scholarly journals Community-based management and care of people with dementia: A training needs assessment among village health teams in Uganda based on WHO guidelines

2019 ◽  
Author(s):  
Christine Karungi ◽  
Celestino Obua ◽  
Godfrey Z. Rukundo ◽  
Samuel Maling ◽  
Jessica E. Haberer ◽  
...  
Keyword(s):  
Rural Communities ◽  
Aging Process ◽  
Normal Aging ◽  
Training Needs ◽  
Dementia Care ◽  
Community Based ◽  
People With Dementia ◽  
Southwestern Uganda ◽  
Village Health ◽  
Village Health Teams

Abstract Background Dementia is a public health problem worldwide with approximately 47 million people living with the disease. Although the symptoms are known and named, dementia remains a hidden problem in low and middle income countries (LMICs) as most people perceive it be a normal aging process. In a bid to improve healthcare, the Uganda government adopted a model of recruiting community-based health assistants known as village health teams (VHTs). These individuals helped in linking the community health units with community members with a goal of promoting health services. However, there is paucity of information about how the VHTs provide community-based management and care for people with dementia and their ability to perform the task. The purpose of this study was to identify the training needs of the VHTs in caring for people with dementia in rural communities of southwestern Uganda.Methods This study utilized a cross-sectional qualitative design conducted with the help of semi-structured interview guide. The WHO guide was adopted in developing interviews on dementia care and management in LMICs.Results From the study, VHTs reported the need for training with specific to dementia care to equip them with knowledge and skills on early detection and management, care and referral system. Results also show that VHTs were not able to detect dementia early since they perceive it as normal aging process. There was no community engagement in helping people with dementia since most people in the community do not take dementia to be a medical condition. Also there was little support for dementia in these areas as VHTs only referred people with dementia to health facilities in an event of physical ailment. Other organisations like churches only offered prayers only to the aged persons who are very close to the church.Conclusions The study found that there is an urgent need for training VHTs on caring for individuals with dementia in rural communities of southwestern Uganda. The identified gaps helped in designing the strategies for capacity building through training of VHTs on dementia care in rural communities of southwestern Uganda.

Library services enriching community engagement for dementia care: The Tales & Travels Program at a Canadian Public Library as a case study

2021 ◽  
pp. 096100062110651
Author(s):  
Jiamin Dai ◽  
Joan C. Bartlett ◽  
Karyn Moffatt
Keyword(s):  
Public Libraries ◽  
Public Library ◽  
Well Being ◽  
Dementia Care ◽  
Future Research ◽  
Library Services ◽  
Structured Interviews ◽  
Community Based ◽  
People With Dementia

Growing dementia-friendly library services are contributing to community-based dementia care. Emerging community programs in libraries and museums provide notable opportunities for promoting engagement and inclusivity, but these programs have yet to receive in-depth assessments and analyses to guide future research and practice. This paper presents a case study examining a social and storytelling program for people with dementia run by a Canadian public library. It investigates two research questions: How can public library programs contribute to community-based dementia care? And what are public libraries’ strengths and challenges in running programs for people with dementia? The study involves participant observations of the program and semi-structured interviews with people with dementia, caregivers, and program facilitators (librarians and Alzheimer Society coordinators). Through thematic analysis of fieldnotes and transcripts, the study reveals how this inclusive platform supports engagement, fosters relationships, helps caregivers, and reaches broader communities. This research further uncovers the librarians’ diversified roles as demonstrated through their collaboration with professionals, preparation and research, and facilitation of the sessions. This paper advances librarianship research on enriching community-based dementia care, including furthering inclusivity and engagement and extending accessible library services. By analyzing library programming for the dementia community and assessing its strengths and challenges, the paper highlights librarians’ awareness of the community’s evolving needs and their collaboration with other professionals. It offers practical insights on useful resources and emerging best practices that will hopefully inspire other initiatives in which information professionals can help improve the well-being of vulnerable populations.

Perspectives of the community-based dementia care workforce: “occupational communion” a key finding from the Work 4 Dementia Project

2013 ◽  
Vol 25 (5) ◽  
pp. 765-774 ◽  
Author(s):  
Kate-Ellen J. Elliott ◽  
Christine M. Stirling ◽  
Angela J. Martin ◽  
Andrew L. Robinson ◽  
Jennifer L. Scott
Keyword(s):  
Organizational Support ◽  
Dementia Care ◽  
Future Research ◽  
Work Experiences ◽  
Structured Interviews ◽  
Community Based ◽  
Job Roles ◽  
People With Dementia ◽  
Care Workers ◽  
Strong Attachment

ABSTRACTBackground: Community care workers’ experience of delivering support to people with dementia is less researched than that of residential workers. The purpose of the study is to explore community-based dementia care workers’ perspectives about their roles and the contextual variables that impact upon their work experiences.Method: A qualitative design was employed. Twenty-five community dementia care workers (average age 53 years, majority female and employed casually) participated in standardized semi-structured interviews about their job roles, training, employer agenda, organizational support, and intention to stay. A deductive approach to Interpretive Phenomenological Analysis was adopted to identify key themes.Results: Three themes highlighted workers’ experiences. Occupational communion described strong attachment to clients and a desire for greater connection with colleagues. Job demands described the challenges of work, which varied with intensity. Job resources ranged from positive (strong organizational commitment) to negative (poor pay and conditions). Occupational communion was identified as a concept that exists at the interface between social and organization psychology that was perceived to be essential for adaptive coping. Identifying themes informed a conceptual model for designing intervention components aimed at improving workers’ skills, capabilities, and employer supportive functions.Conclusion: Occupational communion may be particularly relevant for women's caring careers and future research is needed to explore the relevance of this concept for men. To determine reliable change associated with interventions that target occupational communion, further investigation is required in relation to measurement approaches.

scholarly journals Interventions to Reduce Stigma of Dementia: First Insights From a Rural Community-Based Participatory Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 879-879
Author(s):  
Juanita Bacsu ◽  
Shanthi Johnson ◽  
Megan O’Connell ◽  
Marc Viger
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
Support Groups ◽  
Structured Interviews ◽  
Contributing Factors ◽  
Community Based ◽  
People With Dementia ◽  
Related Stigma ◽  
Asking Questions

Abstract Age is the greatest risk factor for dementia, and the number of rural older adults is rising. Although dementia-related stigma is widely documented, few studies focus on ways to reduce stigma, especially within rural communities. This late breaker presentation aims to: 1) explore the contributing factors of dementia-related stigma in rural communities; and 2) identify interventions to reduce stigma of dementia in rural communities. Drawing on a community-based participatory approach, data were collected through semi-structured interviews with 18 older adults, and a focus group with 7 community leaders in rural Saskatchewan, Canada. Thematic analysis was used to identify key themes and patterns within the data. Contributing factors of dementia-related stigma ranged from fear to lack of dementia knowledge. Several anti-stigma interventions were identified including: forming support groups; hosting educational workshops; inviting guest speakers with dementia; talking openly about dementia; learning more about dementia; asking questions; sharing your lived-experiences; being inclusive; developing inter-generational programs; and avoiding assumptions and hurtful jokes. As the rural population ages, there is a growing need for interventions, programs, and policies to address stigma of dementia. Engaging in rural partnerships and collaborative research is essential to developing community-informed strategies to reduce dementia-related stigma and improve the quality of life for people with dementia.

scholarly journals Subjective wellbeing in people living with dementia: exploring processes of multiple object handling sessions in a museum setting

2021 ◽  
Vol 6 ◽  
pp. 96
Author(s):  
Paul M. Camic ◽  
Laura Dickens ◽  
Hannah Zeilig ◽  
Sarah Strohmaier
Keyword(s):  
Subjective Wellbeing ◽  
Evidence Base ◽  
Dementia Care ◽  
Future Research ◽  
Depth Information ◽  
Community Based ◽  
Theoretical Understanding ◽  
Multiple Object ◽  
People With Dementia ◽  
Group Object

Background: Dementia care guidance highlights the importance of supporting people living with dementia to access engaging and meaningful activities to promote their quality of life. There is a growing evidence base for the efficacy of heritage settings and arts-based interventions to provide social prescribing opportunities to help support wellbeing in this population. This study extended previous research and explored the potential processes underlying this effect in multiple small group object handling sessions in a museum setting.    Methods: A mixed-methods design was used comprising a measure of subjective wellbeing and thematic analysis to explore in-the-moment session content across multiple sessions. Four people with dementia participated in three, one-hour group object handling sessions led by two facilitators. Results: Pre-post wellbeing scores showed increases after each session though this was largely not significant. Qualitative findings provided more compelling results, however, and identified four key themes: facilitating, interest in exploring objects, active participation, and group collaboration; interpretations were made around the dynamic interaction of themes and subthemes over the course of three sessions. Conclusions: This is the first study we are aware of that has taken an in-depth look at multiple museum-based group object handling sessions for people living with dementia. Findings offer ways to optimise object handling sessions for people with dementia by providing in-depth information about the processes involved across multiple object handling sessions facilitated by museum/heritage professionals in a museum setting. This has useful implications for community-based activities as part of dementia care planning and public health programming. The study contributes to a deeper understanding and elucidates the processes that enhance wellbeing for this population who participate in such sessions. It also helps to develop further theoretical understanding about why these types of activities are helpful in community-based dementia care. Limitations and implications for future research are discussed.

scholarly journals Architecture as third skin : spatial dimensions of stimuli for dementia care.

2021 ◽  
Author(s):  
Sebastian Lubczynski
Keyword(s):  
Dementia Care ◽  
Direct Care ◽  
Community Based ◽  
Term Care ◽  
Dementia Patients ◽  
People With Dementia ◽  
Spatial Dimensions ◽  
Short And Long Term ◽  
Mental And Physical Health

Our built environments have a direct correlation with our mental and physical health. This correlation is ever more evident with the process of ageing and the declining of neurological and physiological capacities of the human body. Architecture as Third Skin: Spatial Dimensions of Stimuli for Dementia Care thesis-project asserts that architecture, supported by evidence-based knowledge, can create an environment that triggers positive neurological changes in its users, negotiating the functional and social necessities of people with dementia in supporting their needs. The architectural model that informs this inquiry is explored through the design of a community-based Dementia Respite Care Centre, providing short and long term care as well as physical and mental therapy for those with early-to mid-stage dementia. Situated in Toronto, this thesis-project proposes a model that provides direct care for the specialized needs of dementia patients early in their illness condition to maintain independence and encourage living and ageing.

scholarly journals Telegerontology as a Novel Approach to Address Health and Safety by Supporting Community-Based Rural Dementia Care Triads: Randomized Controlled Trial Protocol (Preprint)

2017 ◽  
Author(s):  
Elizabeth M. Wallack ◽  
Chelsea Harris ◽  
Michelle Ploughman ◽  
Roger Butler
Keyword(s):  
Family Caregivers ◽  
Controlled Trial ◽  
Dementia Care ◽  
Community Dwelling ◽  
Feasibility Trial ◽  
Post Intervention ◽  
Community Based ◽  
Term Care ◽  
People With Dementia ◽  
Novel Approach

BACKGROUND Telegerontology is an approach using videoconferencing to connect an interdisciplinary team in a regional specialty center to patients in rural communities, which is becoming increasingly practical for addressing current limitations in rural community-based dementia care. OBJECTIVE Using the remotely-delivered expertise of the Telegerontology dementia care team, we aim to enhance the caregiver/patient/physician triad and thereby provide the necessary support for the person with dementia to “age in place.” METHODS This is a cluster randomized feasibility trial with four rural regions in the province of Newfoundland and Labrador, Canada (2 regions randomly assigned to “intervention” and 2 to “control”). The study population includes 22 “dementia triads” that consist of a community-dwelling older Canadian with moderate to late dementia, their family caregivers, and their Primary Care Physician (PCP). Over the 6-month active study period, all participants will be provided an iPad. The intervention is intended as an adjunct to existing PCP care, consisting of weekly Skype-based videoconferencing calls with the Telegerontology physician, and other team members as needed (occupational therapist, physical therapist etc). Control participants receive usual community-based dementia care with their PCP. A baseline (pre-) assessment will be performed during a home visit with the study team. Post intervention, 6- and 12-month follow-up assessments will be collected remotely using specialized dementia monitoring applications and Skype calls. Primary outcomes include admission to long-term care, falls, emergency room visits, hospital stays, and caregiver burden. RESULTS Results will be available in March of 2018. CONCLUSIONS Results from this study will demonstrate a novel approach to dementia care that has the potential to impact both rural PCPs, family caregivers, and people with dementia, as well as provide evidence for the utility of Telegerontology in models of eHealth-based care.

scholarly journals Architecture as third skin : spatial dimensions of stimuli for dementia care.

2021 ◽  
Author(s):  
Sebastian Lubczynski
Keyword(s):  
Dementia Care ◽  
Direct Care ◽  
Community Based ◽  
Term Care ◽  
Dementia Patients ◽  
People With Dementia ◽  
Spatial Dimensions ◽  
Short And Long Term ◽  
Mental And Physical Health

Our built environments have a direct correlation with our mental and physical health. This correlation is ever more evident with the process of ageing and the declining of neurological and physiological capacities of the human body. Architecture as Third Skin: Spatial Dimensions of Stimuli for Dementia Care thesis-project asserts that architecture, supported by evidence-based knowledge, can create an environment that triggers positive neurological changes in its users, negotiating the functional and social necessities of people with dementia in supporting their needs. The architectural model that informs this inquiry is explored through the design of a community-based Dementia Respite Care Centre, providing short and long term care as well as physical and mental therapy for those with early-to mid-stage dementia. Situated in Toronto, this thesis-project proposes a model that provides direct care for the specialized needs of dementia patients early in their illness condition to maintain independence and encourage living and ageing.

scholarly journals Lay Health Workers in Community-based Care and Management of Dementia: a ‘Pre’ and ‘Post’ Pilot Intervention Study in Southwestern Uganda

2021 ◽  
Author(s):  
Christine K Karungi ◽  
Edith K Wakida ◽  
Godfrey Z Rukundo ◽  
Zohray M Talib ◽  
Jessica E Haberer ◽  
...  
Keyword(s):  
Low Income ◽  
Intervention Study ◽  
Health Workers ◽  
Qualitative Assessment ◽  
Lay Health Workers ◽  
Community Based ◽  
People With Dementia ◽  
Specific Support ◽  
Pilot Intervention ◽  
Southwestern Uganda

Abstract Background: The global need for efficient and cost-effective use of healthcare resources in low-income countries has led to the introduction of lay health workers (LHWs) as a link of the community to the formal health care services, especially in remote areas. As such, the LHWs perform a variety of tasks such as patient care, education, support for care delivery, and social support across all disease types. However, little is known about their ability to support dementia care and management in the community. Purpose: The goal of the pilot intervention study was to evaluate the ability of LHWs in rural southwestern Uganda to support community-based care and management for people with dementia. Methods: This was a ‘pre’ and ‘post’ pilot intervention study which involved a qualitative assessment of LHWs’ knowledge on community-based management and care for people with dementia. The pilot intervention focused on four core competency domains in the WHO dementia toolkit. It began with a five-day training of the LHWs, followed by eight weeks of implementation of knowledge and skills gained during the training, and an evaluation of their experiences. Analysis focused on apriori themes i.e., needs assessment, early detection and management, community engagement, and support for people with dementia; as well as evaluation of the eight-weeks implementation. Results: Before the training, the LHWs did not know much about dementia and provided no dementia-specific support in the community. Activities were limited to general support, including sanitation, nutrition, and health education. After the training, LHWs had a basic understanding of dementia and began sensitizing their communities. They provided dementia-specific support, although they had challenges in differentiating the signs of early dementia from superstitious beliefs. They felt more comfortable in handling people with dementia and reported a notable change in the attitude of family members towards people with symptoms of dementia. Conclusion: Results from the pilot intervention study showed that, with enhanced capacity, LHWs may be able to support community-based management for people with dementia. A larger study is needed to confirm these findings and further assess effectiveness of the LHWs’ skills.

scholarly journals A Multiple Stakeholder Perspective for Evaluating Community-Based Dementia Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 60-61
Author(s):  
Johan Suen
Keyword(s):  
Dementia Care ◽  
Structural Constraints ◽  
Care Provision ◽  
Care Providers ◽  
Structured Interviews ◽  
Community Based ◽  
Relational Factors ◽  
Care Relationships ◽  
The Individual ◽  
The Impact

Abstract For holistic interventions and research on dementia, it is fundamental to understand care experiences from the perspectives of carers, care recipients, and care professionals. While research on care dyads and triads have highlighted the effects of communication and interactional aspects on care relationships, there is a lack of knowledge on how individual-contextual and relational factors shape the provision and receipt of care in terms of decision-making processes, resource allocation, and expectations of care outcomes. Thus, this paper sheds light on (i) how carers negotiate care provision with other important life domains such as employment, household/family roles and conflicts, as well as their own health problems, life goals, values, and aspirations for ageing; (ii) how older adults with dementia perceive support and those who provide it; (iii) the structural constraints faced by care professionals in delivering a team-based mode of dementia care; and, taken together, (iv) how community-based dementia care is impeded by barriers at the individual, relational, and institutional levels. Findings were derived from semi-structured interviews and observational data from fieldwork conducted with 20 persons with dementia (median age = 82), 20 of their carers (median age = 60), and 4 professional care providers. All respondents were clients and staff of a multidisciplinary and community-based dementia care system in Singapore. Our analysis indicates the impact of dementia care is strongly mediated by the interplay between institutional/familial contexts of care provision and the various ‘orientations’ to cognitive impairment and seeking support, which we characterised as ‘denial/acceptance’, ‘obligated’, ‘overprotective’, and ‘precariously vulnerable’.

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