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1
Hamdy, R. C., J. V. Lewis, Amber Kinser, A. Depelteau, Rebecca Copeland, T. Kendall-Wilson, and K. Whalen. "Too Many Choices Confuse Patients With Dementia." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1231.
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Choices are often difficult to make by patients with Alzheimer Dementia. They often become acutely confused when faced with too many options because they are not able to retain in their working memory enough information about the various individual choices available. In this case study, we describe how an essentially simple benign task (choosing a dress to wear) can rapidly escalate and result in a catastrophic outcome. We examine what went wrong in the patient/caregiver interaction and how that potentially catastrophic situation could have been avoided or defused.
2
Hamdy, Ronald C., Amber Kinser, Tracey Kendall-Wilson, Audrey Depelteau, K. Whalen, and J. Culp. "Driving and Patients With Dementia." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/2738.
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Driving is a symbol of autonomy and independence, eagerly awaited during adolescence, cherished during adulthood and reluctantly rescinded during old age. It is nevertheless an individual’s privilege, not right, especially as driving may affect other drivers and pedestrians on the road. It is therefore not only the individual patient who is at stake but essentially the entire community. In this case scenario, we describe the situation that arose when a patient with multi-infarct dementia wanted to go for a drive and his son and grandson tried to convince him that he could no longer drive. What went wrong in the caregivers/patient interaction is presented. The futility of arguing with patients who have dementia is highlighted as well as the suspiciousness it may generate. Alternate actions that can be useful to avoid/avert the situation from escalating and having a catastrophic ending are discussed. Testing/evaluating patients with dementia for fitness to drive is also reviewed and a list of select resources is included.
3
Bainbridge, Samantha. "Experiences of hospitalized patients with dementia." Honors in the Major Thesis, University of Central Florida, 2012. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/657.
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People with dementia are hospitalized for a variety of reasons. The combination of dementia with additional health conditions creates a unique challenge to caregivers in acute care settings. There is a dearth of information available to provide guidance to the nursing staff caring for these patients. This integrated review of the literature examined the experiences of hospitalization from the perspective of the older adult with dementia, the family caregiver, and the patient care staff. Results showed a limited body of literature that addressed hospital experiences of people with dementia and those of family and professional caregivers. Additionally, few studies addressing this topic have been conducted in the United States. The primary finding from this study is that better communication is needed between nursing staff, patients, and their family caregivers. Nurses should carry out detailed assessments of cognition and pain in all elderly patients, and strive to provide appropriate palliative and end-of-life care. Dementia- specific training for all staff members may help to promote a better understanding of patients with dementia. Lastly, further research into the experiences of hospitalized dementia patients is needed, with a focus on acute care settings within the United States.<br>B.S.N.<br>Bachelors<br>Nursing<br>Nursing
4
Hamdy, Ronald C., Amber Kinser, Audrey Depelteau, Tracey Kendall-Wilson, J. V. Lewis, and Kathleen Whalen. "Patients with Dementia Are Easily Distracted." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/2740.
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Mild cognitive impairment (MCI) is the middle ground between normal, age-appropriate memory impairment, and dementia. Whereas patients with MCI are able to cope with the memory deficit, those with dementia are not: Their memory impairment and other cognitive deficits are of sufficient magnitude to interfere with the patients’ ability to cope independently with daily activities. In both MCI and dementia, there is evidence of declining cognitive functions from a previously higher level of functioning. In both the conditions, there is also an evidence of dysfunction in one or more cognitive domains. There are two subtypes of MCI depending on whether memory is predominantly affected: amnestic type and nonamnestic/behavioral type. Not all patients with MCI transition to dementia, some recover. In this case scenario, we present a 68-year-old man with MCI who lives with his wife. They are getting ready to host dinner. His wife asks him to vacuum the dining room while she runs an urgent errand. We describe how this simple task vacuuming a room ended in a catastrophe with the patient spending the night in jail and his wife hospitalized. We discuss what went wrong in the patient/wife interaction and how the catastrophic ending could have been avoided.
5
Hamdy, Ronald C., J. V. Lewis, Amber Kinser, Audrey Depelteau, Rebecca Copeland, Tracey Kendall-Wilson, and Kathleen Whalen. "Too Many Choices Confuse Patients With Dementia." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/2741.
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Choices are often difficult to make by patients with Alzheimer Dementia. They often become acutely confused when faced with too many options because they are not able to retain in their working memory enough information about the various individual choices available. In this case study, we describe how an essentially simple benign task (choosing a dress to wear) can rapidly escalate and result in a catastrophic outcome. We examine what went wrong in the patient/caregiver interaction and how that potentially catastrophic situation could have been avoided or defused.
6
Hamdy, R. C., Amber E. Kinser, J. V. Lewis, and Rebecca Copeland. "Hallucinations Are Real to Patients With Dementia." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1232.
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In this case study, we present a patient with preexistent posttraumatic stress disorder and psychosis who has been recently diagnosed with Dementia with Lewy Bodies. He is experiencing vivid hallucinations. What went wrong between him and his wife as a result of these hallucinations is presented. Alternative actions that could have been used are suggested.
7
Atee, Mustafa. "Improving Pain Management amongst Patients with Dementia." Thesis, Curtin University, 2021. http://hdl.handle.net/20.500.11937/87949.
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This thesis developed, validated and implemented a multimodal, point-of-care pain assessment tool for people with moderate-to-severe dementia unable to self-report. PainChek® is a novel smart device-enabled application, which uses automated facial analysis to identify pain-relevant facial markers in conjunction with clinical pain behaviours to estimate pain intensity. PainChek® was shown to have sound psychometric and clinimetric properties. Clinical implementation demonstrated a significant advance in pain assessment, allowing optimal pain management for this population.
8
Cook, Ailsa. "Understanding the communication of older people with dementia living in residential care." Thesis, University of Stirling, 2003. http://hdl.handle.net/1893/3301.
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This thesis explores the communication of a group of older people with dementia living in a residential care home and specifically, seeks to understand how living with dementia in a care home influences communication. The study draws broadly on a symbolic interactionist perspective and uses an ethnographic, inclusive, video methodology. In so doing, the study grounds the research in the experiences of the older residents with dementia and explores communication as it is interwoven with social life. The empirical data, on which this thesis is based, were gathered over the course of six months in one residential care home in Central Scotland. Analysis of these data, in conjunction with the theoretical literature informing the study, led to the development of a framework and a set of concepts to understand the communication of the older people with dementia living in residential care. This framework was used to examine the ways in which the older residents' experiences of institutionalisation, ageing, and dementia, generally, and of life in the care setting, specifically, influenced their communication. The findings revealed that the older residents made diverse meanings of their experiences in the home, and mat many of the meanings that they made were threatening to their self-identity, self-determinacy and social relationships. The residents engaged in a range of strategies to respond to the impact of these meanings and to negotiate their life in the care home. The research presented in this thesis has many implications for understanding the experiences of older people with dementia in residential care. In particular, the research highlights the need for a new social understanding of dementia, that examines the experience of dementia in relation to broad structural and cultural processes and that seeks to promote the social inclusion and citizenship of older people with dementia.
9
Sandman, Per-Olof. "Aspects of institutional care of patients with dementia." Doctoral thesis, Umeå universitet, Institutionen för omvårdnad, 1986. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-100563.
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The aim of the present study was to investigate all long-term institutions in the county of Västerbotten, Northern Sweden, to give a detailed description of the institutionalized population with respect to motor functions, vision, hearing, speech, ADL-functions, prevalence of psychiatric symptoms and behavioral disturbances, staff work load, use of psychoactive drugs and prevalence of dementia. Another aim was to select some specific 'problem areas' in the nursing care of demented patients for further descriptive and interventional studies. For this reason, morning care procedure (hygiene, dressing), meal behavior (eating, communication), nutrition, constipation and relocation between institutions were selected. The results of the study have been reported in six papers summarized below: I.The study has shown that the proportion of demented patients is increasing in longterm institutions in Sweden. Furthermore, demented patients were shown to be more impaired in all rated functioning abilities and exhibited more psychiatric symptoms and behavioral symptoms. A high proportion of the demented probands were also prescribed psychoactive drugs, i.e. neuroleptics. II. Five patients with Alzheimer-type dementia were monitored during morning care. A 12-step classification system was developed to be used as a guide to understand and determine abilities essential for performance of morning care for demented patients. The quantitative assessment showed that none of the patients were able to manage morning care independently, but there was a wide variation in their highest level of performance. III. Five patients with Alzheimer-type dementia were observed (video taped) during their meals in a changed meal milieu and with new meal routines. When the patients ate without staff participation, the two least demented patients became 'caregivers'. When two mental nurses joined the group, first in civil clothes and then in white uniforms, the patients dropped their roles as helpers. The patients were able to compose complete meals in 0-79 per cent of the meals. The conversation during the meals could be characterized as incomplete, with short sentences and a lot of breaks. Sixty-three per cent of all utterances were about food and eating and almost all conversation concerned the present time. IV. Thirty-three psychogeriatric patients, with severe constipation were given a high- bran bread instead of their accustomed laxatives. During the high-bran treatment period, the number of bowel evacuations and the volume of faeces increased. The total laxative consumption decreased by 93 per cent. V. Nutritional status and dietary intake were studied in a sample of severely demented, institutionalized patients. Energy and /or protein malnutrition was found in 50 per cent of the patients. The mean energy intake was 2059 kcal. Malnourished patients had had four times as many infectious periods during their hospital stay as patients without malnutrition. Thirty-nine of 44 patients lost weight during their hospital stay. VI. Thirty-three psychogeriatric patients were followed for 36 weeks after relocation from a mental hospital to two newly built nursing homes. An intensive pre-relocation program was performed. No negative effects of the relocation were found. On the contrary, the relocated group improved their ADL-functions after the transfer. Based upon the above cited studies, a model for nursing care of demented patients is presented.<br><p>S. 1-45: sammanfattning, s. 46-192: 6 uppsatser</p><br>digitalisering@umu
10
Mudrenko, Iryna Hryhorivna, Ірина Григорівна Мудренко, and Ирина Григорьевна Мудренко. "Predictors of suicidal behavior in patients with dementia." Thesis, Sumy State University, 2017. http://essuir.sumdu.edu.ua/handle/123456789/57982.
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Hamdy, Ronald C., J. V. Lewis, Rebecca Copeland, Audrey Depelteau, Amber E. Kinser, T. Kendall-Wilson, and Kathleen Whalen. "Patients With Dementia Are Easy Victims to Predators." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1236.
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Patients with dementia, especially Alzheimer’s disease and particularly those in early stages, are susceptible to become victims of predators: Their agnosia (see Case 1) prevents them from detecting and accurately interpreting subtle signals that otherwise would have alerted them that they are about to fall for a scam. Furthermore, their judgment is impaired very early in the disease process, often before other symptoms manifest themselves and usually before a diagnosis is made. Patients with early stages of dementia are therefore prime targets for unscrupulous predators, and it behooves caregivers and health care professionals to ensure the integrity of these patients. In this case study, we discuss how a man with mild Alzheimer’s disease was about to fall for a scam were it not for his vigilant wife. We discuss what went wrong in the patient/caregiver interaction and how the catastrophic ending could have been avoided or averted.
12
Earle, Vicki C. "Nurses' experiences caring for patients with dementia : a phenomenological study /." Internet access available to MUN users only, 2003. http://collections.mun.ca/u?/theses,167121.
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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.
14
Spears, Michelle Monique. "Nonpharmacological Behavioral Interventions for Patients with Dementia: An Integrative Literature Review." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5658.
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The use of antipsychotic medications in older adults with dementia increases risk of
mortality; therefore, it is critical that nurses use nonpharmacological interventions in dementia care. The nurses' role is integral to implementation of treatment strategies to dementia patients and efforts to improve care in patients with dementia using a nonpharmacological approach are necessary. Therefore, guidelines outlining nonpharmacologic dementia care management will enable nurses to provide a wider spectrum of care to dementia patients. The purpose of this project was to make recommendations for the development and implementation of interdisciplinary practice guidelines to standardize care in the organizational setting. An integrative literature review was conducted using the Fineout-Overholt, Melnyk, Stillwell, and Williamson's analytical approach to reviewing evidence using 7 levels for evaluating the hierarchy of evidence. Inclusion criteria were limited to studies from January 2010 to October 2017 in English with full text. A total of 16 studies were reviewed and categorized according to 1 of the 7 hierarchical levels. Findings were summarized at each appropriate level and included systematic review or meta-analysis, randomized controlled trials, controlled trial without randomization, case-control or cohort studies, qualitative or descriptive studies and expert opinion or consensus. Non-pharmacological approaches including music therapy, cognitive-behavioral therapy, distraction, horticultural therapy, ear acupressure, and cognitive stimulation were all shown to be effective in dementia care. Social change based on this project targets improving nurses' knowledge of nonpharmacological interventions in dementia care.
15
陳健禧 and Kin-hei Anthony Chan. "An evidence-based guideline of using music for elderly with dementia to reduce agitated behaviors." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193076.
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Agitated behaviours in dementia elderly predispose to negative outcomes. Music intervention is an evidence-based intervention that could help to ease the situation. The integrative and systematic review studies provide evidence that music intervention is effective in reducing agitated behaviours in dementia elderly. The assessment of the implementation potential, the feasibility and transferability demonstrate the music intervention can be implemented in local setting. An evidence-based guideline based on the reviewed papers is developed to use in local HK hospitals or nursing homes. With the help of an effective communication plan to the stakeholders, it is believed that the intervention can be smoothly implemented. Further evaluation helps to review the potentials for sustaining the intervention in the long run.<br>published_or_final_version<br>Nursing Studies<br>Master<br>Master of Nursing
16
Hamdy, Ronald C., Amber Kinser, Jennifer E. Culp, Tracey Kendall-Wilson, Audrey Depelteau, Rebecca Copeland, and Kathleen Whalen. "Agnosia Interferes With Daily Hygiene in Patients With Dementia." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/2735.
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Patients with dementia, particularly Alzheimer’s disease, may not recognize that their clothes are dirty. They may see the food stains and discoloration of the clothes and yet because of their agnosia are unable to integrate these observations and deduce that their clothes are dirty and need to be changed. They will, therefore, resist attempts to get them to change clothes, especially if these clothes happen to be their favorite ones. This often causes caregivers to become frustrated, especially, if it represents a change in the patient’s previous habits of only wearing clean clothes. In this case study, we present a 72-year-old woman with moderate Alzheimer’s disease who lives with her daughter, who adamantly refuses to change the clothes she has been wearing for a few days and which are now clearly dirty. We report the interaction, highlight what went wrong in the patient–daughter interaction, and discuss how the catastrophic ending could have been avoided or averted.
17
Boone, Norma Jean. "Enhancing Nurses' Assessment of Pain Management in Dementia Patients." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4423.
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Chronic pain contributes to morbidity, mortality, and disability in millions of people. Prevalence rates for pain are as high as 83% among the 5.2 million older adults living with a diagnosis of dementia. The purpose of the quality improvement project was to assess nurses' knowledge of pain assessment and management in a 45-bed Veterans Health Administration long-term care facility serving older adults with dementia. Knowles' adult learning theory served as the theoretical framework and the knowledge to action model supported the translation of evidence into practice. A convenience sample of 27 licensed and unlicensed nursing staff answered the 16-question, 5-point Likert scale survey, Self-Assessment of Knowledge in Assessing Pain in Dementia Patients and 7 demographic questions. Data analysis was conducted using a one way ANOVA. Knowledge of best practices for pain assessment and management varied significantly by job title; RNs had the highest knowledge mean score (M = .74), followed by LPNs (M = .54), and then by CNAs (M = .40; p < .001). Similarly, nurses with an associate degree or higher had better knowledge (M = .74) than nurses without an associate degree (M = .42; p < .001). Knowledge was unrelated to years of employment in long-term care. However, 85% of the nurses believed pain was assessed and managed correctly in the facility. These data suggested that nurses' assessment and management of pain may be disconnected to their self-assessment knowledge scores. Positive social change may be realized as the project findings are used to develop education for the nursing staff related to the knowledge deficits identified by the survey and application of an evidence-based tool to assess pain in cognitively-impaired older residents.
18
Koh, Si En Angel, and 許思恩. "Exercise for improving cognition in community-dwelling elderly with dementia : a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206931.
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Context: Dementia impairs daily functional ability and independence through negatively affecting cognitive function. As the prevalence of dementia increases, the burden on healthcare facilities and families grows, pointing to the need for providing further options available for the management of dementia in the community context. Of these options, physical exercise interventions are easily modifiable and relatively simple to implement. The primary objective of this review is to investigate the effectiveness of exercise for improving cognitive function in elderly people with dementia living in the community.
Methods: A systematic review of 2 databases (PubMed and EMBASE) was carried out for all studies investigating the effects on cognition of a physical exercise intervention among home-dwelling elderly patients with dementia. Data was extracted on baseline characteristics of study participants, type of exercise intervention, length of follow up, and changes in cognitive outcome measures.
Results: Seven studies were included. Three provided statistically significant results that showed an association between exercise and cognition in community-dwelling dementia patients.!The remaining four studies could not establish an association.
Conclusions: The effectiveness of exercise for improving cognition in community-dwelling people with dementia is unclear based on the conclusions of this review. Small sample size and methodological quality limited the results. Further well-designed studies are needed that investigate appropriate community-based exercise interventions for people with dementia.<br>published_or_final_version<br>Public Health<br>Master<br>Master of Public Health
19
Bramble, Marguerite Dorothy. "Promoting Family Involvement in Residential Dementia Care: An Education Intervention." Thesis, Griffith University, 2009. http://hdl.handle.net/10072/368110.
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There has been very little empirical research in Australia that examines the role of the family caregiver of the person with dementia in residential care. Nevertheless, both in Australia and overseas, researchers and clinicians recognise that there are benefits for staff, families and their relative with dementia from increased family accessibility, involvement and engagement as clients in care. Client partnerships are defined as dynamic, therapeutic relationships with health professionals that require articulation of common care goals, the exchange of knowledge and clarification of care roles. In the later stages of the dementia syndrome as the person with dementia experiences profound, deteriorating cognitive effects, the focus inevitably shifts to family caregivers to fulfil the surrogate role in providing information about their relatives’ individual care needs. The aim of this thesis is to explore family involvement as partners with staff in the care of their relative with dementia in residential care. This was achieved by implementing and evaluating a family-staff partnership model of care based on negotiation of therapeutic activities for the person with dementia. The study is a partial replication of an intervention conducted in United States of America (US) with successful care outcomes. The Family Involvement in Care (FIC) education intervention and partnership model has evolved from research over the period of two decades, led by Meridean Maas. Her research demonstrated that, through education and contractual partnership, caregiving arrangements between family and staff not only improved care for the person with dementia, but also resulted in more harmonious and productive partnerships which benefit all.<br>Thesis (PhD Doctorate)<br>Doctor of Philosophy (PhD)<br>School of Nursing and Midwifery<br>Griffith Health<br>Full Text
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Deist, Melanie. "Resilience factors in families caring for a family member diagnosed with dementia." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/80360.
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Thesis (MA)--Stellenbosch University, 2013.<br>ENGLISH ABSTRACT: Dementia is a chronic illness characterised by the progressive deterioration of cognitive
functions. Patients diagnosed with dementia are most often cared for by family
members. Families caring for dementia patients are faced with tasks that are physically
exhausting and psychologically distressing. Nevertheless, some families show resilience
and are able to overcome the adversity of the illness. This study aimed to identify and
explore the resilience factors these families utilised to rise above the hardships faced
when caring for a demented family member. The study was based on McCubbin and
McCubbin’s (1996) Family Resiliency Model of Family Stress, Adjustment and
Adaptation and Walsh’s (2002, 2003) Family Resilience Framework. A mixed-methods
approach was followed to collect data from a convenience sample drawn from the Cape
Metropolitan area in the Western Cape, South Africa. The study sample comprised of
families in which either a spouse (n = 44) was caring for a partner with dementia or adult
children (n = 47) were caring for a parent with dementia. The family resilience factors of
these subgroups were explored separately and were compared with each other. The
quantitative data analysis was conducted using analyses of variance (ANOVA),
Pearson’s product-moment correlation coefficients, and a best-subsets multiple
regression analysis. Qualitative data were analysed using thematic content analysis.
These analyses revealed that positive communication patterns, acceptance, optimism,
family hardiness, family connectedness, and the effective management of symptoms
facilitated family adaptation in both the spouse and child subgroups. Negative patterns of
communication within the family was the only variable that was inversely related to family adaptation in both family subgroups. The level of adaptation in the different family
subgroups did not differ significantly, but the subgroups did differ slightly in terms of their
communication patterns, coping strategies and social support avenues utilised. In
addition to expanding the current literature regarding family resilience, the body of
information collected in this study could be used to help families caring for dementia
patients to create a family environment that maximises adjustment and adaptation. The
results could also be used in the development and evaluation of intervention
programmes tailored to the needs of these family subgroups.<br>AFRIKAANSE OPSOMMING: Demensie is 'n chroniese siekte wat gekenmerk word deur die progressiewe
agteruitgang van kognitiewe funksies. Pasiënte wat met demensie gediagnoseer word,
word meestal deur familielede versorg. Gesinne wat sorg vir demensiepasiënte word
gekonfronteer met take wat fisies uitputtend en sielkundig ontstellend is. Tog toon
sommige families volharding en is hulle in staat is om die teëspoed van hierdie siekte te
oorkom. Hierdie studie het gepoog om die veerkragtigheidsfaktore te identifiseer en
verken wat deur families wat 'n familielid met demensie versorg, aangewend word om bo
hulle omstandighede uit te styg. Die studie is gebaseer op McCubbin en McCubbin
(1996) se Family Resiliency Model of Family Stress, Adjustment and Adaptation en
Walsh (2002, 2003) se Family Resilience Framework. Beide kwalitatiewe en
kwantitatiewe data-insamelingsmetodes is in hierdie studie gebruik. 'n
Gerieflikheidsteekproef is uit die Kaapse Metropolitaanse gebied in die Wes-Kaap, Suid-
Afrika gewerf en het bestaan uit gesinne waarvan eggenote (n = 44) vir hulle eggenoot
met demensie sorg of volwasse kinders (n = 47) vir ’n ouer met demensie sorg. Die
gesinsveerkragtigheidsfaktore van hierdie subgroepe is afsonderlik ondersoek en met
mekaar vergelyk. Die kwantitatiewe data-analise is via variansieontleding (VARO), die
berekening van Pearson se produkmoment-korrelasiekoëffisiënte, en beste-subset
regressie-analises uitgevoer. Kwalitatiewe data is met behulp van tematiese inhoudanalise
ontleed. Hierdie analises het getoon dat positiewe kommunikasiepatrone,
aanvaarding van die situasie, optimisme, familie gehardheid, familie verbondenheid, en
die doeltreffende bestuur van demensiesimptome familie aanpassing in beide die eggenoot- en kind-subgroepe gefasiliteer het. Negatiewe, opruiende
kommunikasiepatrone binne die gesin was die enigste veranderlike wat in beide
subgroepe 'n omgekeerde verwantskap met familie aanpassing gehad het. Die vlak van
aanpassing in die verskillende familie subgroepe het nie beduidend verskil nie, maar die
subgroepe het effens verskil in terme van hulle kommunikasiepatrone,
streshanteringstrategieë, en bronne van sosiale ondersteuning. Die resultate van hierdie
studie brei uit op die huidige literatuur oor gesinsveerkragtigheid en kan gebruik word
om families wat vir demensiepasiënte sorg te help om 'n familie-omgewing te skep wat
die gesin se aanpasbaarheid verbeter. Die resultate kan ook gebruik word in die
ontwikkeling en evaluering van intervensieprogramme wat die behoeftes van hierdie
subgroepe teiken.
21
Rogers, Willetta Howell. "Psychological well-being of family caregivers of dementia patients in nursing homes." free to MU campus, to others for purchase, 1999. http://wwwlib.umi.com/cr/mo/fullcit?p9946290.
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Blackmon, Tami Felicia. "A Nursing Education Program to Decrease Use of Psychotropics Among Dementia Patients." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5979.
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Dementia, a clinical condition that affects the psychological ability of patients, is distinguished by a significant overall decline in cognitive function that results in distorted perception. Guiding nursing practice in the long-term care (LTC) setting to decrease the unnecessary use of psychotropics is critical because doing so relates to the patients' quality of life and safety. In the LTC facility that served as the practicum site for this study, there was an observed overuse of psychotropic medications in the care of patients with dementia. The practice-focused question guiding this project asked whether a nursing staff development program would decrease the use of psychotropics in dementia patients. The purpose of the project was to inform nursing staff through an educational program on alternative methods to use when dementia patients exhibit increased disturbing behaviors. The conceptual framework for the project was the knowledge-to-action model. The nursing staff development program had a positive effect on the nursing staff as evidenced by a statistically significant improvement in knowledge and attitudes about the use of psychotropics in caring for dementia patients. The use of psychotropic in the dementia patient decreased from 22.32% to 15.77%, the lowest score achieved by the organization in 5 years. The dementia patients benefited from this project and its positive social change implications for nursing practice by decreasing dementia patients use of psychotropics, minimizing their side effects to the patients and providing an overall feeling of well-being.
23
Connell, Bettye Rose. "'Elopement' opportunities among dementia patients in nursing homes : architectural considerations." Diss., Georgia Institute of Technology, 1992. http://hdl.handle.net/1853/23363.
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Turner, Alex. "Caring for patients with dementia in a general hospital setting." Thesis, Lancaster University, 2014. http://eprints.lancs.ac.uk/71547/.
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This thesis is divided into three sections. Section one, the literature review, considers the experiences of general hospital staff caring for patients with dementia. 14 papers were included in the meta-synthesis. Five key themes were constructed from the analysis: the unknown and undesirable; constraints of the environmental and organisational context; emphasising the physical health of patients; recognising the benefits of person-centred care; and identifying the need for training. The synthesis identified how a lack of knowledge of dementia, particularly regarding behaviours that are considered challenging, can contribute to low staff confidence and negativity towards these patients. This, along with organisational constraints, can impact on ability to provide person-centred care. The benefits of dementia training have been recognised. Clinical and research implications of the findings are discussed. Section two, the empirical paper, considered the experiences of staff within general hospitals regarding the use of truth and deception when caring for patients with dementia. In particular, it explored their decision making processes when choosing whether to tell the truth or to deceive. A grounded theory methodology was used to construct a theoretical model of this process. The analysis identified how ‘triggers’ set in motion the need for a response. Various ‘mediating factors’ (including a lack of communication, the individual’s interpretation of their role and responsibility, and their ethical framework) influenced how staff chose to ‘respond’ to those triggers. Again, clinical and research implications have been recognised. Section three, the critical appraisal, offers a reflective account of the research journey. These reflections are organised into six categories that consider the researcher’s own decision-making processes when carrying out the empirical paper.
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Bower, Frankie. "Caring for patients with dementia in acute physical health settings." Thesis, University of Leicester, 2017. http://hdl.handle.net/2381/39746.
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There are approximately 800,000 people in the UK with a diagnosis of dementia (Alzheimer’s Society, 2007). The ageing population is leading to increased pressures on dementia care facilities and acute hospital settings. As a result the care of patients with dementia is often suboptimal and staff tend to experience high levels of distress. Review of the literature examined the quantitative evidence base regarding the predictors of distress in staff working in 24 hour dementia care facilities. A narrative synthesis of 12 articles was carried out and identified three areas of predictors, these reflected intrapersonal, interpersonal and environmental predictors of distress. It was found that little attention was paid to environmental predictors of distress, most studies explored individual and relational factors, environmental predictors were often found to be linked to distress when research questions were broad and often investigating predictors of distress generally. Distress as a concept is ill defined, leading to many theories being applied and many tools being used, making synthesis of the results difficult. The findings are discussed in line with the existing evidence base on distress research. The research consisted of interviews with 21 acute care staff to explore how they experienced caring for those with dementia in acute medical units (AMU). Thematic analysis (TA) was used to develop four main themes and twelve subthemes, allowing for identification of the main concerns for staff caring for patients with dementia in their general practice. Findings inform changes that AMU could make to allow for staff to care for patients with dementia in a more effective way. The critical appraisal offers a reflective description of the experience of completing the research and its limitations.
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Hopkins, Wendy. "Evaluating Nurses' Self-Efficacy in Caring for Patients with Dementia." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3450.
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In 2011, 5 million Americans had dementia and this number is predicted to increase. As the number of people with dementia increases, the need for quality nursing care, education, and treatment for patients with dementia increases. To address the need, nurses not only must be prepared with the knowledge, skills, and abilities to care for patients with dementia, but they must also have the self-efficacy to provide quality care. The practice focused question guiding the project was to determine the level of self-efficacy for caring for dementia patients among long-term care nursing staff. Using Bandura's social cognitive theory, the purpose of this project was to gain information about the self-efficacy of nurses caring for dementia patients at one long-term care facility. Forty nurse participants each completed the 25-item, 5-point Likert scale Self-Efficacy in Dementia Care Survey. The quantitative data were descriptively analyzed to identify nursing training needed for tasks related to dementia patient care. Administrating medications, providing early management information, educating patient families, maneuvering the environment, and influencing the emotional response of patients were areas of knowledge and skill deficit for nurse participants. Findings from the project will be used to guide education and training to improve nurse self-efficacy in working with dementia patients. When nurses in long-term care facilities enhance their skills and knowledge, they may be able to provide better care to dementia patients, therefore promoting social change.
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Foster, Catherine Victoria. "Care housing for people with dementia : towards an evaluation." Thesis, University of Stirling, 1997. http://hdl.handle.net/1893/3425.
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This study set out to evaluate a small scale model of care for people with dementia that aimed to support residents within a daily household routine (termed household care). Stemming from a pluralistic evaluation, this thesis examines issues identified as important to residents' experience, namely the ability of the care houses to provide a home for life, the process and effectiveness of recreating a homely environment and the implications of group-living. Three case studies were investigated with multiple methods, including semi-structured interviews with staff, relatives and representatives of managing agencies, structured observation and assessment of dependency. Respondents believed care housing was superior to its alternatives and attributed perceived improvements in residents' well-being to the nature of staff support and the 'homely' setting. Agency representatives were preoccupied with their relationships with each other and how to sustain and expand this model of care. Staff focused on the nature and conditions of the work. Kin were keen that residents should settle and stay in the care houses. Residents' support needs at least matched entry criteria but over half had to move out to hospital because of physical illness and behavioural problems. This study suggests that it was very difficult for residents to accept the houses as 'home'. Residents' and their relatives' participation was, in practice, limited but one house was particularly successful in implementing household care; reasons are suggested for this. Residents' interactions with each other seemed to be increased by household care but their relationships were influenced by a number of factors, including the presence of dementia. The latter exacerbated the tensions of group-living. The challenge for care houses was to sustain care as dementia progressed and extend good quality care to those with more substantial behavioural and physical support needs.
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Brockett, Daniel R. "Predicting intellectual level from the Mini-Mental State Examination : a multivariate approach." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/833470.
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It is necessary to assess the intellectual functioning of dementia patients. However, psychometric instruments such as the Wechsler Adult Intelligence Scale - revised (WAIS-R) are often too demanding for dementia patients, precluding its utility. Clinicians and researchers have indirectly estimated a dementia patient's IQ from the Mini-Mental State Examination (MMSE). This measure is an eleven item screen instrument of global cognitive functioning. Fairly accurate estimates of IQ have been predicted using the MMSE total score.The purpose of the present study was to determine if it is possible to more accurately predict intellectual functioning when the individual MMSE items were used to predict Full Scale, Verbal, and Performance IQ using multiple regression analyses. Forty elderly dementia patients were administered both the MMSE and the WAIS-R. The MMSE total score was entered into a simple linear regression to predict FSIQ. In addition, the eleven item scores of the MMSE were entered into separate stepwise regressions to predict FSIQ, VIQ, and PIQ. The increment in the amount of variance accounted for in the FSIQ between the simple and multiple regression equations were evaluated for statistical significance.The results of these investigations revealed that while the multiple regression equations using MMSE item scores predicted a significant amount of the variance in IQ, they were not statistically superior to using the MMSE total score alone. The MMSE total score was found to account for 76.2% of the variance in Full Scale IQ. The MMSE items that were found to add significantly to the variance in intellectual level accounted for 80.9 %, 75.1 %, and 73.4 % of FSIQ, VIQ, and PIQ respectively. The results of the present study replicated other research that found the MMSE total score to accurately predict intellectual functioning in dementia patients.<br>Department of Counseling Psychology and Guidance Services
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Cousins, Rosanna. "A study of psychological distress in caregivers of Parkinson's disease patients." Thesis, University of Liverpool, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.263702.
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Chung, Yin-kwan Carol. "Stress, appraisal, coping and perceived social support as predictors of mental health outcomes of spouse-caregivers of persons withdementia." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1998. http://hub.hku.hk/bib/B29697888.
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Cai, Yongyong, and 蔡雍咏. "Intervention service programmes for family caregivers of a relative with dementia: a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48422381.
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Background: With the aging of the global population, the prevalence and incidence of Alzheimer’s disease or related dementia are increasing. Most mild or moderate dementia clients are taken care of at home by informal caregivers, which leave a heavy burden to the caregivers. Researchers have found out that with good intervention services and programmes for the caregivers, their burden, emotional distress and even the care recipients’ symptoms and institutionalization rates would be improved.
Objectives: This project is to review these researches to evaluate whether the interventions are effective and/ or cost-effective and how the decision-makers could use the results for evidence-based policy.
Methods: A literature search was performed on randomized controlled trials in education, information/ support intervention programmes published from October 2005 to July 2012. Electronic databases (EBSCO, PubMed and CNKI) were searched until July 2012. The Consolidated Standards of Reporting Trials (CONSORT) checklist for reporting randomized controlled trials was used as the guideline to evaluate the quality of identified papers.
Results: 16 papers (15 studies) were included in this review and classified into three groups, as home-based, individual-based and group-based interventions. This review found that the intervention programmes had various outcomes and showed some evidence of effectiveness. Most of the papers had good quality. The home-based programmes showed cost-effectiveness in the identified studies.
Conclusion: There was some evidence that the home- and group-based interventions were effective and the home-based interventions could be cost-effective. Further studies are recommended and a meta-analysis on the studies and more researches on economic analysis are needed. A community-based long-term dementia management should be built up for better outcomes.<br>published_or_final_version<br>Public Health<br>Master<br>Master of Public Health
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Moroz, Marina, Jeannie Lee, and Sandra Brownstein. "Quality Improvement Project: Reduction of Antipsychotic Use in Nursing Home Patients with Dementia." The University of Arizona, 2013. http://hdl.handle.net/10150/614269.
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Class of 2013 Abstract<br>Specific Aims: The purpose of the project was to determine if implementation of a detailed pharmacist recommendation form written for providers, could be an effective tool to reduce the use of antipsychotics in the psychiatric nursing home patients with dementia by 15%.
Methods: The project was conducted by a pharmacy student and a consultant pharmacist at a single psychiatric nursing home. Thirty recommendations were written to the nursing home providers. The prescribers made comments on the forms and returned them to investigators for analysis. Active orders were compared pre and post pharmacy recommendations.
Main Results: Of the 30 interventions, the prescriber addressed 26 (87%) recommendations and agreed to 15 (58%) of them. Nine recommendations involved either a GDR, discontinuation of a medication, or switching to a non-pharmacological method. Six of the nine (66%) recommendations led to the prescriber reducing the dose or discontinuing the medication. Overall, six out of 30 (20%) interventions resulted in a successful reduction of the use of antipsychotics.
Conclusion: This project showed that when the prescribers see a more detailed pharmacist written recommendation regarding the therapy, they are more likely to respond with an explanation. However, even though the overall reduction was 20%, black box warnings did not seem to be a deterrent for prescribing in this psychiatric nursing home. Antipsychotics are heavily relied on to control behaviors associated with dementia.
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Semper, June. "A longitudinal follow-up of patients presenting for presymptomatic predictive testing for Huntington disease." Thesis, University of Aberdeen, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.327414.
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Bäckman, Lina, and Sara Nilsson. "NURSES POSSIBILITIES OF IDENTIFICATION OF PAIN AMONG PATIENTS DIAGNOSED WITH DEMENTIA." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25617.
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BAKGRUND: En av våra snabbast växande folksjukdomar i dagens samhälle är demens. Individer med demenssjukdom besitter olika hinder därav bl.a. kognitiv påverkan eller kognitiv svikt, vilket i sig medför svårigheter av kommunikationsart. Detta medför vidare problematik kring identifieringen av smärtsymtom. SYFTE: Att undersöka hur sjuksköterskor bedömer smärta hos äldre personer med en diagnostiserad demenssjukdom. METOD: Litteraturstudien utformades som en litteraturöversikt över förekommande forskning där syfte och frågeställningar besvaras utifrån resultat av tidigare vetenskapliga studier. Artikelsökningarna inriktades på de bibliografiska referensdatabaserna CINAHL samt PubMed där både kvantitativa och kvalitativa studier har granskats. RESULTAT: Tre huvudteman identifierades: Observation som instrument, självskattningsskalor som instrument samt sjuksköterskan som instrument. Observationsinstrumenten ADD, PACSLAC-D, PAINAD, DisDAT, NOPPAIN samt STI visade sig vara mest användbara för patienter med svår demens. För de individer med mild till måttlig demens lämpar sig självskattningsinstrument som VAS, VRS och FPS. Utöver instrumenten krävs även att sjuksköterskan har kunskap om såväl demens som individen bakom demensdiagnosen. Även riktlinjer, ett gott intraprofessionellt samarbete och anhörigas kunskap om individen är komponenter som har betydelse för att lindra smärta hos individer med demens. SLUTSATS: Konklusionen av resultatet visar att sjuksköterskans kunskap om demenssjukdom samt kunskap om individen bakom diagnosen utgör tillsammans med anhöriga en grund för att identifiera smärta.<br>BACKGROUND: One of our fastest growing endemic diseases in today's society is dementia. Individuals with dementia possess different series of obstacles including cognitive loss or cognitive impairment, which raises difficulties of communication. This causes further concerns relating to the relief of painful symptoms. OBJECTIVE: To investigate nurses' pain assessment in older people with diagnosed dementia. METHOD: The study was designed as a literature overview, research where the aim and questions answered on the basis of results of previous scientific studies. Searches for articles were focused on the bibliographic reference databases CINAHL and PubMed where both quantitative and qualitative studies have been reviewed. RESULTS: Three main themes were identified: Nurses knowledge as instruments, observation as an instrument and self- rating scales as instruments. Observation instruments ADD, PACSLAC -D, PAINAD, DisDAT, NOPPAIN and STI proved to be most useful for patients with severe dementia. For those individuals with mild to moderate dementia were self -report instrument such as VAS, VRS and FPS suitable. In addition to the instruments also requires that the nurse has knowledge of both dementia as the individual behind the dementia diagnosis. Although guidelines and a good knowledge of the individual is important to relieve pain in people with dementia. CONCLUSION: The results shows that the nurse's knowledge of dementia as a disease, and knowledge of the individual behind the diagnosis, together with relatives included a basis for identifying pain.
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Deemua, Blessing Baridakara. "Coping Methods of Caregivers Dealing with Patients Suffering from Geriatric Dementia." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7284.
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Dementia is a neurological disorder primarily diagnosed in the geriatric population. A problem for paid caregivers of patients diagnosed with stage-4 dementia is that they may experience caregiving stress while rendering care. However, there was no research that described the lived experiences of paid caregivers. Caregiving stress can be accompanied by behaviors or comorbid conditions and specific symptoms of stress can have a differential wellness impact. This phenomenological study explored the lived experiences of paid caregivers of patients with dementia through Vroom's expectancy theory. Data were gathered through interpretative interviews from a sample of 10 to 15 purposefully selected nursing home paid caregivers. Research questions on the lived experiences and perceptions of caregivers when experiencing stress working with stage-4 dementia patients were explored. Responses to the open-ended questions were recorded and themes emerging from the interview questions were developed. Findings indicated that caregivers cope with their stress in part by coping with challenging patients through empathizing and being ready for anything. Results further showed that caregivers cope with stress by briefly withdrawing from the stress trigger, either physically or mentally. Caregiver stress can be reduced, and health maintained by other caregivers who learn from the coping methods of caregivers involved within this study.
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Shaw, Courtney J. "Towards Dementia Friendly Emergency Departments: A mixed method exploratory study identifying opportunities to improve the quality and safety of care for people with dementia in emergency departments." Thesis, University of Bradford, 2018. http://hdl.handle.net/10454/17445.
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This project provides the first comprehensive investigation into the
experiences of people with dementia (PWD), their carers, and the staff who
provide care in emergency departments (ED) in the UK. This is a mixed
methods study which used a national survey (N=403) followed by ED
observation (32 hours) and qualitative interviews with health professionals
(N=29), in an iterative and sequential design to present a holistic evaluation of
the current experiences of the key parties- patients, carers, and ED staff
involved in receiving and providing care. The theoretical perspective of the
Human Factors Approach to patient safety underpins this work. The project
included people with dementia and carers as collaborators and co-designers in
both the development of the research tools and in shaping the project outputs.
This research explores the barriers and facilitators to safe and effective care,
concluding that here are a number of barriers (poor integration of
communication systems, inappropriate physical environments, misalignment of
staff training and workplace staffing models), which may affect the healthcare
team’s ability to provide effective dementia care. These systemic challenges
both give rise to and exacerbate poor organisational and safety cultures.
However, despite these challenges, there are examples of safe and effective
care (positive deviants) where uncommonly good outcomes for this patient
population are achieved. Examining these examples offers valuable insight into
potential adaptions, which could be used to improve existing care.
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Hulko, Wendy. "Dementia and intersectionality : exploring the experiences of older people with dementia and their significant others." Thesis, University of Stirling, 2004. http://hdl.handle.net/1893/855.
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The aim of this thesis is to demonstrate that new and varied views of dementia surface when the concept of intersectionality is applied to dementia research; and that these perspectives pose challenges to our assumptions about what it is like to have dementia. Grounded theory research from a feminist and anti-oppression perspective was undertaken to explore the question of the relationships between older people‘s experiences of dementia and the intersections of gender, class, ‘race’, and ethnicity. During nine months of field research in Canada, interviews, participant observation, photography, and focus groups were undertaken with eight older people with dementia and their significant others. The participants ranged from multiply marginalized to multiply privileged on the basis of their ‘race’, ethnicity, gender, and class. The grounded theory arising from this research explains the complex nature of the relationships between the subjective experiences of older people living with dementia and the intersections of ethnicity, ‘race’, class, and gender. I argue that there is a connection between social location and lived experiences of dementia; and that these relationships can be observed across and within the categories of experiencing, othering, and theorising. Experiencing captures the diversity of older people’s experiences of dementia, which range from ‘not a big deal’ to ‘a nuisance’ to ‘hellish’: these views are associated with social location, with the multiply privileged older people holding the most negative views of dementia and the multiply marginalized older people dismissing the significance of dementia. Othering refers to the marginalisation to which people with dementia are subject: it is shown to be a marked feature of life with dementia and to be connected to social location, with the multiply privileged people being othered more often as a result of their dementia status; the more marginalised participants demonstrating resilience (as an acquired characteristic); and all being subject to both othering practices and enabling behaviours enacted by members of their social worlds, such as their significant others. The theorising category refers to people with dementia being active meaning makers who theorise about dementia: the outcome of this intellectual activity is shown to be related to social location, with the most privileged participants being the only ones to view dementia as a brain disease; and all others making strategic use of the normal aging theory to avoid marginalisation due to dementia. The result of the theorising done by older people with dementia is a dialectical theory of dementia that positions dementia as a bio-psycho-social phenomenon, disrupts the false dichotomy between normal and pathological, and integrates emic and etic perspectives on dementia.
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Åkerlund, Britt Mari. "Dementia care in an ethical perspective : an exploratory study of caregivers' experiences of ethical conflicts when feeding severely demented patients." Doctoral thesis, Umeå universitet, Geriatrik, 1990. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-101294.
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The aim of this study was to explore how caregivers caring for severely demented patients experience ethical conflict situations. Feeding patients in a late state of dementia was chosen as focus. Special attention was paid to analyses of the caregivers' experiences with regard to their feelings, use of force, interpretations of the patients' behaviour and their ethical reasoning. The study was carried out in five separate parts, presented as five papers. A phenomenological - hermeneutic approach was consistent. Personal interviews, a projective defence mechanism test, the Meta Contrast Technique and an analysis of patient/caregiver behaviour as shown in video taped feeding sessions were the methods used. Study participants were forty-one caregivers in psychogeriatric care, registered nurses, licensed practical nurses and nurses' assistants. The result indicated that, when facing ethical decisions the caregivers were caught in a double bind conflict due to the contradicting ethical demands "Keep the patient alive!" and "Don't cause the patient suffering!". The difficulty to interpret what the patients experienced and the impossibility to know for sure what actions would be right or wrong were sources of anxiety. They defined force feeding individually, yet a pattern was found. Some caregivers defined force feeding according to the amount of persuasiveness or violence they had to perform. Some regarded force feeding from a patient wish perspective. A majority combined the two dimensions. The caregivers' ethical reasoning showed that their decision making was to be regarded as a process grounded on ethical rules. Interdependence in the relation caregiver/patient made them develop their reasoning in a direction of existential reasoning.<br><p>S. 1-38: sammanfattning, s. 39-113: 5 uppsatser</p><br>digitalisering@umu
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Leung, Man-fung, and 梁雯鳳. "The use of psycho-education program for caregivers of patients with dementia." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B44625546.
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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.<br>Department of Counseling Psychology and Guidance Services
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Chan, Chun-yip, and 陳駿業. "Factors associated with depressive mood among elderly family caregivers of patients with dementia in the community." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45831063.
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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.<br>published_or_final_version<br>Public Health<br>Master<br>Master of Public Health
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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/.
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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.
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Kelly, Jo Anna M. "Bereavement Responses of Caregivers of Institutionalized vs Community-Living Alzheimer’s Patients." Case Western Reserve University School of Graduate Studies / OhioLINK, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=case1169842336.
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Earnheart, Kristie. "Cardiovascular Problems as a Predictor of Later Cognitive Decline: Moderating Effect of General and Spousal Social Support." Thesis, University of North Texas, 2006. https://digital.library.unt.edu/ark:/67531/metadc5377/.
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Individuals are living longer now than they have in the past. As a result, there is an increased incidence in illnesses that are more prevalent in later life. One group of illnesses that is more prevalent is age related dementia. Alzheimer's disease (AD) and vascular dementia (VaD) are two common types of dementia found in the older adult population. Recent research suggests that these two types of dementia may both have a vascular component that is instrumental in their development. Not only may this vascular component be present in both these illnesses, but also it may be related to a more severe cognitive decline in the aging process. Results indicate that both cardiovascular disease and general and spousal social support in middle age are all three independent significant predictors of mild cognitive impairment and other non-normative cognitive impairment in later life. However, results do not indicate that social support moderates the relationship between cardiovascular disease and cognition.
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Lin, Che-Ying. "The development of quality indicators for Taiwanese institutional dementia care." Thesis, University of Stirling, 2010. http://hdl.handle.net/1893/2542.
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This study is a mixed-method study that seeks to develop a set of institutional dementia care indicators to evaluate quality of care and inform the improvement of quality of life (QOL) for Taiwanese people with dementia living in care homes. It also uses comparative analysis to compare the different features of policy and its delivery in dementia care between Scotland and Taiwan, a comparison designed to aid the development of dementia care policy, and the establishment of quality indicators for institutional dementia care, in Taiwan. This study employed the person-centred care approach at the micro perspective, and the total quality management (TQM) approach at the macro perspective, in order to inform a seamless care model for people with dementia living in care homes. Data were collected in two stages: comments from experts in dementia care were recorded in an exercise using “Delphi” methodology; subsequently the opinions of service receivers were recorded in a fieldwork exercise. The Delphi exercise (stage one) acted as the pre-test, involving 24 experts in dementia care in Scotland and Taiwan in evaluating the usefulness and applicability of proposed quality indicators for institutional dementia care. Quantitative and qualitative data from the Delphi panel were analyzed. The fieldwork (stage two) collected 237 questionnaires (from 122 residents with dementia and 115 family members) in 14 Taiwanese care homes for people with dementia (including special care units within care homes). The field test data were analyzed using reliability and item analysis, confirmatory factor analysis (CFA), and descriptive and inferential statistics. Initially, 43 proposed quality indicators for institutional dementia care were identified through literature review. However, after two Delphi rounds, only six key dimensions (41 quality indicators) were identified by consensus as the important items for use in measurement of quality of care for people with dementia living in Taiwanese care homes. Through reliability and item analysis, and CFA, this research developed a model which is a three-factor structure (social care, health and personal care, and environment) with 18 quality indicators. The 18 quality indicators have high reliability, validity, and credibility and load onto a second order factor which represents quality of care for people with dementia living in care homes. Further analysis was then conducted to explore how relative ratings on these three factors differed according to measured characteristics of the residents and their family members. In general, only a few strong patterns of difference emerged and multiple linear regression analysis suggested that differences in ratings could not be attributed to influences of socio-economic and socio-demographic differences between respondents. The study concludes that the Delphi method could be used as a methodology for health services research to integrate the opinions of multidisciplinary dementia experts and that CFA is an effective technique to study the empirical factor structure. The findings suggest that the 18 quality indicators could be suitable criteria for people with dementia and their family members to evaluate care quality and select an appropriate care home. The indicators also have important policy implications for the Taiwanese Government and regulations intended to ensure that care homes meet the requirements of service receivers.
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Koch, H. J., K. Gurtler, and A. Szecsey. "Correlation of MMSE, SKT and clock test scores in patients with mild and moderate dementia." Nagoya University School of Medicine, 2005. http://hdl.handle.net/2237/5409.
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Abbey, Jennifer Ann, and mikewood@deakin edu au. "Death and late-stage dementia in institutions: a cultural analysis." Deakin University. School of Nursing, 1995. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20050825.153139.
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The first purpose of this study was to describe the deaths of fifteen nursing home residents with late-stage dementia. The devastating effect of dementia on a person has been called a living death (Woods, 1989). The caring which occurs when someone is going through this process in a nursing home was recorded and analysed.
In analysing this act of caring, the second purpose was to look for the origins of the structures and the sources of pressure that shaped the context and therefore helped determine the behaviour of the various groups under observation. These groups were residents and their relatives, the staff of the nursing home and the treating doctors.
Before commencing observations and carrying out this study, an understanding needed to be developed of: the condition of dementia as it is perceived by health professionals and presented in the media; the institutions in which the majority of people with dementia end their days; the background and conditions of the staff who nurse in them; the models of care that guide and determine policies; and the conceptions of life and death which underpin relevant laws and moral standpoints.
Accordingly, in part 1. chapter 1 the history, causes, pathology and effects of dementing conditions are examined. Relevant medical and lay literature including media influences are examined which pertain to the subject of death and dementia and nursing home care. The history of this institutional care is briefly examined together with the growth of the discipline of gerontological nursing. Chapter 2 discusses some of the effects of this history on present day care and the concept of emotional work being carried out within the present day aged care public policy regulations. The moral arguments surrounding illness and dying in Australian society today are briefly discussed.
Chapter 3 describes the conceptual framework for the study, the ethnographic method that has been employed and an outline of critical theory as the basis for analysis. The chapter concludes by recounting the practical steps taken to arrange the field work, secure the consent of participants, record data and gather documents, and outlines the ethical considerations given to the undertaking of the study. Chapter 4 describes the context in which the study took place and the first tentative exploration of the culture from an etic perspective.
Part 2 describes the death trajectories observed and raises some questions about alternative strategies that may have been considered within a different paradigm of caring. In chapter 5 the death trajectories of each of the fifteen residents in the study are described, each written with a particular emphasis to illustrate aspects of the
culture of care that emerged through thematic analysis. Observations, comments and feelings from staff and family are wound in and around these case studies. Chapter 6 looks more closely at the impact of policy and institutional pressure on the milieu in which these deaths took place.
Part 3 draws conclusions from the observations and makes suggestions for emancipatory change as viewed from the author's standpoint of critical ethnographic analysis. In the final chapter an argument is presented for policy change that leads a movement towards palliative care practices for people with late-stage dementia. Approaches to implementation of palliative care will need to take account of any expression by the resident such as an advanced directive, indicating a preferred approach to treatment in the period prior to death; a need for a better understanding of such issues as the significance of body breakdown, the manifestations of pain and electrolyte imbalances; the surrounding ethical complexities and shift in public opinion, and perhaps, most of ail, the culture of the institutions in which this dying will take place. A definition of late-stage dementia which might be used in determining patterns of care is set out.
A discussion about changes in practice which relate lo communication with treating doctors, the administering of antibiotics, the relief of pain, the mobilisation of residents and the provision of food and water takes place in light of the evidence found. The discussion of these issues is raised in the form of debate. Each aspect needs more rigorous analysis and information so that evidence-based practice, rather than care which is value-laden and emotional, can be used when treatment decisions are made for people with late-stage dementia.
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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.
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<p> 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.</p>
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黃敏鳳. "An Evaluation of Adult Day Care for Patients with Dementia： Needs Satisfaction of Patients with Dementia and their Caregivers." Thesis, 1999. http://ndltd.ncl.edu.tw/handle/93987342980977534090.
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碩士<br>長庚大學<br>護理學研究所<br>87<br>The purpose of this study was to evaluate the adult day care for patients with dementia. The contents of the evaluation focused on exploring the needs satisfaction of patients with dementia and their caregivers. This study was carried out in two adult day care centers located in the northern and central parts of Taiwan. Qualitative study design was used in this study. In addition to face-to-face interviews with nine patients with dementia, their caregivers, and six nurses, participant observation and document were used to collect the data. The analytical method described by Miles & Huberman (1994) was used to analyze the data. The results of the study found that adult day care for patients with dementia and their caregivers provided: medical care, daily living care, social work, management of symptoms and related problems of the dementia. Additionally, findings suggest that adult day care can benefit the patients with dementia by providing the medical care and daily living care services, and support for emotional needs. While it can not be confirmed that the symptom of the dementia was improved. Findings also revealed that adult day care satisfied the medical care needs of the caregivers, decreased the caregivers’ psycho-social burden, and provided supports for feeling and emotional needs. It is the important finding of the study that adult day care can satisfy the feeling and emotional needs of the patients with dementia and their caregivers. For patients with dementia, they can still enjoy the closeness with family while accept adult day care services. On the other hand, for the family caregivers, they can still present their love and care, and fulfill the traditional filial duty of retaining the family''s integrity. Based on the results of the study, the needs of the patients with dementia and their caregivers receiving adult day care can be recognized. These findings can serve as a base for further improvement of the service quality of the adult day care services for patients with dementia. Indicators for quality of care can be developed.