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

2021 ◽  
Author(s):  
Sebastian Lubczynski

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.

2021 ◽  
Author(s):  
Sebastian Lubczynski

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.


Impact ◽  
2020 ◽  
Vol 2020 (9) ◽  
pp. 40-42
Author(s):  
Mio Ito

In Japan there are remote villages, mountainous areas and islands where the population includes people who are extremely old. Owing to the remoteness of these places, there are very few long-term care insurance services and medical institutions meaning that the residents often have no choice but to support each other. This situation is particularly problematic for people with dementia. Caring for dementia patients requires specialised knowledge which is often beyond the residents of depopulated areas in Japan. It is with this in mind that Associate Professor Mio Ito has joined forces with Dr Chiho Shimada and Dr Ryo Hirayama to improve care and communication for persons with dementia in depopulated areas.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julian Hirt ◽  
Melanie Karrer ◽  
Laura Adlbrecht ◽  
Susi Saxer ◽  
Adelheid Zeller

Abstract Background To support the implementation of nurse-led interventions in long-term dementia care, in-depth knowledge of specific supporting factors and barriers is required. Conditions and structures of caring for people with dementia differ widely, depending on the country and the care context. Our study aimed to describe the experiences and opinions of nursing experts and managers with regard to facilitators and barriers to the implementation of nurse-led interventions in long-term dementia care. Methods We conducted a qualitative descriptive study using individual interviews based on qualitative vignettes as a useful stimulus to generate narrations allowing to study peoples’ perceptions and beliefs. The study took place in nursing homes in the German-speaking part of Switzerland and in the Principality of Liechtenstein using purposive sampling. We intended to conduct the interviews face-to-face in a quiet room according to the participant’s choice. However, due to the lockdown of nursing homes during the COVID-19 pandemic in spring 2020, we performed interviews face-to-face and by video. We analysed data thematically following Braun and Clarke to achieve a detailed, nuanced description. To verify our interpretation and to ensure congruence with participants’ perspectives, we conducted member checks. The Standards for Reporting Qualitative Research (SRQR) served to structure our manuscript. Results Six dyads of nursing home managers and nursing experts from six nursing homes took part in our study (n = 12). Our thematic analysis yielded seven themes reflecting facilitators and barriers to implementing nurse-led interventions in long-term dementia care: «A common attitude and cohesion within the organization», «Commitment on several levels», «A needs-oriented implementation», «The effect and the public perception of the intervention», «A structured and guided implementation process», «Supporting knowledge and competencies», as well as «Resources for implementing the intervention». Conclusions To support the implementation of nurse-led interventions in long-term dementia care, active commitment-building seems essential. It is necessary that the value of the intervention is perceptible.Commitment-building is the precondition to reach the persons involved, such as nursing home managers, nursing staff, residents and relatives. Furthermore, nurses should precisely inform about the intervention. It is necessary that the value of the intervention is perceptible. In addition, nurses should adjust the interventions to the situational needs of people with dementia, thus. Therefore, it is important to support dementia-specific competencies in long-term care. Findings indicate that the barrier is determined by the intervention and its implementation – and not by the behaviour of the person with dementia.


2021 ◽  
Author(s):  
Yang-Hao Ou ◽  
Ming-Che Chang ◽  
Wen-Fu Wang ◽  
Kai-Ming Jhang

Abstract Background: There is an increasing awareness of caregiver's burden, especially in those caring for people with dementia. The caregiver burden has been studied extensively in Western countries; however, the interpretation of the results and replication of the intervention may deem unfit in the Chinese culture. Therefore, this study identifies the change in caregiver burden by interventional methods under current Taiwan's long-term care Act 2.0.Method: A total of 2,598 newly diagnosed dementia outpatients was evaluated by the Changhua Christian Hospital dementia care team. Eighty patients utilize one of the three care resources, including community-based services (n = 33), home-based services (n = 19), or taking care by foreign caregivers (n = 28). Participants in the control group were selected by matching their global CDR score, gender, age, and caregivers' age with a 1:4 ratio. All caregivers completed the Zarit Burden Interview (ZBI) questionnaires before and six months after utilizing the care resources. Results: The home-based and the foreign caregiver groups have the highest baseline ZBI scores with 37.63±16.14 and 36.57±17.14, respectively. The second ZBI score was assessed about six months after the baseline showing that the home-based group remained the highest caregiver burden (ZBI = 31.74±12.23) and the foreign caregiver group showed the lowest burden (ZBI = 25.68±12.09). The mean difference in the ZBI score confirmed that the foreign caregiver group had the most improvement, averaging a decrease of 17.99±31.08 points (adjust observation time). A linear regression model showed that home-based care and foreign caregiver contributes the most reduction in caregiver burden (-11.83 and -19,07 ZBI scores, respectively).Conclusion: Caring for people with dementia includes caring for their caregivers. Dementia care team should provide proper social resources, which are crucial in the alleviation of caregiver burden.


2009 ◽  
Vol 21 (S1) ◽  
pp. S25-S33 ◽  
Author(s):  
Elizabeth Gould ◽  
Peter Reed

ABSTRACTIn the U.S.A., direct care workers and licensed practical nurses are the professionals who provide the most hands-on care to people with dementia in nursing homes and residential care facilities – yet they do not receive adequate training in dementia care. Dementia care training needs to be universal with all disciplines at all levels of care. Even though there is variability on recommended hours and content, most studies emphasize the importance of dementia care training as a distinct component of required training for any professional or paraprofessional working in long-term care. In 2005, the Alzheimer's Association launched its Quality Care Campaign to improve dementia care through state and federal advocacy; consumer education and empowerment; and staff training. This paper describes the effectiveness of Alzheimer's Association training as measured by knowledge gained and providers' intention to change their behavior immediately after attending the training.Overall, findings indicated that the participants responded positively to evidence-based training in dementia care that emphasized the importance of (i) leadership, (ii) team communication and collaboration, (iii) support and empowerment of direct care staff, (iv) awareness and practice of specific dementia care issues, (v) resident and family involvement in care, and (vi) professional self-care.


Author(s):  
Yohko Maki ◽  
Takashi Sakurai ◽  
Kenji Toba

Facing the unprecedented ageing society, Japan’s contribution to the world should be to lead worldwide discussion on dementia care. This chapter introduces the Japanese initiatives for dementia care. For realization of a society where people with dementia live well, the new concept of ‘prosocial relationship-based care’ for dementia has been introduced as the ethical background; community members are expected to reach out helping hands to each person with dementia to restore their participation in society. Based on this basic concept and the long-term care insurance system, various measures related to primary, secondary and tertiary preventive approaches for dementia have been promoted to achieve appropriate and seamless coordination of medical and long-term care. To establish prosocial relationships, it is critical to promote cooperation among various stakeholders, and develop community networks and social resources.


2020 ◽  
Vol 32 (S1) ◽  
pp. 158-158
Author(s):  
Catarina Pedro ◽  
Mariana Duarte ◽  
Beatriz Jorge ◽  
Daniela Freitas

Introduction:Over the past 20 to 30 years, alternative dementia care models have been developed. Dementia villages challenge popular perceptions about life with dementia and contrast to the traditional model of long-term care facilities that are often seen as institutional, impersonal, and risk-averse. The first dementia village, De Hogeweyk, was developed in 2009 and is located in Weesp, Netherlands. Hogeweyk aims to create a safe environment, enabling the person with dementia to live an “ordinary life” with as much autonomy as possible and also maintaining integration with the local community. Other dementia villages have been established in several countries, following De Hogeweyk model.Objectives:The aim of this presentation is to describe the functioning of dementia villages and evaluate its benefits on dementia patients.Methods:A non-systematic review of the literature was performed on PubMed, PsycINFO and Web of science using selected keywords. We also consult the official websites of the institutions.Results:Dementia villages seem to improve functioning and reduce the need for medication. Anxiety, restlessness and homesickness can still persist, but are reduced by the homelike and hospitable setting in which residents live. In fact, antipsychotic medication use at the residence has decreased from approximately 50% of residents, before the dementia village was introduced, to approximately 12% in 2019. The staff also reported greater job satisfaction. Although dementia villages are growing throughout the Western world, this concept has also been criticized, arguing that this type of living is dishonest, misleading the residents to believe that they are still living in the ‘real community’.Conclusions:Dementia villages are guided by the principles “deinstitutionalize, transform and normalize” care for people with advanced dementia. Although its intuitive advantages, there is no research evidence to demonstrate that this environment has any beneficial effect in behaviour, functional ability or cognition. In future studies, clinical outcomes could be used as a measure of quality of care. Hogeweyk concept has made societies rethinking dementia care and has been inspiring the development of other innovative models of dementia care.


2020 ◽  
pp. 1-33
Author(s):  
Francesco Miele ◽  
Federico Neresini ◽  
Giovanni Boniolo ◽  
Omar Paccagnella

Abstract For many years, dementia care has been dominated by the standard medical approach, in which dementia is treated mainly with drugs, such as anti-anxiety, antidepressant and anti-psychotic medications. With the aim of seeking effective treatments for patients with dementia, over the last years, several contributions have criticised the pervasive use of drugs for the management of behavioural and physiological symptoms related to dementia, proposing personalised interventions aimed at supporting patients and their relatives from diagnosis until death. With particular reference to long-term settings, in this work, we aim at understanding the organisational implications of three types of interventions (labelled supportive care interventions – SCIs) that have characterised this shift in dementia care: person-centred, palliative and multi-disciplinary care. Conducted by following the integrative review method, our review underlines how SCIs have controversial consequences on the quality of care, the care-givers’ quality of life and cultural backgrounds. After an in-depth analysis of selected papers, we offer some considerations about the implications of SCIs for long-term care organisations and future research directions.


Author(s):  
Julie G. Kosteniuk ◽  
Debra G. Morgan ◽  
Valerie Elliot ◽  
Amanda Froehlich Chow ◽  
Melanie Bayly ◽  
...  

Abstract Multiple transitions across care settings can be disruptive for older adults with dementia and their care partners, and can lead to fragmented care with adverse outcomes. This scoping review was conducted to identify and classify care trajectories across multiple settings for people with dementia, and to understand the prevalence of multiple transitions and associated factors at the individual and organizational levels. Searches of three databases, limited to peer-reviewed studies published between 2007 and 2017, provided 33 articles for inclusion. We identified 26 distinct care trajectories. Common trajectories involved hospital readmission or discharge from hospital to long-term care. Factors associated with transitions were identified mainly at the level of demographic and medical characteristics. Findings suggest a need for investing in stronger community-based systems of care that may reduce transitions. Further research is recommended to address knowledge gaps about complex and longitudinal care trajectories and trajectories experienced by sub-populations of people living with dementia.


BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e032637
Author(s):  
Nalinee N Chuakhamfoo ◽  
Pudtan Phanthunane ◽  
Sirintorn Chansirikarn ◽  
Supasit Pannarunothai

ObjectiveTo describe the circumstances of the elderly with dementia and their caregivers’ characteristics in order to examine factors related to activities of daily living (ADL) and household income to propose a long-term care policy for rural areas of Thailand.SettingA cross-sectional study at the household level in three rural regions of Thailand where there were initiatives relating to community care for people with dementia.ParticipantsCaregivers of 140 people with dementia were recruited for the study.Primary and secondary outcome measuresSocioeconomic characteristics including data from assessment of ADL and instrumental ADL and the Thai version of Resource Utilisation in Dementia were collected. Descriptive statistics were used to explain the characteristics of the elderly with dementia and the caregivers while inferential statistics were used to examine the associations between different factors of elderly patients with dementia with their dependency level and household socioeconomic status.ResultsEighty-six per cent of the dementia caregivers were household informal caregivers as half of them also had to work outside the home. Half of the primary caregivers had no support and no minor caregivers. The elderly with dementia with high dependency levels were found to have a significant association with age, dementia severity, chance of hospitalisation and number of hospitalisations. Though most of these rural samples had low household incomes, the patients in the lower-income households had significantly lower dementia severity, but, with the health benefit coverage had significantly higher chances of hospitalisation.ConclusionAs the informal caregivers are the principal human resources for dementia care and services in rural area, policymakers should consider informal care for the Thai elderly with dementia and promote it as the dominant pattern of dementia care in Thailand.


Sign in / Sign up

Export Citation Format

Share Document