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Food and nutrition for people with dementia
- Author:
- UNIVERSITY OF STIRLING. Dementia Services Development Centre
- Publisher:
- University of Stirling. Dementia Services Development Centre
- Publication year:
- 2009
- Pagination:
- 36p.
- Place of publication:
- Stirling
This guide for care workers in the UK was designed by the Dementia Services Development Centre at Stirling University to raise awareness of the eating and drinking difficulties faced by people with dementia. It details problems likely to occur on a daily basis and practical ways to deal with them. Chapter focus on: the importance of individual care and getting to know personal likes and dislikes; the emotional, behavioural and physical changes associated with dementia and the impact that has on a person’s 'normal' intake of food and drink; practical solutions such as making meal and snack times mutually enjoyable to both service user and care worker to techniques designed to maintain calmness, flexibility and dignity in those with dementia; and ways to achieve a healthier diet with reference to fluid balance, finger food, and special diets and supplements. The guide includes two appendices listing important nutrients for those with dementia and advice on what to do if someone chokes. It concludes with a quiz of exercises and multiple choice questions, and discussion points to help check the reader’s level of understanding, with a guide to further reading and contacts points.
Psychological well-being and social support among elders employed as lay helpers
- Author:
- GAMMONLEY Denise
- Journal article citation:
- Journal of Gerontological Social Work, 52(1), January 2009, pp.64-80.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This study was conducted with 17 older people serving as paid, part-time lay helpers in the rural Carolina Companions mental health demonstration project. They provide social support and companionship to 21 older people with severe and persistent mental illnesses, and encourage adherence to their treatment programmes. The study looks at the impact of this role on the helpers’ psychological well-being, and their perceptions of the social support they offer. The findings showed that the burden of the role, especially excessive demands from clients, meant an initial reduction in well-being through loss of autonomy but that this was reversed after about six months. Most helpers maintained their role over the twelve month study period and reported personal benefits including a trend towards believing that they were providing more social support than when they started.
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.
Raymond’s money
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2009
- Place of publication:
- London
Actors have been used in this short film. The film portrays Raymond, a man in his 80s and recently diagnosed with dementia, and Wendy his paid care worker. The setting is Raymond’s flat. Wendy visits daily to provide Raymond with practical support to manage at home. The context of the drama is whether Raymond has capacity to make a decision about spending 50 pounds on lottery tickets. Despite Wendy’s efforts to engage him in conversation, Raymond remains largely silent until she goes to leave. He then becomes animated about the lottery and asks her to buy 50 pounds worth of ‘lucky dip’ tickets. Initially Wendy’s response lacks respect for Raymond’s request. After further discussion, Wendy decides that Raymond has capacity to make what others might think an ‘unwise decision’.While supporting Raymond to make his own independent decision, Wendy records the decision to comply both with the MCA and good record-keeping practice. The final scenes show Raymond enjoying himself as he checks his tickets against the results. This film has now been reviewed and is available under the new title: 'Mental Capacity Act: respecting the right to make 'unwise' decisions.' (Edited publisher abstract)
Facilitating transition from hospital stay to nursing home admission: a hospital-based long-term care ombudsman program
- Authors:
- COX Carolyn, et al
- Journal article citation:
- Journal of Gerontological Social Work, 52(8), November 2009, pp.849-858.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The Older Americans Act requires all US states to establish Long-Term Care Ombudsman Programs in nursing homes and personal care homes to resolve complaints of residents in nursing home or residential care facilities, but does not specify that hospitals that have special beds to provide skilled nursing care need such programmes, although many of these hospital patients subsequently enter a nursing or personal care home. This article describes how a medical centre in Missouri established a hospital-based Long-Term Care Ombudsman Program to address the need for patient advocacy in its skilled nursing facility, and looks at specific actions social workers can take to facilitate the establishment of such a programme in a hospital-based long-term care unit.
The good news and the bad news for frail older people
- Author:
- DWYER Sandra
- Journal article citation:
- Practice: Social Work in Action, 21(4), December 2009, pp.273-289.
- Publisher:
- Taylor and Francis
This paper is focused on the quality of care afforded to frail older people who are unable to live independently of help from statutory services. Positive developments are looked at and ongoing concerns outlined. There are many reasons to be concerned about the overall standards of work and services for older people and some of these ongoing concerns are described. Examples are the large number of people who enter care homes temporarily and end up staying permanently, the little change of entering a council-staffed home, the lack of protection of privately funded permanent residents, and poor training of staff. The personalisation of care is discussed, and the concern raised that for some frail older people the personalisation process could entail a denial of their situation, a neglect of emotional and psychological factors and place more responsibility on carers. However, the paper does argue that a welcome, much-need shift is taking place, whereby the care of older people is in the spotlight and positive changes are afoot. Various causes for optimism include fewer care home admissions, the protection afforded by the Mental Capacity Act 2005, and the welcome focus on dementia.
Music as a therapeutic medium for engagement: training to support the well-being of caregivers as well as their cared-for patients
- Author:
- BURROWS Trish Vella
- Journal article citation:
- Working with Older People, 13(3), September 2009, pp.25-28.
- Publisher:
- Emerald
Many care staff working with people with dementia think that regular musical interactions are likely to have positive effects on the physical and emotional well-being of their clients. This article reports on the Music as a Therapeutic Medium for Engagement (MTME) learning programme designed to provide a practical platform for staff to recognise musical skills that they may be unaware of and to develop these skills, using the example of 4 MTME programmes funded by Kent and Medway Life Long Learning Network and Kent County Council Adult Social Services between April 2008 and May 2009. Feedback from programme participants showed the perceived value both in terms of professional development and personal confidence building.
Rhetoric into reality: the journey towards becoming person-centred
- Authors:
- WYLLIE Sheena, GAINS Val
- Journal article citation:
- Working with Older People, 13(3), September 2009, pp.38-41.
- Publisher:
- Emerald
This article describes the work and company philosophy of Barchester Healthcare, a company with a portfolio of care homes across the United Kingdom, Ireland and the United States, and in particular the Memory Lane Communities and programmes, created and developed to provide support for people experiencing dementia. It uses a case study to demonstrate the company's approach, which includes adapting the environment for the person experiencing a dementia, recognising and emphasising the importance of the individual's past life, enabling staff to understand how to communicate in a meaningful way, staff focusing on people's well-being and understanding that behaviours need to be interpreted as feelings, homes that provide comfort and a sense of belonging for individuals, staff understanding and accepting each person's reality, supporting people in ways that ensure people with dementia feel safe and secure, and ensuring that people do not feel trapped and are still in control.
Predictors of entering 24-h care for people with Alzheimer's disease: results from the LASER-AD study
- Authors:
- HABERMANN Stephanie;, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(11), November 2009, pp.1291-1298.
- Publisher:
- Wiley
This study, part of a longitudinal cohort study of 224 participants with Alzheimer's disease (AD), the London and South East Region (LASER) AD study, considered a comprehensive range of carer and care recipient characteristics derived from a systematic review. The researchers interviewed people with AD and their carers, and determined whether they entered 24 hour care in the subsequent 4.5 years. The results showed that the main independent predictors of shorter time to enter 24 hour care were the patient being more cognitively or functionally impaired and having a paid versus a family carer, the carer being less educated and spending fewer hours caring. Patients who are cared for by their partner stayed longest at home, followed by those cared for by other family or friends, while those whose carer was paid entered 24 hour care earliest. The key points were that people with dementia who were less impaired and had a family carer who spent more time caring for them had a lower risk of entering a care home, that in view of the fact that having a family carer who spent more time caring delayed entry to 24 hour care future research should investigate how to enable carers to provide this, and that other interventions to improve patients’ impairment may not only have benefits for their health but also allow them to remain longer at home
Relational practice as the key to ensuring quality care for frail older people: discharge planning as a case example
- Authors:
- WILLIAMS Sion, NOLAN Mike, KEADY John
- Journal article citation:
- Quality in Ageing, 10(3), September 2009, pp.45-55.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
Discharging frail older people from acute hospital settings has been an issue of concern for over 40 years and recent studies suggest that enduring problems remain. This paper explores the experiences of discharge from three different units: an acute surgical ward, an acute medical ward and a specialist ward for older people. Based on extensive data from interviews with older people, their family carers and ward-based staff, a grounded theory of the discharge experience is presented. This suggests that the quality of discharge hinges largely on whether the focus of efforts is on ‘pace’ (the desire to discharge older people as rapidly as possible) or ‘complexity’ (where due account is taken of the complex interaction of medical and wider social issues). When pace is the focus, ‘pushing’ and ‘fixing’ are the main processes driving discharge. However, when attention is given to complexity, far more subtle processes of ‘informing’ and ‘brokering’ are in evidence. These latter processes are conceived of as forms of ‘relational practice’ and it is argued that such practices lie at the heart of high quality care for older people.