January 10, 2018

the latest Dementia - The international journal of social research and practice

Full text articles are available to members of dementia Australia NSW by emailing NSW.Library@dementia.org.au

Table of Contents
Volume 16, Issue 8, November 2017

Non-pharmacological interventions for managing dementia-related sleep problems within community dwelling pairs: A mixed-method approach
 Rosemary H Gibson et al
pp. 985–1003
Dementia-related sleep problems can be complex and challenging. Environmental interventions which resynchronise the sleep/wake cycle have been trialled with promising results for people with dementia in institutionalised settings. However, there is less research concerning community-dwelling people with dementia and their family carers. This study involved a five-week feasibility study including timed light therapy, exercise and sleep education. Sleep and physical and mental functioning were measured at the beginning and end of the trial using objective measures, standardised questionnaires and structured participant feedback. Of 15 community-dwelling pairs who participated, nine completed the trial. The case studies presented here reveal that it is feasible for this population to use non-pharmacological interventions, with positive outcomes. However, there are also issues that can mask benefits or prevent compliance. The options for treating dementia are limited. Environmental interventions may help manage dementia-related sleep problems and further trials would be worthwhile to improve compliance and evaluate effectiveness

Associations between social network characteristics, cognitive function, and quality of life among residents in a dementia special care unit: A pilot study
 Katherine M Abbott et al
pp. 1004–1019
This research aimed to ascertain the impact of a pragmatic Cognitive Stimulation Therapy course of 10 sessions on the cognitive function of people living with dementia and whether attending a concomitant carers support group was beneficial to carers. A mixed method quasi-experimental approach was adopted; data were collected pre- and post-intervention. The quantitative arm utilised three validated questionnaires rated by the carers. Qualitative data were collected via semi-structured interviews with carers regarding their perceptions of the impact of Cognitive Stimulation Therapy and the carers support group. Quantitative data analysis found no statistically significant differences within or between groups. The qualitative data demonstrated that carers perceived Cognitive Stimulation Therapy had some benefits for the people living with dementia, especially social benefits. Carers also perceived that attending the carers support group was beneficial for them in terms of gaining a better understanding of dementia, developing coping skills and having peer support. The study was limited in scale and further research with a larger sample, using direct measures of the impact of Cognitive Stimulation Therapy with people living with dementia and supplementary research exploring which characteristic of carers support groups are effective would be worthwhile.

Views from health professionals on accessing rehabilitation for people with dementia following a hip fracture
Stephen T Isbel et al
pp. 1020–1031
The literature reports that rehabilitation for elderly patients with mild-to-moderate dementia who have a hip fracture improves functional outcomes. However, access to rehabilitation may be difficult due to misconceptions about the ability of these patients to engage in and benefit from rehabilitation. Additionally, people who are admitted from residential care may not have the same options for rehabilitation as those admitted from home. This study sought to understand from expert clinicians how and why decisions are made to accept a person with dementia post-fracture for rehabilitation. In this Australian-based qualitative study, 12 health professionals across a state and territory were interviewed. These clinicians were the primary decision makers in accepting or rejecting elderly patients with dementia post-fracture into rehabilitation. Three key themes emerged from the data: criteria for accessing rehabilitation, what works well and challenges to rehabilitation. The participants were unanimous in the view that access to rehabilitation should be based on the ability of the patient to engage in a rehabilitation programme and not assessed solely on cognition. In terms of clinical care, a coherent rehabilitation pathway with integration of geriatric and ortho-geriatric services was reported as ideal. Challenges remain, importantly, the perception of some health care staff that people with dementia have limited capability to benefit from rehabilitation. Rehabilitation for this growing group of patients requires multiple resources, including skilled practitioners, integrated clinical systems and staff education regarding the capabilities of people with dementia. Future research in this area with patients with moderate-to-severe dementia in residential care is warranted.

Self-management-support in dementia care: A mixed methods study among nursing staff
 Renate Verkaik et al
pp. 1032–1044
Self-management in patients and family caregivers confronted with dementia is not self-evident. Self-management skills may be limited because of the progressive cognitive decline of the patient and because family caregivers are often also very aged. Self-management support by nursing staff is therefore of paramount importance.
To gain insight into how nursing staff perceive their self-management support tasks, and how they put them into practice. Research questions are: ‘What are the opinions and experiences of Dutch nursing staff working in home care or residential elderly care regarding self-management support for people with dementia and their family caregivers?' and ‘Do nursing staff feel sufficiently trained and skilled for self-management support?’.
Nursing staff in home care do consider self-management support an important and attractive task in dementia care. Their skills for providing self-management support to patients with dementia and family caregivers need improvement.
Nursing staff need sufficient training to enable the proper provision of self-management support for people with dementia. More attention should also be given to the support of self-management for family caregivers

Measuring positive attitudes toward persons with dementia: A validation of the Allophilia scale
 Jennifer M Kinney et al
pp. 1045–1060
Efforts to combat ageism typically focus on negative attitudes toward members of an out-group. Changing attitudes also requires assessment and enhancement of positive attitudes. This study examined the psychometric properties of Allophilia scale when used to measure college students' positive attitudes toward persons with dementia. Data collected from 465 students were analyzed using confirmatory factor analysis and multigroup analysis by gender to assess the validity and reliability of the Allophilia scale. Results showed that the Allophilia scale is valid both for male and female students. The Allophilia scale is a valid assessment tool for measuring positive attitudes toward persons with dementia. Use of this scale will contribute to our understanding of attitudes toward persons with dementia and has implications for the design of interventions to facilitate positive attitudes toward members of this out-group.

Innovative Practice
Editorial: Innovative Practice
 Jo Moriarty
pp. 1061–1063

The challenges of implementing and evaluating a pilot music and movement intervention for people with dementia: Innovative practice
 Patricia Mc Parland et al
pp. 1064–1068
This paper reports on the challenges associated with implementing and evaluating an innovative pilot music and movement project. The evaluation documents that participants enjoyed the sessions and that they created the opportunity for social engagement although there is little to suggest this is unique to this particular type of intervention. Difficulties included matching the programme to the needs of participants, communicating effectively, and over burdensome paperwork. The paper also comments on the challenges associated with last minute, limited funding opportunities for both the organisation commissioning a project and the team evaluating it. In this case, the evaluation team found that many of the more difficult issues associated with the pilot could have been resolved with more time for planning and preparation.

Care to talk? A framework for appreciative conversations about dementia: Innovative practice
 Sean Page et al
; pp. 1069–1074
When people with dementia are admitted to hospital, both they and their carers and families have crucial roles to play. They should be positioned as the only true experts in the unique individuality of the person and brought into the nursing process as an equal partner in care. ‘Care to Talk’ is a conversational model developed through Appreciative Inquiry to facilitate this way of working. The model, its development and outcomes are discussed.

Evaluation of ‘Dementia Friends’ programme for undergraduate nursing students: Innovative practice
 Gary Mitchell
pp. 1075–1080
The ‘dementia friends’ programme was launched by the Alzheimer’s Society in the UK two years ago with the purpose of educating members of the public about the things they can do which can enhance the lives of people living with dementia. The aim of this project was to deliver a two-hour ‘Dementia Friendly Community Workshop’ written by the Alzheimer’s Society, to an entire cohort of first-year undergraduate nursing students in one Higher Education Institutions in Northern Ireland. Following delivery of the programme, students were asked to complete a short questionnaire on their knowledge and confidence in relation to dementia care before and after the Dementia Friendly Community programme. A total of 322 undergraduate first-year nursing students took part in the Dementia Friendly Community programme. Of these, 304 returned questionnaires; 31.25% of students stated their perceived improvement in dementia knowledge was ‘good’ while 49.01% stated their perceived improvement in dementia knowledge was ‘very good’ and 13.49% stated their perceived improvement in dementia knowledge was ‘excellent’. In relation to confidence in engaging with people with dementia, 31.91% stated ‘good’ improvement, 40.79% stated ‘very good’ improvement and 11.84% stated ‘excellent’ improvement. The Dementia Friendly Community programme was positively reviewed by the undergraduate students as it enhanced knowledge and confidence in relation to care of someone living with dementia.

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