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Morton T, Evans SB, Swift R, Bray J, Frost F, Russell C, Brooker D, Wong G, Hullah N. Reaching people and managing membership in community-based dementia support groups: the Get Real with Meeting Centres realist evaluation part 1. Aging Ment Health 2024:1-9. [PMID: 38794875 DOI: 10.1080/13607863.2024.2356885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Abstract
OBJECTIVES There is a need to improve the provision and reach of community services for people living with dementia, a goal in which community-based support groups can play a key role. The Get Real with Meeting Centres project aimed to explore factors involved in the success and sustainability of Meeting Centres (MCs) a form of community-based support proliferating in the UK. This is the first of two linked articles outlining learning from this realist evaluation of MCs, which focusses on findings around reach and membership. METHOD Semi-structured interviews and focus group discussions were conducted with 77 participants across three case study MC sites in England and Wales, including people living with dementia, informal carers, staff, volunteers, trustees, and supporting professionals/practitioners. Data were themed, then analysed using both soft systems methodology and realist logic of analysis. RESULTS Fifty-two 'context-mechanism-outcome' statements were generated, explaining how background circumstances might trigger responses/processes to produce wanted or unwanted outcomes regarding four key areas for MC sustainability: Referrals and the dementia care pathway; Reaching people and membership; Carer engagement and benefit; and Venue and location. CONCLUSION Strong links with formal services and a well-functioning dementia care pathway are essential to sustaining community-based group support such as MCs; group support is also well-placed to assist work to improve pathway issues. Clarity of offer (including benefit to carers), and a wide range of activities, are key to appeal and reach; transport to, and use of, venue are challenges, as are pressures to support people with more advanced dementia.
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Affiliation(s)
- Thomas Morton
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Shirley B Evans
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Ruby Swift
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Jennifer Bray
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Faith Frost
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Chris Russell
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Dawn Brooker
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Geoff Wong
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Thijssen M, Dauwerse L, Lemmers F, der Sanden MNV, Daniels R, Graff M, Kuijer-Siebelink W. 'Practice what you preach'. Perspectives on the involvement of people with dementia and carers in community-based dementia friendly initiatives, a qualitative study. Front Psychiatry 2024; 15:1387536. [PMID: 38818024 PMCID: PMC11137317 DOI: 10.3389/fpsyt.2024.1387536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 04/29/2024] [Indexed: 06/01/2024] Open
Abstract
Introduction People with dementia and their carers experience social stigma and often refrain from social participation. Significant improvement might be achieved by creating Dementia Friendly communities (DFCs) for which dementia friendly initiatives (DFIs) are needed. DFIs are developed by a variation of stakeholders. However, people with dementia and their carers are often unrepresented herein. This study aims to get insight into the perspectives of stakeholders (e.g., health- and social care professionals, volunteers, people with dementia and their carers) about the involvement of people with dementia and their carers during the development and sustainment of DFIs. Methods Descriptive qualitative study, using a co-research design with a carer as co-researcher. Nineteen semi-structured interviews with stakeholders, including people with dementia and their carers, were performed. Inductive content analysis took place using Atlas Ti. Results Four themes were found: 1) the involvement of people with dementia and their carers is important for both people with dementia and their carers and other stakeholders; 2) personal character traits, life histories, and associated emotions evoke the need for involvement; 3) involvement requires an open, responsive stance and building relationships; and 4) the estimation of one's own and others' capacities influences perspectives on involvement. As such, practice what you preach means actively adopting an open, responsive approach and acknowledging the unique abilities and backgrounds of people with dementia and their carers. It emphasizes the importance of actually living by the values you advocate for. Conclusion Central to perspectives on involving people with dementia and their carers is the emphasis on working relationally, differing from service-led and pre-structured patient and public involvement (PPI). Working relationally calls for organizational shifts aligned with a rights-based perspective to avoid tokenism, and promotion of user-led organizations with genuine partnerships. Creative methods, problem-solving, and communication skills are essential for the development and sustainment of inclusive, supportive, person-centered DFIs. Future studies should explore the long-term impact of the involvement and working relationally on the well-being of people with dementia and their carers.
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Affiliation(s)
- Marjolein Thijssen
- Radboudumc Research Institute, Scientific Center for Quality of Health (IQ health), Radboud University Medical Center, Nijmegen, Netherlands
- Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
- Department Occupational Therapy, School of Allied Health, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Linda Dauwerse
- Department of Primary and Community Care, Medical Centre, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Maria Nijhuis-van der Sanden
- Radboudumc Research Institute, Scientific Center for Quality of Health (IQ health), Radboud University Medical Center, Nijmegen, Netherlands
| | - Ramon Daniels
- Research Centre Assistive Technology in Care, Zuyd University of Applied Sciences, Heerlen, Netherlands
| | - Maud Graff
- Radboudumc Research Institute, Scientific Center for Quality of Health (IQ health), Radboud University Medical Center, Nijmegen, Netherlands
- Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
| | - Wietske Kuijer-Siebelink
- School of Education, HAN University of Applied Sciences, Nijmegen, Netherlands
- Radboudumc Health Academy, Research on Learning and Education, Radboud University Medical Center, Nijmegen, Netherlands
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Thijssen M, Graff MJL, Lexis MAS, Nijhuis-van der Sanden MWG, Radford K, Logan PA, Daniels R, Kuijer-Siebelink W. Collaboration for Developing and Sustaining Community Dementia-Friendly Initiatives: A Realist Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4006. [PMID: 36901017 PMCID: PMC10001691 DOI: 10.3390/ijerph20054006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Dementia-friendly communities (DFCs) are seen as key to the inclusion and participation of people with dementia and carers. Dementia-friendly initiatives (DFIs) are important building blocks for the growth of DFCs. The collaboration between different stakeholders is a central aspect in developing and sustaining DFIs. AIM This study tests and refines an initial theory about collaborating for DFIs with special attention for the involvement of people with dementia and their carers during the collaboration for DFIs. The realist approach is used for deepening contextual aspects, mechanisms, outcomes, and its explanatory power. METHODS A participatory case study design using qualitative data (focus groups, observations, reflections, minutes from meetings, and exit interviews) was executed in four Dutch municipalities that have ambitions to become dementia- friendly communities. RESULTS The refined theory on the collaboration for DFIs incorporates contextual aspects such as diversity, shared insights, and clarity. It draws attention to the importance of mechanisms such as the recognition of efforts and progress, informal distributed leadership, interdependency, belonging, significance, and commitment. These mechanisms resonate with feeling useful and feeling collectively powerful in the collaboration. The outcomes of collaboration were activation, getting new ideas, and fun. Our findings address how stakeholders' routines and perspectives impact the involvement of people with dementia and their carers during collaboration. CONCLUSION This study provides detailed information about collaboration for DFIs. The collaboration for DFIs is largely influenced by feeling useful and collectively powerful. Further research is needed to understand how these mechanisms can be triggered with the involvement of people with dementia and their carers in the heart of the collaboration.
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Affiliation(s)
- Marjolein Thijssen
- Radboud University Medical Center, Radboudumc Research Institute, Scientific Center for Quality of Healthcare (IQ Healthcare), 6525 GA Nijmegen, The Netherlands
- Radboud Alzheimer Center, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Department Occupational Therapy, School of Allied Health, HAN University of Applied Sciences, 6525 EN Nijmegen, The Netherlands
| | - Maud J. L. Graff
- Radboud University Medical Center, Radboudumc Research Institute, Scientific Center for Quality of Healthcare (IQ Healthcare), 6525 GA Nijmegen, The Netherlands
- Radboud Alzheimer Center, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Monique A. S. Lexis
- Research Centre Assistive Technology in Care, Zuyd University of Applied Sciences, 6419 DJ Heerlen, The Netherlands
| | - Maria W. G. Nijhuis-van der Sanden
- Radboud University Medical Center, Radboudumc Research Institute, Scientific Center for Quality of Healthcare (IQ Healthcare), 6525 GA Nijmegen, The Netherlands
| | - Kate Radford
- Centre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham NG7 2TU, UK
| | - Pip A. Logan
- Centre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham NG7 2TU, UK
- Nottingham City Care Partnership, Nottingham NG6 8WR, UK
| | - Ramon Daniels
- Research Centre Assistive Technology in Care, Zuyd University of Applied Sciences, 6419 DJ Heerlen, The Netherlands
| | - Wietske Kuijer-Siebelink
- School of Education, HAN University of Applied Sciences, 6525 EN Nijmegen, The Netherlands
- Radboudumc Health Academy, Research on Learning and Education, Radboud University MEDICAL Center, 6525 GA Nijmegen, The Netherlands
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Bernacki GM, Krishnaswami A, Don CW. It is time to be heard and understood: Readmission probably is not the outcome that matters among people with dementia considering percutaneous coronary intervention. J Am Geriatr Soc 2023; 71:1017-1020. [PMID: 36762687 DOI: 10.1111/jgs.18266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 02/11/2023]
Affiliation(s)
- Gwen M Bernacki
- Division of Cardiology, University of Washington, Seattle, Washington, USA.,Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington, USA.,Hospital and Specialty Medicine Service, VA Puget Sound Health Care System, Seattle, Washington, USA.,Geriatric Research, Education and Clinical Center, VA Puget Sound Health Care System, Seattle, Washington, USA
| | | | - Creighton W Don
- Division of Cardiology, University of Washington, Seattle, Washington, USA.,Hospital and Specialty Medicine Service, VA Puget Sound Health Care System, Seattle, Washington, USA
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Thijssen M, Kuijer-Siebelink W, Lexis MA, Nijhuis-van der Sanden MWG, Daniels R, Graff M. What matters in development and sustainment of community dementia friendly initiatives and why? A realist multiple case study. BMC Public Health 2023; 23:296. [PMID: 36759811 PMCID: PMC9909928 DOI: 10.1186/s12889-023-15125-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 01/24/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Dementia friendly communities (DFCs) are seen as key to participation of people with dementia and carers. Dementia-friendly initiatives (DFI) are important building blocks for the growth of DFCs. Therefore, it is essential to understand how DFIs are developed and sustained to secure the growth of DFCs. This study identifies contextual factors and mechanisms that influence the development and sustainment of Dutch DFIs. It also explains how these contextual factors and mechanisms are interrelated and the outcomes to which they lead. METHODS Mixed methods, namely interviews, observations, documentation and focus groups, were used for this realist multiple case study. Participants were professionals (n = 46), volunteers (n = 20), people with dementia (n = 1) and carers (n = 2) who were involved in development and sustainment of DFIs in four Dutch DFCs. RESULTS This study revealed three middle-range program theories as final outcomes: development of a support base, collaboration, and participation in DFIs by people with dementia and carers. These theories address institutional, organisational, interpersonal and individual levels in the community that are essential in development and sustainment of DFIs. CONCLUSIONS The development and sustainment of DFIs requires the development of a support base, collaboration, and participation in DFIs by people with dementia and their carers.
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Affiliation(s)
- Marjolein Thijssen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands. .,Radboud University Medical Center, Radboud Alzheimer Center, Nijmegen, The Netherlands.
| | - Wietske Kuijer-Siebelink
- grid.450078.e0000 0000 8809 2093HAN University of Applied Sciences, School of Education, Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Radboud University Medical Center, Radboudumc Health Academy, Research on Learning and Education, Nijmegen, the Netherlands
| | - Monique A.S. Lexis
- grid.413098.70000 0004 0429 9708Zuyd University of Applied Sciences, Research Centre Assistive Technology in Care, Heerlen, the Netherlands
| | - Maria W. G. Nijhuis-van der Sanden
- grid.10417.330000 0004 0444 9382Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands
| | - Ramon Daniels
- grid.413098.70000 0004 0429 9708Zuyd University of Applied Sciences, Research Centre Assistive Technology in Care, Heerlen, the Netherlands
| | - Maud Graff
- grid.10417.330000 0004 0444 9382Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Radboud University Medical Center, Radboud Alzheimer Center, Nijmegen, The Netherlands
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Manietta C, Purwins D, Reinhard A, Knecht C, Roes M. Characteristics of dementia-friendly hospitals: an integrative review. BMC Geriatr 2022; 22:468. [PMID: 35641899 PMCID: PMC9158310 DOI: 10.1186/s12877-022-03103-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND/OBJECTIVES Dementia-friendly initiatives are becoming common in society, politics, and research, including health care. Regarding efforts to improve care for patients with dementia in hospitals, the term dementia-friendly hospital is being used increasingly. However, a theoretical understanding of this term and the underlying concept are missing. This integrative review aims to identify current descriptions of dementia-friendly hospitals and to analyze their characteristics. METHODS An integrative review was conducted. The databases MEDLINE, CINAHL, PsycInfo, Cochrane Library, and additional resources were searched. Two reviewers independently screened publications for inclusion. We extracted data from the included publications and analyzed the descriptions of dementia-friendly hospitals using inductive content analysis in an iterative process. RESULTS We identified 4191 records and included 34 publications on 17 descriptions of dementia-friendly hospitals. These were found in the context of practice projects (n = 8), recommendations (n = 6) and research (n = 3). Our analysis resulted in six characteristics of dementia-friendly hospitals. Characteristics related to the patients and their care are continuity, person-centeredness, consideration of phenomena within dementia and environment. Additional characteristics are valuing relatives and knowledge and expertise within the hospital. CONCLUSION Dementia-friendly hospitals are currently characterized more by healthcare practices and professional dementia experts than by the results of empirical studies. Additionally, the perspective of people with dementia is underrepresented in current descriptions. Accordingly, further research is needed that involves people with dementia in order to develop a theoretical understanding and suitable concepts of dementia-friendly hospitals, since their perspective is essential.
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Affiliation(s)
- Christina Manietta
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, Germany. .,Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany.
| | - Daniel Purwins
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, Germany.,Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Anneke Reinhard
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, Germany
| | - Christiane Knecht
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany.,FH Münster University of Applied Sciences, Münster, Germany
| | - Martina Roes
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, Germany.,Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
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Schichel MCP, Veenstra MY, Kempen GIJM, Vugt ME, Verhey FRJ. Towards age‐friendly municipalities: What are municipalities doing to support their ageing population with mental health problems? WORLD MEDICAL & HEALTH POLICY 2022. [DOI: 10.1002/wmh3.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Mignon C. P. Schichel
- Department of Psychiatry & Neuropsychology Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNs), Care and Public Health Research Institute (CAPHRI), Maastricht University Maastricht The Netherlands
| | - Marja Y. Veenstra
- Department of Psychiatry & Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNs) Maastricht University, Maastricht, The Netherlands, Burgerkracht Limburg Sittard The Netherlands
| | - Gertrudis I. J. M. Kempen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI) Maastricht University Maastricht The Netherlands
| | - Marjolein E. Vugt
- Department of Psychiatry & Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNs) Maastricht University Maastricht The Netherlands
| | - Frans R. J. Verhey
- Department of Psychiatry & Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNs) Maastricht University Maastricht The Netherlands
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