Dementia (London, England)最新文献

The World Health Organization's iSupport for Dementia program provides an online platform for carer education, yet its suitability for culturally and linguistically diverse communities remains under explored. This study evaluated the cultural and linguistic appropriateness of the adapted Vietnamese iSupport program for carers in Australia and identified factors influencing the future implementation of an iSupport Virtual Assistant (iSupport VA). A qualitative descriptive study was conducted using five focus group discussions with 30 participants, including 18 family carers and 12 formal carers from Vietnamese communities in Australia. Thematic analysis, guided by a deductive-then-inductive approach, was applied to analyse the data. Discussions were conducted in Vietnamese, recorded, transcribed, translated, and systematically coded for recurring themes. The findings showed that participants emphasized the need for culturally sensitive language and visual representation in the adapted iSupport program, stressing the necessity for translations that align with context, incorporate relatable examples, and feature realistic video content. They expressed a strong preference for accessible multimedia formats, favouring video content with voice-over and interactive features over text-heavy materials, particularly for those with limited literacy. The importance of culturally tailored caregiving scenarios was highlighted, with a preference for real actors over animated characters to enhance emotional authenticity. Despite recognising the program's value in improving caregiving skills, carers cited time constraints, competing responsibilities, and digital literacy challenges as barriers to engagement, emphasising the need for a clear value proposition and targeted support mechanisms, including introductory tutorials and peer-based community interaction. Adapting iSupport to align with cultural and linguistic needs enhances its relevance and accessibility for Vietnamese carers in Australia. Refining translations, incorporating culturally familiar multimedia elements, and addressing usability concerns are crucial to optimising engagement and effectiveness.

Gratitude is a character strength that predicts life satisfaction and has been found to be meaningful for older people living with dementia. The age someone develops symptoms of dementia impacts how people relate to and experience dementia. Young onset dementia is the development of dementia symptoms before the age of 65, and can present unique challenges. Gratitude has emerged serendipitously in young onset dementia research in the context of coping. Given the unmet need for tailored support for people with young onset dementia, exploring factors that may contribute to people with young onset dementia's well-being, such as gratitude, is important. This study therefore aimed to explore the meanings and experience of gratitude for people living with young onset dementia. Nine people living with young onset dementia each took part in a semi-structured interview that had been developed in collaboration with a patient and public involvement group. This was an exploratory qualitative study, using Interpretative Phenomenological Analysis. Two overarching themes and six subthemes were developed to capture how participants cultivated and experienced gratitude, in order to live well. The theme 'Gratitude as a cultivated approach to life' included: 'Acknowledging the challenges', 'Slowing down allows me to savour the moment', and 'Choosing a grateful mindset'. The second theme 'Interpersonal gratitude' included: 'Feeling part of something bigger', 'Feeling seen and supported', and 'Sharing the thank-yous'. This study demonstrated that gratitude was a meaningful concept for people living with young onset dementia and had a role in fostering their well-being. Lived experiences of young onset dementia were connected to cultivating gratitude and this process often involved participants making an active choice to experience gratitude. Experiences of gratitude were largely interpersonal, with felt and expressed gratitude for relationships and communities, highlighting the importance of social support.

The psychological health and quality of life (QoL) of family caregivers, who are central to care provision for older adults, may be impacted by the diagnosis of dementia in their care-recipients. However, the relevant literature is largely limited to qualitative studies or Western contexts. Using longitudinal quantitative data from Singapore, a rapidly ageing Asian nation, we assess the change in family caregivers' depressive symptoms and QoL following the diagnosis of dementia in their older care-recipients. Data of 263 caregivers and their care-recipients (≥75 years with functional limitations) was extracted from a four-wave longitudinal study. Based on caregivers' report if the care-recipient had been 'ever diagnosed' (at baseline interview) or 'diagnosed since previous interview' (in follow-up interviews) with dementia, the sample was grouped into: (1) new diagnosis (n = 22), (2) existing diagnosis (n = 57) and (3) not diagnosed (n = 184). Caregiver depressive symptoms (Center for Epidemiologic Studies-Depression scale) and QoL (World Health Organization QoL scale; four domains: physical health, psychological health, social relationships, and environmental health) were measured at each wave. Across the three dementia diagnosis groups, caregivers in the 'new diagnosis' group had the highest depressive symptoms and lowest QoL (physical and psychological health domains) at their last available follow-up interview. Multivariable fixed-effect regression showed that caregivers exhibited a significant decline in QoL (psychological and environmental domains) following their care-recipients' diagnosis of dementia. The detrimental psychological impact of the diagnosis of dementia in their care-recipients on family caregivers is also observed in Asian settings. Our findings emphasize the importance of support mechanisms for caregivers adapting to the diagnosis of dementia in their loved ones.

Community dwelling people with dementia and their family carers (dyads) may become increasingly isolated which can lead to lack of support, heightened stress levels, anxiety and difficulty coping. For both populations, there is a need for supportive and inviting programs that can provide social contact, respite, and promote engagement for well-being. A co-design workshop was conducted which led to the provision of a pilot six-week art program for people with dementia concurrent with a wellbeing program for their family carers. The research had two phases. Phase one was co-design informed by action research to decide on the content for the six-week concurrent programs and phase two used qualitative description to interpret participant perspectives about program outcomes. Data were collected prior to the programs through a co-design workshop, during the program through weekly reflections, and after program completion through interviews with dyads and a focus group with program facilitators. Twenty-one people participated in the co-design workshop which included two industry advocates, four caregivers, three people with dementia and twelve who did not specify. There were six dyads in the concurrent programs and six facilitators overall. Data were analysed using reflexive thematic analysis. Three themes developed in phase two included: relaxation, engagement and trust; recognising and developing new skills and abilities; and connecting over shared experiences. The co-designing process supported trust and led to programs that provided social support and opportunity for engagement. Having the dyads separated but nearby helped people to relax, knowing the other was doing something enriching. Concurrent programs for people with dementia and their caregivers must be tailored to their needs, have small group sizes that allow for social connection and trained facilitators that focus on the process of 'doing' activities and having fun over the outcome or product.

A most crucial aspect in dementia care is recognising and maintaining the person behind the dementia condition. Yet, it has been found that caring for people living with advanced dementia risk becoming mere techniques and undervaluing the significance of inter-embodied relationships. This can lead to that the unique person of those receiving the care becomes overlooked and undermined. Research suggests how the care recipients' unique person fruitfully can be recognised via identifying humanising caring relations in their everyday lives. Thus, it is necessary to explore how formal caregivers engage in care that support people living with advanced dementia as human beings, which is the aim of this study. Following Galvin and Todres' existential lifeworld-led approach to care, the lived experience of formal caregivers' humanisation of their care recipients were explored through participant observations and semi-structured interviews at two nursing homes specialised in advanced dementia; both methods were granted ethical approval from a research ethics committee. Based on the lifeworld-led theory we found four ways within formal caregivers' experience to be able to humanise care recipients living with advanced dementia, which can be described as: The continuity of self, The touch of the world, The kindred understanding, and The invisible bond. We argue that it is not enough just replicating such caring ways in order to deliver humanisation in advanced dementia care, but require of the caregiver to engage in a genuine human relation with those for whom they care. Such engagement in recognising and supporting the intrinsic humanness of the care recipient can guide a more humanly sensitive care practice that recognises and maintains the unique person behind the advanced dementia condition.

It takes time to adjust to a diagnosis of dementia. Post-diagnosis support has an important part to play in navigating this transition. However, it is often scarce and variable according to location. This co-produced study explored experiences of support across the UK. The project was co-designed and implemented with people living with dementia. Five focus groups were attended by 18 people with dementia and 10 spouses from across the UK. The aim was to find out what support people currently received, what aspects they valued, and what they would like to see done differently. Most participants reported feeling abandoned after diagnosis, with little continuity of care. Many felt the burden of navigating post-diagnosis life was on them and their loved ones, with a perceived scarcity of support, and difficulties navigating the benefits system. Peer/voluntary support was seen as vital in promoting confidence, a source of relational support, and finding out crucial information relating to benefits, healthcare, and management of symptoms. Participants felt dementia was stigmatised, receiving less support than other medical conditions. Participants identified aspects of post-diagnosis support they valued, and collaborated on ideas for support structures and services they would like to see introduced. In concluding this study, we argue that post-diagnosis support services could be improved with the input of people living with dementia. This could reduce the burden on those receiving the diagnosis to find advice and support outside of health and social care systems. For future research, the financial implications of a dementia diagnosis have rarely been discussed and warrants further exploration.

Despite the growing number of older and aging people in custody across many countries, and corresponding vulnerability for neurocognitive issues, there has been limited research into the efficacy of cognitive assessment and dementia screening tools in correctional settings. The purpose of this study was to synthesize recent empirical research investigating dementia (and cognitive impairment) in older people in custody using screening tools. A systematic review methodology was adopted, with reporting guided by the PRISMA framework. This included a systematic search of four databases (PsycINFO, MedLine, PubMed, and Academic Search Complete) and handsearching of reference lists of eligible studies. A total of 9 peer-reviewed publications were included. All studies were from high income countries, including the United States (n = 2), Germany (n = 2), Canada (n = 1), England and Wales (n = 2), Australia (n = 1), and France (n = 1). These studies were synthesized according to the following themes: (1) use of screening tools with modification for the correctional setting; (2) use of screening tools without modification for the correctional setting; and, (3) innovative advances in cognitive screening tools and practices for correctional settings. This review identified several cognitive assessment and dementia screening tools that have been used in custodial settings. These tools can help in the early identification of dementia (or cognitive impairment) among older people in custody and, thus, inform the initiation of supports and strategies to manage those at risk. More research is needed to evaluate the performance of these tools compared with a diagnostic assessment.

Background: The number of people in Canada living with dementia is predicted to rise to 912,000 by 2030. Traditional treatments for dementia have been unsuccessful in eliminating negative responsive behaviours (wandering, agitation, vocalizations) and prompted the emergence of alternative strategies, such as art and music therapy. Although previous reviews have been conducted on aspects of the arts and older adulthood, such as the efficacy and benefits of creative arts therapies in people with dementia, to our knowledge, no review has specifically focused on the role of reminiscence within arts-based interventions for dementia care. Purpose: This scoping review aims to assess the state of the evidence on the role of reminiscence in visual art interventions for individuals with dementia, intending to map the range, nature, and focus of articles and identify gaps for future work in this context. Methods: The five-stage scoping review framework of Arksey and O'Malley (2005) guided this review. Data Sources: CINAHL, PubMed, Web of Science, Scopus, and Google Scholar. Results: 1508 articles were retrieved and screened using pre-established inclusion criteria; 21 empirical articles were retained. Data extracted illustrated themes of social connection, bridging the past and present, and increased enjoyment and confidence. Authors noted art's positive impact on individuals with dementia. The benefits of reminiscence in arts-based therapy were unanimously observed across diverse studies in our review and point to a call for future research. Conclusion: Reminiscence is a vital component within art interventions that allow for making a human connection. Art fosters communication, helping individuals navigate the challenges of everyday life.

Cognitive decline and dementia account for the highest number of cognitive disabilities, functional limitations, chronic healthcare conditions, and long-term care needs among older adults aged 65 and older in the US. The optimization of public health policies and advances made from gerontological research have resulted in a steady increase in the number of older adults 65 and above, which makes the risk of cognitive decline and dementia higher. The use of interventions like adult day services (ADS) may delay placement into long-term care homes among older adults living with dementia and other cognitive impairment-related disabilities. The purpose of this scoping review study was to address the research question: What impact do adult day services have on long-term care home placement for people living with dementia? Electronic searches were performed using six databases for sources published between 1998 and May 2024. A total of 150 citations were found. After screening titles and abstracts, full-text reviews were completed for eight articles. Of these eight articles, only two articles addressed the research question directly and reported increased risk for placement. With very few recent studies on the impact of ADS on long-term care placement, more research is needed to draw firm scientific conclusions on the benefit of ADS, and these future studies should include the perspectives of people living with dementia, family caregivers, and ADS providers.

People living with dementia and their carers require ongoing support in the community. Memory clinics can provide a range of supports including education, respite and symptom management. While these clinics improve consumer outcomes, their impact on the carers of people living with dementia is unclear. This review sought to identify and critically synthesise the literature on the effectiveness of memory clinics in supporting carers. An integrative review process was used to identify papers from CINAHL and Medline databases. Of the eight included papers, two were qualitative and six were quantitative studies. Three themes were identified, namely; psychological heath, carer burden and satisfaction with memory clinics. Four studies found decreases in caregiver burden, distress, and psychological symptoms such as anxiety and worry. Satisfaction with the clinic model was discussed as a source of support by carers, highlighting the memory clinics. The variable outcomes seen in this review require further research to elucidate the impacts of memory clinics on carers along the dementia trajectory.