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The relationship between dementia and elder abuse
- Authors:
- OWENS Colm, COOPER Claudia
- Journal article citation:
- Working with Older People, 14(1), March 2010, pp.19-21.
- Publisher:
- Emerald
Noting that people who depend on others for their basic needs, including dementia sufferers, are most likely to be abused, that caring for people with dementia is demanding and stressful work, and that unpaid or informal carers, often untrained family members, provide the bulk of dementia care in the UK, the authors of this article designed the CAring for Relatives with Dementia (CARD) study, which asked family carers of a representative group of dementia sufferers recruited from secondary care about abusive acts towards the people they cared for. A questionnaire was used to ask a sample of carers in north London and Essex about 10 potentially abusive acts, and the results showed that just over half of the family carers reported some abusive behaviour, with one third of the carers reporting that abusive behaviour had occurred at least 'sometimes' in the last three months. The article discusses the findings, and suggests that any policy for safeguarding vulnerable adults should consider strategies directed towards families who provide the majority of care for older people, rather than exclusively formal carers.
Inequalities in receipt of mental and physical healthcare in people with dementia in the UK
- Authors:
- COOPER Claudia, et al
- Journal article citation:
- Age and Ageing, 46(3), 2017, pp.393-400.
- Publisher:
- Oxford University Press
Background: UK Dementia Strategies prioritise fair access to mental and physical healthcare. This study investigated whether there are inequalities by deprivation or gender in healthcare received by people with dementia, and compared healthcare received by people with and without dementia. Methods: The study investigated primary care records of 68,061 community dwelling dementia patients and 259,337 people without dementia (2002–13). It tested hypotheses that people with dementia from more deprived areas, and who are women receive more psychotropic medication, fewer surgery consultations, are less likely to receive annual blood pressure, weight monitoring and an annual review, compared with those from less deprived areas and men. Results: Only half of people with dementia received a documented annual review. Deprivation was not associated with healthcare received. Compared to men with dementia, women with dementia had lower rates of surgery consultations, of annual blood pressure monitoring and of annual weight monitoring. Men with dementia were less likely to be taking psychotropic medication than women with dementia. People with dementia had fewer surgery consultations and were less likely to have their weight and blood pressure monitored at least annually, compared to the non-dementia group. Conclusions: People with dementia, in particular women, appear to receive less primary healthcare, but take more psychotropic medication that may negatively impact their physical health. Reducing these inequalities and improving access of people with dementia to preventative healthcare could improve the health of people with dementia. (Edited publisher abstract)
Systematic review and meta-analysis to estimate potential recruitment to dementia intervention studies
- Authors:
- COOPER Claudia, KETLEY Daniel, LIVINGSTON Gill
- Journal article citation:
- International Journal of Geriatric Psychiatry, 29(5), 2014, pp.515-525.
- Publisher:
- Wiley
Objective: The authors investigated the proportion of people with dementia who are eligible for and willing to participate in intervention studies. Methods:12 studies fitting predetermined criteria, reporting eligibility or participation rates for dementia intervention trials or intervention studies that sought to increase recruitment were systematically reviewed. The assessed the study validity using a checklist, reported trial eligibility and participation rates and meta-analysed these where appropriate. Results: In higher quality studies, 26% [95% confidence interval 19–35%] of people with Alzheimer's disease (AD) attending memory clinics or receiving antidementia medication were eligible for industry drug trials, and 43% of eligible people agreed to participate in one study, suggesting 11% of these populations would take part in drug trials if approached. There was replicated, higher quality evidence that younger people, men and those with more education were more likely to be eligible for AD drug trials. No randomised controlled trials have investigated how to increase recruitment to dementia intervention studies. Conclusion: One in 10 people with AD or taking donepezil would, according to best available evidence, take part in industry drug trials if approached. We found no data regarding non-pharmacological intervention or pragmatic drug trial recruitment, but eligibility and participation rates for these studies are probably higher. If international studies are extrapolated to the UK, they suggest the national target of recruiting 10% of people with dementia diagnoses to research may be achieved through a nationwide policy of asking all people with dementia and their carers for consent to be approached for research participation. (Edited publisher abstract)
A systematic review evaluating the impact of paid home carer training, supervision, and other interventions on the health and well-being of older home care clients
- Authors:
- COOPER Claudia, et al
- Journal article citation:
- International Psychogeriatrics, 29(4), 2017, pp.595-604.
- Publisher:
- Cambridge Journals
Interventions to support and skill paid home carers and managers could potentially improve health and well-being of older home care clients. This is the first systematic review of interventions to improve how home carers and home care agencies deliver care to older people, with regard to clients’ health and well-being and paid carers’ well-being, job satisfaction, and retention. The authors reviewed 10/731 papers found in the electronic search (to January 2016) fitting predetermined criteria, assessed quality using a checklist, and synthesized data using quantitative and qualitative techniques. Ten papers described eight interventions. The six quantitative evaluations used diverse outcomes that precluded meta-analysis. In the only quantitative study (a cluster Randomized Controlled Trial), rated higher quality, setting meaningful goals, carer training, and supervision improved client health-related quality of life. The interventions that improved client outcomes comprised training with additional implementation, such as regular supervision and promoted care focused around clients’ needs and goals. In a qualitative synthesis of four studies, intervention elements carers valued were greater flexibility to work to a needs-based rather than a task-based model, learning more about clients, and improved communication with management and other workers. The paper concludes there is a dearth of evidence regarding effective strategies to improve how home care is delivered to older clients, particularly those with dementia. More research in this sector including feasibility testing of the first home care intervention trials to include health and life quality outcomes for clients with more severe dementia is now needed. (Edited publisher abstract)