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Effects of multisensory and motor stimulation on the behavior of people with dementia
- Authors:
- SPOSITO Giovana, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 16(3), 2017, pp.344-359.
- Publisher:
- Sage
A quasi-experimental study using a pre–posttest design was conducted in four aged care facilities to assess the effects of a person-centred care (PCC) multisensory stimulation (MSS) and motor stimulation (MS) programme, implemented by direct care workers, on the behaviours of residents with dementia. Data were collected at baseline and after the intervention through video recordings of morning care routines. Forty-five residents with moderate and severe dementia participated in the study. A total of 266 morning care routines were recorded. The frequency and duration of a list of behaviours were analysed. The frequency of engagement in task decreased significantly (p = .002) however, its duration increased (p = .039). The duration of gaze directed at direct care workers improved significantly (p = .014) and the frequency of closed eyes decreased (p = .046). There was a significant decrease in the frequency of the expression of sadness. These results support the implementation of PCC–MSS and MS programmes as they may stimulate residents' behaviours. (Edited publisher abstract)
Supportive care for older people with dementia: socio-organisational implications
- Authors:
- MIELE Francesco, et al
- Journal article citation:
- Ageing and Society, 42(2), 2022, pp.376-408.
- Publisher:
- Cambridge University Press
For many years, dementia care has been dominated by the standard medical approach, in which dementia is treated mainly with drugs, such as anti-anxiety, antidepressant and anti-psychotic medications. With the aim of seeking effective treatments for patients with dementia, over the last years, several contributions have criticised the pervasive use of drugs for the management of behavioural and physiological symptoms related to dementia, proposing personalised interventions aimed at supporting patients and their relatives from diagnosis until death. With particular reference to long-term settings, this work is aimed at understanding the organisational implications of three types of interventions (labelled supportive care interventions - SCIs) that have characterised this shift in dementia care: person-centred, palliative and multi-disciplinary care. Conducted by following the integrative review method, this review underlines how SCIs have controversial consequences on the quality of care, the care-givers’ quality of life and cultural backgrounds. After an in-depth analysis of selected papers, this paper offers some considerations about the implications of SCIs for long-term care organisations and future research directions. (Edited publisher abstract)
Integrated emotion-oriented care for older people with ID: defining and understanding intervention components of a person-centered approach
- Authors:
- THALEN Marloes, et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 18(3), 2021, pp.178-186.
- Publisher:
- Wiley
An increase in descriptive evidence regarding person-centered approaches for older people with intellectual disability (ID) is important, due to increased life expectancy and the present lack of sufficiently underpinned interventions. This is especially true of interventions designed to increase well-being and quality of life. A specific Dutch example is the Integrated Emotion-Oriented Care approach. Despite its status as a good practice, its effectiveness has not yet been proved, nor has descriptive evidence been made available. The primary aims of this qualitative study are to identify the intervention components, to provide demonstrative illustrations and to gain an in-depth understanding of the use of these components in the day-to-day support of older people with ID. A content analysis of five key documents was carried out. Five semi-structured interviews were then conducted with early adopters, followed by a concept mapping study with daily users. The final stage in the data collection process was a series of five focus-group interviews with experts and experienced support staff. The five intervention components of Integrated Emotion-Oriented Care for older people with ID have been systematically identified and described in detail in five narrative summaries drawn up in collaboration with early adopters, experts and experienced support staff. This study provides valuable insights that offer descriptive evidence for Integrated Emotion-Oriented Care in the care for older people with ID. Both implications and possible opportunities for future research are discussed. (Edited publisher abstract)
Community connector schemes: Ageing Better programme learning
- Author:
- Ageing Better
- Publisher:
- Big Lottery Fund
- Publication year:
- 2018
- Pagination:
- 6
Reports on emerging evidence and learning from eight Ageing Better programme areas who are using Community Connector type roles. Community Connectors were defined as any mechanism that identifies isolated people over 50 and works with them to help them transition to less isolated through person-centred structured support. This includes community navigators, social prescribing and approaches that involve people overcoming specific barriers, for example mental health. The report provides some insights to policy makers, commissioners and practitioners to help them when shaping this type of service. This includes making the service work at each stage: entry points and first engagement, relationships building and activities, and moving on. (Edited publisher abstract)
Presence redefined: the reciprocal nature of engagement between elder-clowns and persons with dementia
- Author:
- et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 16(1), 2017, pp.46-66.
- Publisher:
- Sage
Elder-clowns are a recent innovation in arts-based approaches to person-centred dementia care. They use improvisation, humour, and empathy, as well as song, dance, and music. The authors examined elder-clown practice and techniques through a 12-week programme with 23 long-term care residents with moderate to severe dementia in Ontario, Canada. Analysis was based on qualitative interviews and ethnographic observations of video-recorded clown-resident interactions and practice reflections. Findings highlight the reciprocal nature of clown-resident engagement and the capacity of residents to initiate as well as respond to verbal and embodied engagement. Termed relational presence, this was achieved and experienced through affective relationality, reciprocal playfulness, and coconstructed imagination. These results highlight the often overlooked capacity of individuals living with dementia to be deliberately funny, playful, and imaginative. Relational presence offers an important perspective with which to rethink care relationships between individuals living with dementia and long-term care staff. (Edited publisher abstract)
Impact of dementia-derived nonpharmacological intervention procedures on cognition and behavior in older adults with intellectual disabilities: a 3-year follow-up study
- Authors:
- DE VREESE Luc P., et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 9(2), June 2012, pp.92-102.
- Publisher:
- Wiley
Some adults with intellectual disabilities (ID), in particular those with Down syndrome, are at increased risk of dementia. The aim of this study was to investigate the efficacy of specialised environmental and psychosocial interventions in delaying onset of dementia or in slowing down its rate of progression in this population. Specifically, the paper presents the preliminary results of an ongoing prospective study, called the DAD (Down Alzheimer Dementia) Project, carried out in Trento Italy. The study participants were a sample of 14 adults with worsening cognition and everyday functioning who were no longer manageable by their family or staff in day centres or group homes, and who were relocated in a model special care unit (SCU) designed to proactively accommodate the needs of people with ID and dementia. Baseline level and rate of decline across a 3-year period were assessed by means of the Dementia Questionnaire for Persons with Intellectual Disabilities and compared to 2 control groups not in dementia-capable programmes matched for age, sex, and severity of ID. After 3 years, the findings showed some improvement in cognition and stabilisation in everyday functioning and behaviours in the SCU residents and a worsening in the control groups. The findings confirm the validity of this ‘in-place progression’ model and provide a platform for continuing progress in person-centred services and care for aging persons with ID.
Person-centred risk management: the Traffic Light approach
- Authors:
- SELLS Debbie, SHIRLEY Louisa
- Journal article citation:
- Journal of Dementia Care, 18(5), September 2010, pp.21-23.
- Publisher:
- Hawker
There have been moves towards introducing person-centred care into residential and nursing care homes. However, despite efforts to meet people’s needs through thorough care planning, staff in older people’s care settings can still experience difficulties when the person with dementia behaves in a way they don’t understand or find challenging. This paper describes the approach used by the Northumberland Country Challenging Behaviour Service to address the needs of the person with dementia living in care. The approach is a 3-tier care plan referred to as the Traffic Light approach. The three stages are described as: proactive (the green stage); reactive (the amber stage); and contingency (the red stage). The proactive stage is aimed at attending to the person’s well-being and ongoing needs. The reactive stage encourages staff to be vigilant to a positive change in the person’s mood, and the contingency stage is required when an untoward event happens and action is needed to maintain the safety of others. This structured approach allows care staff to always feel that they are providing positive care, even in the face of threat.
Strategies that helped Betty feel busy and useful again
- Authors:
- WOOD-MITCHELL Amy, MILBURN Margaret
- Journal article citation:
- Journal of Dementia Care, 16(3), May 2008, pp.24-27.
- Publisher:
- Hawker
The Newcastle Challenging Behaviour Service model is an evidence-based approach used to guide a person-centred therapy for people with challenging behaviour. The authors explain how the team worked with staff to better understand the needs of a woman routinely trying to be 'let out' of a care home.
Older persons’ experiences of Reflective STRENGTH-Giving Dialogues – ‘It's a push to move forward’
- Authors:
- ABERG Cecilia, et al
- Journal article citation:
- Scandinavian Journal of Caring Sciences, 35(3), 2021, pp.779-787.
- Publisher:
- Blackwell Publishing
Rationale: Experiences of the innovative method Reflective STRENGTH-Giving Dialogue (STRENGTH), which is grounded in a lifeworld perspective and developed to improve quality of care, is described in this study. Innovative thinking in developing health and social care, which may include digital solutions, is required to ensure a meaningful and dignified life in old age. Aim: The aim of this study was to describe experiences of the intervention Reflective STRENGTH-Giving Dialogue from the perspective of older persons living with long-term health problems. Method; Individual qualitative interviews were conducted with 27 older persons who participated in the intervention. The older persons wrote notes from each dialogue in booklets, and the booklets became part of the study data, analysed with a Reflective Lifeworld Research approach. Results: STRENGTH is experienced as an opportunity to reflect upon life and identify small and large life projects. Dialogues that lead to change in thoughts and actions influence the older persons' well-being, sense of balance, joy and meaning in life. There is an experience of STRENGTH as a starting point and a push to move forward in an effort to experience joy and meaning in life when living with long-term health problems. Conclusions: STRENGTH has the potential to contribute to quality improvement in person-centred care and enhance meaning in life for older persons living with long-term health problems. However, the use of a digital tool in this particular context poses challenges that must be considered. (Edited publisher abstract)
Using co‐creation and multi‐criteria decision analysis to close service gaps for underserved populations
- Authors:
- MORTIMER Duncan, et al
- Journal article citation:
- Health Expectations, 22(5), 2019, pp.1058-1068. Online only
- Publisher:
- Wiley
Background: Navigating treatment pathways remains a challenge for populations with complex needs due to bottlenecks, service gaps and access barriers. The application of novel methods may be required to identify and remedy such problems. Objective: To demonstrate a novel approach to identifying persistent service gaps, generating potential solutions and prioritizing action. Design: Co‐creation and multi‐criteria decision analysis in the context of a larger, mixed methods study. Setting and participants: Community‐dwelling sample of older women living alone (OWLA), residing in Melbourne, Australia (n = 13‐37). Convenience sample of (n = 11) representatives from providers and patient organizations. Interventions: Novel interventions co‐created to support health, well‐being and independence for OWLA and bridge missing links in pathways to care. Main outcome measures: Performance criteria, criterion weights , performance ratings, summary scores and ranks reflecting the relative value of interventions to OWLA. Results: The co‐creation process generated a list of ten interventions. Both OWLA and stakeholders considered a broad range of criteria when evaluating the relative merits of these ten interventions and a “Do Nothing” alternative. Combining criterion weights with performance ratings yielded a consistent set of high priority interventions, with “Handy Help,” “Volunteer Drivers” and “Exercise Buddies” most highly ranked by both OWLA and stakeholder samples. Discussion and conclusions: The present study described and demonstrated the use of multi‐criteria decision analysis to prioritize a set of novel interventions generated via a co‐creation process. Application of this approach can add community voice to the policy debate and begin to bridge the gap in service provision for underserved populations. (Publisher abstract)