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1
Henschel, Peter W. (Peter William). "Distress and Causal Attributions Associated with Caring for Family Members with Senile Dementia." Thesis, University of North Texas, 1993. https://digital.library.unt.edu/ark:/67531/metadc501261/.
Full textAbstract:
A sample of 22 persons who care for relatives exhibiting initial symptoms of senile dementia were administered paper-and- pencil questionnaires to determine their level of subjective burden and psychological symptomatology. Each participant's attributional style was measured on an internal-external dimension, and their causal attributions regarding their relative's symptomatic behaviors were assessed. Results indicated that attributional style did not predict specific attributions about illness-related behaviors, but the tendency to not blame an afflicted relative for their behavior was predictive of subjective burden and symptoms of depression and anxiety. Subjective burden was found to predict feelings of hostility in caregivers.
2
Wagner, Blake Douglas. "An evaluative investigation of the effects of establishing a personalized system of prosthetic aids to memory for dementing persons in the home environment." Diss., Virginia Polytechnic Institute and State University, 1986. http://hdl.handle.net/10919/76335.
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This research project was a systematic evaluation of the effects of a personalized system of prosthetic aids to memory established in the home environment for individuals with mild to moderate dementia. The system of aids developed were in the form of a free-standing "Memory Center" unit. Caregivers were responsible for actively training their relatives to use the aids to compensate for deficits in orientation and memory for information necessary for daily functioning.
The investigation was conducted in two phases, using a modified multiple baseline across subjects design. The two clients in Phase I met research criteria for Alzheimer type dementia and received a clinical dementia rating of moderate progression. Of the three clients in Phase II, two satisfied research criteria for Alzheimer type dementia, while one met research criteria for vascular dementia. All three were determined to have mild dementia.
The effects of the intervention on the clients and the caregivers were examined over a four week intervention period and at a one month follow-up. The primary question addressed was whether clients could be trained to effectively use the prosthetic aids to orient themselves and compensate for deficits in memory function. This was assessed via daily assessments of verbal orientation. Weekly ratings of the behavioral functioning of clients were provided by the caregivers. And finally, caregivers rated their own stress and mood levels on a weekly basis throughout the study.
Although the rates of learning varied, all of the clients increased their levels of verbal orientation following the introduction of the prosthetic aids and training. Evidence for generalized effects on the behavioral functioning of the clients was found. Overall, the clients were rated as expressing fewer negative emotions and as evidencing more oriented behaviors and less confused and disturbed behaviors during the intervention and at follow-up.
Overall, the caregivers reported a consistent pattern of decline in their levels of stress and dysphoric mood. A common area of improvement was a reduction in negative emotions felt and expressed toward their relatives.
Factors related to the success of the intervention and potential causal elements of change were discussed. Finally, recommendations for clinical practice and future research were provided.Ph. D.
3
Wilkinson, Peter. "De concentv amisso qvaerendo: An investigation into the relative benefits of three different types of ambient music on the observed agitated behaviour and quality of life of dementia sufferers in residential aged care facilities." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2014. https://ro.ecu.edu.au/theses/1562.
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There is an increasing body of research evidence to support the use of music as a therapeutic modality in reducing the agitated behaviour frequently associated with late-stage dementia. Although much of this evidence suggests that music interventions are most effective when they are “individualized”, this type of intervention is often difficult to implement in large, busy, aged care facilities where residents may be located together in communal areas during the day. The challenge therefore is to try and identify a particular musical genre which, when played as “ambient” or “background” music, demonstrates a consistent capacity to reduce agitated behaviour in late-stage dementia across resident populations in multiple facilities. This study was designed to test the comparative utility of three different types of background music identified in the existing research literature as being of possible benefit in this context. These three types of music were: gentle classical music, familiar music and baroque music.
Using a sample of 65 older people with late-stage dementia living in a total of eight residential aged care facilities, this quasi-experimental study used quantitative measures to assess a specific range of agitated behaviours over a one week intervention period. The specific agitated behaviours were documented using the Scale for the Observation of Agitation in Persons with Dementia (SOAP-D) scale (Hurley, Volicer, Camberg, Ashley, Woods, Odenheimer, Ooi, McIntyre, & Mahoney, 1999). In addition, the Quality of Life in Alzheimer’s Disease (QoL-AD) tool (Logsdon, 1999) was used to collect collateral information from family members or experienced care staff at each of the participating facilities about whether they perceived that the playing of music exerted any influence on the quality of life of participants.
Participants were randomly assigned to one of five experimental subgroups of equal size. Participants in three of the five groups received exposure to audio recordings of music. Participants in one of the two remaining sub-groups were exposed to a non-musical intervention (audio recordings of storybooks) at the same time of day as the participants in the three music groups. Data relating to behaviour and perceived quality of life were recorded in the same manner for this group. The final group of participants acted as the control group for the study. Quantitative data were collected in the same manner for this group: however, they were exposed to no intervention.
In addition, a series of structured interviews was undertaken with experienced care providers at each of the participating residential aged care facilities. The purpose of this procedure was to determine whether the experiences and subjective opinions of staff regarding the utility of music as an intervention to settle agitated behaviour in late-stage dementia and improve quality of life were consistent with the observational data recorded using the SOAP-D scale in conjunction with the proxy-rated QoL-AD scale.
Results of the study indicated that overall levels of agitated behaviour were less within the three groups exposed to music compared with the nonmusic intervention group and the control. However, perceived quality of life was not measurably improved in any of the three music intervention groups. This study supports the continued use of music as a therapeutic intervention in the management of maladaptive behaviour associated with late-stage dementia, although the results do not support the preferential use of any of the three selected music forms.
4
Erickson-Taube, Christina Marie. "Special care units: Recreational activities for patients with Alzheimer's disease." CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2843.
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The purpose of this study was to evaluate the recreational activities provided in special care units located in the Inland Empire. The population that this study sought to assist was patients diagnosed with Alzheimer's disease and living in an Alzheimer's special care unit.
5
Chae, Young Mi Lim. "Development of a behavioral nursing intervention strategy in grooming performance of elders with cognitive impairments." Diss., The University of Arizona, 1993. http://hdl.handle.net/10150/186183.
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The purpose of the study was to develop a behavioral nursing intervention strategy for specific deficits in grooming performance of elders with dementia. A quasi-experimental two-group design using switching replications with removed intervention was employed. Three residents with severe cognitive impairments and three residents with mild cognitive impairments were chosen from a special dementia care unit of a long-term care facility. Three residents among six residents were randomly selected to receive the behavioral intervention early. Baseline and post-intervention assistance was provided by nurse aides. Each resident was asked to wash hands, brush teeth, wash face, and comb hair in a sequence. Ten intervention sessions were conducted by the trained intervener for two consecutive weeks. The intervention consisted systematic prompting and social reinforcement. A total of 21 sessions were collected in the morning using videotape recordings. Interobserver agreement for the instruments designed by the investigator was measured by the trained observers. Data were analyzed in two phases. First, the quantitative data were analyzed to determine the independent functional behaviors of individuals, and the change in the intensity of nursing effort associated with grooming of elders with dementia. Data were examined by individual graphic display throughout the three phases (baseline, nursing intervention, post-intervention). Second, the qualitative data were analyzed to determine the antecedents, consequences, and resident responses associated with grooming, the caregiver problem behaviors, and resident problem behaviors associated with grooming performance. The results show that the functional behaviors of even severely demented elders can be promoted, indicating the effectiveness of nursing care strategies on the ADL task of grooming. The data in this research suggest that maintaining or improving functional ability is possible with a behavioral nursing intervention, which was a highly structured and systematic approach that involved modifying the environmental and behavioral context, through strategies such as prompting and social reinforcement, when necessary. Furthermore, through the qualitative analysis, the functional relationships between antecedents, consequences, and behaviors of demented elders allowed the investigator to analyze the caregiver problem behaviors and resident behavior problems associated with grooming.
6
Hill, Heather. "Talking the talk but not walking the walk : barriers to person centred care in dementia /." Access full text, 2004. http://www.lib.latrobe.edu.au/thesis/public/adt-LTU20041215.100826/index.html.
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Thesis (Ph.D.) -- La Trobe University, 2004."A thesis submitted in total fulfillment of the requirements for the degree of Doctor of Philosophy, School of Public Health, Faculty of Health Sciences, La Trobe University, Bundoora." Research. Includes bibliographical references (leaves 343-362). Also available via the World Wide Web.
7
Kixmiller, Jeffrey S. "Subtyping patients with Senile Dementia of the Alzheimer type using cluster analysis." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/833474.
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The purpose of this study was to determine if distinct subgroups of patients with Senile Dementia of the Alzheimer Type (SDAT) could be identified using seven scales of the Cognitive Behavior Rating Scale (CBRS). Ward's method of cluster analysis was used to group 104 patients with a probable diagnosis of SDAT into subtypes.The following three clusters were identified: (a) Moderately Impaired, (b) Severely Impaired, and (c) Emotionally Intact which displayed differences in symptom severity. Clusters could be partially defined by the amount of time they had been diagnosed with the disease. Differences in the cluster's configuration of scores had little/no descriptive utility. Subsequent discrimination analyses indicated that patient demographics were not as useful as the CBRS in classification of patients.This study provided evidence for the CBRS's ability to differentially portray SDAT patients' profiles. Results provide partial support for a stage model of SDAT. Implications of existing subgroups in SDAT are discussed as they pertain to patient management issues.Department of Counseling Psychology and Guidance Services
8
Hilder, Lisa. "The emotional and instrumental experiences of caregivers of senile dementia/Alzheimer type patients." CSUSB ScholarWorks, 1993. https://scholarworks.lib.csusb.edu/etd-project/720.
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9
Lin, Shan, and 林珊. "The effectiveness of community care interventions on caregivers of dementia patients : a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193793.
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Objective: To synthesis evidence from systematic reviews at international level to explore effective community and home based care interventions for family caregivers (FCGs), which may affect quality of life of persons with dementia (PWDs) and their FCGs in China.
Methods: A systematic review of reviews was conducted. Studies were identified through Scopus, PubMed and EBSCO databases. Non-pharmacological interventions targeted on FCGs with outcome domains related to psychological health or quality of life of PWDs and/or their FCGs were within this review scope. Quality of systematic reviews was evaluated by AMSTAR. Quality of primary studies included in the systematic reviews was assessed by their internal and external validity.
Results: Three systematic reviews of moderate to high quality with 74 publications were included in this systematic review. Among the primary studies, about 60% were conducted by randomized controlled design, and about 85% were carried out in high-income countries. Results at review level suggested that communication skills training, internet-based care management, coping strategy, individual behavioral management techniques were effective interventions for FCGs of PWDs. In contrast, most of the primary studies reported that community or home based interventions positively affected FCGs and/or PWDs. Those interventions included communication skills training, internet-based care management, supportive therapy, educational intervention, coping strategy, behavioral management techniques; yet the effects yielded statistically insignificant in most of the trials. In particular, significant effects of community care interventions were found in 8 of 69 trials on FCGs’ psychological health, 3 of 4 trials on FCGs’ competence, 0 of 2 trials on FCGs’ quality of life, and 3 of 7 trials on PWDs’ quality of life. Combination of those community care intervention components was observed in most of the trials with significant effects.
Conclusion: Communication skills training, internet-based care management, supportive therapy, educational intervention, coping strategy, behavioral management techniques had positive effects on FCGs of PWDs living in the community. The combination among those intervention components and designing intervention model in FCG needs-oriented manner underpinned a potential significant effect. Given distinguished social economic contexts in urban and rural areas, implementation of community care interventions specific to FCGs in China should be handled with cautions and strengthened by policy supports to empower aging at home.published_or_final_version
Public Health
Master
Master of Public Health
10
Taing, Sonya. "Race and ethnicity influences| A predictor of nursing home patients admitted with dementia." Thesis, California State University, Long Beach, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1524167.
Full textAbstract:
The United States population of elderly persons is growing quickly, causing an increase in concern for their health care needs. Dementia is a condition that affects the elderly. With an increase in persons with dementia, there is also an increase in apprehension of care choices. National data and published literature were used to study dementia and its effects on the patient and their family caretakers. The study concluded that minority families were less likely to institutionalize elderly dementia patients into nursing care due to a variety of cultural biases. White dementia patients had the highest number of admittance into nursing homes. This was also prevailing in the specialty care unit for dementia patients. Understanding the cultural differences and needs of the minority patient can help organizations improve the disparity among dementia patients admitted into nursing homes.
11
Kihlgren, Mona. "Integrity promoting care of demented patients." Doctoral thesis, Umeå universitet, Institutionen för omvårdnad, 1992. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-100570.
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The purpose of the thesis was to investigate if integrity promoting care improves functions in demented patients over time. The Erikson (1982) theory of ”eight stages of man” was used as a basis for training of staff in a three-month intervention study (I-VI) at a nursing home ward. A collective living unit where staff had had support in the performance of the delivery of care was also evaluated and compared with a nursing home in a long-term study (VII). Patients, relatives, staff, and the environments were investigated. Cerebrospinal fluid concentrations of somatostatin increased, and reduction of distractability, anxiety and confusion was seen in the intervention group (I) in contrast to controls. In the collective living group (VII) EEG activities indicated a reduction of supposed dementia induced changes. Better motor and social ability, some improved intellectual ability, more alertness and reduced signs of depression were seen (I, II, VII). Patients expressed more autonomy (IV, VII) and initiatives (II-VII) and showed a lot of competence (V) in conversations. Five patients (V) showed patterns of behaviour which seemed to reflect life-long characteristics in spite of their severe dementia. The improvement in the patients' functions can be attributed to the physical environment and the integrity promoting care, since the medical treatment of the patients remained unchanged. In the thesis medical, psychological, and nursing sciences were connected in a complementary process. The results were congruent, and indicate that patients in the care of staff who had had training and support, declined less than controls.S. 1-61: sammanfattning, s. 63-184: 7 uppsatser
digitalisering@umu
12
Tweedy, Maureen P. "Change in Depression of Spousal Caregivers of Dementia Patients." Thesis, University of North Texas, 2006. https://digital.library.unt.edu/ark:/67531/metadc5338/.
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Caring for a family member or loved one with dementia places a heavy burden on those providing the care. Caregivers often develop chronic depression because of having to deal with this burden. A great deal of literature has been published discussing coping effectiveness, effects of social support, and other internal and external means of support for the caregiver. However, little has been written about the changes, if any, in depression that the caregiver experiences after the termination of care, either through institutionalization or death of the person with dementia. This study examined whether there is a change in depression of spousal caregivers after institutionalization of the dementia care recipient as well as any changes in depression that may have occurred as a result of the death of the dementia care recipient. Two theoretical models, the wear and tear model and the adaptation model were discussed in terms of caregiver depression after institutionalization of the dementia care recipient. Two other theoretical models, the relief model and the stress model, were discussed in terms of caregiver depression after the death of the dementia care recipient. Datasets from the National Institute on Aging sponsored Health and Retirement Study were analyzed. Results indicate that both male and female spousal caregivers report an increase in depression after the institutionalization or death of the dementia care recipient, but that as time passes, males report a decrease in depression while females continue to report an increase in depression.
13
Sin, Hiu-lam, and 冼曉琳. "Modeling family caregivers' willingness to continue care in community for older persons with dementia." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193470.
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This study aimed to model the process and its relevant variables in predicting the willingness in home care and actual institutionalization of older persons with dementia in a Hong Kong context.
This was a secondary data analysis of a previous research study which collected 122 sample of Chinese caregivers and their older care recipients with clinical diagnosis of dementia, all of whom recruited from a local NGO. Participants were assessed on a battery of instruments that collected both caregivers and patients' characteristics, including demographic details, patients “physical states affected by dementia, caregivers” perceived burden. The period of study was 12 months, with follow up phone calls on state of care every 6 months.
Only a very weak relation was shown between expressed intention to care and actual placement at 12M. Higher odds in intention for home care was significantly predicted by male gender in caregiver gender and lower caregiver burden (ZBI score); ZBI was a total mediator between patients' agitation (CMAI score) and willingness. Higher odds of actual institutionalization was related to the use of day care centre.
Results called for a need to carefully distinguish the genuinely effective services in helping to delay nursing home placement; rather than assuming all to be useful. While caregivers training was not popular among current sample, current model showed the importance of caregivers' perceived burden in altering objective environmental stress' effect on caregiving outcomes. While more than half of the current sample was using day care centre, model suggested day care centre could have encouraged placement. More resources should be allocated in programmes that aimed to manage caregivers' stress and cognition. There should also be more promotions to heighten awareness and participation of such programmes amongst caregivers of HKG.published_or_final_version
Social Work and Social Administration
Master
Master of Philosophy
14
Oates, Virginia C. Oates. "An Educational Intervention: Exploring Home Health Care Nurses' Knowledge and Perceptions of Identifying Dysphagia in Patients with Dementia." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1513883116484059.
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15
Achor, Sam Ndu. "Family visits or contact to dementia elderly at long term care facilities." CSUSB ScholarWorks, 2000. https://scholarworks.lib.csusb.edu/etd-project/1581.
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16
Lai, Kam-yuk, and 賴錦玉. "Improving the quality of life for nursing home residents withdementia: a life story approach." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31228264.
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17
Law, Emma. "Research in care homes : issues of participation and citizenship." Thesis, University of Stirling, 2016. http://hdl.handle.net/1893/25305.
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Across Scotland, there is a lack of research in care homes. This thesis explores this topic by examining links between inclusion, participation in general and participation in research and whether those who work and live in the care home environment experience social citizenship. Using a national survey and interviews with residents, staff, relatives and experts in care home research, this thesis investigated whether participation generally was linked to participation in research for residents, staff and visitors in a care home setting. The thesis further explored how social citizenship functions in a care home environment and whether there is a link between participation and citizenship. The findings suggest there is a lack of general participation which is connected with the leadership style and management within the care homes. There is misunderstanding about research and legislation amongst the care home staff, residents, visitors, as well as the junior research staff which inhibited staff and resident participation. Furthermore, citizenship is not experienced universally by residents or staff due to disempowerment, and exclusion occurs amongst residents due to age, frailty and dementia. By facilitating good leadership, communication and relationship-building such issues may be overcome. In addition, the analysis suggests a link is evident between inclusion, participation and citizenship. Where choice is provided and residents have their social position maintained, as well as have a degree of responsibility for shaping events, this leads to participation and inclusivity as described in Bartlett and O’Connor’s (2010) definition of social citizenship. Furthermore, if inclusion is adapted for cognition and frailty, then participation leads to the experience of social citizenship, encouraging a culture which can welcome research. The explicit emphasis on inclusion and participation in research has enabled this under-researched area of participation and experience of social citizenship in care homes to be more fully explored.
18
HUI-LIN, CHOU, and 周蕙苓. "Inverstigation For The Feasibility Of promoting Group Home care of senile Dementia In National`s Public Hospital." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/c3n7zc.
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碩士國立臺東大學
進修部公共事務管理碩專(假日)
95
Abstract This research is intended to investigate the feasibility of policy for Senile Dementia in Japan for Hospitals of Department of Health,Executive Yuan,ROC. According to domestic and foreign references of policy for Senile Dementia care and the understanding from medical staff and patient
19
Bick, Irene. "Hospitalization Risk Factors of Elderly Home Health Care Patients with Dementia." Thesis, 2018. https://doi.org/10.7916/D8Q25GRS.
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Hospitalizations are a major driver of Medicare spending and adverse outcomes for the 5.3 million elderly Americans with dementia. This is a growing problem given aging and longevity trends. Within the home health care setting, about 3.5 million mostly frail elderly Medicare beneficiaries receive care and 27% are hospitalized annually. Estimates of dementia prevalence range from 31 to 60%, yet little is known about the hospitalization of home health care patients with dementia. This study addresses knowledge gaps on the prevalence, characteristics, hospitalization rate and risk factors of these patients, and explores whether hospitalization risk factors are moderated by dementia.
A systematic literature review on hospitalization risk factors in the home health care setting was completed and the findings informed the selection of variables and hypotheses for this study. This was a retrospective cohort study and the sample was patients admitted to one large non-profit home health care agency during 2014 (n=57,888). Data were from the Outcome and Assessment Information Set and other home health agency data captured at the start of care. The conceptual framework guiding the analysis was Andersen’s Behavioral Model of Health Services Use. Because more than half of those who would meet clinical criteria for dementia are undiagnosed, the operational definition of dementia for this study was a diagnosis of dementia or Alzheimer’s disease, or an indication of cognitive impairment in the start of care assessment. Multivariable logistic regression was used to identify characteristics of dementia patients and hospitalization risk factors, and to explore dementia as a moderator of hospitalization risk factors.
Prevalence of dementia among the study sample was 41.6%. Consistent with prior studies on the general dementia population, older age, Black and Hispanic race/ethnicity, Medicaid eligibility, fall risk, congregate living, more comorbidities, behavioral symptoms, depression, assistance with activities of daily living, and communication disabilities were associated with dementia. However, contrary to prior studies, serious health status, higher need for assistance with activities of daily living, and higher use of health services were negatively associated with dementia. The hospitalization rate for patients with dementia (12.9%) was significantly higher than the rate for patients without dementia (10.7%). Hospitalization risk factors of dementia patients that were consistent with prior studies among home health patients included male gender, Black race, Medicaid eligibility, number of comorbidities, higher need for assistance with activities of daily living, cardiovascular conditions, dyspnea, cancer, diabetes, renal disease, skin ulcers and higher health services use. The moderator analysis found that dementia attenuated the effect of some hospitalization risk factors and had no effect on others.
This study was a first step toward better understanding the characteristics and hospitalization risk factors of home health care patients with dementia. Findings from this research can inform practice, policy and future research on home health care patients with dementia.
20
McConnell-Barker, Michelle. "Comparison of restraint practices for persons with dementia residing in and outside special care units in British Columbia." Thesis, 2000. http://hdl.handle.net/2429/10694.
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The excessive use of chemical and physical restraints in intermediate care facilities has
been a subject of study since the early eighties, and has produced several explanations for why
restraint use continues to be practiced. One of the primary reasons often cited is that restraints
are used to control "problematic behavior" commonly exhibited by a person suffering from
dementia.
The focus of the proposed project is to analyze whether restraint practices for residents
with moderate to severe dementia differ between Special Care Units and integrated units within
long term care facilities. The main objective of the study is to demonstrate whether seniors with
dementia residing in Special Care Units will be less likely to encounter physical and chemical
restraints than demented residents living within an integrated facility. This objective explores
the assumption that Special Care Units were designed to meet the needs of residents with
dementia, and therefore, care providers should be more accepting of deviant behaviours.
The findings revealed that the more severe the level of memory impairment the more likely
a resident would be placed in a Special Care Unit. Once located in these Special Care Units,
residents were more likely to experience physical and chemical restraints than their counterparts
in integrated care units.
21
Kilbourn-Huey, Mary E. "Attitudes, stressors and perceptions of certified nursing assistants giving care to residents with dementia in long term care facilities." 2007. http://proquest.umi.com/pqdweb?did=1472164151&sid=2&Fmt=2&clientId=42585&RQT=309&VName=PQD.
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Thesis (M.A.)--Northern Kentucky University, 2007.Made available through ProQuest. Publication number: AAT 1447177. ProQuest document ID: 1472164151. Includes bibliographical references (p. 61-64)
22
chün, huang ya, and 黃雅君. "The cost-effectiveness analysis of those who living at home only, day care center and nursing home for patients with dementia among the different disease severity." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/57624440280533408260.
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碩士亞洲大學
長期照護研究所
95
The aged population in Taiwan reached 9.7% of the total population in 2005. The prevalence of Dementia is between 1.6% and 6.4%; with every seven seconds there is a person who was diagnosed with Dementia. Different from other chronic diseases, the impairment of patients’ cognitive function will cause trouble in work, community life and mental disorder; as a result of these behaviors, the caregiver carry a great deal of pressure. Dementia patients not only suffer from the disease but also bring psychological burden for the caregiver and heavy economic load for government and family members. Studies show the national net cost for Dementia is NT$12.83 billion, averaging NT$128,349 to NT$910,685 per capita every year. In Australia and Japan, Dementia Disease has been taken seriously and policies on Dementia patients care are emphasized; while in Taiwan, few policies concerning Dementia patients care have been addressed. Therefore, from social perspective, this study intends to evaluate the economic cost of caring for Dementia patients of different level of illness with different care system, including homecare, daycare and nursing home. We perform comparative analysis for cost-effectiveness and also monetize the care time of main caregiver. Data of direct and indirect costs were obtained from health insurance claims from the National Health Research Institutes and questionnaires. Through interviews and fill-out forms, we collected the information concerning cost of the disease and quality of life and burden carried by the caregiver. Research subjects are Dementia patients and their main caregiver amongst a medical center in central Taiwan, a mental hospital in central Taiwan and a nursing home affiliated with a hospital. Consequently, we collected 143 questionnaires. Research results show the average cost for homecare per capita every year is NT$497,745, NT$612,254 for nursing home and NT$765,572 for daycare. Those caregivers of patients using nursing home have the best quality of life, while as those who using homecare have the worst quality of life. Considering the quality of life of caregiver, it is cost-effectiveness to use nursing home when the Dementia patients are in mild, moderate and extremely major conditions; while in major condition, it is cost-effectiveness to use homecare. Considering the burden of caregiver, it is cost-effectiveness for the caregiver to use homecare when the Dementia patients are in mild, major and extremely major conditions; while in moderate condition, it is cost-effectiveness to use daycare. This study only took into account the time cost and productivity loss of chief caregiver without considering the time cost of non-chief caregiver; hence the indirect cost might be underestimated. The daycare cost discussed in this study belongs to the healthcare system; therefore, it cannot represent the daycare cost in a social aspect. The research subjects locate in central Taiwan; so the research results are not necessarily applicable nationwide. According to the research results, we offered suggestion for future studies to examine cost-effectiveness of Dementia patients with different dementia subtypes and in different service style so that the caregiver can have better understanding which service is more cost-effective.
23
"The experiences of Hong Kong family caregivers of elders with dementia: an exploratory study." 2008. http://library.cuhk.edu.hk/record=b5893414.
Full textAbstract:
Chan, Hung Yee.Thesis submitted in: December 2007.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2008.
Includes bibliographical references (leaves 121-142).
Abstracts in English and Chinese.
LIST OF TABLES --- p.xi
Chapter CHAPTER 1 --- INTRODUCTION
The Hong Kong context --- p.1
The research problem --- p.3
Conclusion --- p.4
Chapter CHAPTER 2 --- LITERATURE REVIEW
Introduction --- p.6
Different interpretations of dementia --- p.7
Experiences of caregivers of older people with dementia --- p.10
Factors affecting caregiving experiences --- p.15
Needs of family caregivers --- p.20
Summary --- p.23
Chapter CHAPTER 3 --- METHODOLOGY
Introduction --- p.25
Aim and objectives --- p.25
Research design --- p.25
Sampling method --- p.26
Data collection method --- p.28
Pilot study --- p.32
Data analysis --- p.34
Validity and reliability --- p.37
Ethical consideration --- p.40
Summary --- p.41
Chapter CHAPTER 4 --- RESULTS
Introduction --- p.42
Demographic characteristics of informants and older people with dementia --- p.43
Reasons of caregivers for providing home care --- p.45
Meaning of care --- p.52
Perceived difficulties in caregiving role --- p.56
Sources of stress in the caregiving role --- p.59
Sources of support in caregiving role --- p.62
Needs of caregivers --- p.65
Conclusion --- p.69
Chapter CHAPTER 5 --- DISCUSSION
Introduction --- p.71
Reason of providing home care --- p.72
Chinese cultural influences on family caregiving experiences --- p.80
Perceived difficulties in caregiving roles --- p.91
Sources of stress --- p.96
Sources of support in caregiving role --- p.101
Needs of family caregivers --- p.104
Conclusion --- p.108
Chapter CHAPTER 6 --- CONCLUSION
Introduction --- p.110
Implications to nursing knowledge --- p.110
Implications to current practice --- p.112
Limitation of the study --- p.114
Recommendation to future research areas --- p.116
Conclusion --- p.118
REFERENCES --- p.121
APPENDICES
Chapter Appendix 1 --- "Approval letter from Survey Ethics Committee, CUHK" --- p.143
Chapter Appendix 2 --- Information letter to informant (English) --- p.144
Chapter Appendix 3 --- Information letter to informant (Chinese) --- p.145
Chapter Appendix 4 --- Interview guide --- p.146
Chapter Appendix 5 --- An example of transcript of interview and preliminary analysis --- p.147
Chapter Appendix 6 --- Letter of Access --- p.162
24
Lee, Youjung 1977. "Korean American dementia caregivers' attitude toward caregiving: the role of culture." Thesis, 2007. http://hdl.handle.net/2152/3786.
Full textAbstract:
The purpose of this study was to explore how Korean American caregivers view dementia caregiving and analyze the role of culture in their attitude toward caregiving. Demographic characteristics, stressor factors, social support factors, and cultural factors were examined in the model. Stressor factors were measured by care receivers' problem behaviors, duration of caregiving, and amount of caregiving. Social support factors were composed of the amount of social support and the quality of social support. Cultural factors included level of acculturation, years in the U.S., filial piety, and familism. The study compared a group of spouse caregivers with a group of children providing care in order to investigate the differences in their attitude toward caregiving. In addition, the interaction effect between social support and acculturation on dementia caregiver's attitude toward caregiving was examined. Eighty five Korean American dementia caregivers participated in the survey through a convenience sampling method. Among the Korean American dementia caregivers, child caregivers showed a more positive attitude toward caregiving then spouse caregivers. The effects of social support on caregivers' attitude toward caregiving did not vary with the level of acculturation. Hierarchical multiple regression analysis indicated that, among the study factors including stressor factors, social support factors, and cultural factors, only social support factors contributed significantly to Korean American dementia caregivers' positive attitude toward caregiving. Among the predictors of Korean American dementia caregivers' attitude toward caregivng, the amount of caregiving per day was the most significant variable, followed by the quality of social support and care receivers' problem behaviors. Higher levels of daily caregiving and higher quality of social support were positively related to positive attitude toward caregiving. A higher level of care receivers' problem behaviors was negatively related to positive attitude toward caregiving. Comparison of the beta coefficients from the spouse caregiver group and nonspouse caregiver group revealed that there was a discrepancy of predictors of Korean American caregivers' attitude toward caregiving between the two caregiving groups. The model had a better fit for immigrant spouse caregiver groups indicated by significantly different R² from spouse caregivers and non-spouse caregivers, 85% and 33%, respectively. The results of this study imply the importance of incorporating cultural diversity in social policy. Because of the salient findings in this study, inclusion of content on increasing and enhancing quality of social support is recommended for social work practice with Korean American dementia caregivers.
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Lo, Chiu-Ming, and 羅秋茗. "An Investigation of the Improvement of the Elderly People’s Sense of Well-being through the Program of “Retrospect Activity”: Based on the Interviews of the People with Moderate Senile Dementia in the Residential Care Home." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/09731965062853856648.
Full textAbstract:
碩士國立中正大學
成人及繼續教育研究所
102
The purpose of the present research is to understand the influence of the “Retrospect Activity” on the sense of well-being of the elderly people with moderate senile dementia, and to discuss why these elderly people’s sense of well-being can be improved by participating in the activity, through analyses of their feelings, life experiences and sentiment after their participation. The research is aimed to: (1) to understand the crucial experiences and the feelings of the elderly people with moderate senile dementia when they take part in the whole process of the “Retrospect Activity”; (2) to comprehend the elderly People’s daily interaction with others prior to and posterior to the activity; (3) to grasp the influence of the activity on the sense of well-being of the elderly people with moderate senile dementia. The present research applies qualitative research method and semi-structured interview with six elderly people with moderate senile dementia, three social workers and three family members. Having analyzed the information obtained from the interviews, the researcher concludes as follows: I. Concerning the experiences and the feelings of the elderly people with moderate senile dementia while taking part in the activity; there are two situations can be seen: (1) The elderly people are hesitating to take part in the activity due to poor health condition and low self-confidence. (2) Those who partake in the activity are significantly encouraged and willing to learn more. II. Regarding the elderly people’s daily interaction with others after partaking in the activity, three points to be noted: (1) The daily life-style has been positively changed due to their interaction with peers. (2) Their self-confidence is recovered by family members’ encouragement and concern. (3) They become joyful and are inspired by the church and community members in the process of the activity. III. As for the influence of the activity on the sense of well-being of the elderly people, there are also three things to be said: (1) They not only show obvious interest in the activity and great satisfaction of life, but also find spiritual sustenance in family members’ support. (2) They are willing to serve one another because of the respect and understanding from others, which make them feel happy and confident. (3) The elderly people gain the sense of achievement and support from the society by their earnest commitment in the activity, and in return gratefully feedback to others. Lastly, the researcher will further discuss the results of the present research, and offer some suggestions to the leaders of the retrospect activity, the authority concerned, the government, and provide information for future researchers’ reference. Keywords: elderly people, moderate senile dementia, sense of well-being, the program of retrospect activity
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Valoo, Melissa. "Experiences of spouses caring for their Dementia of Alzheimer's Type partners : a South African perspective." Diss., 2016. http://hdl.handle.net/10500/22061.
Full textAbstract:
Dementia of Alzheimer‟s Type is a degenerative neurocognitive disease accounting for majority of Dementia‟s. It affects millions of people worldwide and thousands of people in South Africa. Apart from the economic burden this illness places on the country, it has detrimental effects for those who provide care for individuals with this illness, who are mostly spouses. The spousal caregivers bears great financial, social and emotional burden which worsens as the disease progresses. The aim of this study is to phenomenologically explore and describe the lived experiences of spousal caregivers in caring for the spouses with Dementia of Alzheimer‟s Type. This South African study was therefore qualitative in nature and was conducted in the province of KwaZulu- Natal, in the city of Pietermaritzburg. Eight participants were interviewed using a semi-structured questionnaire. Data was analysed using interpretative phenomenological analysis (IPA). The main findings of this study are the negative emotional affects that the caregiving role creates. Caregiver stress and strain is experienced as well as the experiences of various losses including lack of intimacy and ruined expectations for the future as the disease progresses. The caregiving role also created negative implications for the social lives of caregivers and coping mechanisms were seen to be very important.Psychology
M.A. (Psychology)