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Caring for older people with dementia and sight loss
- Author:
- LAWRENCE Vanessa
- Journal article citation:
- Nursing and Residential Care, 13(4), April 2011, pp.186-188.
- Publisher:
- MA Healthcare Ltd.
- Place of publication:
- London
A series of interviews were carried out with 17 older people with sight loss and dementia, 17 family carers and 18 care professionals who worked with them. The study aimed to discover the impact of sight loss and dementia, identify needs and make recommendations for supporting older people across care settings. A summary of the findings and recommendations for practice are presented.
Helping staff to implement psychosocial interventions in care homes: augmenting existing practices and meeting needs for support
- Authors:
- LAWRENCE Vanessa, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(3), 2016, p.284–293.
- Publisher:
- Wiley
Objective: To contribute to an optimised training programme for care staff that supports the implementation of evidence-based psychosocial interventions in long-term care. Methods: Qualitative study that involved focus group discussions with 119 care home staff within 16 care homes in the UK. Part of wider clinical trial aimed at developing and evaluating an effective and practical psychosocial intervention and implementation approach for people with dementia in long-term care. Inductive thematic analysis was used to identify themes and interpret the data. Results: The findings highlighted that successful training and support interventions must acknowledge and respond to ‘whole home’ issues. Three overarching themes emerged as influential: the importance of contextual factors such as staff morale, interpersonal relationships within the home, and experience and perceived value of the proposed intervention. Conclusions: Priority must be given to obtain the commitment of all staff, management and relatives to the training programme and ensure that expectations regarding interaction with residents, participation in activities and the reduction of medication are shared across the care home (Publisher abstract)
Improving quality of life for people with dementia in care homes: making psychosocial interventions work
- Authors:
- LAWRENCE Vanessa, et al
- Journal article citation:
- British Journal of Psychiatry, 201(5), November 2012, pp.344-351.
- Publisher:
- Cambridge University Press
The authors conducted a systematic review and syntheses of 39 qualitative research papers looking at the effectiveness of psychosocial interventions for improving behaviour and mood in people with dementia living in care homes. Overall the meta-synthesis revealed a positive picture in which people with dementia, their family and friends and staff members derived important benefits from psychosocial interventions. In particular they helped them to connect with others, make a meaningful contribution and reminisce. Successful implementation rested on the active engagement of staff and family and the continuing provision of tailored interventions and support to match individual preferences and abilities. This necessitated staff time, and raised issues around priorities and risk, but ultimately helped redefine staff attitudes towards residents and the caregiving role. The authors conclude that the evidence that psychosocial interventions must be anchored in person-centred care is unequivocal.
Dying well with dementia: qualitative examination of end-of-life care
- Authors:
- LAWRENCE Vanessa, et al
- Journal article citation:
- British Journal of Psychiatry, 199(5), November 2011, pp.417-422.
- Publisher:
- Cambridge University Press
There is evidence to suggest that people with dementia and their families often receive poorer quality end of life care compared to those who are cognitively intact. This study aimed to define good end-of-life care for people with dementia and to identify how it can be delivered across care settings in the UK. In-depth interviews were conducted with 27 bereaved family carers and 23 care professionals recruited from the community, care homes, general hospitals and continuing care units. Data were analysed using the constant comparison method. The responses highlighted the challenge and imperative of ‘dementia-proofing’ end-of-life care for people with dementia. This requires using dementia expertise to meet physical care needs, going beyond task-focused care and prioritising planning and communication with families. The authors conclude that the quality of end-of-life care exists on a continuum across care settings. Together, the data reveal key elements of good end-of-life care and that staff education, supervision and specialist input can enable its provision.
Threat to valued elements of life: the experience of dementia across three ethnic groups
- Authors:
- LAWRENCE Vanessa, et al
- Journal article citation:
- Gerontologist, 51(1), February 2011, pp.39-50.
- Publisher:
- Oxford University Press
The authors point to a lack of knowledge regarding the experiences of black and minority ethnic, older people with dementia in the UK. This qualitative research involved in depth interviews with 11 black Caribbean, 9 South Asian and 10 White British participants from four south London boroughs. They were questioned about the following: a vignette of Mr. G., who has moderate dementia; their own conditions; and about dementia, memory problems and Alzheimers disease. The main theme to emerge was that their conditions and support needs interfered with “valued elements of life”. Analysis revealed that each element of their evaluation processes was culturally informed. The authors quote many of the participants’ own words under headings of: understanding the condition; attitudes surrounding support needs and individual’s valued roles; relationships; and activities. The implications for policy and practice are discussed in terms of promoting and reducing threats to valued elements of life. The authors claim that through cognitive appraisal there is potential for professional and family carers to modify beliefs about dementia and promote the roles, relationships and activities that each individual with dementia values. By definition, this will result in taking note of the cultural identity of individuals and help in developing a multicultural approach.
Improving care in care homes: a qualitative evaluation of the Croydon care home support team
- Authors:
- LAWRENCE Vanessa, BANERJEE Sube
- Journal article citation:
- Aging and Mental Health, 14(4), May 2010, pp.416-424.
- Publisher:
- Taylor and Francis
The Croydon care home support team (CHST) was developed in response to reports of patient abuse within long-term care in order to improve standards of care within care homes. The CHST adopts a systemic approach that places an equal emphasis on the social, mental health and nursing needs of residents and aims to address the whole culture of care within the individual homes. This paper describes a qualitative methodology used to assess the perceived impact of the CHST among care home staff. In-depth interviews were conducted with 14 care home managers and 24 members of care home staff across 14 care homes. Grounded theory principles guided the collection and analysis of the data. The results demonstrated improved communication between staff, improved staff development and confidence, and improved quality of care, and point towards the effectiveness of the CHST model. The collaborative approach of the CHST was considered pivotal to its success and presented as an effective method of engaging care home managers and staff. The data demonstrate the potential for specialist multi-disciplinary teams to raise standards of care across long-term care settings. Increased awareness of safeguarding issues, improved staff morale and communication and ongoing opportunities for discussion and problem solving promised to sustain improvements.
Understanding the experiences and needs of people with dementia and sight loss
- Authors:
- LAWRENCE Vanessa, MURRAY Joanna
- Journal article citation:
- Working with Older People, 13(3), September 2009, pp.29-33.
- Publisher:
- Emerald
The authors present the findings of their research into how sight loss and dementia affects the lives of older people and their carers, based on 19 case studies in London and the south east involving interviews with 17 people with sight loss and dementia, 17 family carers and 18 care professionals who worked with them. Analysis of the case studies identified 7 areas of concern: joint sight loss and dementia created a sense of disorientation in many older people; concerns about safety threatened older people's independence; experiencing one form of loss increased the difficulty of accepting the second; visual hallucinations were common and disruptive; older people were highly vulnerable to isolation; family carers faced considerable demands; there was a risk of sight loss being overlooked in dementia care. The authors conclude that it is important that service providers and staff within dementia care settings recognise that sight loss creates needs that require extra time and attention from staff in order to support individuals in a way that promotes rather than undermines their autonomy.
Promoting independent living among people with dementia and sight loss
- Authors:
- LAWRENCE Vanessa, MURRAY Joanna
- Journal article citation:
- Journal of Care Services Management, 3(3), April 2009, pp.261-274.
- Publisher:
- Taylor and Francis
This paper presents findings from the first qualitative research project to explore the experiences and needs of older adults with concurrent sight loss and dementia. The study found that individuals experienced a profound sense of disorientation and were highly vulnerable to isolation. The paper highlights the importance of providing this client group with corrective remedies for sight loss, a ‘user-friendly’ environment, optimal lighting, colour and contrast, assistive technology, clear verbal instructions, one-to-one contact and opportunities for interaction and activity. Different services were successful in providing aspects of this care. Mental health professionals tended to regard vision loss as a secondary concern. It is essential that service providers and care professionals acknowledge and respond to the complex needs of this population.
The experiences and needs of people with dementia and serious visual impairment: a qualitative study
- Authors:
- LAWRENCE Vanessa, et al
- Publisher:
- Thomas Pocklington Trust
- Publication year:
- 2008
- Pagination:
- 7p.
- Place of publication:
- London
This publication presents findings from a series of case studies involving interviews with 17 older people with sight loss and dementia, 17 family carers and 18 care professionals who worked with them. The research found: the two conditions together led to a profound sense of disorientation and sense of isolation; sight loss professionals felt they were not equipped to work with people who had mental health needs, while dementia professionals felt the needs created by sight loss risked being overlooked in mental health services; increased co-ordination between mental health and sensory impairment teams would help in identifying individuals’ abilities and needs for support.
The experiences and needs of people with dementia and serious visual impairment: a qualitative study
- Authors:
- LAWRENCE Vanessa, et al
- Publisher:
- Thomas Pocklington Trust
- Publication year:
- 2008
- Pagination:
- 27p.
- Place of publication:
- London
Visual impairment is one of the most common conditions in later life: common causes are aged related macular degeneration, diabetic retinopathy and glaucoma. Despite the high prevalence of sight loss in older adults, there have been few studies to examine its effects on quality of life, its psychological effect, or its effect on people’s ability to carry out activities of daily living. People with dementia are less able to express their needs and are therefore more likely to have uncorrected visual deficits. Poor vision in people with dementia leads to accelerated loss of independence and to an increased risk of psychotic symptoms such as visual hallucinations. The combined effects of dementia and serious sight loss can severely restrict independence with a consequent increase in reliance upon family carers and a higher risk of institutionalisation. It has been estimated that at least 2.5 per cent of people aged over 75 have both dementia and serious visual impairment. By finding out more about the needs and experiences of this group of people, the research team will be able to make recommendations for improving access to appropriate support for both individuals and their carers.