Dementia (London, England)最新文献

Individuals living with young onset dementia or mild cognitive impairment are typically working when cognitive decline emerges. Inability to maintain job demands can lead to loss of employment, loss of purpose and identity, financial instability, and withdrawal from social networks. The Job Demands and Accommodation Planning Tool was developed to identify workplace supports for individuals with episodic disabilities. The aim of this study was to explore the applicability of the Job Demands and Accommodation Planning Tool for individuals working with young onset dementia or mild cognitive impairment. Semi-structured interviews were conducted with 23 individuals: 11 in Canada, 7 in Finland and 5 in Sweden, where they described job demands and workplace challenges they faced. A secondary analysis of interview data was conducted using content analysis and a framework approach to code, categorize, and examine overlap with the Job Demands and Accommodations Planning Tool. Results showed that the Job Demands and Accommodation Planning Tool aligns well with the experiences of individuals living with young onset dementia or mild cognitive impairment. The Job Demands and Accommodation Planning Tool could inform workplace supports for people with young onset dementia or mild cognitive impairment to maintain their presence in the workforce.

People with cognitive impairment such as those with dementia, particularly in the moderate or advanced stages, can be excluded from qualitative interview research. However, the value of people with dementia's participation in research is increasingly acknowledged. Adaptations to qualitative interview techniques for use with people with advanced dementia are underexplored. We draw on 13 semi-structured interviews undertaken with people with advanced dementia in family and care-home settings. We examine researcher intuitive adaptations to contextualise and clarify including the importance of member checking in the moment with direct, closed questions if need be; people with dementia 'coasting' and leading; as well as carers as conversation partners. We draw out learning points around creating safe interview interactions, and strategies to enhance meaning making. We present methodological learnings and considerations when interviewing people with advanced dementia likely to be instructive for other researchers. We suggest that the research topic needs to be relatable and multiple methods of meaning making should be considered. Our analysis contributes to the growing evidence base considering how to improve meaningful engagement with people with dementia in interviewing. We encourage other researchers to reflect on their interview interactions with people with dementia to further delineate successful components and inform future research practices.

Dementia-friendly communities can increase community participation and social wellbeing for people impacted by dementia. However, culturally and linguistically diverse people have typically been excluded or underrepresented from dementia-friendly community design processes. This study aimed to establish the factors that affect community engagement for culturally and linguistically diverse people impacted by dementia, and their suggestions for a dementia-friendly community in Canterbury-Bankstown, Australia. Bilingual researchers conducted semi-structured interviews (N = 17) in three languages: seven were in English (dyads n = 6; former carer n = 1); five were in Arabic (person with dementia n = 1; dyads n = 3; former carer n = 1) and five were in Vietnamese (dyads n = 4; former carer n = 1). These interviews explored barriers and facilitators to community engagement and design considerations for a culturally inclusive dementia-friendly community. Interview transcripts were thematically analysed, inductively. Factors that affected participation included community perceptions of dementia, family support, and the accessibility of transport and public environments. Members of the Arabic and Vietnamese groups faced language barriers and cultural stigma, which increased a sense of exclusion and isolation. In response, they emphasised the need for accessible transport, inclusive social groups, and community-wide dementia education to create a more dementia-friendly environment. Their suggestions aligned with traditional dementia-friendly community principles and were subsequently adopted by the local dementia alliance in designing a more inclusive and culturally responsive dementia-friendly community.

Background: Digital learning environments, including Massive Open Online Courses (MOOCs), synchronous web-based seminars, and interactive educational modules, have demonstrated significant efficacy as pedagogical instruments in dementia education, circumventing traditional instructional constraints. This review explores the impact of e-learning platforms on dementia knowledge acquisition among the general public, including informal caregivers.

Methods: A systematic review was conducted using four databases: PubMed, SCOPUS, Web of Science, and Science Direct. Eligible studies encompassed peer-reviewed publications in English-language journals, with no specific restrictions imposed on publication dates. Following rigorous application of the predetermined selection criteria, eight studies fulfilled the eligibility requirements for inclusion in this systematic review.

Findings: Eight studies were included in the analysis, three quasi-experimental studies, three descriptive studies, and two mixed-methods studies. Findings indicate that digital learning modalities including MOOCs, Tele-Savvy, and Web-based seminars, significantly improve dementia knowledge acquisition, with post-intervention assessments showing notable increases in Dementia Knowledge Assessment Scale (DKAS) scores. Key features such as structured content, interactivity, and multimodal delivery improve engagement and accessibility, contributing to high user satisfaction. Findings from a descriptive study, which included participants ranging from primary school age to 100 years in a mixed-method study, highlight the broad age spectrum of dementia e-learning platforms. Notably, seven out of eight studies demonstrated elevated participant engagement metrics and satisfaction indices among e-learning platform users, with MOOCs demonstrating particularly robust completion rates. Four studies indicated that the platforms' effectiveness is predominantly attributed to their user-friendliness, while linguistic adaptability further augments engagement and knowledge retention.

Conclusion: This systematic review elucidates the significant contribution of e-learning platforms to dementia education, offering scalable and accessible learning solutions. Future research imperatives include investigating longitudinal knowledge retention, evaluating the efficacy of culturally contextualized content, and developing strategies to enhance accessibility across diverse demographic populations.

The UN Convention on the Rights of Persons with Disabilities (UNCRPD) has implications for the use of law with people living with dementia. This systematic review identifies how decisions to deprive people living with dementia of their liberty, using domestic mental capacity and mental health laws, are understood and made by professionals, and are experienced by people living with dementia and their carers. Database searches of Scopus, IBSS, CINAHL, PubMed, HMIC, and Social Policy and Practice were conducted to identify relevant academic and grey literature, with final searches in July 2024. No geographical or time scale restrictions were applied. Studies not written in English were excluded. Study quality was assessed using the Mixed Methods Appraisal Tool and thematic synthesis was used to organise data. The study was funded by Avon and Wiltshire Mental Health Partnership (grant number SP1200) and is registered on Prospero (CRD42023483046). Eleven studies were selected for review. Six papers were qualitative, three were quantitative and two employed mixed methods. Eight studies were based within the UK and all studies were conducted in Europe. Key themes were (1). Levels of legal understanding amongst stakeholder groups. (2). The influence of professional background on decision-making in dementia detention cases. (3). The impact of the severity of dementia and dementia diagnosis on decision-making. (4). The impact of care setting on decision-making. (5). The experiences of carers during decision-making. (6). The exclusion of people living with dementia during decision-making. Limitations are that not enough studies were identified to provide a meta-synthesis, non-English texts were excluded and that we did not specifically search for articles relating to guardianship laws. Our study identified significant gaps between the ideals of the UNCRPD and practice in health and social care settings.

Background: Little is known about travelling and tourism for people living with or caring for someone with dementia. The aim of this scoping review was to synthesise the existing evidence on dementia, travel and tourism, the experiences of people with dementia and their carers, and how venues and businesses are dementia friendly.

Methods: The review protocol was prospectively registered on PROSPERO [ID: CRD42023397637]. Four databases were searched for relevant literature in February 2024. Studies were included if they were published in English, Danish, or German, without any restrictions on publication date. Titles and abstracts, and full texts, were reviewed by two different research team members, and any disagreements were resolved in discussion with the wider team.

Results: From 1,523 screened records, 13 papers were included. Evidence showed wide-ranging barriers for people with dementia and their carers to travel, often limiting the travel to local well-known places with adequate facilities or decisions on whether to travel solo as a carer. Seven studies focused on attitudes of businesses and tourist attractions and their implementations of dementia-friendliness. There was a notable lack of knowledge about dementia, and whilst most sites were willing to adapt existing attractions to include people with dementia, a lack of financial resources was the main barrier consistently referred to.

Conclusion: Little remains known about the experiences of people living with dementia and their carers surrounding tourism and local, national, and international travel, and how different tourism organisations provide dementia-friendly support. With a focus on supporting people with dementia to remain as independent as possible, research needs to explore the population's experiences, and how tourism destinations and modes of travel and transport could improve to be dementia-friendly and inclusive.

The pathway to a diagnosis of dementia and post-diagnostic support can be complicated for people living with dementia and their support networks, leading to delays in care. This paper describes the development and subsequent pilot of a specialist dementia nurse role named the Dementia Liaison Officer (DEMLO) within a tertiary Victorian hospital. The aim of the DEMLO was to identify and address gaps in dementia care. This pilot is based on the principles of the National Comprehensive Dementia Centre framework. Mapping of current outpatient diagnostic and post-diagnostic services for people with suspected cognitive impairment was conducted to identify gaps in care. Interviews with 25 hospital staff were also conducted to gain further perspectives on barriers to diagnostic and post-diagnostic care and inform the development of the DEMLO role. Several challenges to diagnostic/post-diagnostic support were identified, including the perception that waitlists were long, confusing referral criteria, and complex referral processes. The DEMLO was subsequently developed and trialled within the Geriatric Evaluation and Management (GEM) outpatient service. Three key functions were implemented: reviews of eligibility criteria for patients with cognitive impairment on the GEM clinic waitlist, introduction of a pre-clinic comprehensive geriatric assessment for GEM clinic patients and the introduction of a dementia post-diagnostic support service for all patients across the hospital. Challenges to developing and sustaining the pilot included limited timeframe, difficulty with integration and limited funding. Despite this, the pilot was well received, with 141 patients referred. The introduction of a nurse-led dementia intervention has resulted in increased person-centred care that encompasses pre-diagnostic and post-diagnostic support for people living with dementia. Evaluation of the pilot is ongoing.

In the Netherlands, where this study was conducted, there are around 800,000 family carers of people with dementia. Research into the needs and priorities of people with dementia and their family carers is crucial for developing tailored care and meaningful support. However, current research lacks attention to the everyday life experiences of caring for someone with dementia at home. Therefore, the research question this study aimed to address was: how do family carers of people with dementia living at home approach and experience their everyday life in a caring context? The study used a qualitative design, underpinned by a phenomenological approach. 15 family carers (10 partners and five adult children) participated in open interviews. Thematic analysis was used to document and structure the data. A member check was performed on the emergent findings through a focus group with six family carers (all care partners). This process resulted in four discrete but interlinked themes that reflected how family carers approach and experience caring at home for a person with dementia, namely: (1) Finding and keeping routines that work; (2) Focussing on small moments; (3) Rebalancing connections; and (4) Thinking ahead. These themes also emphasise the unfolding nature of everyday life that is constantly changing for family carers.

Background: The study compares the health impacts of various nonpharmacologic interventions on cognitive function, daily functioning, depression, and quality of life among people living with dementia. Methods: A comprehensive search was conducted across three databases-PubMed, Airiti Library, and Scopus-to identify eligible randomized controlled trials published in English or Chinese within the past decade, up to December 2023. This study included a systematic review and a network meta-analysis focusing on various health outcomes. Results: Analysis encompassed 26 studies with a total of 3,403 people living with dementia. Interventions that significantly influencing cognitive function included aerobic exercise combined with resistance exercise (SMD = 1.53, 95% CI: 1.13-1.93), resistance exercise alone (SMD = 1.53, 95% CI: 1.12-1.93), and reminiscence therapy (SMD = 1.25, 95% CI: 0.70-1.80). Resistance exercise had the greatest impact on daily functioning (SMD = 0.95, 95% CI: 0.57-1.33), while reminiscence therapy (SMD = 0.65, 95% CI: 0.20-1.10) and music therapy (SMD = 0.56, 95% CI: 0.31 - 0.81) had the most significant effect on depression. A significant effect on quality of life was not found in this study. Conclusions: Resistance exercise, multicomponent exercise incorporating resistance training, and reminiscence therapy as well as music therapy were found to positively impact the health of people living with dementia. These findings suggest that integrating nonpharmacologic practices could enhance dementia care.

Objectives: Behavioural and psychological symptoms of dementia (BPSD) are prevalent in residential aged care (RAC) settings, negatively impacting residents' quality of life and increasing carer burden. This study investigated current practices and experiences of RAC staff in managing BPSD, including collaborative behaviour support planning with family members. Methods: A cross-sectional survey was conducted with 43 RAC staff supporting residents with dementia. Data was collected about demographics, resident characteristics, and current behaviour support practices and support needs. Quantitative and qualitative data were analysed using descriptive statistics and thematic analysis respectively. Results: Despite the prevalence of written behaviour support plans, their perceived usefulness and staff involvement in their development were inconsistent. Collaboration with family members is valued but often limited by factors such as time constraints and communication difficulties. Staff identified a need for increased training and additional resources to provide effective behaviour support. Conclusion: This study highlights the need for improved training and support for RAC staff in managing BPSD, and a practice framework that clarifies roles and responsibilities across behaviour support service systems. Further research is needed to inform evidence-based behavioural interventions in RAC settings, with emphasis on collaborative practices that support best outcomes for residents with dementia.