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Journal articles on the topic 'Dementia Institutional care'

Author: Grafiati
Published: 4 June 2021
Last updated: 11 February 2022

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1

Matthews, Fiona E., and Tom Dening. "Prevalence of dementia in institutional care." Lancet 360, no. 9328 (July 2002): 225–26. http://dx.doi.org/10.1016/s0140-6736(02)09461-8.

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2

López, J., A. Losada, R. Romero-Moreno, M. Márquez-González, and P. Martínez-Martín. "Factors associated with dementia caregivers’ preference for institutional care." Neurología (English Edition) 27, no. 2 (March 2012): 83–89. http://dx.doi.org/10.1016/j.nrleng.2012.03.004.

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3

Wilz, G., T. Heilmann-Stiegler, J. Deux, and L. Weise. "INDIVIDUALIZED MUSIC FOR PEOPLE WITH DEMENTIA IN INSTITUTIONAL CARE." Innovation in Aging 1, suppl_1 (June 30, 2017): 1045. http://dx.doi.org/10.1093/geroni/igx004.3819.

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4

Cohen, Carole A. "The SMARTT Program: Planning for Dementia Care." Healthcare Management Forum 10, no. 3 (October 1997): 49–51. http://dx.doi.org/10.1016/s0840-4704(10)60963-5.

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Dementia is being recognized as a major public health challenge. Caring for those with dementia poses unique problems for family and health care providers in community and institutional settings. This article describes the development of the Sunnybrook Memory Assessment Research Treatment and Training (SMARTT) Program at an academic health science centre. This program serves as a model for an integrated health system to meet the needs of dementia patients and their families.
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5

Pedro, Catarina, Mariana Duarte, Beatriz Jorge, and Daniela Freitas. "440 - Dementia villages: rethinking dementia care." International Psychogeriatrics 32, S1 (October 2020): 158. http://dx.doi.org/10.1017/s1041610220002926.

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Introduction:Over the past 20 to 30 years, alternative dementia care models have been developed. Dementia villages challenge popular perceptions about life with dementia and contrast to the traditional model of long-term care facilities that are often seen as institutional, impersonal, and risk-averse. The first dementia village, De Hogeweyk, was developed in 2009 and is located in Weesp, Netherlands. Hogeweyk aims to create a safe environment, enabling the person with dementia to live an “ordinary life” with as much autonomy as possible and also maintaining integration with the local community. Other dementia villages have been established in several countries, following De Hogeweyk model.Objectives:The aim of this presentation is to describe the functioning of dementia villages and evaluate its benefits on dementia patients.Methods:A non-systematic review of the literature was performed on PubMed, PsycINFO and Web of science using selected keywords. We also consult the official websites of the institutions.Results:Dementia villages seem to improve functioning and reduce the need for medication. Anxiety, restlessness and homesickness can still persist, but are reduced by the homelike and hospitable setting in which residents live. In fact, antipsychotic medication use at the residence has decreased from approximately 50% of residents, before the dementia village was introduced, to approximately 12% in 2019. The staff also reported greater job satisfaction. Although dementia villages are growing throughout the Western world, this concept has also been criticized, arguing that this type of living is dishonest, misleading the residents to believe that they are still living in the ‘real community’.Conclusions:Dementia villages are guided by the principles “deinstitutionalize, transform and normalize” care for people with advanced dementia. Although its intuitive advantages, there is no research evidence to demonstrate that this environment has any beneficial effect in behaviour, functional ability or cognition. In future studies, clinical outcomes could be used as a measure of quality of care. Hogeweyk concept has made societies rethinking dementia care and has been inspiring the development of other innovative models of dementia care.
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Ito, Hiroto, and Yuki Miyamoto. "Impact of long-term care insurance on institutional dementia care in Japan." Health Policy 64, no. 3 (June 2003): 325–33. http://dx.doi.org/10.1016/s0168-8510(02)00181-1.

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7

Jarrott, Shannon E., Hye Ran Kwack, and Diane Relf. "An Observational Assessment of a Dementia-specific Horticultural Therapy Program." HortTechnology 12, no. 3 (January 2002): 403–10. http://dx.doi.org/10.21273/horttech.12.3.403.

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Horticultural therapy (HT) is used across the lifespan with individuals with a wide range of physical, social, and cognitive abilities. Older adults make up a large group of participants in horticultural activities. As the population of older adults grows, more adults face the risk of experiencing a dementing illness. Many families turn to institutional care programs, such as nursing homes and adult day service (ADS) programs, for assistance with the care of their relative with dementia. HT may be an appropriate activity to incorporate into dementia care activity programs, but formal evaluations of such programs are limited. The current study evaluated a 10-week HT program conducted with adults with dementia at an ADS program. Observations indicated that participants engaged in the horticultural activities for greater periods of time than the nonhorticultural activities. Participant affect during the horticultural and nonhorticultural activities was comparable. HT is appropriate for dementia care programs serving adults with a wide range of cognitive, physical, and social needs, and it should be considered as a viable alternative to more typical dementia care program activities.
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8

Adler, Geri, Linda Ott, Mary Jelinski, James Mortimer, and Renee Christensen. "Institutional Respite Care: Benefits and Risks for Dementia Patients and Caregivers." International Psychogeriatrics 5, no. 1 (March 1993): 67–77. http://dx.doi.org/10.1017/s1041610293001401.

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Thirty-seven dementia patients and their caregivers were studied before and after a two-week in-hospital respite stay. Institutional respite care did not alter behavior problems in dementia patients, nor did changes in performance of activities of daily living (ADLs) by Alzheimer's disease (AD) patients exceed those expected from disease progression. Caregivers exhibited an improvement in burden and depression during the respite study, but levels returned to baseline following the patient's return home.
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9

Gusmano, Michael. "End-of-life care for patients with dementia in the United States: institutional realities." Health Economics, Policy and Law 7, no. 4 (October 2012): 485–98. http://dx.doi.org/10.1017/s1744133112000266.

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AbstractFew are satisfied with end-of-life care in the United States. For families and friends of people with dementia, end-of-life care is particularly frustrating. Providing better end-of-life care to people with dementia is urgent because the prevalence of the disease is increasing rapidly. Dementia is currently the seventh leading cause of death in the United States and fifth leading cause of death among people aged 65 years and older. By 2050, there will be around 19 million people with Alzheimer's disease. This article reviews ethical and policy challenges associated with providing end-of-life care for people with dementia in the United States. I explain how disagreements about the meaning of futility lead to poor care for people with dementia. Most people agree that we should not provide care that is futile, but there is little agreement about how futility should be defined. US policies and politics clearly tip the balance in the direction of treatment, even in the face of strong evidence that such care does more harm than good. Although we may never reach a consensus, it is important to address these questions and think about how to develop policies that respect the different values.
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10

Gilhooly, Mary L. M. "Senile dementia: Factors associated with caregivers' preference for institutional care." British Journal of Medical Psychology 59, no. 2 (June 1986): 165–71. http://dx.doi.org/10.1111/j.2044-8341.1986.tb02681.x.

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11

Ritchie, Karen. "Behavioral Disturbances of Dementia in Ambulatory Care Settings." International Psychogeriatrics 8, S3 (May 1997): 439–42. http://dx.doi.org/10.1017/s1041610297003803.

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Behavioral disturbances are a primary reason elderly patients with dementia are admitted to long-term care facilities. Blackwood and colleagues found that 58% of 130 consecutive patients admitted to a nursing home because of a behavioral disorder had a principal diagnosis of dementia. Similarly, in a study of long-stay institutional care for persons with dementia in France, the author and colleagues found that 67% of 352 patients had been admitted because of a social or behavioral problem. Thus, outpatient management of behavioral disturbances would appear to play a central role in determining whether a patient with dementia can remain in the community.
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12

Suen, Johan. "A Multiple Stakeholder Perspective for Evaluating Community-Based Dementia Care." Innovation in Aging 4, Supplement_1 (December 1, 2020): 60–61. http://dx.doi.org/10.1093/geroni/igaa057.197.

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Abstract For holistic interventions and research on dementia, it is fundamental to understand care experiences from the perspectives of carers, care recipients, and care professionals. While research on care dyads and triads have highlighted the effects of communication and interactional aspects on care relationships, there is a lack of knowledge on how individual-contextual and relational factors shape the provision and receipt of care in terms of decision-making processes, resource allocation, and expectations of care outcomes. Thus, this paper sheds light on (i) how carers negotiate care provision with other important life domains such as employment, household/family roles and conflicts, as well as their own health problems, life goals, values, and aspirations for ageing; (ii) how older adults with dementia perceive support and those who provide it; (iii) the structural constraints faced by care professionals in delivering a team-based mode of dementia care; and, taken together, (iv) how community-based dementia care is impeded by barriers at the individual, relational, and institutional levels. Findings were derived from semi-structured interviews and observational data from fieldwork conducted with 20 persons with dementia (median age = 82), 20 of their carers (median age = 60), and 4 professional care providers. All respondents were clients and staff of a multidisciplinary and community-based dementia care system in Singapore. Our analysis indicates the impact of dementia care is strongly mediated by the interplay between institutional/familial contexts of care provision and the various ‘orientations’ to cognitive impairment and seeking support, which we characterised as ‘denial/acceptance’, ‘obligated’, ‘overprotective’, and ‘precariously vulnerable’.
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13

Wells, Y. D., A. F. Jorm, F. Jordan, and R. Lefroy. "Effects on Care-Givers of Special Day Care Programmes for Dementia Sufferers." Australian & New Zealand Journal of Psychiatry 24, no. 1 (March 1990): 82–90. http://dx.doi.org/10.3109/00048679009062889.

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Two groups of care-givers to dementia sufferers were interviewed to assess their psychological symptoms and the behaviour problems of the dementia sufferers. The first group were using special dementia day care while the second group were about to begin using it. The second group were re-interviewed three months later. Therefore two comparisons could be made; a with/without day care comparison and a before/after admission to day care comparison. Care-givers had a high level of psychological symptoms which were not significantly reduced by using day care. Full-time institutional care did reduce distress. Day centre clients continued to deteriorate as would be expected with a degenerative condition. While special dementia day care centres appear to play a useful role for many care-givers, they may provide too few hours relief per week to markedly reduce the care-givers' psychological symptoms. Family care-givers currently take the major role in caring for dementia sufferers in the community and the burden of care needs to be shared more equitably.
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14

Maercker, Andreas, and Simon Forstmeier. "Healthy brain ageing: the new concept of motivational reserve." Psychiatrist 36, no. 5 (May 2012): 175–77. http://dx.doi.org/10.1192/pb.bp.111.036830.

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SummaryVarious research approaches try to solve the puzzles related to dementia or healthy brain ageing. Neurogenetic, neuroimaging and neuropharmacological research are the most visible of these. Psychological research in dementia has been instrumental in improving familial or institutional care. However, it has not been regarded as basic research. Recent psychological research into the mechanisms of co-forming or shaping the clinical presentation of dementias can be counted as truly basic research. The ‘cognitive or brain reserve’ concept has been fruitful in implementing psychological knowledge on plasticity factors in dementia. The new concept of ‘motivational reserve capacity’ extends these psychological concepts. In particular, it provides a basis for integrating various findings on how lifestyle factors effectively shape clinical dementia presentations – or lead to healthy brain ageing.
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KELLY, FIONA. "Bodywork in dementia care: recognising the commonalities of selfhood to facilitate respectful care in institutional settings." Ageing and Society 34, no. 6 (April 2, 2013): 1073–90. http://dx.doi.org/10.1017/s0144686x13000093.

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ABSTRACTThis 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.
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Brodaty, Henry, Dianne Griffin, and Dusan Hadzi-Pavlovic. "A Survey of Dementia Carers: Doctors' Communications, Problem Behaviours and Institutional Care." Australian & New Zealand Journal of Psychiatry 24, no. 3 (September 1990): 362–70. http://dx.doi.org/10.3109/00048679009077703.

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A survey of carers belonging to the Alzheimer's Disease and Related Disorders Society (ADARDS) had three aims: (i) to investigate the process of health professionals providing information to patients and carers: (ii) to determine the nature of problems burdening carers; and (iii) to examine factors associated with institutional placement. Carers reported on deficiencies in the provision of information and indicated their preferences as to how the information should be given. ADARDS, general practitioners and other health professionals were reportedly helpful, with each appearing to have a role in providing information about dementia. Multiple problem behaviours were reported by most carers, especially difficulties with communication, the need for constant supervision and disruption to personal life. Institutional care was most highly correlated with dependency problems, severity of dementia and a non-spouse carer. Implications include the need for training of doctors in communication and education about dementia with particular attention to management of dependency problems.
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17

Esiri, Margaret M. "The Pathology of Dementia." British Menopause Society Journal 4, no. 2 (June 1998): 66–72. http://dx.doi.org/10.1177/136218079800400209.

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Dementia is a clinical, social and economic problem worldwide as a consequence of increased longevity, and is the commonest condition leading to institutional care. Four conditions, alone or in combination, account for about 95% of cases of dementia: Alzheimer's disease, cerebrovascular disease, Parkinson's disease and frontal lobe dementia. The pathological changes occurring within the brain in these conditions will be discussed and compared to those resulting from the normal aging process.
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18

Fletcher, James Rupert. "A methodological approach to accessing informal dementia care." Working with Older People 23, no. 4 (November 28, 2019): 228–40. http://dx.doi.org/10.1108/wwop-09-2019-0022.

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Purpose A growing body of research seeks to include people with dementia as both participants and co-designers. It is also increasingly recognized that dementia research must pay greater attention to informal care, provided by family and friends in non-institutional settings, because this is the situation of most people affected by dementia. Accessing these kinds of naturalistic care sites through meaningfully inclusive studies can be challenging for researchers in many fields. The paper aims to discuss this issue. Design/methodology/approach This paper describes a methodology designed to facilitate meaningful inclusion and access to hard-to-reach dementia care networks. It describes the implementation of this methodology in the field, the problems that emerged and the lessons learned. Findings A two-step sampling approach was used. People with dementia were sampled through organizations unrelated to dementia. Care networks were sampled through ecomapping with people with dementia. The strategy successfully accessed the desired population, but it was labour-intensive and biased the sample in several respects. Originality/value It is hoped that this outline will encourage further reflection and discussion regarding methodological approaches to complex sampling and recruitment issues in dementia research.
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Huang, Ya Chi, Ruoh Lih Lei, Ruo Wan Lei, and Faizal Ibrahim. "An exploratory study of dignity in dementia care." Nursing Ethics 27, no. 2 (June 17, 2019): 433–45. http://dx.doi.org/10.1177/0969733019849458.

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Background: Generally, a person with dementia may be unable to make decisions by themselves and professionals may decide what is best for them. Unfortunately, in most cases, professionals assist a person with dementia to make decisions without clear explanation or consent. Whether a person with dementia possesses dignity in routine care is an important issue. Research objectives: The purpose of this study was to explore the lived experience of the healthcare professionals in providing dignified dementia care in Taiwan. Research design: A qualitative, hermeneutic-phenomenological approach was conducted. Participants: Participants were enrolled by purpose sampling. Researchers performed in-depth interviews to reveal the essential ingredient of dignity within dementia care in Taiwan. A total of 20 cases were enrolled to achieve data saturation. Ethical considerations: This study was approved by the institutional review board. Before conducting the interview, interviewees provided informed consent. Findings: There were three themes and six categories that were addressed and constructed; within the themes, 23 Guidelines for Taiwan Dignified Dementia Care and 12 Principles for Dignified Dementia Care in Taiwan were developed. Discussion: From the data relating to dignity in dementia care, we can develop a more independent and dignified care environment to improve the quality of life of person with dementia in Taiwan. Conclusion: The results indicated that dignity within dementia care was constructed by the lived experience of the healthcare professionals, as well as affected by the culture of the organizations and society at the same time.
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Haupt, Martin. "Behavioral and Psychological Symptoms of Dementia: Physical Nonaggressive Agitation." International Psychogeriatrics 12, S1 (July 2000): 125–27. http://dx.doi.org/10.1017/s104161020000689x.

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Agitated behaviors occur frequently in patients with dementia. These behaviors affect the quality of life of the dementia sufferers and their caregivers. For example, these behaviors can greatly complicate everyday management in familiar surroundings and in institutional care, and they predict premature nursing home admission.
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Åkerborg, Örjan, Andrea Lang, Anders Wimo, Anders Sköldunger, Laura Fratiglioni, Maren Gaudig, and Mats Rosenlund. "Cost of Dementia and Its Correlation With Dependence." Journal of Aging and Health 28, no. 8 (July 9, 2016): 1448–64. http://dx.doi.org/10.1177/0898264315624899.

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Objective: To estimate the cost of dementia care and its relation to dependence. Method: Disease severity and health care resource utilization was retrieved from the Swedish National Study on Aging and Care. Informal care was assessed with the Resource Utilization in Dementia instrument. A path model investigates the relationship between annual cost of care and dependence, cognitive ability, functioning, neuropsychiatric symptoms, and comorbidities. Results: Average annual cost among patients diagnosed with dementia was €43,259, primarily incurred by accommodation. Resource use, that is, institutional care, community care, and accommodation, and corresponding costs increased significantly by increasing dependency. Path analysis showed that cognitive ability, functioning, and neuropsychiatric symptoms were significantly correlated with dependence, which in turn had a strong impact on annual cost. Discussion: This study confirms that cost of dementia care increases with dependence and that the impact of other disease indicators is mainly mediated by dependence.
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22

Nikmat, Azlina Wati, Graeme Hawthorne, and S. Hassan Al-Mashoor. "Quality of life in dementia patients: nursing home versus home care." International Psychogeriatrics 23, no. 10 (June 24, 2011): 1692–700. http://dx.doi.org/10.1017/s1041610211001050.

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ABSTRACTBackground: Care management providing a high quality of life (QoL) is a crucial issue in dealing with increasing numbers of dementia patients. Although the transition from informal (home-based) care to formal (institutional) care is often a function of dementia stage, for those with early dementia there is currently no definitive evidence showing that informal or formal care provides a higher QoL, particularly where informal care is favored for local cultural reasons. This paper outlines the research protocol for a study comparing formal and informal care in Malaysia. It seeks to provide evidence regarding which is more appropriate and results in higher QoL in early dementia.Methods: This is a quasi-experimental study design involving 224 early dementia patients from both nursing home and community settings. Participants will be assessed for cognitive severity, QoL, needs, activities of daily living, depression and social isolation/connectedness by using the Mini-Mental State Examination (MMSE), Cognitive Impairment Scale – 4 items (CIS-4), EUROPE Health Interview Survey-Quality of Life (WHO8), Assessment of Quality of Life (AQoL8), Camberwell Assessment of Need for the Elderly – Short Version (CANE-S), Barthel Index (BI), Cornell Scale for Depression (CSDD), Geriatric Depression Scale – 15 items (GDS-15), and Friendship Scale (FS) respectively.Conclusion: This study aims to provide a better understanding of care needs in early dementia. Given population aging, the study findings will provide evidence assisting decision-making for policies aimed at reducing the burden of caregiving and preserving the QoL of dementia patients.
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Buse, Christina, and Julia Twigg. "Looking “out of place”: analysing the spatial and symbolic meanings of dementia care settings through dress." International Journal of Ageing and Later Life 9, no. 1 (December 7, 2014): 69–95. http://dx.doi.org/10.3384/ijal.1652-8670.20149169.

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The article explores how clothing exposes – and troubles – the ambiguous location of care homes on the boundaries of public/private, home/institutional space. It deploys a material analysis of the symbolic uses and meanings of dress, extending the remit of the new cultural gerontology to encompass the “fourth age,” and the lives of older people with dementia. The article draws on an ESRC-funded study “Dementia and Dress,” conducted in the United Kingdom (UK), which explored everyday experiences of clothing for people with dementia, carers and careworkers, using ethnographic and qualitative methods. Careworkers and managers were keen to emphasise the “homely” nature of care homes, yet this was sometimes at odds with the desire to maintain presentable and orderly bodies, and with institutional routines of bodywork. Residents’ use of clothing could disrupt boundaries of public/private space, materialising a sense of not being “at home,” and a desire to return there.
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Rimkeit, Sally, and Jacqueline McIntosh. "Experiencing place: Younger people with dementia facing aged care." Australasian Psychiatry 25, no. 6 (May 10, 2017): 554–61. http://dx.doi.org/10.1177/1039856217706821.

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Objectives: There are currently few facilities for people with younger onset dementia and they are placed by default into dementia care facilities designed for the elderly. There is limited understanding of how people with younger onset dementia and their care givers anticipate or experience aged residential care. This qualitative study has used semi-structured interviews to give voice to the opinions and perspectives of nine people with younger onset dementia and 11 care givers. Method: Interpretative Phenomenological Analysis was used for idiographic analysis, allowing examination of the lived experience of younger people with dementia and an iterative exploration of what their experiences mean. Results: Themes of memory, autonomy and therapy emerged from the data. There is a need for a familiar memory of place in an intergenerational community and home-like setting. The loss of autonomy and ensuing stagnation or even institutional internment was much feared. Appropriate exercise and purposeful occupational activities as well as emotional support were valued therapies but often lacking for this group Conclusions: Emotional distress with the loss of a meaningful life can result from the placement of younger people with dementia into old age services. Development of age-appropriate services are required.
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Abbott, Rebecca A., Debbie Cheeseman, Anthony Hemsley, and Jo Thompson Coon. "Can person-centred care for people living with dementia be delivered in the acute care setting?" Age and Ageing 50, no. 4 (April 22, 2021): 1077–80. http://dx.doi.org/10.1093/ageing/afab065.

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Abstract The need to improve care for people living with dementia in the hospital setting has long been recognised. Person-centred care has the potential to improve the experience of care for persons living with dementia and their carers, and has been shown to improve the experiences of hospital staff caring for the persons living with dementia, however it remains challenging to deliver in a time- and task-focussed acute care setting. This commentary suggests that to embed person-centred care across the hospital environment, cultural changes are needed at organisational and ward levels. In particular there needs to be: leadership that supports and advocates for workforce capacity to recognise and meet both psychological and physical needs of people living with dementia, promotion of physical environments that support familiarisation and social interactions, an inclusive approach to carers and the development of a culture of sharing knowledge and information across hierarchies and roles. An evidence-based set of pointers for service change are described which highlight institutional and environmental practices and processes that need to be addressed in order for person-centred care to become part of routine care.
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Haapala, Irja, Simon Biggs, and Susan Kurrle. "Social aspects of dementia and dementia practice." International Psychogeriatrics 30, no. 11 (November 2018): 1579–81. http://dx.doi.org/10.1017/s1041610218001655.

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Social aspects of dementia are becoming increasingly important as part of a wider shift in emphasis from cure to care. This is partly because approaches based on finding a cure have proved far more difficult and complex than originally imagined (WHO, 2016). New evidence on the effectiveness of public health measures, that while incidence is growing as the proportion of older people in society increases its prevalence amongst older adults is actually falling, has also lead to increased interest in social dimensions of prevention, lifestyle change, and practical intervention in community settings (Prince et al., 2016; Kivipelto et al., 2017). This, in turn, has led to a rediscovery of the role of supports to people living with dementia in their daily lives, the needs of informal carers, and professional activities that can maintain the social engagement of each party (Winblad et al., 2016). The expansion of practice around person-centered care, beyond traditional institutional settings, has also contributed to a socialized view of how interactions in dementia care are thought about (Bartlett et al., 2017), as has an increased awareness of the effects of the social construction of dementia in the public mind (Biggs, 2018). Most recently, people living with dementia, and particularly with respect to younger onset dementia, have begun to find a voice and to make connections to the wider disability movement (Dementia Alliance International, 2017). Each of these developments, in their different ways, have led to a re-emphasis on psycho-social elements of dementia, its experience, and how that might translate into clinical practice and service delivery.
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Hodgson, Nancy A. "Do interventions with staff in long-term residential facilities improve quality of care or quality of life for people with dementia? A systematic review of the evidence." International Psychogeriatrics 28, no. 12 (October 17, 2016): 1935–36. http://dx.doi.org/10.1017/s1041610216001757.

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The review by Bird and colleagues (2016), published in this issue of International Psychogeriatrics, is notable for jointly examining the effect of dementia care interventions on both staff and resident quality outcomes. This is an important contribution to improving dementia care because it recognizes the dynamic and dyadic relationship between residents and their caregivers in residential settings. While evidence exists on the dyadic effect of family caregiver intervention on dementia patient outcomes (Gitlin and Hodgson, 2015), less attention has been given to formal caregivers in institutional settings (Dellefield et al., 2015).
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Rothman, Stephanie, Jacob F. Engelskirger, Kyrie S. Carpenter, Kelly Guina, and Nader R. Shabahangi. "P2-334: DEPATHOLOGIZING INSTITUTIONAL CARE: AN EXISTENTIAL PROGRAM OF TREATING DEMENTIA PATIENTS." Alzheimer's & Dementia 10 (July 2014): P601. http://dx.doi.org/10.1016/j.jalz.2014.05.1013.

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29

Berketa, John W. "Dentures in dementia: the oral health management of patients in institutional care." Forensic Science, Medicine, and Pathology 11, no. 4 (June 24, 2015): 630. http://dx.doi.org/10.1007/s12024-015-9689-1.

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30

Thornton, Hazel, and Rosslyn Offord. "Non-pharmacological management of sexual behaviours that challenge in dementia." Reviews in Clinical Gerontology 25, no. 3 (August 2015): 194–201. http://dx.doi.org/10.1017/s0959259815000167.

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SummaryA literature search was conducted to identify and evaluate non-pharmacological interventions available for people living with dementia, who present with sexual behaviours that challenge. A lack of research implementing and evaluating clinical interventions was identified, and the search was broadened to include discussion papers relating to sexuality and dementia. This included work both with couples affected by dementia at home, and with staff in institutional care settings. The papers identified come from a range of countries, with wide variation in care settings and practices. Literature suggests sexual behaviours that challenge in dementia are best understood within the broader context of behavioural and psychological symptoms of dementia (BPSD). There is a consensus highlighting the importance of training staff to recognize the sexual needs of people with dementia and to develop clear policy and guidelines to support staff in managing potential challenges. Few authors attempted to include the perspectives of either care partners or the person with dementia.
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31

Hunter, Andrew, John Keady, Dympna Casey, Annmarie Grealish, and Kathy Murphy. "Psychosocial Intervention Use in Long-Stay Dementia Care." Qualitative Health Research 26, no. 14 (July 9, 2016): 2024–34. http://dx.doi.org/10.1177/1049732316632194.

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The objective of this study was to develop a substantive grounded theory of staff psychosocial intervention use with residents with dementia in long-stay care. “Becoming a person again” emerged as the core category accounting for staffs’ psychosocial intervention use within long-stay care. Interview data were collected from participants in nine Irish long-stay settings: 14 residents with dementia, 19 staff nurses, one clinical facilitator, seven nurse managers, 21 nursing assistants, and five relatives. Constant comparative method guided the data collection and analysis. The researcher’s theoretical memos, based on unstructured observation, and applicable extant literature were also included as data. By identifying the mutuality of the participants’ experiences, this classic grounded theory explains staff motivation toward psychosocial intervention use within long-stay care. It also explains how institutional factors interact with those personal factors that incline individuals toward psychosocial intervention use.
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Reid, R. Colin. "Quality of Care and Mortality among Long-term Care Residents with Dementia." Canadian Studies in Population 35, no. 1 (December 31, 2008): 49. http://dx.doi.org/10.25336/p6dw5k.

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Seniors with dementia who enter long-term care facilities are at greater risk of death than are similar individuals that remain in the community. Previous research has focused primarily on social selection factors such as health status to explain mortality in this population. This study seeks to determine whether resident mortality within 12 months of admission to a facility can be explained by post-admission social causative factors, that is, by institutional quality of care. Logistic regression results are based on the study of 402 residents in 73 long-term care facilities throughout British Columbia, Canada. Mortality data were obtained from Vital Statistics. Although social selection factors (e.g., physical dependency) emerge as the strongest predictors, one social causative factor – facility level restraint use – also predicts mortality. This study provides some evidence that social causative factors play a role in determining mortality among long-term care residents with dementia. Further research on the social causative factors is needed to understand the degree to which they affect mortality, and the way in which they do so.
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Riachi, Rhonda, and Sally Markwell. "Improving well-being in dementia care for clients and carers." Journal of Public Mental Health 19, no. 4 (September 23, 2020): 321–26. http://dx.doi.org/10.1108/jpmh-05-2020-0039.

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Purpose This paper aims to highlight the results and emerging themes from a study concerning the effect of communication techniques that were tailored to each client in relation to the extent of their dementia. Dementia was viewed by the care workers primarily as a memory disability. Design/methodology/approach A short qualitative study of the communication techniques of care workers in England, who had received training in dementia care and some training in the SPECAL® method (Specialised Early Care for Alzheimer’s),was conducted through semi-structured interviews. Resulting data were analysed using a constructivist grounded theory approach. Findings Continued application of the SPECAL techniques appeared to reinforced clients’ sense of well-being and produced benefits for care workers’ own well-being. Research limitations/implications This small qualitative study suggests there can be beneficial effects for both clients and the care team when care workers tailor their communication behaviour to the needs of people with dementia. Further research on communication techniques in dementia care is needed and how these benefits might be translated into institutional settings. Originality/value Few research studies have been made of the SPECAL dementia care method, and this study was the first to look explicitly at the communication techniques that the care workers used with clients. Public health professionals are less likely to be aware of the SPECAL method.
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Hepburn, Kenneth, Janet Severance, Bruce Gates, and Margaret Christensen. "Institutional care of dementia patients: A state-wide survey of long-term care facilities and special care units." American Journal of Alzheimer's Care and Related Disorders & Research 4, no. 2 (March 1989): 19–23. http://dx.doi.org/10.1177/153331758900400208.

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Morgan, Jennifer, Elisabeth Burgess, and Yun-Zih Chen. "Person-Centered Dementia Care: Workforce and Organizational Supports in Nursing Homes." Innovation in Aging 4, Supplement_1 (December 1, 2020): 669. http://dx.doi.org/10.1093/geroni/igaa057.2317.

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Abstract Person-centered care that supports choice and autonomy of residents is foundational to implementing high quality care for long-term care residents including those living with dementia. Organizational change that supports person-centered approaches requires leadership engagement and a stable, well-qualified dementia-capable workforce. This paper uses survey data from a statewide probability sample of nursing homes and their staff (N=438) to identify barriers and facilitators to person-centered care. Findings show key barriers to delivering person-centered care, including a lack of staff empowerment practices and irregular use of consistent assignment. While most organizations are implementing some person-centered resident care practices, few have moved beyond predominantly institutional practices. Staff stability and retention also remain key barriers to person-centered care. Facilitators include adoption of evidence-based and inclusive quality improvement strategies. The paper will discuss implications for state, community and organizational strategies for improving staff empowerment, integrating dementia care competencies, promoting culture change and increasing leadership engagement.
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Morgan, Debra G., Karen M. Semchuk, Norma J. Stewart, and Carl D'Arcy. "The Physical and Social Environments of Small Rural Nursing Homes: Assessing Supportiveness for Residents with Dementia." Canadian Journal on Aging / La Revue canadienne du vieillissement 22, no. 3 (2003): 283–96. http://dx.doi.org/10.1017/s0714980800003901.

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ABSTRACTThe physical and social environments are recognized as important therapeutic tools in the care of nursing home residents with dementia, yet little is known about the environments of rural nursing homes. This study was conducted in one rural health authority (16,000 km 2) in the province of Saskatchewan. Long-term institutional care was provided in seven small (15 to 35 beds), publicly funded nursing homes, none of which had separate dementia special care units (SCUs). The Physical Environmental Assessment Protocol (PEAP) was used to evaluate the facilities on nine key dimensions of dementia care environments. Facilities were most supportive in provision of privacy and least supportive on maximizing awareness and orientation. Focus groups were conducted with registered nurses, nursing aides, and activity workers. Staff caregivers identified six special needs of residents with dementia that were difficult to meet in the nursing homes, two of which were related to the physical environment (safety and a calm, quiet environment) and four of which were related to the social environment (meaningful activity and one-to-one contact, opportunity to use remaining abilities, flexible policy, and knowledgeable caregivers who enjoy working with persons with dementia). Staff suggested separate dementia SCUs as one approach to managing dementia care but also identified challenges in creating dementia units in small rural facilities. Results provide support for conceptual models of dementia care settings that emphasize the interaction of organizational, social, and physical factors.
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Haeusermann, Tobias. "Professionalised intimacy: how dementia care workers navigate between domestic intimacy and institutional detachment." Sociology of Health & Illness 40, no. 5 (May 20, 2018): 907–23. http://dx.doi.org/10.1111/1467-9566.12730.

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Kristensen, Hanne Kaae, and Hanne Peoples. "Experiences related to quality of life in people with dementia living in institutional settings – A meta-aggregation." British Journal of Occupational Therapy 83, no. 3 (October 16, 2019): 145–61. http://dx.doi.org/10.1177/0308022619879080.

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Introduction Within dementia care, there remains a general lack of coherence in evidence-based knowledge on issues of importance for subjective experiences of quality of life in people with dementia. The aim of the meta-aggregation was to investigate experiences related to quality of life in people with dementia living in institutional settings. Method A meta-aggregation inspired by the Joanna Briggs Institute was undertaken. A systematic search was conducted in four databases and additional studies were found in the reference lists of the included studies. Only studies in English, Danish, Swedish, and Norwegian were considered, with publication dates from 2007 to 2018. Findings Ten original qualitative studies were included. Using critical appraisal, methodological quality was assessed. We extracted five main categories: acceptance and adaptation; autonomy; personhood; social connectedness; and activities. Conclusion Significant findings for future occupational therapy in dementia care concerned the importance of coming to terms with the illness and life situation, while being able to experience feelings of autonomy, independence, and personhood. Meaningful social relationships and activities, individualized flexible routines and regulations, and adjusted physical environments with room for privacy were also prioritized in order to achieve high quality of life.
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Jagger, Carol, Michael Clarke, and Andrew Stone. "Predictors of survival with Alzheimer's disease: a community-based study." Psychological Medicine 25, no. 1 (January 1995): 171–77. http://dx.doi.org/10.1017/s0033291700028191.

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SynopsisFactors associated with reduced survival were investigated in elderly people diagnosed as having Alzheimer's disease (AD) and in those free of dementia at diagnosis. The study population comprised 155 people free of dementia and 222 with AD; all were aged 75 years and over and were part of a two-stage prevalence study of dementia during 1988 in Melton Mowbray, Leicestershire. An increased risk of death was found for those with a history of heavy alcohol use, lower cognitive function, a history of heart failure and those in institutional care, these factors acting in the same manner for persons free of dementia and those with AD. For the non-demented group a greater risk of death was found with increasing age and for those with a history of cancer. A greater risk of death was found for males with AD compared to females with the risk increasing over time. The longer survival of women over men may explain the sex differences found in the prevalence of AD without accompanying differences in incidence.
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Gräsel, Elmar. "Temporary Institutional Respite in Dementia Cases: Who Utilizes This Form of Respite Care and What Effect Does It Have?" International Psychogeriatrics 9, no. 4 (December 1997): 437–48. http://dx.doi.org/10.1017/s1041610297004572.

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In the studies on the effects of temporary institutional respite (TIR) published to date, a slight reduction of subjective burden has been established. The hope that this form of respite care might have a positive effect on the activities of daily living or on the health of the care recipients has not yet been confirmed. A considerable deficit in the methodology applied might be a reason for this. There is no denying the fact that there is a clear need for respite services, particularly because every seventh person providing care for a dementia patient requiring personal care belongs to a high-risk group that is characterized by serious reduction in his or her physical health and psychological well-being. TIR is primarily utilized by adult child caregivers (daughters and daughters-in-law) affected by high subjective burden who are providing care for dementia patients with extensive nursing needs.
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Kuo, Yu-Chun, Chung-Fu Lan, Liang-Kung Chen, and Virginia M. Lan. "Dementia care costs and the patient's quality of life (QoL) in Taiwan: Home versus institutional care services." Archives of Gerontology and Geriatrics 51, no. 2 (September 2010): 159–63. http://dx.doi.org/10.1016/j.archger.2009.10.001.

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42

Victor, Elizabeth, and Laura Guidry-Grimes. "Relational autonomy in action: Rethinking dementia and sexuality in care facilities." Nursing Ethics 26, no. 6 (July 18, 2018): 1654–64. http://dx.doi.org/10.1177/0969733018780527.

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Background: Caregivers and administrators in long-term facilities have fragile moral work in caring for residents with dementia. Residents are susceptible to barriers and vulnerabilities associated with the most intimate aspects of their lives, including how they express themselves sexually. The conditions for sexual agency are directly affected by caregivers’ perceptions and attitudes, as well as facility policies. Objective: This article aims to clarify how to approach capacity determinations as it relates to sexual activity, propose how to theorize about patient autonomy in this context, and suggest some considerations for finding an ethically responsible and practically feasible way to respect the sexual rights of this population. Research Design: The focus is on residents with early to moderate dementia in states of daily dependency on professional caregivers. The article critically examines existing empirical research on sexuality among persons with dementia, caregivers’ attitudes, and institutional roadblocks to enabling residents’ sexuality. A relational lens and insights from disability studies are used in the philosophical analysis. Participants and Research Context: No research participants were part of this analysis. Ethical Considerations: This article offers a conceptual analysis and normative framework only. Findings: The analysis highlights the delicate balance that capacity assessments for sexual activity have to strike; while caregivers should protect those who cannot give adequate consent, the denial of sexuality among residents can cause deep, long-ranging harms. Sexual agency features into an ongoing sense of self for many individuals with dementia, and the imposition of inappropriate standards and expectations for sexual autonomy can lead to unwarranted obstacles to sexual activity. Discussion: Recommendations include developing clear and inclusive institutional policies and practices of care, providing education for caregivers on how to discuss and document residents’ sexual preferences over time, and taking advantage of ethics consultation services. Conclusion: This analysis establishes the need for more research and discussion on this sensitive topic. Future research should investigate the specific responsibilities of caregivers in furthering the sexual interests of residents, how exactly to modify existing capacity instruments, and how best to support historically marginalized patients in their sexual identities.
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Gutman, Gloria, and Brian de Vries. "Cultural and Institutional Considerations in Advance Care Planning in Long-Term Care Settings." Innovation in Aging 4, Supplement_1 (December 1, 2020): 754. http://dx.doi.org/10.1093/geroni/igaa057.2716.

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Abstract Advance Care Planning (ACP) is a process that supports individual’s understanding and sharing of personal values, life goals, and preferences regarding future medical care, so that they obtain care consistent with these during serious and chronic illness. While ACP is important for all, it is especially so for people who fall outside traditional, western, heteronormative contexts (e.g. who belong to ethnic, racial and/or sexual/gender minorities). This symposium draws from research conducted by the Diversity Access Team [part of a national project iCAN-ACP Improving Advance Care Planning for Frail Elderly Canadians]. The first paper presents results from focus groups conducted with loved ones of South Asian, Chinese and Lesbian, Gay, Bisexual, and Transgender (LGBT) older adults living in care homes; issues identified as barriers include starting ACP conversations too late (“my husband has severe dementia”), lack of consideration of cultural traditions and, in the case of LGBT older adults, their non-family support networks. The second paper draws from focus groups with care home staff, implicating their own training as a barrier to assisting residents/families with ACP as well as resident, family, institutional and cultural influences. A third paper reports on an educational intervention designed to increase staff understanding of ACP and comfort in assisting residents/families with ACP. The fourth paper reports feedback received on two ACP planning tools, reflecting the importance of minority group representation in visuals and text. Together, these papers underscore the importance of taking culture into consideration in framing and discussions of fostering ACP among minority populations.
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Tseng, Winger Sei-Wo, Wing-Kwong Wong, Chun-Chi Shih, and Yong-Siang Su. "Building a Care Management and Guidance Security System for Assisting Patients with Cognitive Impairment." Sustainability 12, no. 24 (December 15, 2020): 10516. http://dx.doi.org/10.3390/su122410516.

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The care of dementia patients presents a large challenge for caregivers and family members. Whether it is at home or in institutional care, patients have problems with spatial and environmental cognition. It often leads to abnormal behaviors such as a route recognition problem, wandering, or even getting lost. These behaviors require caregivers to keep an eye on the movement of the cognitively impaired elderly and the safety of these movement processes, to avoid them approaching dangerous areas or leaving the care environment. This paper used qualitative research methods (i.e., participatory interviews, case studies, and contextual observation methods) in the demand exploration phase and quantitative research methods in the product’s technological verification phase. In this study, we implemented a three-stage service design process—demand exploration, demand definition, and design execution—to analyze the care status and route recognition obstacles of elders with dementia, to identify hidden needs as a turning point for new product innovations in care management and guidance security. This study summarizes six service needs for care management and guides the surveillance and safety of elders with dementia: (1) offering indoor user-centered guidance, (2) providing the instant location information of elders with dementia to caregivers, (3) landmarks setting, (4) assistance notification, (5) environmental route planning, (6) use of a wearable device as a guide for indoor route guidance. Based on the potential deficiencies and demands of observation, the care management and guidance security system (CMGSS) was designed. The experimental results show that the use of ultra-wide band positioning technology used in the indoor guiding system can accurately guide the behavior of patients to the right position, provide accurate information for caregivers, and record their daily behavior. The error range of this technology was not only within 42.42 cm in indoor static positioning but also within 55 cm in dynamic positioning, even where wall thickness was 18 cm. Although the device was designed for institutional care, it can also be applied to the management and care of general home-based patients.
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Hradcová, Dana. "Relational approach to ethics and quality improvement in institutional care for people with dementia." Annals of Palliative Medicine 6, no. 4 (October 2017): 319–26. http://dx.doi.org/10.21037/apm.2017.06.20.

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46

Thomas, K., and R. Baier. "A MUSIC PROGRAM FOR INSTITUTIONAL LONG-TERM CARE RESIDENTS WITH DEMENTIA: IMPLEMENTATION AND OUTCOMES." Innovation in Aging 1, suppl_1 (June 30, 2017): 1044–45. http://dx.doi.org/10.1093/geroni/igx004.3816.

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47

Fields, Beth, Wendy Wood, and Rebecca Lassell. "Impact of a dementia-specific program of equine-assisted activities: providers’ perspectives." Quality in Ageing and Older Adults 20, no. 2 (May 30, 2019): 37–47. http://dx.doi.org/10.1108/qaoa-10-2018-0047.

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Purpose Establishing acceptability of complex interventions to stakeholders is vital in early scientific development. The purpose of this paper is to ascertain the acceptability of a program of equine-assisted activities (EAAP) for people with dementia by elucidating programmatic practices needed to enhance their safety and quality of life (QoL) from the perspectives of service providers. Design/methodology/approach Semi-structured interviews with five providers were analyzed using a basic qualitative approach. Findings Providers perceived the EAAP as acceptable and revealed potential mechanisms of change supporting well-being, including aspects related to the physical and social environment and person with dementia. Linkages identified among the EAAP and its physical and social context support its complexity. Providers explicated program practices that promoted safety and QoL, such as implementing staff trainings and tailoring activities to each person’s preferences and needs. These practices aligned with best dementia care approaches, underscoring that the EAAP is a promising complex intervention that merits further scientific development. Originality/value This work is novel and adds to the literature by illuminating the role of a community-based, animal-assisted program for enhancing the QoL of older adults with dementia residing in institutional care facilities.
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Mulders, A. J. M. J., S. U. Zuidema, F. R. Verhey, and R. T. C. M. Koopmans. "Characteristics of institutionalized young onset dementia patients – the BEYOnD study." International Psychogeriatrics 26, no. 12 (October 8, 2014): 1973–81. http://dx.doi.org/10.1017/s1041610214001859.

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ABSTRACTBackground:People with Young Onset Dementia (YOD) have specific needs for care. These people eventually require institutional care, usually delivered by institutions designed for the elderly. The Dutch network of care organizations delivering specialized YOD care offers a unique opportunity to obtain more knowledge of this special population.Methods:Our cross-sectional study collected data from 230 people with YOD in eight care homes providing YOD specialized care. Data collected: demographic data, disease duration, dementia subtype, comorbidity, dementia severity (Global Deterioration Scale – GDS), neuropsychiatric symptoms (NPS; Neuropsychiatric Inventory – NPI, Cohen Mansfield Agitation Inventory – CMAI), disease awareness (Guidelines for the Rating of Awareness Deficits – GRAD), need for assistance (hierarchic Activities of Daily Living (ADL) scale – Resident Assessment Instrument – Minimum Data Set (RAI-MDS)).Results:The mean age of the residents with YOD in care homes was 60 years and 53% of them were men. There is a large variety of etiologic diagnoses underlying the dementia. Dementia severity was very mild to mild in 18%, moderate in 25%, and severe or very severe in 58% of the participants. The prevalence of NPS was high with 90% exhibiting one or more clinically relevant NPS. Comorbidity was present in more than three quarters of the participants, most frequently psychiatric disorders.Conclusions:The institutionalized YOD population is heterogeneous. NPS occur in almost all institutionalized people with YOD, and frequency and severity of NPS are higher than in late onset dementia (LOD) and community-dwelling YOD patients. Care should be delivered in settings accommodating a mixed male and female population, with appropriate, meaningful activities for all individuals. Further research is needed on NPS in YOD, to enhance quality of life and work in specialized YOD-care.
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Aaltonen, Mari S., Leena P. Forma, Jutta M. Pulkki, Jani A. Raitanen, Pekka Rissanen, and Marja K. Jylhä. "The Joint Impact of Age at Death and Dementia on Long-Term Care Use in the Last Years of Life: Changes From 1996 to 2013 in Finland." Gerontology and Geriatric Medicine 5 (January 2019): 233372141987062. http://dx.doi.org/10.1177/2333721419870629.

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Welfare states increasingly rely on aging in place policies and have cut back on institutional long-term care (LTC) provision. Simultaneously, the major determinants of LTC use, that is, dementia and living to very old age, are increasing. We investigated how increasing longevity and concomitant dementia were associated with changes in round-the-clock LTC use in the last 5 years of life between 1996 and 2013. Retrospective data drawn from national registers included all those who died aged 70+ in 2007 and 2013, plus a 40% random sample from 2001 ( N = 86,554). A generalized estimating equations (GEE) were used to estimate the association of dementia and age with LTC use during three study periods 1996-2001, 2002-2007, and 2008-2013. Between the study periods, the total number of days spent in LTC increased by around 2 months. Higher ages at death and the increased number of persons with dementia contributed to this increase. The group of the most frequent LTC users, that is, people aged 90+ with or without dementia, grew the most in size, yet their LTC use decreased. The implications of very old age and concomitant dementia for care needs must be acknowledged to guarantee an adequate quantity and quality of care.
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SIINER, MAARJA. "Let me grow old and senile in peace: Norwegian newspaper accounts of voice and agency with dementia." Ageing and Society 39, no. 5 (December 14, 2017): 977–97. http://dx.doi.org/10.1017/s0144686x17001374.

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ABSTRACTThis study analyses the remaking of dementia as a social and cultural phenomenon in the public media discourse in a welfare state Norway. A content analysis was carried out of articles on dementia published in Norwegian paper media from 1995 to 2015. The study combined the tools from quantitative corpus analyses and qualitative critical discourse analyses, making it possible to detect and interpret diachronic changes in the dementia discourse. Although the main focus in Norwegian dementia discourse has changed from the disease to the personhood, the agents defining what it means to live well with dementia continued to be predominantly institutional: non-governmental organisations, municipalities, health-care institutions and politicians. An analysis of the uses of the politically incorrect Norwegian term for dementia, ‘senility’, revealed that this term offered an alternative to the institutionalised dementia discourse and functioned as an unconventional and therapeutic-free space where older people and persons with dementia could use humour to subvert these norms and power relations.
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