WORLD HEALTH ORGANIZATION. Regional Office for Europe
Publisher:
World Health Organization. Regional Office for Europe
Publication year:
2022
Pagination:
22
Place of publication:
Copenhagen
The pandemic of coronavirus disease 2019 has revealed and accentuated important gaps in the provision of appropriate, community-based, long-term care services for a rapidly growing number of people experiencing decline in functional ability, across the WHO European Region. As countries work to rebuild and strengthen health and long-term care systems, it is essential to support broad dialogue, a common vision for change and focused interventions to bridge existing divides. This policy brief proposes a conceptual framework that maps long-term care actions within the health and social policy landscape and highlights the need and potential for deeper integration and coordination across systems.
(Edited publisher abstract)
The pandemic of coronavirus disease 2019 has revealed and accentuated important gaps in the provision of appropriate, community-based, long-term care services for a rapidly growing number of people experiencing decline in functional ability, across the WHO European Region. As countries work to rebuild and strengthen health and long-term care systems, it is essential to support broad dialogue, a common vision for change and focused interventions to bridge existing divides. This policy brief proposes a conceptual framework that maps long-term care actions within the health and social policy landscape and highlights the need and potential for deeper integration and coordination across systems.
(Edited publisher abstract)
Subject terms:
long term care, policy, ageing, service provision, community care, social policy, models, older people, dementia;
Dementia: the International Journal of Social Research and Practice, 21(1), 2022, pp.181-195.
Publisher:
Sage
Background: Hypersexuality is one of the behavioural and psychological symptoms of dementia. This symptom can lead to poor quality of life for the person who lives with dementia, as well as for his or her caregiver, who might be exposed to sexual assault. Aim: This study aimed to highlight the experience of an older woman living and coping with a spouse who exhibits dementia-related...
(Edited publisher abstract)
Background: Hypersexuality is one of the behavioural and psychological symptoms of dementia. This symptom can lead to poor quality of life for the person who lives with dementia, as well as for his or her caregiver, who might be exposed to sexual assault. Aim: This study aimed to highlight the experience of an older woman living and coping with a spouse who exhibits dementia-related hypersexuality. Method: A narrative case-study of a single case was designed, composed of four semi-structured interviews conducted over a 10-month period. The data were analyzed through thematic, structural, and performance analysis. Findings: Four phases were revealed, depicting the experience of being a partner and caregiver of a spouse with dementia-related hypersexuality: a) “I need help”: A distress call; b) “It depends how long I agree to go on with it”: Living with the ambiguous reality of dementia-related hypersexual behavior within an ongoing intimate relationship; c) “It’s as if I’m hugging someone who’s no longer alive”: The transition from the previous couplehood identity to a new couplehood identity; and d) “I am just taking care of him as if he is a child”: A compassionate couplehood identity construction. Conclusions: Living with a partner with dementia-related hypersexuality is a distressing experience for the caregiver-spouse. Yet, positive memories from a long intimate relationship can lead to the creation of a compassionate identity, which supports the caregiving process, and creates a sense of acceptance and meaning making. This, in turn, enables a positive aging experience. These finding have some practical implications for supporting and intervening in such cases.
(Edited publisher abstract)
Subject terms:
case studies, dementia, sexual behaviour, sexuality, behaviour problems, partner abuse, partners, sexual abuse, ageing;
...considering loneliness, functional dependency, stroke outcomes, prescribing and acute deterioration. Health services research in care homes is represented by two studies that demonstrate realist evaluation as a way to make sense of service innovations. Papers are included that consider: non-pharmacological strategies for residents with dementia, end-of-life care, sexuality and intimacy and the care-home
(Edited publisher abstract)
Care homes enable people with advanced physical and cognitive impairment to live well with 24-h support from staff. They are a feature of care systems in most countries. They have proved pivotal to the coronavirus disease 2019 (COVID-19) response. We searched Age and Ageing for care-home articles published since 2015. From these we collated 42 into the Age and Ageing care-home collection. This collection draws together important papers that show how Age and Ageing is helping to shape and grow care-home research. The collection outlines the technical issues that researchers face by grouping together important feasibility trials conducted in the sector. It looks at the challenges of measuring quality of life and working with routine data in care homes. It brings together observational studies considering loneliness, functional dependency, stroke outcomes, prescribing and acute deterioration. Health services research in care homes is represented by two studies that demonstrate realist evaluation as a way to make sense of service innovations. Papers are included that consider: non-pharmacological strategies for residents with dementia, end-of-life care, sexuality and intimacy and the care-home workforce. Given the importance of the COVID-19 pandemic in care homes, all of the care home COVID-19 papers published in Age and Ageing to date are included. Finally, a group of papers that present innovative approaches to research in care homes, each of which give voice to residents and/or staff, are collated and presented as a way of moving towards a more resident and care home centred research agenda.
(Edited publisher abstract)
Subject terms:
ageing, care homes, evidence, evidence-based practice, research, research methods, older people;
This report focuses on two of the ways in which ageing can affect people’s lives that are closely linked with the need for support from the health and social care systems: limitations on activities of daily living (ADLs), such as showering and eating, and diagnosed long-term conditions, such as dementia, diabetes and coronary heart disease. The report focuses on the population aged 65 and older
(Edited publisher abstract)
This report focuses on two of the ways in which ageing can affect people’s lives that are closely linked with the need for support from the health and social care systems: limitations on activities of daily living (ADLs), such as showering and eating, and diagnosed long-term conditions, such as dementia, diabetes and coronary heart disease. The report focuses on the population aged 65 and older, as this is when measures of this type begin to rise most steeply with age. England’s population is ageing. In the next 25 years, the number of people older than 85 will double to 2.6 million. An ageing population might lead to the presumption that there will be an increased need for health and social care services. But the reality is more complicated. The proportion of older people who need social care support at any given age has fallen. This means a higher proportion of older people are now able to live independent lives. Although demand is still increasing overall, this fall in the proportion of older people needing social care has counterbalanced some of the increase driven by our ageing population. However, the proportion of older people aged above 75 with a long-term condition has risen, and their needs are likely to become more complex, leading to increased demand for NHS services. These findings suggest that older people are living with an increased number of long-term conditions, typically managed through the NHS, without on average needing more support with social care. But those who do have social care needs may also be managing an increased number of long-term conditions. As government seeks to reform adult social care, policymakers need to be aware of the complexities involved in predicting future demand – rather than assuming social care demand will increase in correlation with increased prevalence of long-term health conditions.
(Edited publisher abstract)
Subject terms:
older people, ageing, long term conditions, service uptake, activities of daily living, health care, adult social care;
Journal of Long-Term Care, January 2021, pp.24-32. Online only
Publisher:
King's College London
Place of publication:
London
Background: Aged residential care (ARC) is a significant cost of dementia care. However, little is known about the predictors of ARC placement in New Zealand (NZ), which is important for service planning and funding. The aim of this study was to investigate the sociodemographic and clinical characteristics that predict future ARC placement among people who received a new diagnosis of dementia...
(Edited publisher abstract)
Background: Aged residential care (ARC) is a significant cost of dementia care. However, little is known about the predictors of ARC placement in New Zealand (NZ), which is important for service planning and funding. The aim of this study was to investigate the sociodemographic and clinical characteristics that predict future ARC placement among people who received a new diagnosis of dementia at a NZ memory service. Methods: Routinely collected baseline sociodemographic and clinical data in a memory service from 14/06/13 and 14/12/19 were linked with administrative LTC admission data up to 24/1/2020. Survival analysis was carried out using multivariate Cox regression models to determine significant risk factors and their association with ARC placement. Results: A total of 657 NZ European, Māori and Pacific Islander patients were included in the analyses. There were significant differences by ethnicity including age, living situation, comorbidity and ARC placement. Adjusted analyses showed that risk of ARC placement was increased by older age (HR 1.02 per year, 95%CI:1.00–1.05), moderate dementia (HR 1.45, 95%CI:1.05–1.99), severe dementia (HR 2.25, 95%CI:1.33–3.81), and antipsychotics (HR 1.55, 95%CI:1.04–2.32); while risk was reduced in Māori (HR 0.35, 95%CI:0.18–0.68) and Pacific Islanders (HR 0.32, 95%CI:0.20–0.51). Conclusions: Despite having more severe dementia and higher comorbidity, Māori and Pacific Islanders had reduced risks of ARC placement. There is an urgent need to better understand dementia care issues and to ensure culturally safe and responsive dementia services are accessible by Māori and Pacific Islanders living in the community.
(Edited publisher abstract)
Subject terms:
dementia, risk, residential care, ageing, placement, planning, multicultural approach;
British Journal of Learning Disabilities, 49(3), 2021, pp.365-372.
Publisher:
Wiley
...1 Background: For people with intellectual disabilities and dementia, transitions are likely to become increasingly common as they age. While transitions experienced by people with intellectual disabilities in young adulthood are frequently studied, less is known about transitions in older adults, including residential, vocational and leisure changes. This article aims to explore the experiences
(Edited publisher abstract)
...1 Background: For people with intellectual disabilities and dementia, transitions are likely to become increasingly common as they age. While transitions experienced by people with intellectual disabilities in young adulthood are frequently studied, less is known about transitions in older adults, including residential, vocational and leisure changes. This article aims to explore the experiences of transition from the perspectives of people with intellectual disabilities and dementia, including the impact on their daily lives. 2 Methodology: Three women with intellectual disabilities and dementia living in residential settings participated in participant observations and informal interviews across a variety of environments and activities. Field notes and interview transcripts underwent a thematic analysis focusing on transitions. 3 Findings: Participants experienced the impact of transitions in their residential placements, day programming, leisure activities and relationships. Themes related to their experiences of transitions included making sense of transitions, utilising peer care networks for support and tackling the looming threat of loss and transition. 4 Conclusions: Peer care networks and friendships are crucial in supporting people during and after transitions. Receiving effective supports to maintain relationships, roles and activities, even in seemingly minor ways, is an important right for people with intellectual disabilities and dementia, particularly as care needs increase.
(Edited publisher abstract)
Subject terms:
learning disabilities, dementia, service transitions, ageing, group homes, residential care;
Disability and Rehabilitation: Assistive Technology, 16(7), 2021, pp.758-768.
Publisher:
Taylor and Francis
Place of publication:
London
Purpose: The aim of this paper is to identify structural problems and challenges for the delivery of digital technologies for ageing in place to elderly with dementia. Methods: To that end, I conducted a case study in a Swedish municipality. Results: The results showed that elderly with dementia are not exploiting their full potential of receiving help in the form of technology, since the four...
(Edited publisher abstract)
Purpose: The aim of this paper is to identify structural problems and challenges for the delivery of digital technologies for ageing in place to elderly with dementia. Methods: To that end, I conducted a case study in a Swedish municipality. Results: The results showed that elderly with dementia are not exploiting their full potential of receiving help in the form of technology, since the four conditions of the Consumer Direction (Control and Direct services – Variety of digital technologies for ageing in place options – Information and Support – Participation in systems design) were met to a very low degree. Conclusions: I propose that the municipality in question creates a proper knowledge-sharing platform so that occupational therapists are well informed about digital technologies for ageing in place, to allow them to provide accurate information and support to elderly with dementia, resulting in a possible increase in use of technology and subsequently support the empowerment goal of Consumer Direction. I also believe, according to the findings of this study, that the module of Information and Support should be treated as the most important condition for achieving increased Consumer Direction.
(Edited publisher abstract)
Subject terms:
case studies, digital technology, dementia, older people, ageing, place-based approach;
...functioning of older adults, as well as those of supportive web platforms on behavioral and psychological symptoms of dementia and caregiver self-efficacy. The effects of these solutions on depression in both target groups were inconclusive. The methodological quality of the studies was moderate to good. However, some important limitations were observed. Discussion and Implications: The review identified
(Edited publisher abstract)
Background and Objectives: e-Health solutions are an innovative approach to support aging with cognitive impairment. Because technology is developing at a fast pace, the aim of this review was to present an overview of the research regarding the effectiveness of these solutions. Moreover, the availability of these solutions was examined. Research Design and Methods: Systematic searches were conducted in 7 databases. Full texts of potentially relevant references were assessed by 2 reviewers, and discrepancies were solved through discussion. Data on study characteristics, technology type, application domain, availability, outcomes, and effects were extracted. A categorization exercise and narrative synthesis were conducted. Results: In total, 72 studies describing 70 e-Health solutions were identified. The majority of solutions comprised cognitive training for older adults, followed by educational and supportive web platforms for caregivers. Outcomes included mainly measures of cognition, psychosocial functioning, caregiving processes, caregiver–care receiver relationship, and activities of daily living. Positive effects of cognitive training technologies were observed on cognitive functioning of older adults, as well as those of supportive web platforms on behavioral and psychological symptoms of dementia and caregiver self-efficacy. The effects of these solutions on depression in both target groups were inconclusive. The methodological quality of the studies was moderate to good. However, some important limitations were observed. Discussion and Implications: The review identified cognitive training solutions and supportive web platforms as the most effective on a limited number of outcomes. Although other solutions seem promising, further research has to overcome methodological issues. Furthermore, solutions for leisure and reminiscence and outcomes specifically related to independent living deserve more attention.
(Edited publisher abstract)
Subject terms:
systematic reviews, ageing, cognitive impairment, telecare, assistive technology, evaluation, digital technology, outcomes, dementia, activities of daily living, innovation;
Journal of Aging and Social Policy, early cite October 2021, pp.1-21.
Publisher:
Routledge
Place of publication:
Philadelphia, USA
Communities play an important role in supporting people living with dementia. The aim of this study was to explore what could be changed in the local community to enable those with dementia to live well. People with dementia and carers taking part in the IDEAL programme responded to open-ended questions. Responses from 1,172 people with dementia and 702 caregivers were analyzed using thematic...
(Edited publisher abstract)
Communities play an important role in supporting people living with dementia. The aim of this study was to explore what could be changed in the local community to enable those with dementia to live well. People with dementia and carers taking part in the IDEAL programme responded to open-ended questions. Responses from 1,172 people with dementia and 702 caregivers were analyzed using thematic analysis. Four themes were identified: raising awareness, improving access to support services, providing social events and activities, and supporting people to engage in the community. These highlight the role of individuals, resources and the environment in supporting those with dementia. Longer-term investment in services is needed to underpin dementia-inclusive communities.
(Edited publisher abstract)
Subject terms:
user views, dementia, carer views, carers, communities, qualitative research, ageing, community care, service provision, access to services, participation;
Dementia: the International Journal of Social Research and Practice, 20(7), 2021, pp.2462-2477.
Publisher:
Sage
The Visit, an immersive participatory artwork (viewed on a screen or virtual reality headset), was produced as part of a research programme investigating the subjective experience of dementia and the relational dynamic between people with dementia and others. It invites viewers to engage with a digital human character, ‘Viv’, as she shares her experiences of living with dementia. The experiences...
(Edited publisher abstract)
The Visit, an immersive participatory artwork (viewed on a screen or virtual reality headset), was produced as part of a research programme investigating the subjective experience of dementia and the relational dynamic between people with dementia and others. It invites viewers to engage with a digital human character, ‘Viv’, as she shares her experiences of living with dementia. The experiences that Viv recounts are based on verbatim accounts from in-depth interviews with four women living with dementia. The artwork was designed with the combined aim of generating insights into the lived experience of dementia and establishing conditions under which viewers might cultivate empathy for the character portrayed. Viewers engaging with Viv were invited to complete pre- and post-engagement measures of state empathy alongside an assessment of emotional distance. State empathy was significantly greater after engaging with The Visit, and correspondingly, there was a significant decrease in emotional distance (aversion), suggesting that the aims were met.
(Edited publisher abstract)
Subject terms:
arts, dementia, ageing, empathy, stigma, user views, emotions;