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November 11, 2014
Dementia : the international journal of social research and practice - November 2014
As the incidence of
dementia rises globally, the rate and scale at which it is currently escalating
has forced governments to make it a health priority, and from a consumer’s
perspective, it is therefore very timely to re-consider the language being used
to represent people with dementia and its impact on stigma…'
Enriching the care of patients with dementia in acute settings? The
Dementia Champions Programme in Scotland
to hospital has been found to have a negative impact on people with dementia.
The Scottish Dementia Champions programme was developed to prepare health and
social service Dementia Champions working in acute settings as Change Agents.
The programme was initially delivered to a cohort of 100 health professionals
via blended learning, and comprised five study days,
a half day spent in a local community setting, and e-learning. In order to
complete the programme and graduate, participants were required to complete and
submit reports relating to three work-based activities.
Conversation analysis as a method for investigating interaction in care
This article gives an outline of how the socio-linguistic approach of
conversation analysis can be applied to the analysis of carer–patient
interaction in care homes. A single case study from a routine encounter in a
residential care home is presented. This is used to show how the conversation analysis method works, the kinds of interactional and
communication features it can expose, and what specific contribution this kind
of micro-interactional approach may make to improving quality of care in these
Attachment in people with dementia and their caregivers: A systematic
Attachment bonds are important for personality development, emotion
regulation and mental
health throughout the lifespan. This systematic review explores the
relevance of attachment for people with dementia, and how attachment influences
the experience of caregivers of people with dementia. Eighteen studies were
included. Three focused on attachment in terms of parent fixation in dementia,
three examined attachment behaviour in dementia, five addressed attachment and
dementia-related behavioural problems, and seven concentrated on attachmentin caregivers. Attachment behaviours were
evident at various stages of dementia and the presence of parent fixation was
observed when attachment needs were not being met. Insecure attachment was
related to neuropsychiatric symptoms. Attachment security had important
consequences for caregiver psychological health. Implications of methodological
issues such as the choice of respondent, measurement issues, and the lack of a
longitudinal perspective are discussed. The implications of attachment for the
support of people with dementia and caregivers are considered.
Psycho-educational support for relatives of people with a recent
diagnosis of mild to moderate dementia: An evaluation of a 'Course for Carers'
Currently there are 820,000 people with dementia in the UK, a figure
projected to reach 1.7 million by 2050. Policy and practice emphasis on early
intervention in dementia and support of family carers foreground a need to
explore service efficacy for relatives of those with a recent diagnosis.
Existing evidence suggests that psycho-educational interventions can significantly
enhance carer well being especially when well targeted and group based. A
rolling programme of seven psycho-educational Courses for ‘new carers’ in one
area of England was the subject of a systematic evaluation incorporating a
quantitative rating scale and qualitative data. Findings suggest that the
Courses achieved a number of intersecting aims: they provided psychological
support; offered advice; enhanced coping skills; boosted confidence; increased knowledge;
and prepared the carer for the future. That the Courses were designed and delivered
by specialist staff – primarily psychologists, offered a social dimension, were
time limited and free are noteworthy features. The evaluation suggests that as
a model the Course has considerable short and longer term preventive potential;
also that it could be replicated elsewhere in the country and achieve similar
experience of sons caring for a parent with dementia
study explored the experiences of sons caring for a parent with dementia.
Individual, semi-structured interviews were conducted with a purposeful sample
of sons (n = 13)
in a rural part of Ireland. Interviews were audiotaped, transcribed verbatim
and analysed for common themes. The key themes that emerged were ‘the parental
bond’, ‘a binding role’, ‘coordinating care and support’ and a ‘getting on with
it’ approach to care. The study highlighted the commitment of sons to their
caregiving role and the strong sense of duty that motivated them to provide
care. The findings suggested that while many aspects of the caregiving
experience such as lack of information and support are gender neutral, there
are differences in the caregiving experiences of men and women in how they view
their relationship with their parent and in the management of their caregiving
role that merit further investigation.
Caregiving stress and coping: A thematic analysis of
Chinese family caregivers of persons with dementia
study aims to identify caregiving stressors and coping strategies in a sample
of family caregivers of persons with dementia living in Shanghai, China.
Methods: A sample
of 18 family caregivers participated in semi-structured face-to-face
interviews. Information regarding caregiver appraisal of caregiving situations,
difficulties with care provision, and ways of dealing with stressors were
obtained. Thematic analysis was used to assess the interview data.
addition to stressors directly related to caregiving demands (i.e., burden due
to care recipient limitations in physical, cognitive, or behavioral functions),
other salient stressors that emerged were role strains, family conflicts, and
pressure from the social environment. Yet, caregivers demonstrated resilience
by drawing on their coping resources from a variety of sources, including
personal experience, family, technology and information, religion, and
Implications: Specific attention needs to be given to help
family caregivers alleviate stress due to family conflicts and pressure from
the social environment. Policy formulation and program design needs to build on
caregiver strengths to support and empower Chinese families caring for
relatives with dementia patients.
Is gardening a stimulating activity for people with
advanced Huntington's disease?
study evaluated adapted gardening as an activity for people with advanced
Huntington's disease (HD) and explored its therapeutic aspects. Visitors and
staff completed a questionnaire and participated in structured interviews to
capture further information, whereas a pictorial questionnaire was designed for
residents with communication difficulties. Staff reported that gardening was a
constructive, outdoor activity that promoted social interaction, physical
activity including functional movement and posed cognitive challenges. Half the
staff thought the activity was problem free and a third used the garden for
therapy. Visitors used the garden to meet with residents socially. Despite
their disabilities, HD clients enjoyed growing flourishing flowers and
vegetables, labelling plants, being outside in the sun and the quiet of the
garden. The garden is valued by all three groups. The study demonstrates the
adapted method of gardening is a stimulating and enjoyable activity for people
with advanced HD.
Staging casual conversations for people with dementia
isolation is a key concern for individuals with dementia in long-term care. A
possible solution is to promote social interaction between residents. A first
step toward facilitating positive relationships between residents with dementia
is to understand the mechanisms behind their interactions with each other, and
also how their relationships with each other are built through such
interactions. Drawing on casual conversations between residents in a special
care unit for dementia, this paper uses systemic functional linguistics to
examine how people with dementia use language to enact and construct their
role-relations with each other. Results suggest people with dementia are able
and willing conversationalists. However, factors such as the extent of
communication breakdown and compatibility of the interlocutors may influence
whether positive relations develop or not. Casual conversation is suggested to
be a promising activity to encourage positive interpersonal processes between
individuals with dementia in residential care.
Pathways through care at the end of life: A guide to person-centred care.
Anita Hayes, Claire Henry, Margaret Holloway, Katie Lindsey, Eleanor
Sherwen and Tes Smith
For me, the book proved
highly accessible and readable, providing an excellent presentation of how open
and inclusive communication plays a major role in providing end of life care. The
opening chapter sets the context and offers some consideration of terms, such
as ‘end of life’, ‘palliative’ and ‘secularisation’. A small surprise was that
the differentiation of such terms from ‘dying care pathways’ (p. 157) is not
introduced until later in the book…
Mark Harrison, St Luke’s Hospice, Winsford, Cheshire
ABC of dementia
Bernard Coope and Felicity Richards (eds),
I read this book in a
couple of sittings and found it to be a really informative, clear and easyto- read
guide. I feel it would be helpful for those professionals working with people
living with dementia as well as family carers. It would also be a great
resource for student nurses.The further reading
recommendations at the end of each chapter are very helpful additions, as it is
an easy reference to the information and filters what could feel overwhelming otherwise.
I found including the chapter ‘Dementia and the Law’ particularly useful, as this
is often confused and misunderstood. Having all the information in one place is
certainly of benefit, whilst the logical, organised way the chapter is
presented reduces the risk of misinterpretation. It also highlights the need
for timely decision making and the importance of early diagnosis….
Lorriane Butterworth, Admiral Nurse Clinical Lead, Cornwall Care House
Creating culturally appropriate outside spaces and experiences for
people with dementia: using nature and the outdoors in person-centred care
Mary Marshall and Jane Gilliard (eds)
Marshall and Gilliard have
drawn together a thought-provoking and diverse international mix of
contributions concerned with the relationship of culture, identity and the
environment. Their argument is that the outdoors is not just ‘the outdoors’,
but something we perceive and experience through a cultural lens. A premise for
the book is that people may avoid outdoor environments if they are unable to
make sense of them: The first step on this journey towards making outside
spaces more familiar is to change our language. We need to talk about ‘outside
spaces’ or ‘outdoor spaces’ rather than ‘gardens’. If we use the term ‘gardens’ we
immediately begin to have preconceptions about what we are trying to provide….
Richard Ward,Lecturer, School of Applied Social Science, University of Stirling