Dementia eUpdate



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Dementia eUpdate

Care

(1) BAALEN Angela van. How to evaluate quality of care from the perspective of people with dementia: an overview of the literature. Dementia the International Journal of Social Research and Practice 2011;10(1):112-137

This literature review looks at research on including the perspectives of people with dementia when evaluating quality of care. Studies that included the views of individuals with dementia were few and relatively small scale, particularly those that focused on issues such as quality of care. However the evidence suggests that there is consensus that people with mild to moderate dementia are able to talk about their experiences of care with clarity and insight. A minimum level of orientation to place, attention and language skills in the person with dementia are important for a successful subjective evaluation. On the basis of the literature, the authors produced practical guidelines for use when collecting information from people with dementia by interviewing, through self-administered questionnaires, or using focus groups. It is concluded that, in people with mild to moderate dementia, assessment of quality of care can best be done by individual interviewing and focus groups. Full Text/Order

(2) LANDAU Ruth. Who should make the decision on the use of GPS for people with dementia? Aging and Mental Health 2011;15(1):78-84

This paper investigated who should decide about the use of GPS tracking for older people with dementia. Two hundred and ninety six cognitively intact older people, family carers, social workers, professionals, and social work students rated nine potential decision-makers to make this decision. Findings revealed that family members, particularly the spouse or the most involved family carer, were perceived more important in the decision-making process than those outside the family. The person with dementia was ranked third in the order of the figures. Since the decision to use GPS for tracking raises ethical issues over personal safety versus autonomy and privacy, the findings indicate that the reluctance of professional caregivers to assist family caregivers to make this decision is experienced as frustrating. The authors suggest that in order to reach a balance between the wishes and interests of people with dementia and their informal carers, there is a need for active involvement of the professional carers to aid in the decision-making process. Full Text/Order

(3) Lee D, Thomas A. Sleep in dementia and caregiving - assessment and treatment implications: a review. International Psychogeriatrics 2011;23(2):190-201 Full Text/Order.

(4) MONIZ-COOK Esme, CLARKE Chris. Dementia care: coping with aggressive behaviour. Nursing and Residential Care 2011;13(2):86-90

The reasons why a person with dementia might be described as aggressive and what might lead to this behaviour are considered. Possible reasons put forward include unmet needs and lowered stress thresholds. Effective ways of preventing and responding to aggression and perceived aggression also presented. Three short case studies are included. Full Text/Order

(5) Moyle W, Borbasi S, Wallis M, Olorenshaw R, Gracia N. Acute care management of older people with dementia: a qualitative perspective. Journal of Clinical Nursing 2011;20(3/4):420-8

This Australian study explored management for older people with dementia in an acute hospital setting. As the population ages, increasing numbers of older people with dementia are placed into an acute care hospital to manage a condition other than dementia. These people require special care that takes into account the unique needs of confused older people. Current nursing and medical literature provides some direction in relation to best practice management; however, few studies have examined this management from the perspective of hospital staff. A descriptive qualitative approach was used. Data were collected using semi-structured audio-taped interviews with a cross section of thirteen staff that worked in acute medical or surgical wards in a large South East Queensland, Australia Hospital. Analysis of data revealed five subthemes with the overarching theme being paradoxical care, in that an inconsistent approach to care emphasised safety at the expense of well-being and dignity. A risk management approach was used rather than one that incorporated injury prevention as one facet of an overall strategy. Using untrained staff to sit and observe people with dementia as a risk management strategy does not encourage an evidence-based approach. Staff education and environmental resources may improve the current situation so that people with dementia receive care that takes into account their individual needs and human dignity. Nurses can assist older people with dementia by encouraging evidence-based care practices to become the part of hospital policy. Full Text/Order

(6) THEIN Nwe Winn, D'SOUZA Geraldine, SHEENHAN Bart. Expectations and experience of moving to a care home: perceptions of older people with dementia. Dementia the International Journal of Social Research and Practice 2011;10(1):7-18

The difficulty of engaging people with dementia in the research process has meant that they often have little involvement in decisions taken by family or professionals about their care. This qualitative study explored their subjective experiences of moving permanently into a care home. Eighteen people with dementia, recruited through the old age psychiatry service in Coventry, were interviewed before and after their move. Before moving, a realisation of one’s own difficulties, clearly expressed hopes and fears, and a wish for a role in the preparation for the move were identified. After the move, both positive and negative experiences of the process were recalled. Major themes identified were: acceptance of the situation, acceptance by others, and the role of family. Most participants clearly identified what had helped them most in the process. The majority of participants liked their homes and acknowledged the safety, security and care they received. Limitations of the study include care staff being present during some follow up interviews and these taking place on average only five weeks after the move. The authors conclude that moving to a care home need not be a depressing process for people with dementia if they can be meaningfully involved in the process. Full Text/Order

Diagnosis & Treatment

(7) Strong evidence for benefits of activity and participation. Journal of Dementia Care 2011;19(1):11 Full Text/Order

(8) Ballard C, Corbett A, Pickett J. Depression and dementia. Mental Health Today 2011:23-5 Full Text/Order

(9) Hean S, Nojeed N, Warr J. Developing an integrated memory assessment and support service for people with dementia. Journal of Psychiatric & Mental Health Nursing 2011;18(1):81-8

This paper describes the development of an integrated Memory Assessment and Support Service guided by best practice principles offered by a National Dementia Strategy (Department of Health). Previous service provision is outlined and comparisons made from both quantitative and qualitative evaluation data to consider the effectiveness of the new service. Conclusions and recommendations are offered to assist others with similar practice development requirements. Full Text/Order

(10) McClive-Reed K, P., Gellis Z, D. Anxiety and related symptoms in older persons with dementia: directions for practice. Journal of Gerontological Social Work 2011;54(1):6-28 Full Text/Order

(11) Murfield J, Cooke M, Moyle W, Shum D, Harrison S. Conducting randomized controlled trials with older people with dementia in long-term care: challenges and lessons learnt. International Journal of Nursing Practice 2011;17(1):52-9

Murfield J, Cooke M, Moyle W, Shum D, Harrison S. International Journal of Nursing Practice 2011; : 52-59 The characteristics of older people with dementia and the long-term care environment can make conducting research a challenge and, as such, this population and setting are often understudied, particularly in terms of clinical or randomized controlled trials. This paper provides a critical discussion of some of the difficulties faced whilst implementing a randomized controlled trial exploring the effect of a live music programme on the behaviour of older people with dementia in long-term care. A discussion of how these challenges were addressed is presented to aid investigators planning the design of similar research and help encourage a proactive approach in dealing with research-related challenges right from project conception. The article is structured according to the three principles of a randomized controlled trial in order to keep experimental rigour at the forefront of this research area Full Text/Order

Information for carers and patients

(12) Chan S. Family caregiving in dementia: the asian perspective of a global problem. Dementia & Geriatric Cognitive Disorders 2011;30(6):469-78

Background/Aims: With an increasing life expectancy, the number of people suffering from dementia globally will rise to about 115.4 million by 2050. It is projected that in the 21st century, the majority of the world's older people will be living in Asia. This paper examines the global issues of family caregiving for older persons with dementia from an Asian perspective. Methods: Literature review of published empirical studies from 1990 to October 2010. Results: A full understanding of the specific way that culture could influence family caregivers' burdens may play an important part in the development of a holistic model for family-centered care. Well-designed psychoeducation interventions or multicomponent interventions could help in reducing caregivers' burden. With socio-economical and demographical changes, families need to be supported when taking on the caregiving role and be offered alternatives of care. Conclusion: There is a need for future trials with more rigorous randomization and longitudinal follow-up to assess family caregiver burdens at different illness stages. Future studies could focus on protective factors that promote caregivers' resilience. It is essential to develop psychometrically robust measures for family caregiver burden and gain. Copyright © 2011 S. Karger AG, Basel Full Text/Order

(13) Jenny T. S, C., Achterberg W, P., Ribbe M, W., C. W. H. Family perceptions of wishes of dementia patients regarding end-of-life care. International Journal of Geriatric Psychiatry 2011;26(2):217-20 Full Text/Order

(14) Morris J. Carers of patients with dementia must receive a needs assessment. Guidelines in Practice 2011;14(2):6 Full Text/Order

(15) Watson R, Manthorpe J, Stimpson A. Continuing professional development: carers and dementia. Learning from carers' experiences: helping older people with dementia to eat and drink. Nursing Older People 2003;14(10):23-8

Eating and drinking difficulties are common in people with dementia and yet some health staff are inclined to neglect this important area of care. This article explores how, combined with the skills of nurses, the experiences of those caring for relatives with dementia can help potential problems to be avoided. Full Text/Order

Research

(16) Bisla J, Calem M, Begum A, Stewart R. Have we forgotten about dementia in care homes? The importance of maintaining survey research in this sector. Age & Ageing 2011;40(1):5-6 Full Text/Order

(17) Boustani M, A., Sachs G, A., Alder C, A., Munger S, Schubert C, C., Austrom M, Guerriero, et al. Implementing innovative models of dementia care: the healthy aging brain center. Aging & Mental Health 2011;15(1):13-22

Background: Recent randomized controlled trials have demonstrated the effectiveness of the collaborative dementia care model targeting both the patients suffering from dementia and their informal caregivers. Objective: To implement a sustainable collaborative dementia care program in a public health care system in Indianapolis. Methods: We used the framework of Complex Adaptive System and the tool of the Reflective Adaptive Process to translate the results of the dementia care trial into the Healthy Aging Brain Center (HABC). Results: Within its first year of operation, the HABC delivered 528 visits to serve 208 patients and 176 informal caregivers. The mean age of HABC patients was 73.8 (standard deviation, SD 9.5), 40% were African-Americans, 42% had less than high school education, 14% had normal cognitive status, 39% received a diagnosis of mild cognitive impairment, and 46% were diagnosed with dementia. Within 12 months of the initial HABC visit, 28% of patients had at least one visit to an emergency room (ER) and 14% were hospitalized with a mean length of stay of five days. The rate of a one-week ER revisit was 14% and the 30-day rehospitalization rate was 11%. Only 5% of HABC patients received an order for neuroleptics and only 16% had simultaneous orders for both definite anticholinergic and anti-dementia drugs. Conclusion: The tools of 'implementation science' can be utilized to translate a health care delivery model developed in the research laboratory to a practical, operational, health care delivery program. Full Text/Order

(18) Restifo S, Lemon V, Waters F. Pharmacological treatment of behavioural and psychological symptoms of dementia in psychogeriatric inpatient units. Australasian Psychiatry 2011;19(1):59-63 Full Text/Order

(19) Svanberg E, Spector A, Stott J. The impact of young onset dementia on the family: a literature review. International Psychogeriatrics 2011;23(3):356-71 Full Text/Order

(20) TRIGG Richard. Predictors of quality of life ratings from persons with dementia: the role of insight. International Journal of Geriatric Psychiatry 2011;26(1):83-91

Noting that responses from people with dementia to questions about quality of life may be affected by their reduced insight, this study aimed to explore predictors of quality of life ratings in a sample of people with mild dementia, with a particular focus on the role of insight. The analysis was based on data from an ongoing 3-year longitudinal study. The sample included 69 participants with dementia from a memory clinic and their caregivers, and assessments were carried out in patients' homes. The findings indicated that the strongest predictor of quality of life ratings from people with dementia was their awareness of memory function, with lower awareness associated with higher quality of life ratings. The study also found that patients with better activities of daily living ability and who exhibited more frequent displays of enjoyment were likely to report higher levels of quality of life. The authors discuss the findings and their implications. Full Text/Order.

(21) Trueland J. Revised dementia strategy renews impetus for change. Nursing Older People 2011;23(1):6-7 Full Text/Order

(22) Wood R. Invest in dementia research to avert crisis. Independent Nurse 2011:17 Full Text/Order

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