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Scottish dementia strategy - progress still needed
- Author:
- PEARSON Jim
- Journal article citation:
- Journal of Dementia Care, 25(6), 2017, pp.27-29.
- Publisher:
- Hawker
A third national dementia strategy has just been published by the Scottish government, but the author questions how it will differ from the other two. The article describes the historical background, how it was developed, the aims and commitments of the strategy and what the author considers to be its shortcomings. (Original abstract)
Mentalization in dementia care: an autoethnographic account of a project worker’s experiences
- Authors:
- LUXMOORE Bethany, McEVOY Phil
- Journal article citation:
- Working with Older People, 21(3), 2017, pp.147-156.
- Publisher:
- Emerald
Purpose: Mentalization is a psychodynamic concept that can help us to understand our emotional responses to others. The purpose of this paper to illustrate how the concept of mentalization may be applied in dementia care. Design/methodology/approach: An autoethnographic account of the author’s experiences (first author), working as a project manager in which the author used the concept of mentalization to pay close attention to how the author’s emotional responses to people with dementia influenced thier communicative interactions. Findings: This paper outlines how the author processed the author’s own internal experiences in both mentalizing and non-mentalizing modes, as the author wrestled with feelings of conscious incompetence. In the non-mentalizing mode, the author was pre-occupied with the author’s own anxieties. The author struggled to relate to or make sense of the experiences of the individuals with advanced dementia that the author engaged with. Moving towards a mentalizing stance helped the author to attune to the embodied experiences of the people with dementia and recognise the reciprocal nature of our communicative interactions. Originality/value: This paper illustrates the role that mentalization may play in developing natural and authentic strategies to support communicative engagement in dementia care. These strategies may be of potential value to family carers. Family carers who can maintain a mentalizing stance may be more able to respond in empathic, person- centred ways to people who are living with dementia. On the other hand, non-mentalizing responses may be a root cause of mis-understanding and emotional disengagement. (Publisher abstract)
A social model of loneliness: the roles of disability, social resources, and cognitive impairment
- Authors:
- BURHOLT Vanessa, et al
- Journal article citation:
- Gerontologist, 57(6), 2017, pp.1020-1030.
- Publisher:
- Oxford University Press
Purpose of the study: The authors consider the points at which cognitive impairment may impact on the pathway to loneliness for older people, through impeding social interaction with family and friends, or by interfering with judgements concerning satisfaction with relationships. Design and methods: The authors conceptualise a mediation model anticipating that social resources (LSNS-6) will mediate the pathway between disability (Townsend Disability Scale) and loneliness (De Jong Gierveld 6-item scale) and a moderated-mediation model in which the authors hypothesise that cognitive impairment (MMSE) will moderate the association between disability and social resources and between social resources and loneliness. To validate the hypothesised pathways, the authors draw on the CFAS Wales data set (N = 3,593) which is a nationally representative study of community-dwelling people aged 65 and older in Wales. Results: Disability had a significant indirect effect on loneliness through the mediating variable social resources. Cognitive impairment was significantly associated with social resources, but did not moderate the relationship between disability and social resources. Cognitive impairment had a significant impact on loneliness, and moderated the effect of social resources on loneliness. Implications: Social structures can (dis)empower people with cognitive impairment and lead to exclusion from social resources or impact on the social construction of ageing, cognitive impairment, and dementia. The sense of self for an older person with cognitive impairment may be influenced by social norms and stereotypes, or through a temporal social comparison with an “earlier” sense of self. The authors conclude that loneliness interventions should be theoretically informed to identify key areas for modification. (Edited publisher abstract)
Dementia and sight loss: a challenging combination
- Authors:
- URSELL Paul, JOLLY Gemma
- Journal article citation:
- Journal of Dementia Care, 25(5), 2017, pp.26-27.
- Publisher:
- Hawker
Sight loss affects tens of thousands of people with dementia, but with the right understanding, education and awareness, they can be supported to live well. The authors show how one influential committee, Dementia and Sight Loss Interest Committee (DaSLIC) is making a difference. (Edited publisher abstract)
Music therapy: positive results, changes that last
- Author:
- HSU Ming Hung
- Journal article citation:
- Journal of Dementia Care, 25(5), 2017, pp.28-29.
- Publisher:
- Hawker
Music therapy is an established clinical intervention, delivered by qualified music therapists who are registered with the Health and Care Professions Council. Music therapy sessions have parallels with psychotherapy sessions where music is used to regulate a resident's emotions through music. This article explains how music therapy can help care professionals respond better to the needs of people with dementia. (Original abstract)
Observing wandering-related boundary transgression in people with severe dementia
- Authors:
- MacANDREW Margaret, et al
- Journal article citation:
- Aging and Mental Health, 21(11), 2017, pp.1197-1205.
- Publisher:
- Taylor and Francis
Objectives: Wandering-related boundary transgression (BT) in long term care (LTC) frequently manifests as intrusion into another resident's bedroom and is associated with adverse outcomes (loss of privacy, resident-to-resident altercations, and becoming lost). This observational study is the first to empirically describe the characteristics of wandering-related BT in LTC residents with severe dementia. Method: Using real-time observation, seven independently ambulant residents with severe dementia and a positive history of wandering and BT were observed for a minimum of twelve 30 minute periods randomised over two non-consecutive days (n=92 observation periods). Frequency and duration of locomoting/non-locomoting phases and BT (entry into out of bounds/private space), patterns of ambulation (direct, random, pacing, and lapping), and activities observed during BT were measured during observation periods. Results: Across 431 locomoting phases, 58 (13%) resulted in a BT and the bedroom of another resident was most frequently (86%) involved. BT was statistically associated with random ambulation and peak activity periods, and was observed more often in those with more frequent ambulation. Most BT events were unwitnessed by others and occurred when the participant was alone. Conclusions: Describing BT has increased understanding of when, where, and how BT occurs and provides background for future intervention research. (Publisher abstract)
Clock drawing test in screening for Alzheimer's dementia and mild cognitive impairment in clinical practice
- Authors:
- VYHNALEK Martin, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(9), 2017, pp.933-939.
- Publisher:
- Wiley
Objectives: The clock drawing test (CDT) is a commonly used brief cognitive measure. The authors evaluated diagnostic accuracy of subjective ratings of CDT by physicians (with/without specialty in cognitive neurology) and neuropsychologists in discriminating amnestic mild cognitive impairment (aMCI), Alzheimer's dementia (AD) and cognitively healthy older adults. They further compared the diagnostic accuracy of subjective categorical ratings with complex scoring of CDT. Methods: Three cognitive neurologists, three neuropsychologists and six neurology residents without experience in cognitive neurology blinded to the diagnosis rated 187 CDTs (50 mild AD, 49 aMCI and 88 cognitively healthy older adults) using a “yes” (abnormal) versus “suspected” versus “no” (normal) classification. The rating suspected was combined with yes or no to obtain two sets of sensitivity estimates. The authors also used a 17-point CDT rating system. Results: When using the categorical rating, neuropsychologists had highest sensitivity (89%) in differentiating patients with mild AD (yes/suspected versus no), followed by neurologic residents (80%) and cognitive neurologists (79%). When differentiating patients with aMCI (yes/suspected versus no), the sensitivity was 84% for neuropsychologists, 64% for cognitive neurologists and 62% for residents. The sensitivity using the complex scoring system was 92% in patients with mild AD and 69% in patients with aMCI. Conclusions: A categorical rating of CDT shows high sensitivity for mild AD even in non-experienced raters. Neuropsychologists outperformed physicians in differentiating patients with aMCI from cognitively healthy older adults (specificity), which was counterbalanced by the lower specificity of their ratings. The diagnostic accuracy was not substantially improved by using complex scoring system. (Edited publisher abstract)
Woodland Wellbeing: a pilot for people with dementia
- Authors:
- GIBSON Elanor, et al
- Journal article citation:
- Working with Older People, 21(3), 2017, pp.178-185.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to understand whether a woodland-based intervention might offer something helpful and engaging for people affected by dementia. In total, 18 people came to Woodland Wellbeing groups over summer and autumn in 2016. Design/methodology/approach: The authors made observations during the groups, kept some notes and conducted some interviews around three months after people had participated in Woodland Wellbeing. Findings: Feedback from participants indicated themes around connection with nature and to one another; the joy in new learning and activities; and the inspirational impact of feeling part of nature. Originality/value: This paper adds to the growing literature on natural approaches in supporting the wellbeing of people affected by dementia, and highlights the value of partnership working. (Publisher abstract)
Forgotten but not gone: older Irish with dementia in England
- Author:
- TIKI Mary
- Journal article citation:
- Journal of Dementia Care, 25(3), 2017, pp.30-31.
- Publisher:
- Hawker
This article discusses the cultural needs of older Irish people in England. The author points out that their specific needs are often overlooked, as ethnicity is often seen in terms of skin colour. However, it is argued that the cultural differences of Irish older people become important when memory fail. The article looks at what this means for the provision of culturally sensitive dementia care. (Edited publisher abstract)
Embracing touch in dementia care: a person-centred approach to touch and relationships
- Author:
- TANNER Luke
- Publisher:
- Jessica Kingsley
- Publication year:
- 2017
- Pagination:
- 256
- Place of publication:
- London
This practical guide instructs carers on how to re-evaluate their use of physical contact in dementia care to create a more effective, person-centred care system. It demonstrates the vital role touch plays in supporting relationships and wellbeing, and challenges the barriers preventing staff from using touch in meaningful ways. It demonstrates that touch and other forms of non-verbal communication are essential for 'being with' and not just 'doing to' people living with a dementia. It provides training exercises on consent and non-verbal communication, explaining how and when to use touch effectively in everyday interactions, and in all stages of dementia. (Edited publisher abstract)