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Symptoms of psychological distress among older adults in Canadian long-term care centres
- Authors:
- VOYER P., et al
- Journal article citation:
- Aging and Mental Health, 9(6), November 2005, pp.542-554.
- Publisher:
- Taylor and Francis
Psychological distress can lead to negative consequences affecting the quality of life of older adults living in long-term care centres. This study aimed to determine the prevalence of symptoms of psychological distress and their associated factors among these residents. A cross-sectional descriptive study was conducted among 1999 long-term care residents aged 65 and over. Nine hundred and eleven persons (45.6%) displayed at least one symptom of psychological distress either at one time or more in the week preceding data collection, and 22.4% were identified as psychologically distressed. Multivariate analysis indicated that psychological distress was associated with disruptive behaviours and benzodiazepine use among women residents, and with insomnia in men residents. The authors conclude that when clinicians screen for mental health disorders, they should take into consideration that symptoms of insomnia or disruptive behaviours may mask psychological distress.
Minimising the use of restraint in care homes for older people: creative approaches
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2010
- Place of publication:
- London
Exploring the case of an unsettled new care home resident, this video shows how finding out more about a person’s life story provides clues to new approaches to care. There is an interview with the care home manager who describes what happened in this particular case and how, by providing relevant activities for the resident, it was possible to take him off antipsychotic drug treatment. The National Director of the National Association of Providers of Activities for Older People (NAPA) also encourages care home managers to support their staff in examining routine care practices. Staff can be empowered to look at what is going on and to make creative changes to the care they provide. Other interviews include the Director of Dementia Care for BUPA and the new Clinical Director for Older People.
The East Lancashire Clinic Model: supporting care homes to understand reactive behaviours (Innovative Practice)
- Authors:
- SMITH Michael, SAYER Kelly
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 20(2), 2021, pp.807-813.
- Publisher:
- Sage
The East Lancashire Clinic model is a consultancy-based approach to supporting care home staff to assess and respond to reactive behaviours of people with dementia and reduce the need to refer into secondary mental health services. The clinics are person centred and solution focused, aiming to promote recognition of unmet needs and early interventions implemented by staff. The pilot was able to resolve most cases and reduce referral rates into secondary care services. Through working collaboratively, it empowers staff to improve the care of all their residents, improves relationship with secondary care services and has potential to offer efficiency savings. (Edited publisher abstract)
Implementing e-learning and e-tools for care home staff supporting residents with dementia and challenging behaviour: a process evaluation of the ResCare study using normalisation process theory
- Authors:
- KEENAN Julia, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 19(5), 2020, pp.1604-1620.
- Publisher:
- Sage
Dementia-related symptoms, sometimes termed challenging or distressing behaviour, can give rise to significant distress in care homes. Individualised formulation-led interventions show promise in reducing these behaviours. ResCare, a cluster randomised controlled trial in England, tested an online individualised intervention, comprising e-learning and decision support e-tools, designed to enable staff to better support residents with such symptoms. Normalisation process theory was used to understand the implementation processes. The authors analysed contextual process data for all 27 ‘intervention’ care homes and identified three implementation mechanisms. These were examined for four illustrative case study homes. Seven qualitative interviews with care home staff and one interview with two research therapists informed this understanding. The main barrier to implementation was difficulty in conveying a sustained understanding of the value of individually tailored interventions. Emphasis was placed on training rather than practice change. Implementation seemed easier in smaller homes and in those with flexible managerial styles where transfer of knowledge and skill might have been easier to achieve. Take up of e-learning and e-tools proved hard. There may be a need to continually promote ‘buy-in’ of the potential benefits of individualised formulation-led interventions, and this would have to be congruent with other priorities. Interventions within care homes need to consider organisational readiness, capacity for innovation and ongoing appraisal and adjustment to maintain changes in practice. (Edited publisher abstract)
The behaviours that dementia care home staff in South Africa find challenging: an exploratory study
- Authors:
- VAN WYK Adele, MANTHORPE Jill, CLARK Charlotte
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 16(7), 2017, p.865–877.
- Publisher:
- Sage
Background: Behavioural and psychological symptoms of dementia are often the reasons for moving to a care home. Care staff, often with limited dementia training, may have to support residents with distressed behaviour on a daily basis. Evidence about the support of residents with distressed or challenging behaviour in the South African context is lacking. This exploratory study aimed to gain an understanding of what care home staff perceived to be distressed behaviour, their coping strategies and how they learned to work with residents with behavioural symptoms of dementia. Methods: An exploratory study was conducted among 17 participants working in four care homes in the Western Cape province of South Africa in 2014. Semi-structured interviews were audio-recorded. Data were analysed thematically. Findings: Findings reflected the literature with regard to examples of behavioural symptoms of people with dementia that staff find challenging to manage. Overall, the majority of staff reported holding positive feelings about working with people with dementia. All preferred interpersonal approaches to manage distressed behaviour above medication although a small minority noted the use of medication in some cases. Dementia training was considered by most participants as an unmet need. Conclusion: This exploratory study identified care home workers’ desires for training about dementia and their preferences for interpersonal as opposed to pharmacological approaches to managing residents’ distressed behaviour. The legacy of race and cultural perspectives in South Africa appears to still influence care practice and provision. Staff commitment, their interest in advancing their practice and their aspirations to offer more person-centred care were evident. Dementia training was identified as potentially helpful to care home staff who manage residents’ distressed behaviour. Training should be developed in South Africa to promote good practice. (Edited publisher abstract)
Effect of music care on depression and behavioral problems in elderly people with dementia in Taiwan: a quasi-experimental, longitudinal study
- Authors:
- WANG Su-Chin, YU Ching-Len, CHANG Su-Hsien
- Journal article citation:
- Aging and Mental Health, 21(2), 2017, pp.156-162.
- Publisher:
- Taylor and Francis
Objectives: The purpose was to examine the effectiveness of music care on cognitive function, depression, and behavioural problems among elderly people with dementia in long-term care facilities in Taiwan. Methods: The study had a quasi-experimental, longitudinal research design and used two groups of subjects. Subjects were not randomly assigned to experimental group (n = 90) or comparison group (n = 56). Based on Bandura's social cognition theory, subjects in the experimental group received Kagayashiki music care (KMC) twice per week for 24 weeks. Subjects in the comparison group were provided with activities as usual. Results: Results found, using the control score of the Clifton Assessment Procedures for the Elderly Behavior Rating Scale (baseline) and time of attending KMC activities as a covariate, the two groups of subjects had statistically significant differences in the mini-mental state examination (MMSE). Results also showed that, using the control score of the Cornell Scale for Depression in Dementia (baseline) and MMSE (baseline) as a covariate, the two groups of subjects had statistically significant differences in the Clifton Assessment Procedures for the Elderly Behavior Rating Scale. Conclusion: These findings provide information for staff caregivers in long-term care facilities to develop a non-invasive care model for elderly people with dementia to deal with depression, anxiety, and behavioural problems. (Edited publisher abstract)
The social positioning of older people living with Alzheimer’s disease who scream in long-term care homes
- Authors:
- BOURBONNAIS Anne, DUCHARME Francine
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 14(6), 2015, pp.751-768.
- Publisher:
- Sage
This article describes the social positioning of older people living with Alzheimer’s disease who scream in a long-term care home. Few studies have focused on the social positions taken by older people, their family and formal caregivers during interaction and their effects on screams. A secondary data analysis was conducted using Harré and Van Langenhove’s positioning theory. The results show that older people are capable of positioning and repositioning themselves in relational patterns. Family and formal caregivers position older people who scream according to their beliefs about their lived experience. They also react emotionally to older people and try to influence their behaviours. Understanding the social positioning of older people with Alzheimer’s disease brought out their capacities and their caregivers’ concerns for their well-being. Interventions should focus on these strengths and on promoting healthy relations in the triads to enhance quality of care in long-term care homes. (Publisher abstract)
Moving and handling: support for residents with dementia
- Author:
- STURMAN-FLOYD Melanie
- Journal article citation:
- Nursing and Residential Care, 15(5), 2013, pp.276-280.
- Publisher:
- MA Healthcare Ltd.
- Place of publication:
- London
Moving and supporting people with memory problems and dementia-related illnesses can be challenging. This article offers guidance on how staff can support people with dementia to move about the home. It looks at how dementia can affect mobility, provides advice on managing violent or aggressive behaviour, understanding restraint, and safe interventions for managing physically challenging behaviour. Finally the article provides a check list of things to consider when designing dementia-friendly establishments. (Original abstract)
Reimagining care
- Authors:
- KARASIK Rona J., BERRY Judy
- Journal article citation:
- Journal of Dementia Care, 21(3), 2013, pp.28-31.
- Publisher:
- Hawker
The Lakeview Ranch care home in the United States is investing heavily in upfront costs to help better support for people with dementia before problems develop. Their model of dementia care begins from the premise that challenging behaviours stem from the unmet needs that a person with dementia is trying to communicate. Key elements of the model of care include: a high staff ratio, extensive staff support and training to reduce turnover, ongoing staff mentoring in the models care philosophy, medication reviews, a nature based setting which includes animal therapy and a focus on residents' emotional and spiritual needs. Two studies have been conducted to evaluate the models effectiveness, one looked at levels of medication and hospitalisation and the other family satisfaction with care. Both evaluations provided positive results. Although there were mixed satisfaction ratings regarding the cost of care. (Original abstract)
Exploring 'unmet needs' in dementia care
- Authors:
- JACKMAN Louisa J., YOUNG Julie
- Journal article citation:
- Journal of Dementia Care, 21(3), 2013, pp.32-34.
- Publisher:
- Hawker
The authors share how they have been exploring the problem of 'unmet need' with care home staff, with a view to responding better to behaviour that is challenging. The authors looks at what is meant by 'need', how Maslow's hiearchy of needs can be used to help explain need to care staff, and present an exercise that helps staff put themselves in the shoes of the person with dementia to help identify unmet need. A case study of one care home resident is used to show the link between needs and intervention. (Original abstract)