Search results for ‘Subject term:"vulnerable adults"’ Sort:
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Prediction of general hospital admission in people with dementia: cohort study
- Authors:
- RUSS Tom C., et al
- Journal article citation:
- British Journal of Psychiatry, 206(2), 2015, pp.153-159.
- Publisher:
- Cambridge University Press
Background: People with dementia are extremely vulnerable in hospital and unscheduled admissions should be avoided if possible. Aims: to identify any predictors of general hospital admission in people with dementia in a well-characterised national prospective cohort study. Method: A cohort of 730 persons with dementia was drawn from the Scottish Dementia Research Interest Register (47.8% female; mean age 76.3 years, s.d. = 8.2, range 50-94), with a mean follow-up period of 1.2 years. Results: In the age- and gender-adjusted multivariable model (n = 681; 251 admitted), Neuropsychiatric Inventory score (hazard ratio per s.d. disadvantage 1.21, 95% CI 1.08-1.36) was identified as an independent predictor of admission to hospital. Conclusions: Neuropsychiatric symptoms in dementia, measured using the Neuropsychiatric Inventory, predict non-psychiatric hospital admission of people with dementia. Further studies are merited to test whether interventions to reduce such symptoms might reduce unscheduled admissions to acute hospitals. (Publisher abstract)
Practical issues in the selection and use of GPS tracking and location technologies to support vulnerable people at risk of becoming lost or threatened
- Authors:
- WILLIAMS Gareth, KING Peter, DOUGHTY Kevin
- Journal article citation:
- Journal of Assistive Technologies, 5(3), 2011, pp.146-151.
- Publisher:
- Emerald
The aim of this article is to help telecare service providers and individuals managing risks to vulnerable people (for example, locating a person with dementia who is missing and in danger) to identify the relevant issues in specifying the most appropriate GPS location device from the many models now on the market. It reports on a comparison of commercial devices with different characteristics, which considered technical measures of performance along with the subjective views of a panel of stakeholders about issues such as usability, wearability and aesthetics, and value for money. The article discusses location technologies, locating with GPS devices and systems, geo-fencing (the facility to construct safe zones and provide alerts when these are left), power requirements, the form and aesthetics of devices, and monitoring and tracking options. It concludes that telecare services should include a number of different devices on their inventory and offer products that are cost effective and suited to the requirements and preferences of individual service users. It notes that it is necessary to consider the particular characteristics of GPS devices (including the shape or form a device, issues of battery management, geo-fence shapes and alerts) when selecting the best device for an individual's needs.
Exploration of the impact of the COVID-19 pandemic on people with dementia and carers from black and minority ethnic groups
- Authors:
- WEST Emily, et al
- Journal article citation:
- BMJ Open, 11(5), 2021, p.e050066. Online only
- Publisher:
- BMJ Publishing Group
Introduction: Despite community efforts to support and enable older and vulnerable people during the COVID-19 pandemic, many people with dementia and their family carers are still finding it difficult to adjust their daily living in light of the disruption that the pandemic has caused. There may be needs specific to black, Asian and minority ethnic (BAME) populations in these circumstances that remain thus far unexplored. Objective: The aim of the study was to explore the effects of the COVID-19 pandemic on people living with dementia and their family carers of BAME backgrounds, in relation to their experiences of community dementia care and the impact on their daily lives. Design: 15 participants (persons with dementia and carers) were recruited for semistructured qualitative interviews. Respondents were of South Asian and Afro-Caribbean backgrounds. This study used thematic analysis to analyse the data from a constructivist perspective, which emphasises the importance of multiple perspectives, contexts and values. Results: There were a number of ways that the COVID-19 pandemic has impacted BAME persons with dementia and carers with regard to their experiences of dementia community care and the impact on their everyday lives. This study identified eight key themes, with subthemes: fear and anxiety, food and eating (encompassing food shopping and eating patterns), isolation and identity, community and social relationships, adapting to COVID-19, social isolation and support structures, and medical interactions. Fear and anxiety formed an overarching theme that encompassed all others. Discussion: This paper covers unique and underexplored topics in a COVID-19-vulnerable group. There is limited work with these groups in the UK and this is especially true in COVID-19. The results showed that such impacts were far-reaching and affected not only day-to-day concerns, but also care decisions with long-ranging consequences, and existential interests around fear, faith, death and identity. (Edited publisher abstract)
The challenges of COVID‐19 for people with dementia with Lewy bodies and family caregivers
- Authors:
- KILLEN Alison, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 35(12), 2020, pp.1431-1436.
- Publisher:
- Wiley
Commentary. During the current SARS‐CoV‐2 pandemic dementia has been identified as disproportionally common in adults aged over 65 who develop severe COVID‐19. This perspective makes three key points: the physical, cognitive and neuropsychiatric challenges associated with dementia with Lewy bodies make people particularly vulnerable to COVID‐19; adverse effects may also occur from social isolation, the under‐treatment of existing DLB related symptoms/problems and the negative impact on caregivers and; a vigilant multi‐disciplinary approach is needed to meet the health and psychosocial needs of people with DLB and support family caregivers. (Original abstract)
Spontaneous concerns about risk and abuse reported by people with dementia and their carers
- Authors:
- BENBOW Susan M., KINGSTON Paul
- Journal article citation:
- Journal of Adult Protection, 19(2), 2017, pp.92-99.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to look at concerns about risk/abuse expressed spontaneously by people with dementia (PwD) and their carers in narratives describing their journeys with dementia. Design/methodology/approach: A total of 35 narratives were elicited from PwD, carers of PwD and couples where one partner was living with dementia as part of a study on the impact of producing narratives on PwD and their carers. Participants were found to allude to risk/abuse, or specifically mention thoughts on risk and abuse in their narratives. A secondary analysis of the theme of risk/abuse is reported here. Findings: Concerns about risk/exploitation were often expressed in the narratives, and covered a range of areas including driving, safety in the home, safety outdoors, falls, finances, risk to PwD from others, risk to others from PwD, potential or actual police incidents and neglect. Research limitations/implications: The narratives were elicited as part of another project and participants were not asked directly about risk; themes reported here were brought up spontaneously by participants. Practical implications: In relation to dementia a wide range of risk/abuse issues is of concern to PwD and their carers, including driving and financial vulnerabilities. PwD and carers are prepared to talk about risk/abuse when given an opportunity. It is important to investigate and understand experiences and concerns about risk/abuse if they are to be addressed in health and social care practice. Originality/value: The narratives offer unique insights into the concerns of PwD and family carers. (Publisher abstract)
Mental capacity and deprivation of liberty: summary
- Author:
- LAW COMMISSION
- Publisher:
- Law Commission
- Publication year:
- 2017
- Pagination:
- 29
- Place of publication:
- London
Summary of the Law Commission's final report into the review of the Mental Capacity and Deprivation of Liberty Safeguards (DoLS), which considered how the law should protect people who need to be deprived of their liberty in order to receive care or treatment and lack the capacity to consent to this. The review proposes that the DoLS should be replaced by a new scheme, the Liberty Protection Safeguards. This summary provides an overview of the recommendations and the case for reform. It outlines how the new system would operate, with a detailed explanation of some of the key aspects of the new scheme, including its scope, who they would apply to, and conditions for authorisation. (Edited publisher abstract)
Serious case reviews into dementia care: an analysis of context and content
- Authors:
- MANTHORPE Jill, MARTINEAU Stephen
- Journal article citation:
- British Journal of Social Work, 46(2), 2016, pp.514-531.
- Publisher:
- Oxford University Press
Adult Serious Case Reviews (SCRs) are commissioned by local Safeguarding Boards to investigate how local professionals and agencies worked together to safeguard a vulnerable adult following an incident of abuse, harm or death if the Board identifies concerns about agencies' actions from which lessons may be learned. This paper presents the results of a study undertaken in 2013 analysing Adult SCRs where the person who was at risk of harm, or had been harmed or died, had a dementia. Of the eighty-four SCRs available, fourteen were identified as involving a person with dementia and in a further seven the victim(s) may have had dementia. Discrete themes are presented: the situation of self- or publicly funded residents; the potential of poor care quality in all settings for people with dementia, and by different staff and family carers; the lack of communication with family members; and poor integration of care for people with dementia. The SCRs provide vivid illustrations of the ‘faultlines’ that may exist in dementia support systems. In England, Adult SCRs are moving to a statutory basis under the Care Act 2014 and this paper draws attention to their potential as learning materials in dementia care for commissioners, for social workers and for safeguarding practice. (Publisher abstract)
Exploring the role of occupation for spouse-carers before and after the death of a spouse with dementia
- Authors:
- MATTOCK Sarah, MCINTYRE Anne
- Journal article citation:
- British Journal of Occupational Therapy, 79(2), 2016, pp.69-77.
- Publisher:
- Sage
Introduction: When a person with dementia dies, their former spouse-carer can find their personal resources so depleted that re-engaging in life can be difficult, leaving their mental health vulnerable. This qualitative study aimed to explore whether the occupations of spouse-carers contribute in the transition to the post-care period. Method: Purposive sampling was used to recruit nine spouse-carers, who were between 1 and 5 years post-bereavement, via two branches of the Alzheimer’s Society, in the United Kingdom. In-depth interviews collected data for this interpretative phenomenological study, which were subject to template analysis. Findings: Exploration of the data produced themes of continuity, roles and occupations, support and change and transition. Many of the findings supported published literature. However, a new finding emerged, where spouse-carers’ engagement in a ‘sustaining occupation’ (researcher’s term) appeared to counter the effect of role overload. Conclusion: Four key ways that occupations of spouse-carers contributed to the transition to post-care were identified: ‘sustaining occupations’; occupations that maintain spouse-carers’ identity; continuing bonds with the deceased care-recipient; developing new roles. The first two of these began before bereavement and assisted in equipping spouse-carers for the transition to post-care. The second two followed bereavement and enabled spouse-carers to build confidence and re-engage with life. (Publisher abstract)
The will to mobility: life-space satisfaction and distress in people with dementia who live alone
- Authors:
- LLOYD BARBARA Teresa, STIRLING Christine
- Journal article citation:
- Ageing and Society, 35(9), 2015, pp.1801-1820.
- Publisher:
- Cambridge University Press
Increasing numbers of people with dementia reside in single-person households, yet little is known of their experiences and priorities. This exploratory Australian study elicited perceptions of seven people with dementia living alone, regarding their domestic environment and its surroundings. The general aim was to identify unmet service needs in this vulnerable population. Drawing upon the theoretical concepts of ‘the will to mobility’ and ‘life-space’, we identified four factors of particular salience to our respondents. These were access to public space, social distance and proximity, changing meanings of space and objects, and imaginative co-presence. Participants provided useful insights into a soon-to-be-common scenario in which increased numbers of people with dementia will be living without a resident carer. The findings have implications for the development of more personalised and targeted dementia care in the domestic setting, more inclusive public planning and more extensive public education programmes. (Publisher abstract)
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)