to be important barriers to help-seeking in LMIC. Cancer awareness campaigns developed with LMIC communities need to address cultural influences on medical help-seeking behaviour.

scholarly journals Association of Anxiety Awareness with Risk Factors of Cognitive Decline in MCI

2021 ◽  
Vol 11 (2) ◽  
pp. 135
Author(s):  
Ariela Gigi ◽  
Merav Papirovitz
Keyword(s):  
Cognitive Decline ◽  
State Anxiety ◽  
Verbal Learning ◽  
Memory Loss ◽  
Control Group ◽  
General Tendency ◽  
General Anxiety ◽  
Auditory Verbal Learning ◽  
Skin Conductivity ◽  
Learning Test

Studies demonstrate that anxiety is a risk factor for cognitive decline. However, there are also study findings regarding anxiety incidence among people with mild cognitive impairment (MCI), which mostly examined general anxiety evaluated by subjective questionnaires. This study aimed to compare subjective and objective anxiety (using autonomic measures) and anxiety as a general tendency and anxiety as a reaction to memory examination. Participants were 50 adults aged 59–82 years who were divided into two groups: MCI group and control group, according to their objective cognitive performance in the Rey Auditory Verbal Learning Test. Objective changes in the anxiety response were measured by skin conductivity in all tests and questionnaires. To evaluate subjective anxiety as a reaction to memory loss, a questionnaire on “state-anxiety” was used immediately after completing memory tests. Our main finding was that although both healthy and memory-impaired participants exhibited elevations in physiological arousal during the memory test, only healthy participants reported an enhanced state anxiety (p = 0.025). Our results suggest that people with MCI have impaired awareness of their emotional state.

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