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Support for family carers for an elderly person at home: a systematic literature review
- Authors:
- STOLTZ Peter, UDDEN Giggi, WILLMAN Ania
- Journal article citation:
- Scandinavian Journal of Caring Sciences, 18(2), June 2004, pp.111-119.
- Publisher:
- Blackwell Publishing
Sweden, like other countries, has an ageing population, and support for the carers of older people in their own homes is an important policy issue. Support may take a variety of forms, both formal and informal, and this review aims to identify and synthesise high quality evidence on family carers’ perspectives of their situations and needs. Twenty-six papers (primarily American and of carers of people with Alzheimer’s disease) are included in the review, showing that carers fear social isolation and want to network with their peers, either for social or learning purposes. They also want respite care. However, the evidence is not clear on whether they actually benefit from these forms of support, or how service provision should be attempted.
Well-being, appraisal, and coping in Latina and Caucasian female dementia caregivers: findings from the REACH study
- Authors:
- COON D. W., et al
- Journal article citation:
- Aging and Mental Health, 9(4), July 2004, pp.340-345.
- Publisher:
- Taylor and Francis
While there has been considerable interest in studying ethnically diverse family caregivers, few studies have investigated the influence of dementia caregiving on Latino families. The current study includes participants from two sites of the REACH (Resources for Enhancing Alzheimer's Caregiver Health) project to compare well-being, appraisal, and religiosity by ethnicity, with specific attention to levels of acculturation. Latina (n = 191) and Caucasian female (n = 229) dementia family caregivers from two regions of the United States (Miami, Florida and Northern California) were compared at baseline on demographics, care recipient characteristics, mental and physical health, and psychosocial resources, including appraisal style and religiosity. Latina caregivers reported lower appraisals of stress, greater perceived benefits of caregiving, and greater use of religious coping than Caucasian caregivers. The relationship of these variables to level of acculturation for the Latina caregivers was also explored. Implications of these results for psychosocial interventions with Latino and Caucasian family caregivers are discussed.
Thinking through delusions in Alzheimer’s disease
- Authors:
- SHANKS Michael F., VENNERI Annalena
- Journal article citation:
- British Journal of Psychiatry, 184(3), March 2004, pp.193-194.
- Publisher:
- Cambridge University Press
Delusions are common, disabling and persistent in the course of Alzheimer’s disease and are likely to relate to a range of specific cognitive failures with regional associations as much as to an interaction between neurological and psychosocial factors. It can be suggested that Alzheimer’s disease, far from being a diffuse degenerative disease in the course of which poorly differentiated psychotic symptoms emerge from global neurological causes, offers an opportunity to increase our understanding of higher cognitive functions including normal and abnormal belief formation. The investigation of delusions in this disease, compared with studies of the functional psychoses, has the advantage that a population is studied whose abnormal beliefs appear in a context often relatively free from overlapping psychopathological and treatment effects, perhaps in a form less integral with the individual psyche and against a background of normal cognitive development. Such studies of the breakdown in higher mental functions in the course of Alzheimer’s disease can clarify the fundamental mechanisms involved in delusional thinking and abnormal experience and inform qualitative comparisons with the phenomena seen in the schizophrenias and other delusional disorders. The ‘purer’ culture of individual symptoms in Alzheimer’s disease may, in the end, help provide the basis for a more truly scientific psychopathology.
Family functioning in the caregivers of patients with dementia
- Authors:
- HERU Alison M., RYAN Christine E., IQBAL Asma
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(6), June 2004, pp.533-537.
- Publisher:
- Wiley
Caregiver burden has been extensively studied in the dementia population. The marital relationship has been suggested as a mediational model through which variables influence the caregiver and contribute to the experience of burden or reward. This study examines family functioning, caregiver burden and reward and quality of life in 38 family members caring for a relative with dementia. Caregivers of out-patients with dementia completed self report questionnaires. 63% of caregivers were female with a mean age of 62 years. Patient mean age was 73 years. The average number of caregiving years was 3.1. Caregivers were more likely to be spouses (61%) than children (29%) or other relatives (11%). Despite the fact that caregivers reported that their relatives were moderately disabled, they perceived more reward than burden. Caregivers who reported poor family functioning had higher ratings of strain and burden. Family functioning in these caregivers was poorest in the dimensions of affective responsiveness, problem solving and communication but it was also impaired in roles and affective involvement.
What causes problems in Alzheimer's disease: attributions by caregivers. a qualitative study
- Authors:
- PATON Joni, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(6), June 2004, pp.527-532.
- Publisher:
- Wiley
The aim was to gain insight into caregivers' understanding of the causes of behaviours they find problematic in people with Alzheimer's disease in order to inform the development of educational strategies. A qualitative, semi-structured interview was used. Participants were 205 caregivers for a person with Alzheimer's disease, all of whom were aware of the diagnosis and who had been recruited as part of a larger longitudinal study. Participants were from inner-city and suburban London/semi-rural Essex. The main outcome measures were caregivers' understanding of: the cause of problematic behaviour; the ability of the person with dementia to control this behaviour; the prognosis of the illness. Most carers attribute the cognitive, behavioural and psychological symptoms of dementia to causes other than dementia; many believe that the person with dementia has control over their behaviour and substantial numbers believe the person with dementia will return to normal. This study suggests that providing facts about the illness to caregivers is not enough, as caregivers may not understand that the symptoms they observe are related to the diagnosis. Education by clinicians should focus on the understanding of caregivers and in particular explore the caregivers' attributions of the symptoms which are present in the person for whom they care.
Emotional and behavioural responses to music in people with dementia: an observational study
- Authors:
- SHERRATT, K., THORTON A., HATTON C.
- Journal article citation:
- Aging and Mental Health, 8(3), May 2004, pp.233-241.
- Publisher:
- Taylor and Francis
Using continuous time sampling and direct observation methodology, this study examined the impact of social interaction in music listening on behavioural responses of people with moderate-to-severe dementia (n = 24). Using Kitwood's theory of personhood as a framework, it was hypothesized that levels of well-being and engagement would be greatest during a live music condition compared with recorded and no music conditions and that levels of challenging behaviour would decrease most in the live music conditions compared with the other music conditions. The relationship between severity of cognitive impairment and well-being, engagement and challenging behaviours across conditions was also examined. The findings suggest that live music was significantly more effective in increasing levels of engagement and well-being regardless of level of cognitive impairment. No significant differences across conditions were found for challenging behaviours, but the correlation between these and cognitive impairment revealed mixed results. Clinical implications regarding the use of live music in dementia care settings are highlighted and recommendations for future research of interventions aimed at reducing challenging behaviours are discussed.
Keeping wandering nursing home residents at the table: improving food intake using a behavioral communication intervention
- Authors:
- BEATTIE E. R. A., ALGASE D. L., SONG J.
- Journal article citation:
- Aging and Mental Health, 8(2), March 2004, pp.109-116.
- Publisher:
- Taylor and Francis
The purpose of this multiple case design study (n¼3) with an embedded experiment was to determine the effect of the systematic use of a behavioral nursing intervention on the mealtime behavior of nursing home residents with probable Alzheimer’s disease. It was hypothesized that the systematic behavioural intervention would increase time spent seated during the meal and proportion of food consumed while decreasing the frequency of table-leaving events during mealtime. The intervention was designed to impact the proximal factors of physiological need and social interaction from the Need-Driven Behaviour Model. Results demonstrate that all cases were able to sit at the table longer and eat more food during the intervention, while body weight for all cases remained stable throughout the study. Two of the three cases left the table fewer times during the intervention. There were no statistically significant changes in proportion of fluids consumed in any case.
Clinical evidence: mental health; the international source of the best available evidence for effective mental health care
- Editor:
- GODLEE Fiona
- Publisher:
- BMJ Publishing,|Gaskell
- Publication year:
- 2004
- Pagination:
- 264p.bibliog.
- Place of publication:
- London
This book is designed to make the best available evidence easily accessible to mental health practitioners, general practitioners and students. The content is maintains standards of rigorous quality control and ease of access to relevant evidence. For each of the following conditions the literature has been thoroughly searched, appraised and condensed into concise but comprehensive summaries: Alzheimer's disease, Anorexia nervosa, Attention deficit hyperactivity disorder in children, Bulimia nervosa, Chronic fatigue syndrome, Depression in children and adolescents, Depressive disorders, Generalised anxiety disorder, Obsessive compulsive disorder, Panic disorder, Post-traumatic stress disorder, and Schizophrenia.
Intentions of first-degree relatives of patients with Alzheimer's disease to seek a cognitive status examination
- Authors:
- WERNER Peerla, HEINIK Jermia
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(5), May 2004, pp.479-486.
- Publisher:
- Wiley
The aim of the present study was to examine the factors influencing intentions to seek a cognitive status evaluation among first-degree relatives of persons with Alzheimer's disease. Phone interviews were conducted with 93 first-degree relatives of persons with Alzheimer's disease, recruited from a large memory clinic. Intentions to seek a cognitive status examination were examined by asking participants to rate their willingness to seek a cognitive status examination during the next year and during the next five years. Independent variables included participants' and patients' characteristics, caregiving characteristics, knowledge about AD, worries about memory problems, and perceptions of the benefits and barriers of seeking a cognitive status examination. Overall, first-degree relatives reported only moderate intentions to seek a cognitive status examination. Their willingness to seek an examination was related to the characteristics of the first-degree relative (income and subjective memory), the characteristics of the patients (behavioral problems), the caregiving characteristics (primary caregiver), and to the perceptions of barriers associated with the examination. These findings stress the complexity of the decision-making process confronting first-degree relatives regarding their intentions to seek a cognitive status examination, and suggest the need to provide information to reach an informed decision.
Emotion processing in Alzheimer's disease
- Authors:
- BUCKS R.S., RADFORD S.A.
- Journal article citation:
- Aging and Mental Health, 8(3), May 2004, pp.222-232.
- Publisher:
- Taylor and Francis
To date, there have been few studies of emotion processing in those suffering from Alzheimer's disease, yet this may have an important effect on the quality of life of both sufferers and their families. This paper describes an investigation of the relative changes in cognition and in recognition and identification of non-verbal communicative signals of emotion in those suffering from Alzheimer's disease, and seeks to address the implications for clinical practice. Twelve adults with a diagnosis of 'probable' Alzheimer's disease and 12 matched older adult healthy comparison participants undertook a series of tasks involving face and prosody discrimination. Facial stimuli were presented on cards, and prosodic stimuli on audiotape. Scores were compared with a measure of general cognitive ability. There was a significant difference between the Alzheimer's disease group and healthy older adult group on emotion and cognition tasks respectively. However, the ability to recognize and identify non-verbal affect cues in emotional facial expression and emotional prosody was preserved relative to general cognitive ability in those suffering from Alzheimer's disease. In addition, there were no differences found in the recognition of different emotions (happiness, sadness, anger, fear or neutral). This relative sparing of non-verbal emotional processing skills has implications for provision of assessment and interventions based on the creation of effective forms of communication that are less reliant on cognitive ability.