Views from health professionals on accessing rehabilitation for people with dementia following a hip fracture

Dementia ◽  
2016 ◽  
Vol 16 (8) ◽  
pp. 1020-1031 ◽  
Author(s):  
Stephen T Isbel ◽  
Maggie I Jamieson
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Residential Care ◽  
Health Professionals ◽  
Clinical Care ◽  
Care Staff ◽  
Future Research ◽  
Health Care Staff ◽  
People With Dementia ◽  
Moderate Dementia

The literature reports that rehabilitation for elderly patients with mild-to-moderate dementia who have a hip fracture improves functional outcomes. However, access to rehabilitation may be difficult due to misconceptions about the ability of these patients to engage in and benefit from rehabilitation. Additionally, people who are admitted from residential care may not have the same options for rehabilitation as those admitted from home. This study sought to understand from expert clinicians how and why decisions are made to accept a person with dementia post-fracture for rehabilitation. In this Australian-based qualitative study, 12 health professionals across a state and territory were interviewed. These clinicians were the primary decision makers in accepting or rejecting elderly patients with dementia post-fracture into rehabilitation. Three key themes emerged from the data: criteria for accessing rehabilitation, what works well and challenges to rehabilitation. The participants were unanimous in the view that access to rehabilitation should be based on the ability of the patient to engage in a rehabilitation programme and not assessed solely on cognition. In terms of clinical care, a coherent rehabilitation pathway with integration of geriatric and ortho-geriatric services was reported as ideal. Challenges remain, importantly, the perception of some health care staff that people with dementia have limited capability to benefit from rehabilitation. Rehabilitation for this growing group of patients requires multiple resources, including skilled practitioners, integrated clinical systems and staff education regarding the capabilities of people with dementia. Future research in this area with patients with moderate-to-severe dementia in residential care is warranted.

Sexuality Among Institutionalized Elderly Patients with Dementia

1999 ◽  
Vol 6 (2) ◽  
pp. 144-149 ◽  
Author(s):  
M Ehrenfeld ◽  
G Bronner ◽  
N Tabak ◽  
R Alpert ◽  
R Bergman
Keyword(s):  
Elderly Patients ◽  
Elderly People ◽  
Care Staff ◽  
Health Care Staff ◽  
Institutionalized Elderly ◽  
Mostly Heterosexual ◽  
Continued Education ◽  
People With Dementia ◽  
The Subject ◽  
Common Misconceptions

The subject of sexuality among elderly patients with dementia was examined, focusing on two main aspects: the sexual behaviour of institutionalized elderly people with dementia; and the reactions of other patients, staff and family members to this behaviour. The behaviour was found to be mostly heterosexual and ranged from love and caring to romance and outright eroticism. Reactions varied, being accepting of love and care but often objecting to erotic behaviour. Understanding of the sexual needs of elderly people should become an integral part of the training and continued education of health care staff, thus helping to resolve conflicts and clarify common misconceptions.

scholarly journals Care staff and the creative arts: exploring the context of involving care personnel in arts interventions

2017 ◽  
Vol 29 (12) ◽  
pp. 1979-1991 ◽  
Author(s):  
Emma Broome ◽  
Tom Dening ◽  
Justine Schneider ◽  
Dawn Brooker
Keyword(s):  
Residential Care ◽  
Web Of Science ◽  
Care Staff ◽  
Care Practice ◽  
Search Process ◽  
Creative Arts ◽  
Daily Care ◽  
People With Dementia ◽  
Arts Programs ◽  
Intervention Context

ABSTRACTBackground:Arts-based interventions play an important role in the care of people with dementia. Yet, creative arts are seldom implemented as a tool to enhance the care and wellbeing of people with dementia.Methods:We examined the involvement of care staff in creative arts activities in residential care. Aspects of involvement that appear to influence outcomes in people with dementia were identified and analyzed. A broad systematic literature search of MedLine, EMBASE, PsychInfo, CINAHL, ASSIA, SCOPUS, and Web of Science led to the identification of 14 papers. The studies identified through the search process were examined in terms of intervention, context, mechanism and outcome, and the relationships between these aspects.Results:Training sessions were identified as an opportunity to educate care personnel on useful techniques that are relevant to daily care practice. Evidence from the literature suggests that creative arts programs play a significant role in the way staff and residents interact and as a result influence the care practice of staff. Under certain conditions creative arts programs, that involve and engage staff, facilitate enhanced interactions and improve care strategies, which leads to the recognition and validation of personhood in residents with dementia.Conclusions:These findings provide a basis for illustrating which elements of care staff involvement in creative arts programs could be implemented in residential care contexts in order to have the upmost benefit.

scholarly journals Suicide by prisoners

2004 ◽  
Vol 184 (3) ◽  
pp. 263-267 ◽  
Author(s):  
Jenny Shaw ◽  
Denise Baker ◽  
Isabelle M. Hunt ◽  
Anne Moloney ◽  
Louis Appleby
Keyword(s):  
Mental Disorder ◽  
Clinical Care ◽  
National Sample ◽  
Primary Diagnosis ◽  
Care Staff ◽  
Health Care Staff ◽  
Prevention Measures ◽  
Prison Health ◽  
History Of ◽  
Clinical Survey

BackgroundThe number of suicides in prison has increased over recent years. This is the first study to describe the clinical care of a national sample of prison suicides.AimsTo describe the clinical and social circumstances of self-inflicted deaths among prisoners.MethodA national clinical survey based on a 2-year sample of self-inflicted deaths in prisoners. Detailed clinical and social information was collected from prison governors and prison health care staff.ResultsThere were 172 self-inflicted deaths: 85 (49%; 95% CI 42–57) were of prisoners on remand; 55 (32%; 95% CI 25–39) occurred within 7 days of reception into prison. The commonest method was hanging or self-strangulation (92%; 95% CI 88–96). A total of 110 (72%; 95% CI 65–79) had a history of mental disorder. The commonest primary diagnosis was drug dependence (39, 27%; 95% CI 20–35). Eighty-nine (57%; 95% CI 49–64) had symptoms suggestive of mental disorder at reception into prison.ConclusionsSuicide prevention measures should be concentrated in the period immediately following reception into prison. Because hanging is the commonest method of suicide, removal of potential ligature points from cells should be a priority.

scholarly journals Breastfeeding in COVID-19: A Pragmatic Approach

2020 ◽  
Vol 37 (13) ◽  
pp. 1377-1384
Author(s):  
Yvonne Peng Mei Ng ◽  
Yi Fen Low ◽  
Xin Lei Goh ◽  
Doris Fok ◽  
Zubair Amin
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Team ◽  
Care Staff ◽  
Future Research ◽  
Health Care Staff ◽  
Care Providers ◽  
Joint Decision ◽  
Skin Contact ◽  
Novel Coronavirus

The novel coronavirus disease 2019 (COVID-19) pandemic has resulted in changes to perinatal and neonatal care, concentrating on minimizing risks of transmission to the newborn and health care staff while ensuring medical care is not compromised for both mother and infant. Current recommendations on infant care and feeding when mother has COVID-19 ranges from mother–infant separation and avoidance of human milk feeding, to initiation of early skin-to-skin contact and direct breastfeeding. Health care providers fearing risks of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) maternal–infant transmission may veer toward restricted breastfeeding practices. We reviewed guidelines and published literature and propose three options for infant feeding depending on various scenarios. Option A involves direct breastfeeding with the infant being cared for by the mother or caregiver. In option B, the infant is cared for by another caregiver and receives mother's expressed milk. In the third option, the infant is not breastfed directly and does not receive mother's expressed milk. We recommend joint decision making by parents and the health care team. This decision is also flexible as situation changes. We also provide a framework for counseling mothers on these options using a visual aid and a corresponding structured training program for health care providers. Future research questions are also proposed. We conclude that evidence and knowledge about COVID-19 and breastfeeding are still evolving. Our options can provide a quick and flexible reference guide that can be adapted to local needs. Key Points

Health professionals’ attitude towards information disclosure to cancer patients in China

2011 ◽  
Vol 18 (3) ◽  
pp. 356-363 ◽  
Author(s):  
Zeng Tieying ◽  
Huang Haishan ◽  
Zhao Meizhen ◽  
Li Yan ◽  
Fang Pengqian
Keyword(s):  
Cancer Patients ◽  
Health Professionals ◽  
Information Disclosure ◽  
Chinese Culture ◽  
Mainland China ◽  
Care Staff ◽  
Health Care Staff ◽  
Current State ◽  
Medical Disputes ◽  
Large Teaching Hospital

A self-designed questionnaire was given to 634 health professionals in a large teaching hospital in Hubei Province in mainland China, to clarify the participants’ attitude towards information disclosure to cancer patients. Statistic description was used to analyze the data. The item ‘inappropriate information about cancer easily leads to medical disputes’ scored highest at 3.86, while the scores of such items as ‘advantages of fully informing patients outweigh disadvantages’, ‘if their family members demand nondisclosure, you will find it difficult to cooperate in good faith with patients’, and ‘telling white lies to patients disturbs you a lot’ were less than 3. The health care staff placed a high value on both the desire and priority of patients to know the truth, though most of them did not think that patients had received enough information about their disease. In order to improve cancer patients’ current state of knowledge, health professionals should learn more about informed consent, and special methods and guidelines compatible with Chinese culture are urgently required in China.

scholarly journals Clowning in health care settings: The point of view of adults

2016 ◽  
Vol 12 (3) ◽  
pp. 473-488 ◽  
Author(s):  
Alberto Dionigi ◽  
Carla Canestrari
Keyword(s):  
Health Care ◽  
Positive Emotions ◽  
Emotional Reactivity ◽  
Psychological Symptoms ◽  
Empirical Studies ◽  
Well Being ◽  
Care Staff ◽  
Future Research ◽  
Health Care Staff ◽  
Pilot Studies

Within the past decade, there has been a surge of interest in investigating the effects of clown intervention in a large variety of clinical settings. Many studies have focused on the effects of clown intervention on children. However, few studies have investigated clowning effects on adults. This paper presents an overview of the concept of medical clowning followed by a literature review conducted on the empirical studies drawn from three data bases (PubMed, PsycINFO, and Google Scholar), with the aim of mapping and discussing the evidence of clowning effects on non-children, namely adults. The following areas were investigated: Adult and elderly patients (mainly those with dementia), observers of clowning, namely non-hospitalized adults who are at the hospital as relatives of patients or health-care staff, and finally clowns themselves. The main results are that 1) clown intervention induces positive emotions, thereby enhancing the patient’s well-being, reduces psychological symptoms and emotional reactivity, and prompts a decrease in negative emotions, such as anxiety and stress; 2) clown doctors are also well-perceived by relatives and healthcare staff and their presence appears to be useful in creating a lighter atmosphere in the health setting; 3) few pilot studies have been conducted on clown doctors and this lacuna represents a subject for future research.

The Development of the strain in dementia care scale (SDCS)

2015 ◽  
Vol 27 (12) ◽  
pp. 2017-2030 ◽  
Author(s):  
Anna-Karin Edberg ◽  
Katrina Anderson ◽  
Anneli Orrung Wallin ◽  
Mike Bird
Keyword(s):  
Factor Analysis ◽  
Residential Care ◽  
Outcome Measurement ◽  
Well Being ◽  
Critical Issue ◽  
Dementia Care ◽  
Residential Facilities ◽  
Care Staff ◽  
People With Dementia ◽  
Item Scale

ABSTRACTBackground:Though many staff gain satisfaction from working with people with dementia in residential facilities, they also experience significant stress. This is a serious issue because this in turn can affect the quality of care. There is, however, a lack of instruments to measure staff strain in the dementia-specific residential care environment, and the aim of this study, accordingly, was to develop the “Strain in Dementia Care Scale.”Methods:The instrument was developed in three steps. In the first step, items were derived from six focus group discussions with 35 nurses in the United Kingdom, Australia, and Sweden concerning their experience of strain. In the second step, a preliminary 64-item scale was distributed to 927 dementia care staff in Australia and Sweden, which, based on exploratory factor analysis, resulted in a 29-item scale. In the final step, the 29-item scale was distributed to a new sample of 346 staff in Sweden, and the results were subjected to confirmatory factor analysis.Results:The final scale comprised the following 27 items producing a five-factor solution: Frustrated empathy; difficulties understanding and interpreting; balancing competing needs; balancing emotional involvement; and lack of recognition.Conclusions:The scale can be used (a) as an outcome measurement in residential care intervention studies; (b) to help residential facilities identify interventions needed to improve staff well-being, and, by extension, those they care for; and (c) to generally make more salient the critical issue of staff strain and the importance of ameliorating it.

The ‘tipping point’: Exploring the factors associated with entry into residential care for people with dementia in Western Australia

Dementia ◽  
2021 ◽  
pp. 147130122110012
Author(s):  
Thomas McGrath ◽  
Barbara Blundell ◽  
Claire Morrisby
Keyword(s):  
Social Support ◽  
Residential Care ◽  
Western Australia ◽  
Contextual Factors ◽  
Tipping Point ◽  
Care Staff ◽  
Community Research ◽  
Informal Carer ◽  
People With Dementia ◽  
At Home

Background People with dementia usually prefer to live in the community. Research is needed to identify the ‘tipping point’ for residential care entry and to highlight how people with dementia can be supported to remain at home as long as possible. Few previous studies have examined caregivers’ perceptions and explanations for the reasons people with dementia need to enter residential care in Australia. Aim To explore the factors contributing to people with dementia entering residential care in Perth, Western Australia, from the perspectives of informal carers and care staff. Method This phenomenological study used purposive sampling to recruit informal and formal caregivers of people with dementia. Semi-structured in-depth interviews were conducted with 13 family carers and 11 home care staff. Data were thematically analysed to identify individual, carer and contextual factors that impact on residential care entry. Findings The majority of participants identified a combination of factors as the ‘tipping point’ to residential care entry; a few also identified the cause as a sudden event or specific issue. Factors identified included deterioration related to worsening cognition, changed behaviours and a decline in the performance of activities of daily living; co-occurring health conditions; safety concerns; carer no longer able to meet care needs; impact of providing support becoming too much for the informal carer; lack of family or social support and needing assistance from services that were unavailable or inaccessible. Factors assisting people with dementia to remain living at home longer were family and social support, formal services and dog ownership. Conclusion This study identified individual, carer and contextual factors that contribute to people with dementia entering residential care in Australia. The ‘tipping point’ was recognised as when the needs of a person with dementia outweigh the capacity of their informal and formal carers, services and supports to care for them.

scholarly journals The Acceptability and Usefulness of Cognitive Stimulation Therapy for Older Adults with Dementia: A Narrative Review

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Hui Moon Toh ◽  
Shazli Ezzat Ghazali ◽  
Ponnusamy Subramaniam
Keyword(s):  
Older Adults ◽  
Cultural Context ◽  
Qualitative Studies ◽  
Cognitive Stimulation ◽  
Future Research ◽  
Cognitive Stimulation Therapy ◽  
People With Dementia ◽  
Moderate Dementia ◽  
Evidence Based Therapy

Cognitive stimulation therapy (CST) is an evidence-based therapy for individuals with mild-to-moderate dementia. Past reviews have only synthesized outcomes obtained through quantitative study which does not fully represent the understanding on the acceptability and usefulness of CST. Therefore, the present review aims to integrate outcomes obtained from both quantitative and qualitative studies to provide a deeper understanding on the acceptability and usefulness of CST for older adults with dementia. Findings of literature were retrieved from searches of computerized databases in relation to CST for people with dementia. Literatures were selected according to selection criteria outlined. Results obtained in previous studies pertaining to the effects of CST were discussed in relation to variables such as cognitive function, quality of life, and family caregivers’ wellbeing. The review also explores the use of CST in different cultural context, the perception on its effectiveness, and individualized CST (iCST). There is considerable evidence obtained through quantitative and qualitative studies on the usefulness and acceptability of CST for older adults with dementia. Recommendations for future research are provided to strengthen the evidence of CST’s effectiveness.

Intimacy and sexuality of nursing home residents with dementia: a systematic review

2014 ◽  
Vol 27 (3) ◽  
pp. 367-384 ◽  
Author(s):  
Tineke S. M. Roelofs ◽  
Katrien G. Luijkx ◽  
Petri J. C. M. Embregts
Keyword(s):  
Sexual Behavior ◽  
Nursing Home ◽  
Design Research ◽  
Nursing Home Residents ◽  
Care Staff ◽  
Research Quality ◽  
Future Research ◽  
Full Spectrum ◽  
People With Dementia ◽  
Wide Range

ABSTRACTBackground:Considering people with dementia, increasing cognitive, physical, and environmental impairments can impede the capacity to express and experience intimacy and sexuality. When a move to a residential (nursing) home becomes inevitable, increasing dependency can influence this even more. The aim of the review is to provide a structured overview of all elements of intimacy across the full spectrum of intimacy and sexuality in people with dementia, living in specialist residential care.Methods:A systematic search and review were conducted. Research published between 1990 and 2013 was identified in the electronic databases: Pubmed, PsychInfo, and Medline. Inclusion and exclusion criteria were predefined. Selected studies were assessed on quality, using the Mixed Methods Appraisal Tool.Results:Twelve of the 215 initially retrieved unique research publications were selected. A varied range of studies were found; these studies differed in design, research quality, searched population, and research theme. Different themes emerged: intimate and sexual behavior, knowledge and attitudes, capacity to consent and care culture, and staff training and guidelines.Conclusions:Although results were found in a wide range of intimate and sexual behavior, knowledge, attitudes and needs of others, and descriptions of culture in residential and nursing homes, the perspective of residents was lacking in literature. Also a “protective” care paradigm was found throughout. Future research is needed to highlight resident perspective and develop training opportunities and guidelines for care staff.

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