scholarly journals Generating insights into what matters to emergency nurses and family members when caring for older people with dementia: how to use generativity as a principle of appreciative inquiry

2020 ◽  
Vol 10 (2) ◽  
pp. 1-16
Author(s):  
Sarah Watkins ◽  
◽  
Belinda Dewar ◽  
Margaret Graham ◽  
Fiona Murphy ◽  
...  
Keyword(s):  
Family Member ◽  
Appreciative Inquiry ◽  
Emergency Nurses ◽  
People With Dementia ◽  
The Status ◽  
Clinical Environments ◽  
Collaborative Sensemaking ◽  
Person With Dementia ◽  
Practice Development ◽  
What Matters

Background: Participatory research approaches aim to hear the voices of those who give and receive services in order to co-create insights into future improvements in care experiences. Appreciative inquiry is one such participatory approach. Its purpose is generativity, which is defined as helping people to see old things in new ways. Generativity shows much potential but there is little research describing the ‘how to’ of doing this in practice. This article describes the how to of generativity in the dream phase of an appreciative inquiry study. Aim: The aim was to share and co-analyse, with emergency nurses, family member experiences of being in an emergency department with an older person with dementia. Methods: Three critical methods were used to generate data – storytelling, appreciative framing and dialogue, and collaborative sensemaking. The principles of appreciative inquiry provided a framework for data analysis. Findings: In using appreciative inquiry methodology, emergency nurses were able to envision a preferred future based on what people value and what matters in approaches to care. Generativity enabled them to visualise what it would take to bring this new way of nursing to reality. Conclusion: Creative methods, when maximised, can be powerful tools in reframing narratives and helping practitioners to transcend the rut that perpetuates the status quo and obscures hope of future improvement. Generation of new insights and perspectives is critical to identifying and developing strategies for practice enhancement. Implications for practice: Generativity is an underexplored concept yet it has the potential to help practitioners to see things with new eyes Patient and/or family member stories play an important part in practice development, to determine what matters and is valued in enhancing experiences of care Finding ways to integrate the relational aspects of care provides a mechanism for nurses to articulate their skills and contribution in highly technical and task-orientated clinical environments

scholarly journals Caring for an older person with dementia in the Emergency Department (ED): An Appreciative Inquiry exploring family member and ED nurse experiences

2019 ◽  
Vol 28 (15-16) ◽  
pp. 2801-2812
Author(s):  
Sarah Watkins ◽  
Fiona Murphy ◽  
Catriona Kennedy ◽  
Belinda Dewar ◽  
Margaret Graham
Keyword(s):  
Emergency Department ◽  
Family Member ◽  
Appreciative Inquiry ◽  
Older Person ◽  
Person With Dementia

Co-research with people living with dementia for change

2018 ◽  
Vol 17 (4) ◽  
pp. 573-590 ◽  
Author(s):  
Jim Mann ◽  
Lillian Hung
Keyword(s):  
Action Research ◽  
Acute Care ◽  
Appreciative Inquiry ◽  
Lived Experiences ◽  
The Core ◽  
Shared Experiences ◽  
People With Dementia ◽  
Inquiry Approach ◽  
Conducting Research ◽  
Person With Dementia

Research about patients with dementia in the context of acute care has been traditionally designed and carried out by researchers with little or no involvement of people with dementia. Moving away from the traditional way of conducting research on people with dementia, this study involved people with dementia as experts of lived experiences to co-develop knowledge for change. The paper presents our shared experiences (a person with dementia and a researcher) gained from an action research, titled Co-creating Person-Centred Care in Acute Care. We highlight our successes and possibilities for making real impacts on hospital care for patients with dementia by using an appreciative inquiry approach. The project was informed by the core principles of appreciative inquiry. The research involved seven patients with dementia together with a team of 50 interdisciplinary staff to inquire and take actions for improving dementia care in a medical unit. This article draws attention to a range of ethical responsibilities and challenges, which go beyond the traditional principles in University Research Ethics. The strengths and challenges of conducting action research with people living with dementia are discussed. We conclude by offering our learnings and practical tips to encourage more collaboration between researchers and people with dementia in undertaking action research to make social change.

scholarly journals Advance care planning for people with dementia: Ordinary everyday conversations

Dementia ◽  
2018 ◽  
Vol 18 (7-8) ◽  
pp. 3023-3035 ◽  
Author(s):  
Kay de Vries ◽  
Jenny Drury-Ruddlesden
Keyword(s):  
End Of Life ◽  
Family Member ◽  
Advance Care Planning ◽  
Planning Process ◽  
Developed Countries ◽  
Dementia Care ◽  
Care Planning ◽  
People With Dementia ◽  
Advance Care ◽  
Person With Dementia

Advance care planning for people with dementia has become a focus of dementia care policies in developed countries. In New Zealand, the framework for dementia care relies on the person with dementia having a level of competence to enable them to participate in the planning process. For people with dementia, it may be too late to initiate these discussions in terms of decision-making capacity. Consequently, decisions about end-of-life care for people with dementia are typically made by a family member who acts as a surrogate decision maker on behalf of the person with dementia. An exploratory qualitative study of 23 people who had been carers or provided support for a family member with dementia who had died within five years of the interview was undertaken. The overarching theme, ‘ordinary everyday conversations’, describes how informal conversations and discussions within the family relating to preferences at the end of life had been embedded in interactions within the families over years. Sub-themes revealed three important components enabling adherence to the prior wishes of the person with dementia through these conversations: knowing the person and belief in ‘doing the right thing’; the importance of Wills and Enduring Power of Attorney; and negotiating unexpected encounters. There is potential for families to be well prepared for the time when they may need to make decisions for the person with dementia based on ordinary everyday conversation that take place within families and throughout life. This study also suggests that more innovative approaches to making a Will may provide an important vehicle for expressing advanced care wishes.

The impact of migration experiences and migration identities on the experiences of services and caring for a family member with dementia for Sikhs living in Wolverhampton, UK

2014 ◽  
Vol 35 (5) ◽  
pp. 1032-1054 ◽  
Author(s):  
KARAN JUTLLA
Keyword(s):  
Family Member ◽  
Life Histories ◽  
Care Services ◽  
People With Dementia ◽  
Health And Social Care ◽  
Biographical Approach ◽  
And Migration ◽  
Person With Dementia ◽  
Migration Experiences ◽  
The Impact

ABSTRACTThis article is based upon qualitative research carried out with members of the Sikh community caring for a person with dementia. Previous research with South Asian carers of people with dementia has reported problems with both access to, and use of, health and social care services namely due to cultural and language barriers within existing services. The research reported in this article sought for an in-depth understanding of the experiences of Sikhs caring for their family member with dementia. The aim of the research was to explore how migration experiences and life histories impact on perceptions and experiences of caring for a family member with dementia for Sikhs living in Wolverhampton in the West Midlands, United Kingdom. The research, undertaken by the author, applied a biographical approach using narrative interviews. Twelve Sikh carers of a family member with dementia were interviewed. Findings highlighted that migration experiences and migration identities are important for understanding participants’ experiences of services and experiences of caring for a family member with dementia. Person-centred dementia care as a model for practice highlights the importance of understanding life histories to support people to live well with dementia, including their family carers. This paper reinforces this message, demonstrating the impact of specific migration experiences on the experiences of caring for a family member with dementia.

On What Matters

2017 ◽  
Author(s):  
Derek Parfit
Keyword(s):  
Ethical Theory ◽  
Previous Treatment ◽  
Moral Discourse ◽  
Wide Sense ◽  
Normative Naturalism ◽  
The Status ◽  
The Way ◽  
What Matters

This third volume of this series develops further previous treatment of reasons, normativity, the meaning of moral discourse, and the status of morality. It engages with critics, and shows the way to resolution of their differences. This volume is partly about what it is for things to matter, in the sense that we all have reasons to care about these things. Much of the book discusses three of the main kinds of meta-ethical theory: normative naturalism, quasi-realist expressivism, and non-metaphysical non-naturalism, which this book refers to as non-realist cognitivism. This third theory claims that, if we use the word ‘reality’ in an ontologically weighty sense, irreducibly normative truths have no mysterious or incredible ontological implications. If instead we use ‘reality’ in a wide sense, according to which all truths are truths about reality, this theory claims that some non-empirically discoverable truths — such as logical, mathematical, modal, and some normative truths — raise no difficult ontological questions. This book discusses these theories partly by commenting on the views of some of the contributors to Peter Singer's collection Does Anything Really Matter? Parfit on Objectivity.

scholarly journals ‘Getting back to normality seems as big of a step as going into lockdown’: the impact of the COVID-19 pandemic on people with early to middle stage dementia

2021 ◽  
Author(s):  
Catherine V Talbot ◽  
Pam Briggs
Keyword(s):  
Well Being ◽  
Cognitive Stimulation ◽  
Social Worlds ◽  
Middle Stage ◽  
People With Dementia ◽  
The Social ◽  
Function Loss ◽  
The Government ◽  
Person With Dementia ◽  
The Impact

Abstract People with dementia can experience shrinkage of their social worlds, leading to a loss of independence, control and reduced well-being. We used ‘the shrinking world’ theory to examine how the COVID 19 pandemic has impacted the lives of people with early to middle stage dementia and what longer-term impacts may result. Interviews were conducted with 19 people with dementia and a thematic analysis generated five themes: the forgotten person with dementia, confusion over government guidance, deterioration of cognitive function, loss of meaning and social isolation, safety of the lockdown bubble. The findings suggest that the pandemic has accelerated the ‘shrinking world’ effect and created tension in how people with dementia perceive the outside world. Participants felt safe and secure in lockdown but also missed the social interaction, cognitive stimulation and meaningful activities that took place outdoors. As time in lockdown continued, these individuals experienced a loss of confidence and were anxious about their ability to re-engage in the everyday practises that allow them to participate in society. We recommend ways in which the government, communities and organisations might counteract some of the harms posed by this shrinking world.

scholarly journals Artificial intelligence in hospitals: providing a status quo of ethical considerations in academia to guide future research

AI & Society ◽  
2021 ◽  
Author(s):  
Milad Mirbabaie ◽  
Lennart Hofeditz ◽  
Nicholas R. J. Frick ◽  
Stefan Stieglitz
Keyword(s):  
Artificial Intelligence ◽  
Citation Network ◽  
Status Quo ◽  
Biomedical Ethics ◽  
Future Research ◽  
Ethical Considerations ◽  
Ethical Discourse ◽  
The Status ◽  
Clinical Environments ◽  
Research Questions

AbstractThe application of artificial intelligence (AI) in hospitals yields many advantages but also confronts healthcare with ethical questions and challenges. While various disciplines have conducted specific research on the ethical considerations of AI in hospitals, the literature still requires a holistic overview. By conducting a systematic discourse approach highlighted by expert interviews with healthcare specialists, we identified the status quo of interdisciplinary research in academia on ethical considerations and dimensions of AI in hospitals. We found 15 fundamental manuscripts by constructing a citation network for the ethical discourse, and we extracted actionable principles and their relationships. We provide an agenda to guide academia, framed under the principles of biomedical ethics. We provide an understanding of the current ethical discourse of AI in clinical environments, identify where further research is pressingly needed, and discuss additional research questions that should be addressed. We also guide practitioners to acknowledge AI-related benefits in hospitals and to understand the related ethical concerns.

scholarly journals Non-Pharmacologic Interventions for Caregivers of People With Dementia in Latin America: A Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 275-276
Author(s):  
Jose Aravena ◽  
Jean Gajardo ◽  
Laura Gitlin
Keyword(s):  
Quality Of Life ◽  
Latin America ◽  
Depressive Symptoms ◽  
Latin American ◽  
Randomized Clinical Trials ◽  
Social Inequalities ◽  
Neuropsychiatric Symptoms ◽  
People With Dementia ◽  
Person With Dementia

Abstract In a scenario of increasing longevity and social inequalities, Latin-America is an important contributor to the worldwide dementia burden. Caregivers’ health is fundamental to maintain the person with dementia quality of life. However, caregiving is a culturally sensible role that requires tailored solutions. The aim is to synthesize the evidence about non-pharmacologic interventions targeted to caregivers of people with dementia in Latin-American contexts. A comprehensive review of interventions in caregivers and persons with dementia in Latin-American countries was conducted using MEDLINE, Embase, PsycINFO, and Scopus with studies published until January 27th, 2020. Randomized clinical trials of non-pharmacologic interventions targeted to caregivers of people with dementia or dyads where included. Qualitative synthesis of the evidence was presented and analyzed. Overall, 9 pilot RCT were included for the final analysis (6 Brazil, 1 Colombia, 1 Mexico, 1 Perú). The biggest study recruited 69 caregivers and the smallest 13 dyads, with follow-up range of 3-6 months. 5 control groups received at least some other non-standard care type of intervention. 8 were targeted exclusively to caregivers (4 group intervention, 3 individual, and 1 combined) and 1 multicomponent intervention. Most frequent measured outcomes were caregiver’s burden, anxiety, depressive symptoms, and quality of life, and person with dementia neuropsychiatric symptoms. Individual interventions report better results in caregiver parameters such as burden and depressive symptoms and person with dementia neuropsychiatric symptoms. Group interventions presented mixed results. Nevertheless, the quality of evidence was low. There is a critical need to study interventions for caregivers in Latin-American contexts.

scholarly journals Wayfinding in People with Alzheimer’s Disease: Perspective Taking and Architectural Cognition—A Vision Paper on Future Dementia Care Research Opportunities

2021 ◽  
Vol 13 (3) ◽  
pp. 1084
Author(s):  
Saskia Kuliga ◽  
Martin Berwig ◽  
Martina Roes
Keyword(s):  
Perspective Taking ◽  
Spatial Orientation ◽  
Environmental Design ◽  
Spatial Disorientation ◽  
Planning And Design ◽  
People With Dementia ◽  
Starting Point ◽  
Planning Processes ◽  
Person With Dementia ◽  
Underlying Processes

Based on a targeted literature review, this vision paper emphasizes the importance of dementia-sensitive built space. The article specifically focuses on supporting spatial orientation and wayfinding for people living with dementia. First, we discuss types of wayfinding challenges, underlying processes, and consequences of spatial disorientation in the context of dementia of the Alzheimer’s type. Second, we focus on current efforts aimed at planning and evaluating dementia-sensitive built space, i.e., environmental design principles, interventions, evaluation tools, strategies, and planning processes. Third, we use our findings as a starting point for developing an interdisciplinary research vision aimed at encouraging further debates and research about: (1) the perspective of a person with dementia, specifically in the context of wayfinding and spatial orientation, and (2) how this perspective supplements planning and design processes of dementia-sensitive built space. We conclude that more closely considering the perspective of people with dementia supports the development of demographically sustainable future cities and care institutions.

Physical Activity and its Influencing Factors in Community-Dwelling Older Adults With Dementia: A Path Analysis

2021 ◽  
pp. 105477382110339
Author(s):  
Bei Li ◽  
Xiuxiu Huang ◽  
Chenchen Meng ◽  
Qiaoqin Wan ◽  
Yongan Sun
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Path Analysis ◽  
Neuropsychiatric Symptoms ◽  
Community Dwelling ◽  
Cross Sectional ◽  
People With Dementia ◽  
The Status ◽  
Path Analysis Approach ◽  
Community Dwelling Older Adults

Dementia is prevalent in worldwide, and increases the care burden and potential costs. Physical activity (PA) has been increasingly shown to be beneficial for them. This was a cross-sectional observational study aiming to investigate the status of PA among community-dwelling older adults with dementia in Beijing or Hangzhou, China, and verify the relationships between neuropsychiatric symptoms, activities of daily living (ADL), caregivers’ fear of patients’ falling and their PA using a path analysis approach. The level of PA among 216 included people with dementia was low. PA was related to the neuropsychiatric symptoms, with ADL and caregivers’ fear of patients’ falling have mediation roles. The findings indicated that person-centered strategies related to the management of these symptoms might be helpful to improve ADL, relieve caregivers’ concerns about them falling and consequently foster positive participation in PA.

Sign in / Sign up

Export Citation Format

Share Document