1
|
Peterson LJ, Hackett SE, Dobbs D, Haley WE. Dementia Caregivers' Perspectives on Disaster Preparedness: Barriers, Resources, and Recommendations. THE GERONTOLOGIST 2024; 64:gnad076. [PMID: 37351950 DOI: 10.1093/geront/gnad076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Disaster preparedness is an urgent concern, particularly for caregivers of persons with dementia. Developing and executing plans for oneself and another person who needs care can be difficult when the care recipient is cognitively impaired. We sought to better understand caregivers' disaster preparedness for the purpose of generating guidance for future interventions to increase caregiver resilience. RESEARCH DESIGN AND METHODS We conducted a qualitative descriptive study of caregiver disaster experiences and perceptions of their preparedness. Fifty-two participants from diverse backgrounds participated in a focus group or interview. Deductive thematic data analysis was utilized to identify themes. Stress process models guided the interpretation of our findings. RESULTS Analyses of caregivers' experiences and observations revealed that disaster preparedness was challenging for caregivers, though also perceived to be an important responsibility. We identified 3 main themes: (a) barriers to preparing for a disaster as a caregiver for a person living with dementia, (b) why it is important for a caregiver to develop a disaster plan, and (c) how to facilitate preparedness for caregivers of persons living with dementia. DISCUSSION AND IMPLICATIONS This study highlighted the difficulties of preparing for a disaster while caring for a person with dementia. Applying stress process models to our results provided strong evidence that interventions could be developed to bolster caregivers' resources to cope with stressors associated with disaster preparedness. A key issue for public officials is the question of whether disaster shelters are appropriate for persons with dementia.
Collapse
Affiliation(s)
- Lindsay J Peterson
- School of Aging Studies, Florida Policy Exchange Center on Aging, University of South Florida, Tampa, Florida, USA
| | - Sara E Hackett
- School of Aging Studies, Florida Policy Exchange Center on Aging, University of South Florida, Tampa, Florida, USA
| | - Debra Dobbs
- School of Aging Studies, Florida Policy Exchange Center on Aging, University of South Florida, Tampa, Florida, USA
| | - William E Haley
- School of Aging Studies, Florida Policy Exchange Center on Aging, University of South Florida, Tampa, Florida, USA
| |
Collapse
|
2
|
Kuo WC, Ersig AL, Johnson HM, Brown RL, Oakley LD, Hagen EW, Barnet JH, Peppard PE. Association between stressful life events and non-optimal lipid levels among women with hyperlipidaemia. Eur J Cardiovasc Nurs 2023; 22:210-219. [PMID: 35714051 DOI: 10.1093/eurjcn/zvac032] [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: 12/13/2021] [Revised: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 11/14/2022]
Abstract
AIMS Psychological stress has been linked to lipid dysregulation with noticeable gender differences, but it remains unclear whether women are more susceptible to non-optimal lipid levels than men, when experiencing stressful life events. This study aims to examine the association between stressful life events and non-optimal lipid levels among persons with hyperlipidaemia and whether the association differs between men and women. METHODS AND RESULTS A nested case-control study was performed using data from the Wisconsin Sleep Cohort (WSC) Study from 2011 to 2015, including 224 participants with hyperlipidaemia and without a history of myocardial infarction or heart failure. Among them, 63 participants with non-optimal LDL cholesterol or triglyceride levels were identified as cases, and 161 participants with optimal LDL cholesterol and triglyceride levels were identified as controls. Cases and controls were traced back to their self-reported life events collected through the Retirement and Sleep Trajectories study during 2010-11. The association between stressful life events and non-optimal lipid levels was examined using multivariable logistic regression; confounding effects were addressed using propensity score weighting and Mahalanobis distance matching; gender differences were examined using subgroup analysis. Results showed that a higher number of stressful life events during 2010-11 was associated with greater odds of non-optimal lipid levels during 2011-15 (odds ratio = 1.45, P = 0.03) among women with hyperlipidaemia, whereas the association was not significant among men with hyperlipidaemia (P = 0.910). CONCLUSION Future studies are needed to examine the underlying mechanisms that explain gender differences in the association between stressful life events and non-optimal lipid levels. REGISTRATION ClinicalTrials.gov NCT00005557.
Collapse
Affiliation(s)
- Wan-Chin Kuo
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Anne L Ersig
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Heather M Johnson
- Christine E. Lynn Women's Health and Wellness Institute, Boca Raton Regional Hospital/Baptist Health South Florida, Florida Atlantic University, Boca Raton, FL, USA
| | - Roger L Brown
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Linda D Oakley
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Erika W Hagen
- School of Medicine and Public Health, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Jodi H Barnet
- School of Medicine and Public Health, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Paul E Peppard
- School of Medicine and Public Health, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
| |
Collapse
|
3
|
Lee L, Hillier LM. Family physicians’ perspectives on memory clinics in primary care. Neurodegener Dis Manag 2016; 6:467-478. [DOI: 10.2217/nmt-2016-0031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Aim: To identify family physicians’ perception of the primary care collaborative memory clinic (PCCMC) care model. Methods: Physicians with access to a PCCMC completed a survey to assess their satisfaction with various aspects of PCCMC care delivery (n = 78). Interviews were conducted with a purposeful sample of physicians (n = 20) to gather their opinions on the strengths, gaps in care and benefits associated with the PCCMC model. Results: There was support for this care model in providing timely quality dementia care at a primary care level, making it easier for referring physicians to manage challenging aspects of dementia care. Conclusion: PCCMCs provide a significant opportunity for supporting physicians to manage the care of persons with dementia within primary care practice.
Collapse
Affiliation(s)
- Linda Lee
- Department of Family Medicine, Centre for Family Medicine Family Health Team, McMaster University, ON, Canada
| | - Loretta M Hillier
- Specialized Geriatric Services, St Joseph’s Health Care London, Aging, Rehabilitation & Geriatric Care Research Centre, Lawson Health Research Institute, ON, Canada
| |
Collapse
|
4
|
Downs M, Ariss SM, Grant E, Keady J, Turner S, Bryans M, Wilcock J, Levin E, O'carroll R, Iliffe S. Family carers' accounts of general practice contacts for their relatives with early signs of dementia. DEMENTIA 2016. [DOI: 10.1177/1471301206067111] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The role of families in supporting people with dementia is widely acknowledged in literature and UK government policy. The role of general practice in ensuring early and effective support for people living with mental health problems including dementia is also enshrined in UK policy. As part of a larger study, a total of 122 carers were asked to rate predefined aspects of the primary care response. For some responses they were also asked to provide a reason for their rating. The purpose of this study was to examine carers' accounts of contacts with general practitioners (GPs) and general practice teams when they were first approached with concerns about their relative. Findings suggest that, on average, carers rate the service as being at least ‘good'. However, their accounts describe a wide variety of experiences and demonstrate that expressed satisfaction does not necessarily reflect a satisfactory service. Both practitioner-related and carer-related issues were cited as reasons for their ratings. Implications for practice and research are discussed.
Collapse
|
5
|
Austrom MG, Hartwell C, Moore P, Perkins AJ, Damush T, Unverzagt FW, Boustani M, Hendrie HC, Callahan CM. An integrated model of comprehensive care for people with Alzheimer's disease and their caregivers in a primary care setting. DEMENTIA 2016. [DOI: 10.1177/1471301206067108] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Most people with Alzheimer's disease and their families receive care in primary care. This article describes an integrated model of Alzheimer's disease care in a primary care setting serving a predominantly ethnic minority population. This model included: a comprehensive screening and diagnosis process; a multidisciplinary team approach to care, coordinated by a geriatric advanced practice nurse; and a proactive, longitudinal tracking system. The psychosocial intervention included specific responses to the treatment and management of behavioral and psychological symptoms of dementia, including caregiver directed interventions and pharmacological treatment if needed. Results suggest that this type of model can be implemented in primary care, particularly with the involvement of geriatric advanced practice nurses who can effectively manage the complex nature of Alzheimer's disease.
Collapse
|
6
|
Otero P, Smit F, Cuijpers P, Torres A, Blanco V, Vázquez FL. Long-term efficacy of indicated prevention of depression in non-professional caregivers: randomized controlled trial. Psychol Med 2015; 45:1401-1412. [PMID: 25331992 DOI: 10.1017/s0033291714002505] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although depression is a common problem among non-professional caregivers, only one trial has evaluated the efficacy of indicated prevention targeting this population and the long-term efficacy is unknown. The aim of this study was to evaluate the long-term efficacy of a brief intervention for the indicated prevention of depression in a sample of female caregivers. METHOD A randomized controlled trial was conducted involving 173 participants (mean age 53.9 years) who were allocated to the intervention (n = 89) or the usual-care control group (n = 84). Blinded interviewers conducted assessments at 1, 3, 6 and 12 months of follow-up. The main outcome measure was the incidence of major depression and the secondary outcomes were compliance with treatment, depressive symptoms, emotional distress and caregiver burden. RESULTS At the 12-month follow-up, a lower incidence of depression as evaluated using the Structured Clinical Interview for Axis I Disorders of the DSM-IV was found in the intervention group compared with the control group (10.1% v. 25.0%). The relative risk was 0.40 and statistically significant [χ2 = 6.68, degrees of freedom = 1, p = 0.010, 95% confidence interval (CI) 0.20-0.81], and the number needed to treat was 7 (95% CI 4-27). There was a significant delay in the onset of depression in the intervention group (p = 0.008). The good complier caregivers had a lower incidence of depression. The intervention effect on depressive symptoms, emotional distress and caregiver burden were maintained for 12 months. CONCLUSIONS This is the first study to demonstrate that a brief problem-solving intervention can prevent the onset of depression among non-professional caregivers over the longer term.
Collapse
Affiliation(s)
- P Otero
- Department of Clinical Psychology and Psychobiology,Unit of Depressive Disorders, University of Santiago de Compostela,Santiago de Compostela,Spain
| | - F Smit
- Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University,Amsterdam,The Netherlands
| | - P Cuijpers
- Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University,Amsterdam,The Netherlands
| | - A Torres
- Department of Psychiatry, Radiology and Public Health,University of Santiago de Compostela,Santiago de Compostela,Spain
| | - V Blanco
- Department of Clinical Psychology and Psychobiology,Unit of Depressive Disorders, University of Santiago de Compostela,Santiago de Compostela,Spain
| | - F L Vázquez
- Department of Clinical Psychology and Psychobiology,University of Santiago de Compostela,Santiago de Compostela,Spain
| |
Collapse
|
7
|
Lee L, Hillier LM, Harvey D. Integrating community services into primary care: improving the quality of dementia care. Neurodegener Dis Manag 2014; 4:11-21. [DOI: 10.2217/nmt.13.72] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
SUMMARY Aim: The purpose of this study was to describe the impact associated with a unique partnership between the Alzheimer‘s Society (AS) and primary care-based memory clinics, and in particular to describe the impact on access to community-based services, the role of the AS in these clinics and to identify key lessons learned in partnership formation. Participants & methods: A total of 35 memory clinic healthcare providers and nine AS representatives completed a survey assessing the impacts of this partnership, and 25 memory clinic members and 11 AS representatives were interviewed regarding the implementation and outcomes of this partnership. The number of referrals to the AS from the participating primary care settings in the 6 months prior to and following the formation of this partnership were collected. Results: There was a fivefold increase in referrals to the AS in the 6 months following the launch of this partnership. Other identified impacts included improved care integration and coordination across community and primary care sectors, improved access to information and community supports at the time of diagnosis, and increased healthcare provider awareness of available community services. AS representatives assumed various roles in the clinic depending on available resources and existing gaps. Some key lessons were learnt in order to support the implementation of this partnership in other jurisdictions. Conclusion: This partnership was perceived as a significant quality improvement opportunity to better meet the needs of individuals with dementia and their caregivers, and highlights the importance of the integration of community agencies in primary care to improve access to community services.
Collapse
Affiliation(s)
- Linda Lee
- Centre for Family Medicine Family Health Team, Faculty of Medicine, Department of Family Medicine, McMaster University, 10B Victoria Street South, Kitchener, ON, N2G 1C5, Canada
| | - Loretta M Hillier
- Specialized Geriatric Services, St Joseph‘s Health Care London, Aging, Rehabilitation & Geriatric Care Research Centre, Lawson Health Research Institute, 801 Commissioners Road, East London, ON, N6C 5J1, Canada
| | - David Harvey
- Alzheimer‘s Society of Ontario, 20 Eglinton Avenue West, Suite 1600, Toronto, ON, M4R 1K8, Canada
| |
Collapse
|
8
|
Mcainey CA, Harvey D, Schulz ME. First Link: Strengthening Primary Care Partnerships for Dementia Support. ACTA ACUST UNITED AC 2008. [DOI: 10.7870/cjcmh-2008-0022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
While primary care faces many challenges, including an increasing prevalence of older individuals, emerging knowledge about the potential benefits of collaborative partnerships has encouraged the development of new means of providing and supporting primary care. First Link™ is an innovative program involving collaborations among primary care providers, Alzheimer Societies, and other health professionals. The program aims to support persons with Alzheimer's and related diseases after the diagnosis is made and to link them with support services earlier in the disease course. This paper describes the First Link program, provides an overview of a study currently underway to evaluate it, and identifies some of the benefits and challenges associated with this partnership.
Collapse
Affiliation(s)
- Carrie A. Mcainey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University Hamilton Family Health Team, and Geriatric Psychiatry Service, St. Joseph’s Healthcare Hamilton, Ontario
| | | | | |
Collapse
|
9
|
Pruchno RA, Meeks S. Health-related stress, affect, and depressive symptoms experienced by caregiving mothers of adults with a developmental disability. Psychol Aging 2005; 19:394-401. [PMID: 15382990 DOI: 10.1037/0882-7974.19.3.394] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The interrelationships among health-related stress, positive and negative affect, and depressive symptoms patterned in the dynamic model of affect (J. Reich, A. Zautra, & M. Davis, 2003) were examined using data from 932 women having an adult child with a developmental disability. Results indicate that women experience a moderate inverse correlation between positive and negative affect under conditions of low levels of health-related stress, whereas at high levels of stress, positive and negative affect become more strongly inversely correlated. Under high-stress conditions, both negative affect and positive affect have a stronger relationship to depressive symptoms than they do under low-stress conditions.
Collapse
|
10
|
|
11
|
Jang Y, Mortimer JA, Haley WE, Chisolm TEH, Graves AB. Nonauditory determinants of self-perceived hearing problems among older adults: the role of stressful life conditions, neuroticism, and social resources. J Gerontol A Biol Sci Med Sci 2002; 57:M466-9. [PMID: 12084810 DOI: 10.1093/gerona/57.7.m466] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The present study explored factors that influenced older individuals' subjective perception of hearing problems. In addition to objectively screened hearing ability, nonauditory factors such as stressful life conditions (visual impairment, chronic disease, disability, and recent stressful life events), neuroticism, and social resources were hypothesized to be predictors of self-perceived hearing problems. METHODS These hypotheses were tested with a hierarchical regression model using a stratified sample of 425 community-dwelling older individuals (mean age = 72.2). RESULTS Individuals with more recent stressful life events, higher levels of neuroticism, and less emotional support reported greater hearing problems after controlling for objectively screened hearing. In addition to the main effects, a significant interaction was observed between neuroticism and screened hearing, indicating that the combination of poor hearing and high neuroticism increased the level of self-perceived hearing problems. CONCLUSIONS The findings suggest that the effects of nonauditory factors should be taken into account in the application of self-assessed measures of hearing problems.
Collapse
Affiliation(s)
- Yuri Jang
- Institute on Aging, University of South Florida, Tampa 33612, USA.
| | | | | | | | | |
Collapse
|
12
|
Current awareness in geriatric psychiatry. Int J Geriatr Psychiatry 2002; 17:494-501. [PMID: 11994944 DOI: 10.1002/gps.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|