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Faulkner T, Dickinson J, Limbert S, Giebel C. The experiences and perspectives of older adult mental health professional staff teams when supporting people with young-onset dementia. Dementia (London) 2024; 23:567-583. [PMID: 38441077 DOI: 10.1177/14713012241236106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Background. The diagnosis of young-onset dementia presents significant challenges both for the person and their families, which often differ from the challenges faced with late-onset dementia. Evidence of the experience of service users and carers tends to reveal a negative appraisal of the care received, citing longer diagnosis times, poor clinician knowledge and lack of age-appropriate care. However, evidence looking into staff experiences of supporting someone with young-onset dementia is relatively scarce. The aim of this study was to explore the experiences and reflections of health and social care staff who support people with young-onset dementia within older adult mental health services, and whether their knowledge of the systems they work in could reveal the existence of barriers or facilitators to young-onset dementia care. Methods. Health and social care professionals working with people and carers with young-onset dementia across England were remotely interviewed between September and December 2021. Data were analysed using inductive thematic analysis. Findings. Sixteen staff members were interviewed. Three themes were constructed with six sub-themes. The first theme related to the perception of greater complexity around young-onset dementia support. The second theme describes staff fears around their ability to effectively support people with young-onset dementia, including the perception that young-onset dementia requires specialist input. The final theme describes systemic and structural inefficiencies which provide additional challenges for staff. Conclusions. Providing effective support for people with young-onset dementia and their families requires adjustments both within the clinician role and mental health services. Staff considered young-onset dementia support to be a specialist intervention and felt the services they work for are suited to generic mental health and dementia provision. Findings are discussed with recommendations relating to developing a standardised model of dementia care for young-onset dementia which recognises and responds to the unique experiences of young-onset dementia.
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Affiliation(s)
- Thomas Faulkner
- Mersey Care NHS Foundation Trust, UK
- NIHR Applied Research Collaboration North-West Coast, UK
| | | | - Stan Limbert
- NIHR Applied Research Collaboration North-West Coast, UK
| | - Clarissa Giebel
- NIHR Applied Research Collaboration North-West Coast, UK
- Department of Primary Care and Mental Health, University of Liverpool, UK
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Kogata T, Saito C, Kato F, Kudo J, Yamaguchi Y, Lee S, Washimi Y. An analysis of the contents of the young-onset dementia helpline: profiles of clients who consulted the helpline themselves. Psychogeriatrics 2024; 24:617-626. [PMID: 38433324 DOI: 10.1111/psyg.13105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/08/2024] [Accepted: 02/20/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Young-onset dementia (YOD) community care requires personalised approaches. Yet, the specific details of YOD consultations are unclear. This study explored how initial consultations correlate with client profiles. METHODS Data from regional YOD helplines were used to analyze the main characteristics of people living with YOD or who had concerns about the possibility of YOD (n = 132). Among several categorical variables, the following were used for analysis: age group, sex, type of living arrangement, employment status, presence of dementia, and content of the consultation. To identify groups of items that frequently occur together, strongly connected rules were identified using association rule analysis with the a priori algorithm. To focus on the characteristics of clients, rules related to client characteristics were extracted based on the type of consultation. RESULTS A total of 51 rules were identified for the consultations. These rules fell into two categories: (1) consultations for medical matters, which mainly involved employed individuals with undiagnosed dementia, and (2) other consultations on daily life or work, which mainly involved individuals diagnosed with dementia and were characterised by the influence of sex. These rules indicate the importance of medical involvement in confirming the diagnosis and specific individualised care following diagnosis for people living with YOD. CONCLUSION Clients with or without a dementia diagnosis were consulted differently in the YOD helplines. Before receiving a diagnosis, medical matters were the main theme of consultations, whereas after receiving a diagnosis, adjustments to daily life or work were the main themes. The results of this study suggest that the needs of people living with YOD and the services they require may vary depending on their backgrounds.
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Affiliation(s)
- Tomohiro Kogata
- Obu Centre for Dementia Care Research and Practices, Obu, Japan
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Chiaki Saito
- Obu Centre for Dementia Care Research and Practices, Obu, Japan
| | - Fukiko Kato
- Obu Centre for Dementia Care Research and Practices, Obu, Japan
| | - Jumpei Kudo
- Obu Centre for Dementia Care Research and Practices, Obu, Japan
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
| | | | - Sangyoon Lee
- Obu Centre for Dementia Care Research and Practices, Obu, Japan
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
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Gerritzen EV, Orrell M, McDermott O. Optimising Online Peer Support for People with Young Onset Dementia. Int J Environ Res Public Health 2024; 21:60. [PMID: 38248525 PMCID: PMC10815045 DOI: 10.3390/ijerph21010060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/16/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024]
Abstract
People with Young Onset Dementia (YOD) can be hesitant to engage with online peer support. This work aims to explore (1) why people are hesitant to engage in online peer support, (2) how to get more people involved in online peer support, and (3) what makes online peer support work well. Nine interviews with people with YOD were conducted on MS Teams. Participants were recruited through purposive sampling. Data were analysed thematically. Reasons for being hesitant to engage with online peer support include being unsure what to expect and concerns about seeing others in more advanced stages of dementia. Additionally, it can be difficult to identify groups that suit one's needs and interests. Group facilitators of online peer support groups should provide a detailed description of their group so that people can better assess whether the group would suit them. The insights obtained from this study will be used to develop a Best Practice Guidance on online peer support for people with YOD. Moreover, the findings can be useful for further research exploring how to support people with dementia in general in accessing online health and social care services.
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Affiliation(s)
- Esther Vera Gerritzen
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham NG7 2TU, UK; (M.O.); (O.M.)
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Cui X, Wang J, Wu B, Zhao Q, Tang X, Wang J. Interventions for Persons with Young-Onset Dementia and Their Families: A Scoping Review. J Alzheimers Dis 2024; 97:1519-1531. [PMID: 38277297 DOI: 10.3233/jad-231006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
Background Dementia occurring before age 65 is known as young-onset dementia (YOD), with Alzheimer's disease being the most common type. YOD poses unique challenges for persons and families, impacting their working-age years and family responsibilities. Person-centered interventions and services are essential to improve their quality of life and social engagement. Objective This study aims to synthesize non-pharmacological interventions for persons with YOD and their families to inform future targeted interventions. Methods We conducted a systematic literature search across four databases: PubMed, PsycINFO, Scopus, and CINAHL. The included articles were carefully screened, categorized, and synthesized by following Arksey and O'Malley's five stages framework. Results We included 20 studies reported in 24 papers, with 11 studies (14 papers) on persons with YOD and nine studies (10 papers) on families. Quantitative intervention results vary, but qualitative interviews show positive feedback. Stakeholders provided positive evaluations, stating these interventions provided a sense of normalcy, facilitated communication among families, enhanced the independence of persons with YOD, and improved the families' caregiving self-efficacy, thereby reducing care burden and psychological distress. The heterogeneity among the studies posed integration challenges. Conclusions Interventions for YOD can improve the quality of life for both persons with YOD and their families. More extensive intervention studies are urgently needed, especially in developing countries, with a focus on family-centered and life course perspectives. In future intervention research design, a more extensive incorporation of stakeholder involvement is essential for successful implementation. Moreover, the integration of new technologies shows promise as a potential avenue for intervention advancement.
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Affiliation(s)
- Xiaoyan Cui
- Fudan University School of Nursing, Shanghai, China
| | - Junqiao Wang
- Fudan University School of Nursing, Shanghai, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, NY, USA
| | - Qianhua Zhao
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xueting Tang
- Fudan University School of Nursing, Shanghai, China
| | - Jing Wang
- University of New Hampshire, NH, USA
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Maters J, van der Steen JT, de Vugt ME, Bakker C, Koopmans RT. Palliative Care in Nursing Home Residents with Young-Onset Dementia: Professional and Family Caregiver Perspectives. J Alzheimers Dis 2024; 97:573-586. [PMID: 38217594 PMCID: PMC10836558 DOI: 10.3233/jad-230486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND The evidence underpinning palliative care in dementia is mostly based on research in older populations. Little is known about the palliative care needs of people with young-onset dementia (YOD). OBJECTIVE To describe palliative care practices including advance care planning (ACP) in people with YOD residing in Dutch nursing homes. METHODS The study presents baseline questionnaire data from an observational cohort study. Physicians, family caregivers, and nursing staff completed questionnaires about 185 residents with YOD. The questionnaires included items on sociodemographics, quality of life measured with the quality of life in late-stage dementia (QUALID) scale, dementia-related somatic health problems, symptoms, pain medication, psychotropic drugs, and ACP. RESULTS The mean age was 63.9 (SD 5.8) years. Half (50.3%) of them were female. Alzheimer's disease dementia (42.2%) was the most prevalent subtype. The mean QUALID score was 24.0 (SD 7.9) as assessed by family caregivers, and 25.3 (SD 8.6) as assessed by the nursing staff. Swallowing problems were the most prevalent dementia-related health problem (11.4%). Agitation was often reported by physicians (42.0%) and nursing staff (40.5%). Psychotropics were prescribed frequently (72.3%). A minority had written advance directives (5.4%) or documentation on treatment preferences by the former general practitioner (27.2%). Global care goals most often focused on comfort (73.9%). Proportions of do-not-treat orders were higher than do-treat orders for all interventions except for hospitalization and antibiotics. CONCLUSIONS ACP must be initiated earlier, before nursing home admission. A palliative approach seems appropriate even though residents are relatively young and experience few dementia-related health problems.
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Affiliation(s)
- Jasper Maters
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
- Radboudumc Alzheimer Center, Nijmegen, the Netherlands
| | - Jenny T. van der Steen
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
- Radboudumc Alzheimer Center, Nijmegen, the Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Marjolein E. de Vugt
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Christian Bakker
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
- Radboudumc Alzheimer Center, Nijmegen, the Netherlands
- Groenhuysen, Center for Geriatric Care, Roosendaal, the Netherlands
| | - Raymond T.C.M. Koopmans
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
- Radboudumc Alzheimer Center, Nijmegen, the Netherlands
- Joachim en Anna, Center for Specialized Geriatric Care, Nijmegen, the Netherlands
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Oyebode JR, La Fontaine J, Stamou V, O'Malley M, Parkes J, Carter J. Establishing and sustaining high-quality services for people with young onset dementia: the perspective of senior service providers and commissioners. Int Psychogeriatr 2023:1-10. [PMID: 37731261 DOI: 10.1017/s1041610223000443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
OBJECTIVES We aimed to understand the facilitators to developing and sustaining high-quality services for people with young onset dementia (YOD) and their families/supporters. DESIGN This qualitative study used semi-structured interviews with commissioners and service managers, analyzed using inductive thematic analysis. SETTING A purposive sample of providers was selected from diverse areas and contrasting YOD services. PARTICIPANTS Eighteen senior staff from YOD services and two dementia service commissioners took part. MEASUREMENTS For commissioners, key interview topics were experiences of commissioning YOD services, perceived facilitators or barriers, and how future guidance should be structured for ease of use. For service providers, key topics explored experiences of delivering YOD services; what was achievable or challenging; how the service was funded; how it linked with broader provision for YOD in the area; and how guidance should be structured. RESULTS Recorded interviews lasted 30-40 minutes. Seven key facilitators to the development and sustaining of YOD services were identified: having knowledgeable, committed local champions; involvement of people living with YOD and family supporters; initial delivery within existing resources; partnership working within and between sectors; having a reflective, supportive organizational culture; gathering evidence of impact; and having wider support and guidance. CONCLUSIONS Improvements in provision for those with YOD and their families need to be built on understanding of service-level and interpersonal influences as well as on understanding of YOD itself. Our findings highlight a set of facilitators which need to be in place to establish and sustain high-quality YOD services that fit the local context.
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Affiliation(s)
- Jan Rachel Oyebode
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Jenny La Fontaine
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Vasileios Stamou
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Mary O'Malley
- Centre for Applied Mental Health Research, Faculty of Health and Society, University of Northampton, Northampton, UK
| | - Jacqueline Parkes
- Centre for Applied Mental Health Research, Faculty of Health and Society, University of Northampton, Northampton, UK
| | - Janet Carter
- Division of Psychiatry, Faculty of Brain Sciences, Maple House, University College London, London, UK
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Abstract
PURPOSE OF REVIEW Young-onset dementia (YOD) refers to a dementia for which symptom onset occurs below the age of 65. This review summarizes the recent literature in this area, focusing on updates in epidemiology, diagnosis and service provision. RECENT FINDINGS In the last year, internationally, the prevalence of YOD was reported as 119 per 100 000, but this may vary according to population types. Although the commonest causes of YOD are Alzheimer's disease (AD) and frontotemporal dementia (FTD), there is increasing recognition that YOD is diagnostically and phenotypically broader than AD and FTD. YOD may be due to many other diseases (e.g. Huntington's disease, vascular dementia) whereas accumulation of the same protein (e.g. amyloid protein) may lead to different phenotypes of Alzheimer's disease (such as posterior cortical atrophy and behavioural-variant/frontal-variant AD). This heterogeneity of phenotypic presentation is also seen in YOD due to known genetic mutations. Biomarkers such as plasma and cerebrospinal fluid proteins, neuroimaging and genetics have shown promise in the early identification of YOD as well as providing further understanding behind the overlap between psychiatric and neurodegenerative conditions occurring in younger people. The management of YOD needs to consider age-specific issues for younger people with dementia and their family networks together with better integration with other health services such as aged, disability and improved access to services and financial assistance. SUMMARY These findings emphasize the need for early identification and appropriate age-specific and person-centred management for people with young-onset dementia.
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Affiliation(s)
- Samantha M Loi
- Department of Neuropsychiatry, Royal Melbourne Hospital
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Yolande Pijnenburg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Dennis Velakoulis
- Department of Neuropsychiatry, Royal Melbourne Hospital
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
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Kogata T. Strengthening the National Care System for Young Onset Dementia. Int J Public Health 2022; 67:1605099. [PMID: 36405531 PMCID: PMC9668884 DOI: 10.3389/ijph.2022.1605099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Tomohiro Kogata
- Obu Center for Dementia Care Research and Practices, Obu, Japan,Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya, Japan,*Correspondence: Tomohiro Kogata,
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Zimmerman S, Cesari M, Gaugler JE, Gleckman H, Grabowski DC, Katz PR, Konetzka RT, McGilton KS, Mor V, Saliba D, Shippee TP, Sloane PD, Stone RI, Werner RM. The Inevitability of Reimagining Long-Term Care. J Am Med Dir Assoc 2022; 23:187-189. [DOI: 10.1016/j.jamda.2021.12.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 12/22/2021] [Indexed: 11/26/2022]
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