Dementia (London, England)最新文献

Background and Objectives: Dementia and hearing loss are highly prevalent and increase in prevalence and severity with age. Hearing loss is often overlooked in people living with dementia, resulting in under-diagnosis and lack of appropriate management. Both conditions present substantial challenges for individuals and healthcare systems more broadly. The presence of both conditions can mask each other, presenting challenges for both diagnosis, treatment and support. The aim of this study was to qualitatively explore the experience, needs and opinions of how to manage hearing loss in people living with dementia in social care settings from multiple perspectives. Research Design and Methods: A qualitative study using focus groups with key stakeholder groups was conducted. Data were analysed using thematic analysis. Participants included seven social care professionals (aged 25-68), six informal carers (aged 56-92) and one person living with dementia and hearing loss (aged 69) (m = 21%, f = 79%). Results: Five themes were identified: (i) inclusion; (ii) communication, (iii) hearing aids, (iv) health services and (v) training of care staff. Discussion and Implications: Findings highlight the need for comprehensive training to help support the management of hearing loss in people living with dementia. Training on the use and maintenance of hearing aids would be particularly valuable for staff. Due to the progressive nature of both conditions, individuals in receipt of social care should be reviewed regularly to ensure that care needs are adapted to suit the progressive nature of the conditions.

This qualitative study explores the significance of Pre-Assessment Counselling (PAC) in supporting timely diagnoses for people with dementia from the perspectives of clinicians. Reflexive thematic analysis was employed to analyse in-depth interviews with a multidisciplinary team of clinicians specialising in dementia care. Three themes were identified: (1) The centrality of people with dementia in their diagnosis journey, (2) The importance of candid conversations in building therapeutic alliances, and (3) Recognising people with dementia are more than their diagnoses. These themes elucidate the multifaceted aspects of PAC and its implications for well-being and engagement in dementia care. The findings underscore the significance of timely diagnoses for the well-being of people with dementia while highlighting the nuanced nature of diagnosis delivery. Moreover, they emphasise the importance of empowering people with dementia in decision-making processes and fostering resilience through comprehensive support. The clinical and research implications of PAC implementation in dementia care are discussed.

This qualitative study investigates the experiences of individuals with dementia and their caregivers following earthquakes, focusing on identifying challenges, coping mechanisms, and support needs during this critical period. Semi-structured interviews were conducted with participants who lived through earthquake events. The data were analyzed using interpretive phenomenological analysis to extract meaningful insights into their post-earthquake experiences. The analysis revealed four main themes: (1) "Adapting to Change and Addressing Unmet Needs," highlighting how individuals with dementia and their caregivers struggled to adapt to post-disaster circumstances, often facing unmet needs in healthcare and daily living; (2) "Crisis Care Dilemma: Balancing Concerns for Loved Ones with Dementia," illustrating the caregivers' internal conflicts in prioritizing their safety while addressing the ongoing care needs of their loved ones with dementia; (3) "Healthcare Hurdles: Struggles in Access and Support," shedding light on the difficulties in obtaining timely and appropriate medical care during and after the earthquakes, with limited resources exacerbating the stress of caregiving; and (4) "Navigating Challenges: Recommendations for Well-being," presenting practical suggestions from participants on how healthcare and support systems can be improved to better serve this vulnerable group during crises. The findings emphasize the multifaceted and complex nature of post-earthquake experiences for people with dementia and their caregivers. Targeted interventions are essential to provide specialized healthcare services and crisis management support. These interventions should be integrated into policy and practice to ensure that the unique needs of this population are addressed effectively in disaster preparedness and response efforts. The study's insights have important implications for guiding future support strategies to enhance the well-being of individuals with dementia and their caregivers in post-disaster contexts.

The high prevalence of eating difficulties among nursing home residents living with dementia has a significant impact on their health and well-being. While various interventions have been evaluated to reduce eating difficulties and enhance nutritional intake, quantitative evaluation alone may not capture the full impact of the intervention given the trajectory of dementia. Following the implementation of a mealtime intervention, combining Spaced Retrieval with Montessori-based activities, 13 staff members who provided regular direct mealtime support to participating residents living with dementia were interviewed. Using a qualitative descriptive approach, individual semi-structured interviews were conducted. Thematic analysis guided the analysis and interpretation of the interviews. Three overarching themes represented the participants' views: (1) Mealtime challenges, reflecting physical, cognitive, and behavioural impairments that hindered independent eating; (2) Individualised mealtime support, highlighting the critical role of person-centred strategies tailored to individual unique needs and abilities; and (3) Enhanced outcomes, describing improvements in eating independence, engagement, social interaction, mood, and self-esteem. Staff insights highlighted the importance of individualised, person-centred mealtime support grounded in a reablement approach. The specific challenges experienced by residents living with dementia should be proactively addressed when planning and implementing interventions. This intervention not only promoted eating independence but also enhanced psychosocial well-being, engagement, and mood. This emphasises the broad potential for such interventions to be integrated into daily clinical practice to improve both the quality of care and residents' well-being and quality of life.

There has been an international effort to improve the quality of care available to persons living with dementia and their caregivers. As such, research has emphasized the importance of community-based interventions designed to help mitigate some of the health effects associated with caregiving. Physical activity and social support are two elements with the potential to enhance caregivers' health and may be beneficial to include when designing and implementing interventions. Thus, to inform implementation and future research, this scoping review sought to describe and identify what is already known about physical activity and/or social support and dementia caregivers' physical, mental and social well-being. To do this, we followed Arksey and O'Malley's framework for scoping reviews. Five databases (SPORTdiscus, CINAHL, PubMed, MEDLINE, PsychINFO) were searched in October 2022 and again in February 2024, and July 2025. Covidence was used to organize all relevant studies, and two researchers independently reviewed all articles. Knowledge users (dementia caregivers & community program providers) (n = 4) were also consulted during a focus group to determine if their lived experiences aligned with the findings. Thirty-four studies met the inclusion criteria. Ten studies examined physical activity; 14 studies examined social support; and 10 studies examined interventions inclusive of physical activity and social support. Regardless of intervention type, the most common finding was participation increased caregivers' mental well-being. No difference in physical or mental health outcomes were found between in-person and online interventions. Participation in joint reminiscence therapy was the only intervention to result in a decrease in health. All knowledge users agreed with this finding. From this review it is evident that participation in PA and/or social support is beneficial for the physical, mental and social well-being of dementia caregivers. The findings from this review may help to inform the development and improvement of community-based interventions for this population.

Young-onset dementia presents unique challenges, including employment disruption, financial strain, and stigma, which affect various aspects of social health, such as social frailty and social isolation. However, little is known about the experiences of people living with young-onset dementia regarding social frailty and social isolation, and support needs to improve their social health. This study aimed to explore the lived experiences and support needs on social frailty and social isolation of people living with young-onset dementia, to inform strategies and interventions to improve social health in this population. A descriptive qualitative design was employed. Semi-structured interviews were conducted with 12 community-dwelling individuals living with young-onset dementia in Ireland and the United Kingdom. Participants had been identified as socially frail, socially pre-frail, or socially isolated in a prior survey. Data were collected from December 2024 to March 2025 and analysed thematically. Five themes were identified: (1) Persevering in independence and voice, highlighting autonomy and being heard; (2) Challenges to stability: employment, finance, and family, describing disruptions and need for family-oriented support; (3) Impact on support: living with young-onset dementia and finding hope, disclosing the social and psychological barriers, and the importance of early and empowering information; (4) Exclusion from inclusion: building a dementia-friendly environment, bridging the need for addressing stigma and advocacy for public awareness; and (5) Gaps: Limited support and challenges, demonstrating age-related and geographic inequalities and sustainability challenges in dementia support access for people living with young-onset dementia. People living with young-onset dementia face significant, distinct and complex social health challenges often not addressed by existing dementia services. Their voices must guide the development of age-appropriate dementia care, with inclusive and empowering support systems. Tailored interventions and policies are needed to address social health needs and promote equity in dementia care for younger populations.

Care partners of individuals with Parkinson's disease experience challenges while managing new responsibilities like transportation, finances, and activities of daily living, which influence their own mental and physical health. While previous qualitative research has investigated the perspectives of people with Parkinson's disease who participate in singing groups, the perspective of their care partners is less frequently studied. The purpose of this manuscript is to understand the involvement and perspective of care partners of people with Parkinson's disease participating in a singing group. Eight care partners were interviewed online over Zoom using pre-determined questions detailing the care partners' involvement and relationship to the group. All transcripts were analyzed using a phenomenological approach and content analysis. Seven primary and eight secondary themes were generated, and these findings indicated that care partners enjoy both observing their partner benefit from a singing group, while finding meaningful relationships with other care partners, supporting singing groups as a promising relational intervention.

As the global prevalence of dementia continues to rise, expanding and upskilling the health and social care workforce is a top priority. To address this need, some health and social care services have implemented Dementia Champions (DCs). DCs are typically existing staff who are recognised and developed as dementia specialists to advocate for the needs of people affected by dementia within their service. However, evidence around the DC role across health and social care is limited. In this narrative review, we aimed to understand and define the DC role by exploring who becomes a DC; where they work; what their tasks and responsibilities are; and what is needed for the role to be successful. For the latter, we aimed to develop a Theory of Change framework for implementing, embedding, and maintaining the DC role in health and social care settings. A systematic search of the literature identified DCs working predominantly in hospitals and care home settings with a notable absence of the DC role within homecare services. Tasks and responsibilities of the DC role varied between settings and services. Findings highlighted that to be successful, the role needs clear definitions and boundaries; organisational and managerial support and buy-in (including establishing protected time for the role); and ongoing professional development. While DCs are implemented in pockets of the health and social care workforce, the role is not well established. Further research is needed to assess the impact of DCs on workforce effectiveness and staff well-being, patient and family carer outcomes, and cost-effectiveness in diverse health and social care settings.

Purpose: People living with delirium, dementia and exhibiting behaviours of concern (DDBoC) are becoming increasingly common in hospitals. Allied Health (AH) are a group of professionals who frequently work with people with DDBoC in the inpatient setting to support their rehabilitation goals. Little is known about the effect working with DDBoC has on the mental health and wellbeing of AH staff. The aim of this study was to examine the impact of working with patients living with DDBoC on AH staff on inpatient wards. Materials and methods: This study used a mixed methods concurrent triangulation design with three data collection methods: (i) retrospective audit (Jan 2021 to Dec 2022) of clinical incident data to establish prevalence of incidents related to patients with DDBoC and involving AH; (ii) cross-sectional online survey of AH staff wellbeing, and exposure to and experience with patients living with DDBoC; and (iii) semi-structured one-on-one interviews with AH staff exploring experiences working with DDBoC. The study period was between April and June 2023. Results: Thirty-nine incidents related to DDBoC involving AH staff were reported during the study period. Survey participants reported frequent exposure to DDBoC (44% reported >5 encounters in the past month) and high levels of support seeking (n = 35/50; 70%). Twenty-six percent (n = 13/50) of participants reported low levels of resilience and 28% (n = 14/50) reported high levels of burnout. Analysis of interview transcripts yielded four key themes: 'What we experience', 'How we are impacted', 'How we manage' and 'How we work together'. Despite most participants reporting normal levels of stress (n = 35; 70%), interview data suggested senior staff may experience and respond to stress differently. Work in this area impacted on team communication, confidence, and response to external factors outside team control. Conclusions: Working with DDBoC has a complex effect on AH staff wellbeing, eliciting feelings of reward, empathy, stress, fatigue and moral distress where person-centred care cannot be provided. AH staff appear to under-report incidents and require strategies to support their wellbeing when working with this patient population.

Elder clowning is a psychosocial intervention delivered to persons living with dementia in long-term care. It aims to improve quality of life through interpersonal interaction and connection. This review aimed to synthesise international cross-disciplinary qualitative research regarding elder clowning specialist capabilities, engagement techniques, and potential benefits, for persons living with dementia, their families, and staff. The method was informed by systematic review methodologies. A comprehensive search of major health databases was undertaken. The search identified 198 studies, 15 articles from 10 studies were appraised and included in the review. Three major themes resulted from the synthesis: 1) understanding the elder clown, 2) journeying together to cultivate connection, and 3) promoting wellbeing through connection. Elder clowns were suggested to be perceptive, attuned, empathetic, present, adaptive, and performative. These capabilities supported a wide range of engagement techniques used to prepare for, approach, initiate, sustain, redirect, appeal for, and exit engagement with persons with dementia, which resulted in potential benefits across cognitive, behavioural, emotional, social, and experiential domains. The synthesis offers a common rubric for describing the components of elder clowning interventions for use across disciplines and identifies potential benefits to aid in the design of future trials of effectiveness.