scholarly journals Behaviour-directed Interventions for Problematic Person Transfer Situations in Two Dementia Care Dyads: A Single-case Design Study

2021 ◽  
Author(s):  
Hanna Lagerlund ◽  
Charlotta Thunborg ◽  
Maria Sandborgh
Keyword(s):  
Perceived Control ◽  
Single Case ◽  
Dementia Care ◽  
Dyadic Interaction ◽  
Special Care Unit ◽  
Physical Strain ◽  
Tailored Interventions ◽  
Behavioural Analysis ◽  
Resistiveness To Care ◽  
Person With Dementia

Abstract Background:Persons with dementia living in nursing homes need assistance with moving and transfers; however, caregivers assisting persons with dementia in their daily person transfers report strain-related and complicated transfer-related behavioural problems. The reciprocity of complex dyadic transfer-related behaviours is affected by environmental factors, the health status of the person with dementia and the caregiver’s skills and knowledge. The aim of this study was to explore tailored interventions guided by a functional behaviour analysis for problematic person transfer situations in two dementia care dyads.Methods:This study was a quasi-experimental single-case study with an A-B design. Tailored interventions were developed in a five-step model for functional behavioural analysis. The study was conducted in a dementia special care unit at a nursing home, and the inclusion criteria were caregivers’ experiences of physical strain and/or resistiveness to care, which led to complex transfer-related behaviour. Two care dyads were included. Transfer situations were video-recorded and evaluated with the Dyadic Interaction in Dementia Transfer Assessment Scale, Pain Assessment in Advanced Dementia Scale, and Resistiveness to Care Scale for Dementia of the Alzheimer’s Type. The caregiver experience was evaluated with study-specific items addressing caregiver self-efficacy, catastrophizing thoughts, perceived control, and perceived physical strain. Scorings were graphically displayed. The graphs were inspected visually to identify changes in trend, level, latency, and variability. Nonoverlap of all pairs (NAP), including 90% confidence intervals (CIs), was calculated to complement the visual inspection.Results:Verbal and nonverbal discomfort decreased in care dyad 1, which mirrored the caregiver changes in adapting their actions to the needs of the person with dementia. High variability was seen in both the intervention and the baseline phases in care dyad 2. In both care dyads, caregiver transfer-related behaviour improved significantly.Conclusions:The results indicate that the transfer-related behaviours of the care dyad might be improved through a behaviour-directed intervention tailored to meet the care dyad´s needs. The study is a replication of a previous study in a new clinical setting, which in turn strengthens the generalizability for a functional behavioural analysis-guided intervention for problematic transfer situations in dementia care dyads.

scholarly journals A ‘history of problematizations’ for dementia education: a Foucauldian approach to understanding the framing of dementia

2019 ◽  
Vol 24 (3-4) ◽  
pp. 212-230 ◽  
Author(s):  
Chris Knifton ◽  
Scott Yates
Keyword(s):  
Nursing Education ◽  
Lived Experience ◽  
Terminal Illness ◽  
Historical Context ◽  
Dementia Care ◽  
Western Society ◽  
Health And Social Care ◽  
History Of ◽  
Person With Dementia ◽  
Dementia Education

Background Debates relevant to both undergraduate and postgraduate nurse education regarding the conceptualisation and disciplinary ownership of dementia, including its framing as a neuro-psychiatric condition, a terminal illness or a consequence of ageing, are important in supporting an understanding of the lived experience of dementia for individuals and their family carers and how, as a condition, it has come to be problematised in Western society. The work of Michel Foucault is useful in setting this debate within a critical historical context. Aims Using Foucault's ‘history of problematizations’ we present such debates around dementia's conceptualisation in Western society and consider how a Foucauldian critical historical project influences nursing education by re-examining the problematisation of dementia within society, what it is to be a person with dementia, and how alternative conceptualisations shape how we see the condition – as well as how we provide learning opportunities for dementia-care professionals. Results Six differing ways of conceptualising or problematising dementia were found (as a natural consequence of ageing, a mental disorder, a bio-medical disease, a neuro-cognitive disorder, a disability and a terminal illness), each offering alternative ways we might present it in an educational context. Conclusions We argue for both undergraduate and postgraduate student nurses to engage in learning that locates what it is to be a person with dementia within particular conceptual frameworks that would allow understanding of how these ideas or constructs are reliant on historically contingent assumptions. Here, taken-for-granted assumptions are unsettled, and a more critically reflective position is adopted. This will have an impact on the type of nurse to emerge from educational institutions, thus also affecting service delivery and the dementia care provided, as well as the knock-on effects for dementia education in other medical, health and social care courses and for institutions whose role it is to approve professional practice curricula content.

From reality disjunctions to dramatic reality: Bridging realities through the performance of life stories in dementia care

Dramatherapy ◽  
2019 ◽  
Vol 40 (3) ◽  
pp. 122-133
Author(s):  
Christine Novy
Keyword(s):  
Narrative Therapy ◽  
Common Ground ◽  
Life Stories ◽  
Life Story ◽  
Single Case ◽  
Drama Therapy ◽  
Dementia Care ◽  
Alternative Framework

This article explores the potential for a performative life story project to build bridges between different realities and, in so doing, to establish common ground between people who are living with dementia and members of their community. The discussion is anchored in a practice vignette from a single-case life story performance. Two features of the methodology, the ‘saying hullo again’ metaphor from narrative therapy and dramatic reality from drama therapy, are highlighted. Their combined effectiveness as an alternative framework for understanding and working with reality disjunctions in dementia care is discussed.

The Impact of Singing in Caring for a Person With Dementia: Single Case Analysis of Video Recorded Sessions

2010 ◽  
Vol 3 (2) ◽  
pp. 95-101 ◽  
Author(s):  
G. Engstrom ◽  
L. Marmstal Hammar ◽  
C. Williams ◽  
E. Gotell
Keyword(s):  
Single Case ◽  
Case Analysis ◽  
Person With Dementia ◽  
The Impact

scholarly journals The extended palliative phase of dementia – An integrative literature review

Dementia ◽  
2016 ◽  
Vol 18 (1) ◽  
pp. 108-134 ◽  
Author(s):  
Elizabeth Hanson ◽  
Amanda Hellström ◽  
Åsa Sandvide ◽  
Graham A Jackson ◽  
Rhoda MacRae ◽  
...  
Keyword(s):  
Literature Review ◽  
End Of Life Care ◽  
Dementia Care ◽  
Educational Opportunities ◽  
Advanced Dementia ◽  
Subsequent Work ◽  
People With Dementia ◽  
Definition Of ◽  
Palliative Phase ◽  
Person With Dementia

This article presents an integrative literature review of the experience of dementia care associated with the extended palliative phase of dementia. The aim was to highlight how dementia is defined in the literature and describe what is known about the symptomatology and management of advanced dementia regarding the needs and preferences of the person with dementia and their family carer/s. There was no consistent definition of advanced dementia. The extended palliative phase was generally synonymous with end-of-life care. Advanced care planning is purported to enable professionals to work together with people with dementia and their families. A lack of understanding of palliative care among frontline practitioners was related to a dearth of educational opportunities in advanced dementia care. There are few robust concepts and theories that embrace living the best life possible during the later stages of dementia. These findings informed our subsequent work around the concept, ‘Dementia Palliare’.

scholarly journals Leveraging everyday technology for people living with dementia: a case study

2014 ◽  
Vol 8 (4) ◽  
pp. 164-176 ◽  
Author(s):  
A.J. Astell ◽  
B. Malone ◽  
G. Williams ◽  
F. Hwang ◽  
M.P. Ellis
Keyword(s):  
Single Case ◽  
Personal Perspective ◽  
Content Type ◽  
Innovative Solutions ◽  
Negative Perceptions ◽  
Impact Of Technology ◽  
Positive Outlook ◽  
Person With Dementia ◽  
The Impact

Purpose – The purpose of this paper is to present the self-described “journey” of a person with dementia (Brian; author 3) in his re-learning of old technologies and learning of new ones and the impact this had on his life. Design/methodology/approach – This is a single case study detailing the participant's experiences collaborating with a researcher to co-create methods of facilitating this learning process, which he documented in the form of an online blog and diary entries. These were analysed using NVivo to reveal the key themes. Findings – Brian was able to relearn previously used technologies and learn two new ones. This lead to an overarching theme of positive outlook on life supported by person-centredness, identity and technology, which challenged negative perceptions about dementia. Research limitations/implications – The paper provides an example of how learning and technology improved the life of one person with dementia. By sharing the approach the authors hope to encourage others to embrace the challenge of designing and developing innovative solutions for people with a dementia diagnosis by leveraging both current mainstream technology and creating novel bespoke interventions for dementia. Originality/value – The personal perspective of a person with dementia and his experiences of (re-) learning provide a unique insight into the impact of technology on his life.

Therapeutic Lies in Dementia Care: Should Psychologists Teach Others to be Person-Centred Liars?

2018 ◽  
Vol 46 (4) ◽  
pp. 454-462 ◽  
Author(s):  
Ian A. James ◽  
Roberta Caiazza
Keyword(s):  
Mental Health ◽  
Communication Strategies ◽  
Daily Practice ◽  
Dementia Care ◽  
Communication Strategy ◽  
Before And After ◽  
Mental Health Foundation ◽  
Person With Dementia ◽  
Comprehensive Discussion

Background: Therapeutic lies are frequently used communication strategies, often employed when the person with dementia does not share the same reality as the carer (James and Jackman, 2017; Tuckett 2004; Blum, 1994). Their use is complex and controversial, and a number of protocols have been produced to guide their usage (Mental Health Foundation, 2016). Aims: The study examined clinicians’ perspective on using therapeutic lies in their daily practice and their roles in encouraging the proper use of such a communication strategy. Method: This project sampled the views of clinicians, mainly psychologists, before and after attending a workshop on communication in dementia care; they were asked whether psychologists should have a role in teaching others to lie more effectively. Results: It was found that following a comprehensive discussion on the use of lies, the clinicians recognized they lied more than they had originally thought, and were also significantly more supportive of having a role in teaching others to lie effectively. Conclusions: Clinicians, mainly psychologists, increased their support in the use of therapeutic lying. They considered others would benefit from the psychologists giving supervision in how to lie effectively.

scholarly journals Evaluating the capabilities model of dementia care: a non-randomized controlled trial exploring resident quality of life and care staff attitudes and experiences

2016 ◽  
Vol 28 (7) ◽  
pp. 1091-1100 ◽  
Author(s):  
Wendy Moyle ◽  
Lorraine Venturato ◽  
Marie Cooke ◽  
Jenny Murfield ◽  
Susan Griffiths ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Intervention Group ◽  
Dementia Care ◽  
Care Staff ◽  
Staff Attitudes ◽  
Randomized Controlled ◽  
Person With Dementia

ABSTRACTBackground:This 12 month, Australian study sought to compare the Capabilities Model of Dementia Care (CMDC) with usual long-term care (LTC), in terms of (1) the effectiveness of the CMDC in assisting care staff to improve Quality Of Life (QOL) for older people with dementia; and (2) whether implementation of the CMDC improved staff attitudes towards, and experiences of working and caring for the person with dementia.Methods:A single blind, non-randomized controlled trial design, involving CMDC intervention group (three facilities) and a comparison usual LTC practice control group (one facility), was conducted from August 2010 to September 2011. Eighty-one staff members and 48 family members of a person with dementia were recruited from these four LTC facilities. At baseline, 6 and 12 months, staff completed a modified Staff Experiences of Working with Demented Residents questionnaire (SEWDR), and families completed the Quality of Life – Alzheimer's Disease questionnaire (QOL-AD).Results:LTC staff in the usual care group reported significantly lower SEWDR scores (i.e. less work satisfaction) than those in the CMDC intervention group at 12 months (p = 0.005). Similarly, family members in the comparison group reported significantly lower levels of perceived QOL for their relative with dementia (QOL-AD scores) than their counterparts in the CMDC intervention group at 12 months (p = 0.012).Conclusions:Although the study has a number of limitations the CMDC appears to be an effective model of dementia care – more so than usual LTC practice. The CMDC requires further evaluation with participants from a diverse range of LTC facilities and stages of cognitive impairment.

Ethical aspects in dementia care - The use of psychosocial interventions

2020 ◽  
pp. 096973302095212
Author(s):  
Benedicte Sørensen Strøm ◽  
Knut Engedal
Keyword(s):  
Psychosocial Interventions ◽  
Well Being ◽  
Dementia Care ◽  
Ethical Challenge ◽  
Ethical Aspects ◽  
Respect For Autonomy ◽  
Daily Care ◽  
People With Dementia ◽  
Clinical Practise ◽  
Person With Dementia

The use of psychosocial interventions for people with dementia is common and recommended because they focus on the underlying problem and well-being of the person. The promotion of well-being is a relevant dimension in person-centred care, where the aim is to confirm the person’s ‘personhood’. Most literature about ethics in dementia care instructs us on how and when to include people with dementia in our research. Little is written about the ethical aspects regarding the use of psychosocial interventions in daily care. In clinical practise, several challenges arise about the use of psychosocial interventions. Those include questions about the person’s ability to participate in decision-making and how we know what is best for them. Furthermore, we must consider what kinds of psychosocial interventions are best for everybody, or if intervention causes discomfort for the person. This article emphasizes the necessity to consider the ethical aspects of the implementation of psychosocial interventions while taking into consideration the persons individual needs. A particular ethical challenge arises when a person with dementia is unable to express themselves verbally. Therefore, it is essential that the staff know the history and preferences of each person with dementia. The ethical aspects of psychosocial interventions for people with dementia will be discussed using Beauchamp and Childress four ethical principles: respect for autonomy, beneficence, non-maleficence and justice. The person-centred approach proposed by Kitwood’s and Brooker.

scholarly journals Literature review: technological interventions and their impact on quality of life for people living with dementia

2020 ◽  
Vol 27 (1) ◽  
pp. e100064
Author(s):  
David Sanders ◽  
Philip Scott
Keyword(s):  
Quality Of Life ◽  
Well Being ◽  
Dementia Care ◽  
Assistive Technologies ◽  
Healthcare Sector ◽  
Supporting Evidence ◽  
Technological Advancement ◽  
People With Dementia ◽  
Person With Dementia

ObjectivesRapid technology-driven innovation in the healthcare sector has led to an increasing ability to effectively respond to health challenges. However, the cognitive challenges faced by a person with dementia exacerbate the difficulty of designing enduring technological dementia care solutions. Despite this, and in the absence of a cure, facilitating well-being and improved quality of life becomes pivotal for those living with dementia and their caregivers. This review aimed to identify and consolidate the provision of technological solutions for dementia care, and how these are perceived to impact the quality of life of a person with dementia.MethodsArticles and journals were identified using keywords including those relating to quality of life, assistive technologies and technology adoption and acceptance. Greater priority was given to resources published after 2010 due to the speed of technological advancement, and peer-reviewed articles were preferred.Results91 resources were identified, with 38 contributing to the final review. In addition to multiple quality of life measurement tools, the literature identified a large variety of solutions that fell into three categories: those used ‘by’, ‘with’ or ‘on’ a person with dementia.ConclusionsThis review concludes that the ‘one size fits all’ approach to many solutions reflects the lack of supporting evidence, negatively impacting trust in their usefulness among caregivers and their subsequent adoption rates. This could be attributed to limited involvement of people with dementia in studies of effectiveness and adoption. Additional research is recommended to further consolidate research on quality of life and to understand the individuality and progression of dementia and its influence on dementia care solutions.

scholarly journals RELATIONSHIP BETWEEN CARE CHALLENGE TYPE AND PSYCHOSOCIAL OUTCOMES IN FAMILY CAREGIVERS OF PERSONS WITH DEMENTIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S916-S916
Author(s):  
Clarissa Shaw ◽  
Kristine N Williams ◽  
Maria Hein ◽  
Carissa Coleman ◽  
Yelena Perkhounkova
Keyword(s):  
Public Health ◽  
Sleep Quality ◽  
Family Caregivers ◽  
Daily Living ◽  
Psychological Symptoms ◽  
Memory Loss ◽  
Dementia Care ◽  
Dementia Caregivers ◽  
Tailored Interventions ◽  
Behavioral And Psychological Symptoms

Abstract Enhancing dementia care is a public health priority and supporting family caregivers of persons living with dementia (PLWD) is a critical need. This poster reports the relationships between the types of care challenges reported by family caregivers and their scores on psychosocial measures. Family caregivers (N=83) participating in the FamTechCare clinical trial identified three top priority care challenges and completed a series of measures (i.e., burden, depression, sleep quality, and reaction to dementia behaviors) at baseline. Priority care challenges were classified using the 10-category Technology-supported Dementia Care Typology. Three of the categories (i.e., behavioral and psychological symptoms of dementia [BPSD], activities of daily living [ADL], and disease expectations [DE]) were reported by an adequate number of caregivers in order to test relationships with psychosocial measures using the Kruskal-Wallis Test. Caregivers reporting 2 or 3 BPSD challenges had higher burden (p=.007), more depression (p=.022) and worse sleep quality (p=.020) compared to those reporting 0 or 1 care challenges related to BPSD. In comparison, caregivers with 2 or 3 challenges related to DE (e.g., PLWD memory loss) had less burden (p=.008), less depression (p=.030), and better sleep quality (p=.042), compared to those reporting 0 or 1 challenge related to DE. Caregivers identifying 2 or 3 care challenges related to ADLs also reported higher levels of depression (p=.036). Dementia caregivers face vast caregiving responsibilities. Caregivers facing BPSD challenges report greater burden and depression. These results reinforce the need for tailored interventions to assist family caregivers in the managing varied care challenges.

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