scholarly journals To see, meet and adapt – an interview study about physiotherapists’ pedagogical approach to dementia

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Karin Nordell ◽  
Karin Hellström ◽  
Anncristine Fjellman-Wiklund

Abstract Background Physiotherapists need to use pedagogical approaches and strategies in their work. However, there is no previous definition of what a pedagogical approach in physiotherapy means neither in general nor specifically to dementia. The purpose of this study was therefore to gain greater insight into physiotherapists’ pedagogical approach to dementia by investigating physiotherapists’ views and working methods in contact with older people with dementia, relatives, and nursing staff in elderly care. Methods This was a qualitative study with an inductive approach. Semi-structured individual interviews were conducted with 15 physiotherapists with experience of working with older people with dementia in elderly care. The interviews were analyzed with qualitative content analysis. Results The term “pedagogical approach” could sometimes be experienced as “vague” or “hard to grasp”. Our research nonetheless identified one overarching theme To see, meet and adapt which is based on insights from the interviews grouped in to five categories. This theme can be seen as an expression of the physiotherapists’ pedagogical approach in contact with older people with dementia, relatives, and nursing staff. It captures the participants’ desire to always see the person in front of them, meet them where they are and adapt their own way of working accordingly. Creating a trusting relationship was described as important and made it easier for the participants to adapt their working methods. The participants’ adaptations could apply to the way they communicated with people with dementia, and how they organized tutoring/education of relatives and nursing staff to maximize learning. Learning through experience and reflection was described as a key to advancing the pedagogical approach and the participants experienced their own learning as constantly ongoing. Conclusions This study provides increased understanding into physiotherapists’ pedagogical approach in contact with older people with dementia, relatives, and nursing staff in elderly care and shows that learning through experience and reflection can contribute to the development of the pedagogical approach. Thus, opportunity for reflection should be accommodated in the physiotherapists’ work. The importance of more pedagogical education for physiotherapists both in bachelor and master level were also highlighted. Increasing mobility and physical activity in older people with dementia is important since physical inactivity and sedentary behavior is common. Future research may be directed at further exploring physiotherapists’ pedagogical approach in tutoring/education of nursing staff, with the aim of increasing physical activity among older people with dementia.

2016 ◽  
Vol 29 (1) ◽  
pp. 81-91 ◽  
Author(s):  
Morag E. Taylor ◽  
Stephen R. Lord ◽  
Henry Brodaty ◽  
Susan E. Kurrle ◽  
Sarah Hamilton ◽  
...  

ABSTRACTBackground:Older people with dementia are at increased risk of physical decline and falls. Balance and mood are significant predictors of falls in this population. The aim of this study was to determine the effect of a tailored home-based exercise program in community-dwelling older people with dementia.Methods:Forty-two participants with mild to moderate dementia were recruited from routine health services. All participants were offered a six-month home-based, carer-enhanced, progressive, and individually tailored exercise program. Physical activity, quality of life, physical, and psychological assessments were administered at the beginning and end of the trial.Results:Of 33 participants (78.6%) who completed the six-month reassessment ten (30%) reported falls and six (18%) multiple falls during the follow-up period. At reassessment, participants had better balance (sway on floor and foam), reduced concern about falls, increased planned physical activity, but worse knee extension strength and no change in depression scores. The average adherence to the prescribed exercise sessions was 45% and 22 participants (52%) were still exercising at trial completion. Those who adhered to ≥70% of prescribed sessions had significantly better balance at reassessment compared with those who adhered to <70% of sessions.Conclusions:This trial of a tailored home-based exercise intervention presents preliminary evidence that this intervention can improve balance, concern about falls, and planned physical activity in community-dwelling older people with dementia. Future research should determine whether exercise interventions are effective in reducing falls and elucidate strategies for enhancing uptake and adherence in this population.


Author(s):  
Benedicte Sørensen Strøm ◽  
Hilde Lausund ◽  
Anne Marie  Mork Rokstad ◽  
Knut Engedal ◽  
Alka Goyal

Background: Despite the increased prevalence of dementia in India, there is reported to be little awareness of the disease. This could lead to a late diagnosis, a reduced number of choices regarding future care, and misinterpretation of the symptoms or neglect. Taking into consideration that most nurses caring for older people in the future will work with people with dementia, there is concern that they may not be able to meet the needs of this group of patients unless they have the necessary knowledge and a positive attitude. Aim: To explore the knowledge about and attitude towards dementia among nursing staff working in residential care facilities for older people in India. Method: An explorative and descriptive qualitative design was used. Two semi-structured focus group interviews were conducted with nursing staff working in 6 nursing homes in India. Qualitative content analysis was used. Ethical approval was granted by the Norwegian Social Science Data Services. Findings: The participants highlighted the following 3 dimensions in relation to their knowledge of and attitudes toward dementia in residential care facilities in India: (1) people with dementia – a walking mystery; (2) we need to go along with them, but it is challenging; and (3) if we know, we can care for them in a better way. Conclusion: The findings revealed a wide range of differences in attitude towards and inadequate knowledge of dementia among nursing staff. However, their overall attitudes toward people with dementia was positive.


2008 ◽  
Vol 14 (1) ◽  
pp. 25 ◽  
Author(s):  
Debbie Kralik ◽  
Kate Visentin ◽  
Geoff March ◽  
Barbara Anderson ◽  
Andrew Gilbert ◽  
...  

The purpose of this paper is to report the findings of an integrative review of the literature on medication management for individuals who live in the community and have both chronic illness and mild to moderate dementia. The aim of the review was to summarise what is known about this topic, evaluate and compare previous research on the topic of medication management for people with dementia, and locate gaps in current work, thus pointing to directions for future research. Dementia is a national health priority for Australia. A significant component of community care for people with dementia is the management and administration of the medications required for other chronic conditions. Medication management is a broad term that encompasses several aspects, such as client-centred medication review, rational prescribing and support, repeat prescribing, client information/education, capacity to communicate with multiple health providers and having access to medicines. Cognitive impairment has been associated with medication management issues so it is important to ensure quality outcomes of medicine use by community-dwelling older people with dementia. The literature revealed a number of issues, such as the importance of person-centred care, the need for the coordination of care, and consumer partnerships in medication management. These are all important considerations in planning primary care services to support people with dementia and chronic illnesses. People with dementia who have chronic illness require coordinated, tailored, and flexible care processes in the community. There exists a range of services and programs such as home medicine reviews to support people living in the community with chronic illness and dementia; however, there is little coordination of care and evaluation of interventions is, at best, inconsistent. Currently, Australia lacks an integrative primary health care (PHC) framework, within which consumer involvement in decision-making and/or care planning is valued and sought. Current services are limited in the degree to which there is collaboration between key partners and Australian PHC initiatives are fragmented and have limited impact on service delivery.


Electronics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 1925
Author(s):  
Soe Ye Yint Tun ◽  
Samaneh Madanian ◽  
Dave Parry

The elderly population is increasing globally, putting more pressure on aged care and public health systems. To address this issue and help increase the independence of older people, different digital technologies, including the Internet of things (IoT), can play an important role. Although there has been an increase in the number of studies in this field, most of them concentrate on IoT applications in elderly care from a technology perspective, with very little contribution from the clinical side. Therefore, this paper aims to investigate and identify the available IoT applications and their clinical utility for common diseases in elderly people. The results of this study could be useful for information technology professionals in developing and understanding the clinical requirements for IoT applications in healthcare for older people. Clinicians will also be informed about the clinical possibilities of using IoT devices in this area. Based on our findings, future research should focus on enhancing the clinical utility of current IoT applications in different settings and on developing new applications to support practitioners and older people.


2021 ◽  
Vol 33 (S1) ◽  
pp. 45-45
Author(s):  
Gerrie Van Voorden ◽  
Mijke Lips ◽  
Sytse Zuidema ◽  
Richard Christiaan Oude Voshaar ◽  
Martin Smalbrugge ◽  
...  

Introduction:Little is known about the raising number of specialized units for patients with dementia and very severe challenging behavior in the Netherlands. This study describes organizational and treatment characteristics of a sample of these units.Methods:The organizational and treatment characteristics were studied with digital questionnaires completed by the unit managers, interviews with the main physician(s) and observation of the physical environment. The questionnaire consisted of questions about general patient characteristics, unit characteristics and staff characteristics. Furthermore, an interview was held with the main/treating physician often together with another physician or psychologist. The interview guide consisted of questions about admission criteria, the role of staff involved and the treatment process.Results:Thirteen units participated. Five units were part of a mental health (MH) institution, seven units were part of a nursing home (NH) organization and one unit was a cooperation of MH and NH. Unit sizes ranged from 10 to 28 places. Ten of thirteen units started in 2010 or later. The age of patients admitted was estimated at 75 years. The percentage of involuntary admitted patients was 53% at MH-units and 18% at NH-units. Unit managers mentioned that due to a difference in reimbursement between MH and NH units had difficulty providing the specialized care. Another problem managers faced was recruiting nursing staff. Units strived for expertise in general staffing from both MH and NH. The education level of the nursing staff was comparable between MH and NH. At every unit a physician with background in elderly care medicine or geriatrics and a psychiatrist was involved. Interviewees stressed the role of the nursing staff in the treatment. They were key in providing the care and treatment that, since the main goal of interventions is treatment of and coping with challenging behavior.Conclusion:The main finding of this study is that units caring for patients with dementia and challenging behavior, despite barriers in regulations and staffing shortage, search for combining expertise from nursing home care and psychiatry in their treatment.


2017 ◽  
Vol 19 (3) ◽  
pp. 225-241 ◽  
Author(s):  
Hanna-Kaisa Hoppania ◽  
Anna Mäki-Petäjä-Leinonen ◽  
Henna Nikumaa

The rights of older people to care have become a major political and legal issue with the ageing populations of many European and OECD countries. Finland is an interesting case in this respect because in 2013, extensive new legislation was passed there concerning the rights of the older population to access care services. This article describes the context in which the ‘Act on Supporting the Functional Capacity of the Older Population and on Social and Health Services for Older Persons’ (980/2012 Elderly Care Act) was drafted, and what the Act aims to accomplish. It argues that while the Act is ambitious and symbolically significant, it remains unsatisfactory in practice. This is the case especially for people with dementia, who end up being disadvantaged. We compare the Elderly Care Act with other relevant legislation, in particular legislation pertaining to disability services, and estimate the significance of the law from the perspective of older people with dementia. We also discuss the situation in Finland in relation to the global situation of people with dementia as the UN Convention on the Rights of Persons with Disabilities was recently ratified in Finland. We show that disability legislation, rather than elderly care legislation, should be the framework through which the right to services should be secured for people with dementia.


2020 ◽  
Author(s):  
Anna Sondell ◽  
Josefine Lampinen ◽  
Mia Conradsson ◽  
Håkan Littbrand ◽  
Undis Englund ◽  
...  

Abstract Background: There is a great need for the development of feasible rehabilitation interventions for older people with dementia. An increased understanding of this population’s experiences of rehabilitation program participation is therefore important. The purpose of this study was to explore how community-dwelling older people with dementia experienced their participation in a person-centered multidimensional interdisciplinary rehabilitation program.Methods: Sixteen older people with dementia were interviewed about their experiences of participation in a person-centred multidimensional interdisciplinary rehabilitation program. The program comprised assessments by a comprehensive team followed by a rehabilitation period of 16 weeks among people with dementia and their informal primary caregivers. The interviews were conducted in close conjunction with the rehabilitation visits and analysed with qualitative content analysis.Results: The analysis resulted in one overarching theme: Empowered through participation and togetherness and four sub-themes: Being strengthened through challenges; Gaining insights, motives, and raising concerns about the future; Being seen makes participation worthwhile; and Feelings of togetherness in prosperity and adversity. The participants increased their self-esteem by daring and coping in the rehabilitation. The insights about themselves and their condition motivated them to continue with their prioritized activities, but also raised concerns about how the future would play out. Collaboration in the group and being seen and acknowledged by staff strengthened their own motivation and self-efficacy. Conclusion: A person-centered multidimensional interdisciplinary rehabilitation program seems feasible among community-dwelling older people with dementia according to reported experiences. The participants seemed empowered through the rehabilitation and reported mostly positive experiences and perceived improvements, which seemed to affect their wellbeing and daily life. Providers of interdisciplinary rehabilitation programs for this group should consider aspects raised by the participants e.g. the positive experience of being challenged in both exercise and daily activities; the importance of being seen and feeling secure; the benefits and challenges of collaboration with others in the same situation; and the generation of new perspectives of current and future situation. Trial registration: ISRCTN, ISRCTN59155421.http://www.isrctn.com/ISRCTN59155421. Registered November 3 2015.


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