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Paid caregiver communication with homebound older adults, their families, and the health care team
- Authors:
- RECKREY Jennifer M., et al
- Journal article citation:
- Gerontologist, 60(4), 2020, pp.745-753.
- Publisher:
- Oxford University Press
Background and Objectives: Although paid caregivers (e.g., home health aides and home care workers) provide essential care for homebound older adults with serious illness in their homes, little is known about how and to whom paid caregivers communicate about the health needs they encounter. This study explored how paid caregivers (i) communicate when older adults experience symptoms or clinical changes and (ii) interact with the health care team. Research Design and Methods: The authors conducted separate one-on-one, semi-structured interviews (n = 30) lasting 40–60 min with homebound older adults (or their proxies if they had cognitive impairment) and their paid caregivers (provided they had worked with the older adult for ≥8 hr per week for ≥6 months). Interviews were audio-recorded, transcribed, and coded. Results: Thematic analysis identified four themes: (i) older adults or their families were the gatekeepers to paid caregiver communication with the health care team; (ii) communication between older adults, their families, and paid caregivers was enhanced when close relationships were present; (iii) paid caregivers responded to health care team inquiries but rarely communicated proactively; and (4) most older adults, families, and paid caregivers were satisfied with existing paid caregiver communication with the health care team. Discussion and Implications: Rather than discuss concerns with the health care team, paid caregivers communicated directly with older adults or their families about the health needs they encounter. Understanding how communication occurs in the home is the first step to maximizing the potentially positive impact of paid caregivers on the health of older adults living at home. (Edited publisher abstract)
The importance of hearing: a review of the literature on hearing loss for older people with learning disabilities
- Authors:
- BENT Sarah, McSHEA Lynzee, BRENNAN Siobhan
- Journal article citation:
- British Journal of Learning Disabilities, 43(4), 2015, pp.277-284.
- Publisher:
- Wiley
Background: Hearing loss has a significant impact on living well and on communication in all adults, with the numbers affected increasing with age, and adults with learning disabilities being at particular risk. Methods: A review of the literature on hearing loss in older adults with learning disabilities was completed. Results: A significant increase in hearing loss with increasing age in this group was demonstrated, at a greater level than in the general population. Prevalence rates have been the main focus of research, with few considerations of access to hearing assessment or benefits of rehabilitation such as hearing aids, or the effect that age has on living with hearing loss. Conclusions: With advances in audiology services and increased life expectancy of those with learning disabilities, further research would be valuable. In addition, all health and social care services should consider actively promoting hearing assessment and rehabilitation. Individuals, carers and families should also take action, not only when concerns around memory arise, but proactively for all. (Publisher abstract)
Crossing the bridge – connecting with people in the later stages of dementia
- Author:
- BRADLEY Andy
- Journal article citation:
- Working with Older People, 19(4), 2015, pp.177-181.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to provoke reflection on the risks of people in the later stages of dementia being marginalised in care settings and to set out some key principles and approaches which enable ongoing connection. The paper provides practice examples to illuminate ways in which connected relationships can be maintained. Design/methodology/approach: This is a view point paper based on both a personal perspective (the writer grew up in a care home) and professional experience in the field of care work and culture change. Findings: Connecting with people who are in the later stages of dementia is of central importance in offering person-centred relational care. Originality/value: The PACE principles described are original and are published here for the first time. (Publisher abstract)
Verbal mistreatment of the elderly
- Authors:
- FULMER Terry, RODGERS Rachel F., PELGER Allison
- Journal article citation:
- Journal of Elder Abuse and Neglect, 26(4), 2014, pp.351-364.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Elder mistreatment is expected to rise with the aging of the American population. To date, the association between specific forms of mistreatment and decreased quality of life is poorly understood. The aim of the present study was to explore the association between verbal mistreatment among elderly individuals and depression and quality of life. A sample of 142 older adults (40% male) aged 65 or over was enrolled from a large medical practice and academic dental practice, mean (SD) age = 74.88 (6.98) years. Thirty-eight percent of the sample reported verbal mistreatment. Controlling for sociodemographic characteristics and depression, verbal mistreatment was a significant predictor of social functioning (r = –.28, p < .001), mental health (r = –.25, p < .001), and role limitations OR = 3.02, 95% CI [1.34–6.77]. The present findings highlight the prevalence of verbal mistreatment of elderly individuals. (Publisher abstract)
How to construct a case of Alzheimer's disease in three languages: case-based reasoning in narrative gerontology
- Authors:
- SCHRAUF Robert W., et al
- Journal article citation:
- Ageing and Society, 34(2), 2014, pp.280-309.
- Publisher:
- Cambridge University Press
This paper explores how people reason about Alzheimer's disease by telling stories about others who have the disease. More specifically, the paper is a cross-linguistic investigation of the narrative and linguistic devices used by African Americans in English, Mexican Americans in Spanish, and refugees/immigrants from the former Soviet Union (to the United States of America) in Russian in their oral productions of such stories. The authors examine the narratives as instances of case-based reasoning in which lay people (non-medical professionals) distinguish, represent and ‘perform’ symptomatic behaviours and construct a ‘case’ of the disease as a way of probing the difference between the normal and the pathological in conversational contexts. In particular, the authors examine situations in which stories are accepted and confirmed and situations in which stories are contested and negotiated. Common narrative and discursive devices across the three languages include concatenation, intertextuality, conjunction and conjunctive adverbs, lexical opposition, past progressive tenses, temporal adverbials, reported speech and prosodic cues. The fine-grained analysis of these narrative and discursive devices lays bare the inner-workings of case-based reasoning as a conversational task and suggests specific linguistic tools for intervening in lay narrative reasoning in clinical settings and in public health messaging about Alzheimer's disease. (Edited publisher abstract)
The assessment of pain in older people
- Authors:
- ROYAL COLLEGE OF PHYSICIANS, BRITISH GERIATRICS SOCIETY, BRITISH PAIN SOCIETY
- Publisher:
- Royal College of Physicians
- Publication year:
- 2007
- Pagination:
- 13p.
- Place of publication:
- London
Pain is under-recognised and under-treated in older people, and the assessment of pain is particularly challenging in the presence of severe cognitive impairments, communication difficulties or language and cultural barriers. This guidance sets out the key components of assessing pain in older people, together with a range of practical scales that can be used with different groups, including those with cognitive or communication impairment. It aims to provide professionals with a set of practical skills to assess pain as the first step towards its effective management. It describes the background and methodology used, key components of an assessment of pain, and types of scale used to assess pain. It also provides a summary of recommendations in the full guidelines covering: pain awareness, pain enquiry, pain description, pain location and intensity, communication, assessment in people with impaired cognition/communication, cause of pain, and re-evaluation. It notes that the basic guidelines should be a routine part of the training and care provision of all healthcare professionals. The appendices include the guideline development process, an algorithm for the assessment of pain in older people, a pain map, and examples of pain scales.
Creative interaction with people in advanced dementia
- Author:
- ZOUTEWELLE-MORRIS Sarah
- Journal article citation:
- Journal of Dementia Care, 18(1), January 2010, pp.20-22.
- Publisher:
- Hawker
In this final article in a series discussing how a creative attitude can open new possibilities for caregivers in the areas of communication and activity design for people with dementia, the author suggests ideas for applying the principles of creative communication and activity to caring for and communicating with people in advanced stages of dementia, using examples from her work with a non-profit organisation in Holland. The article covers addressing the healthy part of the person, activities based on hand movements and other gestures, holding and physical objects, just being there, and witnessing as an active gesture of accepting what is without trying to do anything about it. The author asserts that non-verbal communication, humour, the ability to take emotional risks and to improvise in the moment are not extras in the field of dementia care but essentials.
The enigma of Japanese ageing-in-place practice in the information age: does digital gadget help the (good) practice for inter-generation care?
- Author:
- LAI On-Kwok
- Journal article citation:
- Ageing International, 32(3), September 2008, pp.236-255.
- Publisher:
- Springer
- Place of publication:
- New York
Against the background of Japanese demographic transition towards a very aged one, the socio-familial reluctance for ageing-in-institutions, and the limited (already the inadequacy of) institutional care, ageing-in-place is both the socio-familial desirable and the policy solution. This paper examines the coping strategies of Japanese society, in the shortage of caring services, with socio-techno innovations derived from information and communication technologies (ICT), towards ageing-in-place. It examines and discusses the socio-familial-spatial (social networking, location and place) relevance of mobile communication, emphasizing the use of ICT and mobile communication by/with/for ageing population, for realizing the benefits of ageing-in-place. It especially considers elderly and their families, in the need for socially and geo-spatially fixed anchors (the essence of ageing-in-place), despite (or perhaps because of) the ‘mobility’ through ICT.
Communication and dementia: how talking mats can help people with dementia to express themselves
- Authors:
- MURPHY Joan, GRAY Cindy M., COX Sylvia
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2007
- Pagination:
- 88p., bibliog.
- Place of publication:
- York
An assessment of Talking Mats, a low-tech communication tool, as a way of helping people at different stages of dementia to express their views. As dementia progresses, communication deteriorates and it becomes increasingly difficult to ensure that the person’s views are heard. This study involved 31 people who were each interviewed about their well-being using both Talking Mats – a system of simple picture symbols – and usual communication methods.
Long distance parental caregivers' experiences with siblings: a qualitative study
- Authors:
- ROFF L.L., et al
- Journal article citation:
- Qualitative Social Work, 6(3), September 2007, pp.315-334.
- Publisher:
- Sage
Increasing numbers of middle-aged adults provide long-distance care for their parents, yet relatively few studies have addressed their experiences. Particularly neglected themes include siblings' communication and division of labour when one or more live at a distance from the parent. The researchers interviewed 22 adult children (10 women and 12 men) aged 37 to 65 in the United States. Participants were members of sibling groups numbering two to seven. Using open-ended questions, the researchers addressed aspects of caregiving including: coordination of care, division of labour, distant siblings' views of caregiving activities, and caregiving and sibling relationships. The researchers used QSR Nu*dist software to assist with coding and analysis of the qualitative data. The study showed different experiences and expectations of hometown siblings compared with long distance siblings. Participants' perceptions of their siblings' caregiving competencies, willingness to care, financial ability to help, and personal relationships with the parent affected caregiving decision making and division of labour.