scholarly journals Designing Dementia Care Pathways to Transform Non Dementia-Friendly Hospitals: Scoping Review

2021 ◽  
Vol 18 (17) ◽  
pp. 9296
Author(s):  
Jorge Riquelme-Galindo ◽  
Manuel Lillo-Crespo
Keyword(s):  
Cognitive Impairment ◽  
Scoping Review ◽  
Care Pathway ◽  
Dementia Care ◽  
Stressful Situation ◽  
Care Plans ◽  
Hospital Environments ◽  
People With Dementia ◽  
Centered Care ◽  
Core Elements

People with dementia (PwD) occupy around 25% of the hospital beds. Once PwD are admitted to hospitals, their cognitive impairment is not considered in most of the cases. Thus, it causes an impact on the development of the disease becoming a stressful situation as care plans are not adapted to PwD. The aim of this study was to explore the published core elements when designing a dementia care pathway for hospital settings. A scoping review was conducted to provide an overview of the available research evidence and identify the knowledge gaps regarding the topic. This review highlights person-centered care, compassionate care and end-of-life process as some of the key elements that should integrate the framework when designing a dementia care pathway. Architectonical outdoor and indoor hospital elements have also been found to be considered when adapting the healthcare context to PwD. Findings provide information about the key points to focus on to successfully design dementia interventions in hospital environments within available resources, mostly in those contexts in which national dementia plans are in its infancy. Hospitals should transform their patients’ routes and processes considering the increasing demographic changes of people with cognitive impairment.

The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review

Dementia ◽  
2021 ◽  
pp. 147130122110126
Author(s):  
Alexandra E Harper ◽  
Lauren Terhorst ◽  
Marybeth Moscirella ◽  
Rose L Turner ◽  
Catherine V Piersol ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Scoping Review ◽  
Informal Caregivers ◽  
Nursing Home Care ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Background Person-centered care has been shown to increase desired outcomes for people with dementia, yet informal caregivers’ dissatisfaction with care is often reported. For those living in a nursing home, informal caregivers are uniquely situated to provide key insights into the individual’s care. However, little is known of the informal caregivers’ perspective, which hinders efforts to improve their satisfaction with person-centered nursing home care. Thus, we examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia. Methods In collaboration with stakeholders, a scoping review of Medline (Ovid), EMBASE.com , CINAHL (EBSCO), the Cochrane Library (Wiley), and PsycINFO (Ovid) databases from January 2000 to July 2020 was conducted. Data were extracted reflecting the experiences, priorities, and preferences of caregivers of people with dementia residing in nursing homes. Results We identified 114 articles that revealed nine themes: (1) communication, (2) transition to nursing home, (3) quality of care, (4) quality of life, (5) informal caregiver role, (6) knowledge of dementia, (7) end-of-life preferences, (8) medication use to manage neuropsychiatric behaviors, and (9) finances. Conclusion Informal caregivers described aspects of care that led to both positive and negative experiences with and perceptions of nursing home care. The shortcomings in communication were discussed most frequently, indicating a high priority area. While researchers define the identified themes individually, informal caregivers perceive them to be interwoven as they relate to person-centered care delivery. Although we did not assess the quality of included articles, by identifying themes relevant to caregivers’ perspectives of nursing home care, our findings may help to inform efforts to optimize caregivers’ satisfaction with nursing home care for residents with dementia.

scholarly journals 414 - Supporting staff delivering person-centered care to people with dementia in Dutch nursing homes

2021 ◽  
Vol 33 (S1) ◽  
pp. 37-38
Author(s):  
Henriëtte van der Roest ◽  
Milan van der Kuil ◽  
Anouk Overbeek ◽  
Egbert Hartstra
Keyword(s):  
Nursing Homes ◽  
Living Arrangements ◽  
Online Survey ◽  
Dementia Care ◽  
Person Centered Care ◽  
People With Dementia ◽  
Modifiable Factors ◽  
Centered Care ◽  
Organizational Features

BackgroundPositive evidence has been found for person-centered care provisioning (PCC), the level of person- centeredness of care is positively associated with residents’ quality of life, quality of care an wellbeing.When providing PCC, care and support are provided in line with the needs, preferences and capacities of people with dementia. PCC is seen as the golden standard for dementia care. However, in nursing homes, needs and preferences of people with dementia are not always obvious, due to the relatively high levels of cognitive impairment. This, and amongst others time constraints might hinder high PCC by care professionals. Limited evidence show that certain organizational and environmental conditions, such as satisfactory leadership, interdisciplinary collaboration, and continuing education, lead to higher PCC. In order to facilitate care professionals as much as possible in providing PCC, more insight is desirable.ObjectiveThis study aims to provide more insight into the modifiable factors that contribute to PCC for people with dementia in Dutch nursing homes.MethodsA cross-sectional design was applied. Data were collected during the fifth assessment of the Living Arrangements for people with Dementia (LAD)-study from April 2019 until February 2020. Care professionals working in psychogeriatric units in nursing homes filled in an online survey. Organizational characteristics of participating nursing homes were inventoried.The level of PCC was assessed with the Dutch version of the ‘Person-centred care questionnaire’ (PCCq). Modifiable factors potentially impacting the level of provided PCC with regard to staff characteristics (e.g. autonomy, education), organizational features (e.g. size, involvement of family in care), and culture (e.g. learning climate) were included in multiple linear modelling.Preliminary resultsIn total 58 nursing home facilities were included in the study, and 814 care professionals completed the survey. Average PCCq score was 3.2 (SD = 0.4; range 0 to 4, higher scores indicating higher PCC).ConclusionFactors related to staff, and organizational features and culture, that contribute to PPC will be presented. The outcomes of the study will provide input for the optimal organization of dementia care, in order to support care professionals working in nursing homes to provide PCC.

scholarly journals What hinders and facilitates the implementation of nurse-led interventions in dementia care? A scoping review

2020 ◽  
Author(s):  
Melanie Karrer ◽  
Julian Hirt ◽  
Adelheid Zeller ◽  
Susi Saxer
Keyword(s):  
Scoping Review ◽  
Implementation Process ◽  
Dementia Care ◽  
Barriers And Facilitators ◽  
Successful Implementation ◽  
Evidence Based ◽  
Management Support ◽  
Implementation Processes ◽  
Culture Of Care ◽  
People With Dementia

Abstract Background The implementation of evidence-based interventions for people with dementia is complex and challenging. However, successful implementation might be a key element to ensure evidence-based practice and high quality of care. There is a need to improve implementation processes in dementia care by better understanding the arising challenges. Thus, the aim of this study was to identify recent knowledge concerning barriers and facilitators to implementing nurse-led interventions in dementia care. Methods We performed a scoping review using the methodological framework of Arksey and O’Malley. Studies explicitly reporting on the implementation process and factors influencing the implementation of a nurse-led intervention in dementia care in all settings were included. We searched eight databases from January 2015 until January 2019. Two authors independently selected the studies. For data analysis, we used an inductive approach to build domains and categories. Results We included 26 studies in the review and identified barriers as well as facilitators in five domains: policy (e.g. financing issues, health insurance), organisation (e.g. organisational culture and vision, resources, management support), intervention/implementation (e.g. complexity of the intervention, perceived value of the intervention), staff (e.g. knowledge, experience and skills, attitude towards the intervention), and person with dementia/family (e.g. nature and stage of dementia, response of persons with dementia and their families). Conclusions Besides general influencing factors for implementing nursing interventions, we identified dementia-specific factors reaching beyond already known barriers and facilitators. A pre-existing person-centred culture of care as well as consistent team cultures and attitudes have a facilitating effect on implementation processes. Furthermore, there is a need for interventions that are highly flexible and sensitive to patients’ condition, needs and behaviour.

Implementing Microlearning in Nursing Homes: Implications for Policy and Practice in Person-Centered Dementia Care

2020 ◽  
pp. 073346482092983
Author(s):  
Jenny Inker ◽  
Christine Jensen ◽  
Sonya Barsness ◽  
Mary Martha Stewart
Keyword(s):  
Job Satisfaction ◽  
Nursing Homes ◽  
Best Practices ◽  
Policy Development ◽  
Dementia Care ◽  
Policy And Practice ◽  
Knowledge And Attitudes ◽  
People With Dementia ◽  
Training Modality ◽  
Centered Care

The aim of this study was to develop and pilot a 52-week Microlearning curriculum on person-centered dementia care in nine nursing homes. The goal was to evaluate the usability and application of Microlearning as a tool to increase staff knowledge and improve perceptions of people with dementia, thus increasing their ability to deliver person-centered care and their job satisfaction. Findings indicate that participants enjoyed the flexible, 24/7 access to training and found that the immediacy of the format encouraged them to apply their learning directly to practice. Staff knowledge and attitudes toward people with dementia were positively impacted by the training, as was job satisfaction. Further research to test the efficacy of Microlearning compared to usual training is warranted, as are coordinated policy development efforts that can guide the implementation of best practices in the use of Microlearning as an innovative training modality in nursing homes.

Personhood and Dementia Care: A Qualitative Evidence Synthesis of the Perspectives of People With Dementia

2019 ◽  
Author(s):  
Niamh Hennelly ◽  
Adeline Cooney ◽  
Catherine Houghton ◽  
Eamon O’Shea
Keyword(s):  
Evidence Synthesis ◽  
Dementia Care ◽  
Care Process ◽  
Qualitative Evidence Synthesis ◽  
Formal Caregivers ◽  
Cart Analysis ◽  
Qualitative Evidence ◽  
People With Dementia ◽  
Centered Care ◽  
Design And Methods

Abstract Background and Objectives Personhood is considered the cornerstone of person-centered care for people with dementia. However, there is little research on personhood in dementia care from the perspective of the person with dementia themselves. This article presents a qualitative evidence synthesis of the experiences and perceptions of people with dementia on personhood in dementia care. Research Design and Methods A systematic search of nine databases was conducted. In addition to initial screening, CART analysis was used to determine the most relevant papers. Thematic synthesis was conducted on 20 papers. The CASP tool was used to examine the quality of the included papers. GRADE CERQual analysis examined confidence in the review findings. Results People with dementia experience many changes due to the disease and the experience of being cared for in different settings. Personhood is affirmed through personal interactions with family, friends, other care recipients, and formal caregivers, as well as through continued engagement in social and occupational roles. Discussion and Implications The review has important implications for practice, regulation, and policy. The person and their personhood should be protected rather than undermined, and relationships should be enhanced not diminished by the formal care process. The focus should be on creating and amplifying opportunities for people with dementia to affirm the self through interactions with others and engaging in occupational and social roles to ensure continuity of self.

scholarly journals 29 Adapting Dementia and Delirium Awareness Training to a Rehabilitation Setting

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Emma O'Brien ◽  
Monica Devine ◽  
Sarah Maxwell ◽  
Catherine McDonnell ◽  
Stuart Lee
Keyword(s):  
Cognitive Impairment ◽  
Occupational Therapy ◽  
Dementia Care ◽  
Awareness Training ◽  
Likert Scales ◽  
Staff Members ◽  
Patient Profile ◽  
People With Dementia ◽  
Adult Rehabilitation ◽  
The Impact

Abstract Background The patient profile in a Dublin rehabilitation hospital has changed in recent years to include older adult rehabilitation alongside orthopaedic rehabilitation. A snapshot audit completed by the occupational therapy department on one day in 2018 demonstrated that 64% of patients had an assessment score indicative of a cognitive impairment. A subjective gap in knowledge regarding dementia care and a misunderstanding of the ability of people with dementia to engage in rehabilitation was identified. It was imperative that dementia awareness training was provided with a particular focus on modifying rehabilitation techniques to cater for these patients. Methods A dementia care committee was established with an Educational Development subgroup responsible for addressing dementia and delirium awareness training. Educational material was received from the field of occupational therapy, nursing, medicine, pharmacy and dietetics. The programme was accredited by the Nursing and Midwifery Board of Ireland. A focus group was completed pre/post formulation of the presentation with various departmental representatives. Feedback provided was used to inform and finalise the training content. Results Sessions are completed once monthly. One hundred and seven participants to date have attended. Ten-point Likert scales are completed pre and post training. Data from the Likert scales were analysed revealing on average a 24.4 % increase in knowledge of dementia, a 27.6% increase in awareness of the impact of dementia on function and a 23.3% increase in confidence in caring for a patient with dementia. Highest contingent of staff members trained were household and catering staff (19%) nursing staff (18%), and health care attendants (13%). Conclusion This essential training is ongoing with thirty per cent of staff trained to date. The objective is for all staff to complete this training for enhanced care and rehabilitation for all patients with dementia. It will also aim to review treatment for all patients with cognitive impairment so unique rehabilitation programmes can be tailored.

Characteristics and Real-Life Outcomes of Dementia and Cognitive Impairment at a Geriatric Clinic

2020 ◽  
Vol 49 (3) ◽  
pp. 312-320
Author(s):  
Kritapas Chulakadabba ◽  
Weerasak Muangpaisan ◽  
Pitiporn Siritipakorn ◽  
Titima Wongviriyawong ◽  
Patumporn Suraarunsumrit ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Psychological Symptoms ◽  
Real Life ◽  
Retrospective Chart Review ◽  
Acetylcholinesterase Inhibitors ◽  
Dementia Care ◽  
Subjective Cognitive Decline ◽  
Geriatric Syndromes ◽  
People With Dementia ◽  
Geriatric Clinic

<b><i>Background:</i></b> Various patterns of dementia care have been developed in different settings, depending on the availability of healthcare resources and facilities. The purpose of this study was to examine the epidemiology and characteristics of dementia care at a geriatric clinic, a field that has been subject to little prior evaluation. <b><i>Methods:</i></b> A retrospective chart review was undertaken of cohort patients with cognitive impairment who had received a diagnosis and were still on active follow-up at a geriatric clinic. A total of 892 patients were included. In addition, 203 geriatric patients with no cognitive impairment who attended the clinic during the study period were sampled as a control. <b><i>Results:</i></b> The main diagnoses of dementia were Alzheimer’s disease (AD) (40.1%), vascular dementia (16.9%), unspecified dementia (16.3%), mixed dementia (9.0%), AD with cerebrovascular disease (8.7%), and Parkinson’s disease dementia (6.1%). Atypical dementia was presented in 3.0% of cases. There were 178 patients with mild cognitive impairment, 20 with vascular cognitive impairment, and 18 with subjective cognitive decline. Other comorbidities were found in 97% of the subjects. Patients with cognitive impairment had a higher total number of other geriatric syndromes and higher percentages for delirium, falls, immobility, loss of appetite, and incontinence. Potentially reversible causes of dementia were found in 11.3% of the cases. Acetylcholinesterase inhibitors were administered to 61%, whereas 23.5% received an NMDA receptor antagonist. The need for a change in the antidementia medication was identified for 10.7% of the subjects; the major cause was adverse drug side effects. Nonpharmacological therapy only was administered to 52.4% of the people with dementia who had behavioral and psychological symptoms. <b><i>Conclusions:</i></b> Mixed brain pathologies, comorbidities, and the coexistence of other geriatric syndromes are common at geriatric clinics. Holistic, integrated, and continuous care are needed to improve the outcomes of patients with more complicated comorbidities.

scholarly journals Toward the Integration of Technology-Based Interventions in the Care Pathway for People with Dementia: A Cross-National Study

2021 ◽  
Vol 18 (19) ◽  
pp. 10405
Author(s):  
Vera Stara ◽  
Benjamin Vera ◽  
Daniel Bolliger ◽  
Susy Paolini ◽  
Michiel de Jong ◽  
...  
Keyword(s):  
Care Pathway ◽  
Patient Centered Care ◽  
National Study ◽  
Multidisciplinary Teams ◽  
Virtual Agents ◽  
Virtual Agent ◽  
Patient Centered ◽  
People With Dementia ◽  
Integration Of Technology ◽  
Centered Care

Background: The integration of technology-based interventions into health and care provision in our aging society is still a challenge especially in the care pathway for people with dementia. Objective: The study aims to: (1) identify which socio-demographic characteristics are independently associated with the use of the embodied conversational agent among subjects with dementia, (2) uncover patient cluster profiles based on these characteristics, and (3) discuss technology-based interventions challenges. Methods: A virtual agent was used for four weeks by 55 persons with dementia living in their home environment. Results: Participants evaluated the agent as easy-to-use and quickly learnable. They felt confident while using the system and expressed the willingness to use it frequently. Moreover, 21/55 of the patients perceived the virtual agent as a friend and assistant who they could feel close to and who would remind them of important things. Conclusions: Technology-based interventions require a significant effort, such as personalized features and patient-centered care pathways, to be effective. Therefore, this study enriches the open discussion on how such virtual agents must be evidence-based related and designed by multidisciplinary teams, following patient-centered care as well as user-centered design approaches.

scholarly journals Improving the HealthCare of People with Dementia beyond the Diagnosis: The “Carlo Poma Dementia Care Pathway” Study Protocol

2018 ◽  
Vol 3 (1) ◽  
pp. 1-1
Author(s):  
Vincenza Frisardi ◽  
◽  
Sara Faroni ◽  
Angela Bellani ◽  
Felice Biagi ◽  
...  
Keyword(s):  
Study Protocol ◽  
Care Pathway ◽  
Dementia Care ◽  
People With Dementia

scholarly journals Using touchscreen tablets to support social connections and reduce responsive behaviours among people with dementia in care settings: A scoping review

Dementia ◽  
2020 ◽  
pp. 147130122092274
Author(s):  
Lillian Hung ◽  
Bryan Chow ◽  
John Shadarevian ◽  
Ryan O’Neill ◽  
Annette Berndt ◽  
...  
Keyword(s):  
Scoping Review ◽  
Care Home ◽  
Dementia Care ◽  
Lessons Learned ◽  
Social Connections ◽  
Term Care ◽  
People With Dementia ◽  
Person With Dementia ◽  
The Impact

The use of touchscreen tablets, such as the iPad, offers potential to support the person with dementia staying in a care setting, ranging from a long-term care home to an adult day programme. Although electronic devices are used among people with dementia, a comprehensive review of studies focusing on their impact and how they may be used effectively in care settings is lacking. We conducted a scoping review to summarize existing knowledge about the impact of touchscreen tablets in supporting social connections and reducing responsive behaviours of people with dementia in care settings. Our research team consists of patient partners and family partners, physicians, nurses, a medical student and an academic professor. A total of 17 articles were included in the review. Our analysis identified three ways in which touchscreen tablets support dementia care: (1) increased the person’s engagement, (2) decreased responsive behaviours and (3) positive effect on enjoyment/quality of life for people with dementia. Lessons learned and barriers to the use of touchscreen tablets in the care of people with dementia are described. Overall, only a few studies delineated strategies that helped to overcome barriers to technology adoption in care settings. Knowledge translation studies are needed to identify effective processes and practical tips to overcome barriers and realize the potential of assistive technology in dementia care.

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