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Cognitive therapy for carers: distinguishing fact from fiction
- Authors:
- JAMES Ian, POWELL Ian
- Journal article citation:
- Journal of Dementia Care, 9(6), November 2001, pp.24-26.
- Publisher:
- Hawker
The authors describe how they encourage carers to monitor their own thoughts as a way of understanding the strong emotions they experience. This knowledge can then help carers to find better strategies for coping with difficult caring situations.
Dolls; handle with care
- Author:
- STEVENSON Amanda
- Journal article citation:
- Journal of Dementia Care, 18(5), September 2010, pp.16-17.
- Publisher:
- Hawker
Doll therapy in dementia care is a controversial approach, and research has shown that individuals differ considerably in their responses to doll therapy. Guidelines for the use of dolls warn that some residents may be reminded of negative memories by being around dolls. This article describes a situation where dolls caused stress to one resident and how this led to the discovery of traumatic events in her life. The care home where the woman lived had been using doll therapy for 10 years. This woman became distressed and concerned at seeing other residents using dolls. Investigations into her background revealed several incidents that could explain her distressed reaction, particularly the death of a baby nephew who she had nursed until his death. As emotional memories are often more easily activated than those that are neutral, these type of memories may be more difficult to inhibit in individuals with reduced cognitive ability. The article concludes that care teams should consider an individual’s personal history before introducing them to doll therapy or before exposing them to an environment where dolls are present.
Concepts and causation of depression: a cross-cultural study of the beliefs of older adults
- Authors:
- LAWRENCE Vanessa, et al
- Journal article citation:
- Gerontologist, 46(1), February 2006, pp.23-32.
- Publisher:
- Oxford University Press
This U.K. study explored how older adults with depression (treated and untreated) and the general older population conceptualize depression. A multicultural approach was used that incorporated the perspectives of Black Caribbean, South Asian, and White British older adults. The study sought to explore and compare beliefs about the nature and causes of depression, and to suggest ways in which these beliefs act to facilitate or deter older people from accessing treatment. One hundred and ten in-depth separate interviews were conducted for 45 White British, 33 South Asian, and 32 Black Caribbean individuals. The interviews explored what the word depression meant to participants, and their beliefs regarding depression's causes. Depression was often viewed as an illness arising from adverse personal and social circumstances that accrue in old age. White British and Black Caribbean participants defined depression in terms of low mood and hopelessness; South Asian and Black Caribbean participants frequently defined depression in terms of worry. Those receiving antidepressants were more likely to acknowledge psychological symptoms of depression. Differences in attribution were found between the ethnic groups. A social model of depression is closer to the beliefs of older people than the traditional medical model. Culturally appropriate inquiries about recent life events could be used to facilitate discussion about depression. Our data suggest that many older adults would respond to probing by primary care physicians about their mood. Health and social care professionals need to be sensitive to the language of depression used by different ethnic groups.
The role of hope in psychotherapy with older adults
- Authors:
- BERGIN L., WALSH S.
- Journal article citation:
- Aging and Mental Health, 9(1), January 2005, pp.7-15.
- Publisher:
- Taylor and Francis
The positive impact of psychotherapy upon the mental health problems of older people is increasingly accepted. However little attention has been paid to the role of hope in working therapeutically with older adults. Three relevant bodies of literature, namely adult psychotherapy, hope in older adulthood, and coping with chronic and terminal illness, provide a starting point for examining the therapeutic uses of hope. However, it is argued that these literatures cannot provide a sufficiently comprehensive conceptualisation of hope in psychotherapy with elders. Firstly, it is considered that hope in therapy is directly affected by key experiences of ageing, namely: facing physical and/or cognitive deterioration and facing death. Also, these three bodies of literature have tended to dichotomise hope as either beneficial and adaptive or dysfunctional and maladaptive. A developmental perspective is used to critique this dichotomy and a clinical framework is provided which examines the role and utility of hope in older adult psychotherapy from a more integrated viewpoint embedded in the client's life history. The framework is comprised of three types of 'hope work': 'facilitating realistic hope,' 'the work of despair' and 'surviving not thriving'. Suggestions are made about how this work may be carried out and with whom.
The effects of reminiscence on depressive symptoms and mood status of older institutionalized adults in Taiwan
- Author:
- WANG Jing-Yy
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(1), January 2005, pp.57-62.
- Publisher:
- Wiley
This study examined the effects of reminiscence on depressive symptoms and mood status of elderly people residing in long-term care facilities. A longitudinal quasi-experimental design was conducted, using two equivalent groups for pre-post test and purposive sampling. Each subject was administered pre- and post- tests at a 4 month interval, but subjects in the experimental group underwent weekly individual reminiscence therapy. Geriatric Depression Scale short form (GDS-SF) and Apparent Emotion Rating Scale (AER) were used as study instruments. Forty-eight subjects completed the study, with 25 in the experimental group and 23 in the control group. The experimental findings indicated that the experimental group demonstrated fewer depressive symptoms (p < 0.05) and better mood status (p = 0.05) on the post-test comparing to the control group. These warranted that reminiscence therapy is a recommended therapy for older people who reside in care facilities. It can provide a basis for planning geriatric care in community to promote the well being and quality of life of older people.
A follow-up study of change in quality of life among persons with dementia residing in a long-term care facility
- Authors:
- LYKETSOS Constantine, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(4), April 2003, pp.275-281.
- Publisher:
- Wiley
Dementia is a major public health problem. Increased attention is being paid to the quality of life (QOL) of people with this chronic disease. There have been no longitudinal studies of QOL change in dementia. Longitudinal study of a cohort of 47 persons with dementia residing in a long-term care facility was undertaken. The QOL of participants was assessed at baseline using the Alzheimer's Disease Related Quality of Life (ADRQL) scale. At this time participants were also assessed on a series of other clinical measures. QOL was reassessed on the ADRQL scores two years later. There was small but significant mean decline in ADRQL over the two-year study interval. However, for 49% of participants, ADRQL scores did not change or improved. Small but significant declines occurred in all ADRQL domains, with the exception of feelings and mood. Of the baseline variables assessed, only a lower baseline ADRQL score was associated with greater decline in ADRQL score at follow-up. There was no association between sociodemographic variables, baseline ratings of dementia severity (MMSE), ADL impairment, behavioral impairment, and depression, or MMSE change during follow-up and ADRQL decline. Among long-term care residents with dementia there is a small decline in QOL ratings over two years. However, for nearly half, QOL ratings stay the same or improve. The ADRQL is a sensitive measure of change in QOL and is appropriate for use as an outcome measure in intervention studies. The predictors of QOL change are complex and require further study.
Sensory stimulation in dementia :an effective option for managing behavioural problems
- Authors:
- BURNS Alistair, et al
- Journal article citation:
- British Medical Journal, 7.12.02, 2002, pp.1312-1313.
- Publisher:
- British Medical Association
People with dementia are among the most vulnerable in our society. Symptoms often need to be treated expediently, and drugs, although moderately effective, can be hazardous. Aromatherapy and bright light treatment seem to be safe and effective and may have an important role in managing behavioural problems in people with dementia.
Grief and intellectual disability: a systemic approach
- Author:
- BLACKMAN Noelle J.
- Journal article citation:
- Journal of Gerontological Social Work, 38(1/2), 2002, pp.253-263.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
People with intellectual disabilities are living longer, which in turn leads to a higher probability that they will experience significant loss due to the death of someone they know. This paper describes a systemic therapeutic model, ROC, which combines bereavement therapy with training and support for staff. On reporting the effects of the ROC model, it is noted that changes over time in the type and nature of referrals has shown the therapeutic value of the program. The author makes a case that the best way to detect and possibly prevent serious emotional problems in this population is to provide training and support in dealing with death and related issues for the service network surrounding these individuals.
The effects of emotion-oriented approaches in the care for persons suffering from dementia: a review of the literature
- Authors:
- FINNEMA Evelyn, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 15(2), February 2000, pp.141-161.
- Publisher:
- Wiley
This article presents an overview of the results of intervention studies in various emotion oriented approaches in the care for people suffering with dementia. Recommendations are made with regard to clinical practice and future research. The articles were analysed with regard to research group, setting, design, effect variables, intervention, measuring instruments, statistical analyses and results. It is shown that mainly positive results (including increased social interaction and decrease of behaviour problems) are achieved with these emotional orientated problems. Concludes that emotion oriented care approaches offer the opportunity to tailor the care to the individual needs of dementing elderly and can be complemented with other psychosocial approaches when necessary. The challenge for the care sector is to develop guidelines to determine which approach should be applied to whom and when. Scientific research can contribute by examining which emotion-oriented approaches, possibly in combination with each other or with psychosocial therapies, effect an increase in the well being and improve functioning in which patients.