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Key issues in evolving dementia care: international theory-based policy and practice
- Authors:
- INNES Anthea, KELLY Fiona, MCCABE Louise, (eds.)
- Publisher:
- Jessica Kingsley
- Publication year:
- 2012
- Pagination:
- 264p.
- Place of publication:
- London
This book focuses on theoretical, policy and practice issues which are predicted to become fundamental priorities in the near future, and how dementia care works across the globe. It explores the theory underpinning dementia care, the applications of theory in dementia care research, and how this research is influencing and shaping practice. The contributors are practitioners, policy influencers and researchers who analyse case studies from the UK, the USA, Canada, Australia, India, France and Malta with the aim of encouraging a dialogue and exchange of interdisciplinary initiatives and ideas. Their insights into how policy and national dementia strategies are developed, and the range of approaches that can be taken in practice, will provide a positive step towards ensuring that the needs of those with dementia are met, both now and in the future. This book is designed for practitioners, researchers, policy makers and students in the field of dementia care.
Bodywork in dementia care: recognising the commonalities of selfhood to facilitate respectful care in institutional settings
- Author:
- KELLY Fiona
- Journal article citation:
- Ageing and Society, 34(6), 2014, pp.1073-1090.
- Publisher:
- Cambridge University Press
This paper draws on two data sources (Kelly's ethnographic study and a British Broadcasting Corporation television programme) to explore the practice of bodywork in the care of frail people with dementia in institutional settings. It explores the complexity of engaging in bodywork, particularly work that is distasteful to the care-worker, and shows how non-recognition of the selfhood of the person with dementia can result in practices that are demeaning and potentially abusive to those in receipt of such work. In contrast to a person-centred approach that urges practitioners to acknowledge people with dementia as unique individuals, with unique needs, wishes, abilities and desires, this paper argues for the use of Sabat's Selfs 1–3 construct to look for commonalities of selfhood, enabling care workers to recognise aspects of themselves in their patients as they carry out care, thereby facilitating care that empathically respects their patients' dignity and potential for vulnerability. Thus, it aims to advance theory and improve practice by arguing for the necessity of putting selfhood at the forefront of bodywork in order to facilitate respectful care that dignifies rather than objectifies the person. (Publisher abstract)
Care home design for people with dementia: what do people with dementia and their family carers value?
- Authors:
- INNES Anthea, KELLY Fiona, DINCARSLAN Ozlem
- Journal article citation:
- Aging and Mental Health, 15(5), July 2011, pp.548-556.
- Publisher:
- Taylor and Francis
This study investigated the views of people with dementia in care homes, and their family carers, on aspects of building design that are important to them. Two focus groups were held in Northern Ireland, and four in Scotland, with a total of 40 participants – 29 with dementia, and 11 family carers. Carers, in general, discussed the features of a building they took into account when selecting a care home. Key themes reported by people with dementia and their family carers included how the space in the environment is used, including the presence or absence of certain design features. Outside space and way-finding aids were identified as positive features of the home, along with a general lack of concern about en-suite provision. The findings illustrated the complexity of building design as it must provide living space acceptable to people with dementia living there and family members who visit, as well as provide a workable environment for staff. The authors concluded that the findings should be considered by care home teams involved in the building or redevelopment of a care homes.
Abusive interactions: research in locked wards for people with dementia
- Author:
- KELLY Fiona
- Journal article citation:
- Social Policy and Society, 9(2), April 2010, pp.267-277.
- Publisher:
- Cambridge University Press
This paper, presenting data from field notes and video footage, reports on a study of 14 consenting older people with dementia, from three locked psycho-geriatric wards of a hospital allowing ethnographic exploration into the everyday social worlds and behaviour of the study group. The author attempted to: identify abusive practice through observation of staff interactions with their patients; explain abusive practice in relation to staffs’ conceptualisation of the selfhood of their patients; explore the transactional and institutional drivers for abusive practice and their impact on those perpetrating and experiencing it; and explore the nature of resistance, defeat and resilience within a conceptualised selfhood. Results indicated abusive practice in the wards and showed that participants in receipt of such practice responded with self-defence and resistance, but were eventually defeated. In a development of Sabat’s (2001) Selfs 1–3 framework, the author identifies how abusive practice arose due to staffs’ inability to recognise different aspects of the patients’ self. Recommendations for practice include integrating a developed Selfs 1–3 framework into staff training and evaluating its impact on practice.
Recognising and supporting self in dementia: a new way to facilitate a person-centred approach to dementia care
- Author:
- KELLY Fiona
- Journal article citation:
- Ageing and Society, 30(1), January 2010, pp.103-124.
- Publisher:
- Cambridge University Press
This paper reports findings from a three-year study which integrated Kitwood's (1997) person-centred and Sabat's (2001) selfhood approaches in the design, fieldwork and analysis of a multi-method observational study that explored the social worlds of 14 people with dementia in long term care. The types of interactions that participants experienced in everyday ward life and during creative sessions were identified by observing, video-recording and engaging with them and by Dementia Care Mapping. The participants' responses to such interactions in terms of their well- or ill-being and expressions of self were identified and documented. The findings indicate that in the wards, staff interactions were often limited and sometimes abusive and that participants experienced ill-being, whereas during creative sessions, interactions were generally facilitatory and celebratory with the participants experiencing wellbeing. By developing the selfhood approach and integrating it with the person-centred approach, the author argues that recognising and supporting selfhood (or not) during interactions can lead to qualitatively different staff behaviours, with consequences for the well- or ill-being of people with dementia. There is scope for incorporating this developed selfhood framework into staff training.