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Couvrette R, Milot É, Fortin G. Factors Influencing Palliative and End-of-Life Care for Adults with Intellectual Disabilities: A Scoping Review of Health and Care Workers' Experiences. J Soc Work End Life Palliat Care 2024:1-19. [PMID: 38704821 DOI: 10.1080/15524256.2024.2346113] [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] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
In developed countries, there has been an increase in the longevity of adults with intellectual disabilities. In the later stages of their lives, people with intellectual disability have specific needs in terms of palliative and end-of-life care that need to be better understood in order to offer appropriate care. This scoping review aimed to identify the main factors influencing the provision of palliative and end-of-life care from the perspective of health and care workers involved with adults with an intellectual disability at the end of life. Seven databases were systematically searched for relevant articles published between 2002 and 2022. NVivo qualitative research analysis software was used to conduct a thematic analysis of the 50 included studies. Three main factors were identified: the location of care and death, the involvement of the person with intellectual disability, and collaborative practices.
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Affiliation(s)
- Romane Couvrette
- School of Social Work and Criminology, Université Laval, Québec City, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec City, Canada
- Centre for Research and Expertise in Social Gerontology (CREGES), Montréal, Canada
| | - É Milot
- School of Social Work and Criminology, Université Laval, Québec City, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec City, Canada
- Centre for Research and Expertise in Social Gerontology (CREGES), Montréal, Canada
| | - G Fortin
- School of Social Work and Criminology, Université Laval, Québec City, Canada
- Centre de recherche du Centre hospitalier universitaire de Québec, Université Laval, Québec, Canada
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2
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De Veer AJE, Voss H, Francke AL, de Man Y. Improvement of palliative care for people with intellectual disabilities: A multi-site evaluation. J Appl Res Intellect Disabil 2024; 37:e13223. [PMID: 38469929 DOI: 10.1111/jar.13223] [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] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/23/2023] [Accepted: 02/20/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND To improve the quality of palliative care, six evidence-based tools were implemented in 10 care services specialised in care for people with intellectual disabilities. Contextual differences were taken into account by using a participatory action research approach. METHOD The RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance) structured the evaluation. Data sources were online questionnaires completed by 299 professionals at baseline (response 45.2%) and 250 professionals after 2.5 years (35.1%), 11 semi-structured group interviews with 43 professionals, field notes and implementation plans. RESULTS A total of 767 professionals and 43 teams were reached. The effectiveness of the intervention was demonstrated in an improved knowledge of palliative care policy and increased competences among professionals. 79% of the professionals adopted tools in the toolbox. The participatory action research method was perceived as valuable in driving change. CONCLUSIONS Improving palliative care needs a context-specific, flexible approach, with involvement of all stakeholders.
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Affiliation(s)
- Anke J E De Veer
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Hille Voss
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Anneke L Francke
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, APH Amsterdam Public Health research institute, Amsterdam, The Netherlands
- Expertise Centre Palliative Care Amsterdam UMC, Amsterdam, The Netherlands
| | - Y de Man
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
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Jacobs P, Watchman K, Wilkinson H, Hoyle L. Couples with intellectual disability where one partner has dementia – a scoping review exploring relationships in the context of dementia and intellectual disability. Ageing and Society 2023. [DOI: 10.1017/s0144686x22001416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Abstract
Relationships and marriages between couples with intellectual disability are to be celebrated, as is the longer life expectancy now enjoyed by many with intellectual disability. However, dementia disproportionately affects people with intellectual disability, especially people with Down's syndrome. Research into experiences of couples without intellectual disability who are affected by dementia suggests that a relational perspective provides health and social care professionals with information to support the wellbeing of both partners. This dyadic perspective is missing for couples with an intellectual disability where one partner has dementia. There is currently no evidence base informing how each partner may best be supported. This scoping review, with three separate searches, aims to address this gap. The first search sought to establish if any studies had explored the experiences of couples with intellectual disability where one partner has dementia. After determining that no studies have been published to date, the review explores what is known about relationships in the context of dementia (N = 8) and in the context of intellectual disability (N = 10), in second and third searches. Different ways to approach care and support in relationships among partners, staff and other family members were identified and it was evident that support could act as a facilitator as well as a barrier to people and their relationships. While the lives of couples affected by dementia appeared to remain largely private, couples with intellectual disability had a high involvement of staff and family members in their life. Potential implications for future research with couples with intellectual disability affected by dementia are discussed, highlighting the importance of exploring how couples navigate emotional complexities and changes in their relationship, while understanding that the context in which the lives of people with intellectual disability take place and relationships happen is different.
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Velepucha-Iniguez J, Bonilla Sierra P, Bruera E. Barriers to Palliative Care Access in Patients With Intellectual Disability: A Scoping Review. J Pain Symptom Manage 2022; 64:e347-e356. [PMID: 35995282 DOI: 10.1016/j.jpainsymman.2022.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/12/2022] [Accepted: 08/11/2022] [Indexed: 01/04/2023]
Abstract
UNLABELLED There is limited knowledge about inequalities regarding palliative care access among patients with intellectual disability. The present scoping review aimed to identify the existing barriers that limit access to palliative care (PC) in patients with intellectual disability. METHODS We conducted a literature review on publications since 2014 from three databases (MEDLINE, Biomed Central, and Elsevier Scopus), along with hand searches in scientific journals. The review included peer-reviewed studies written in English and Spanish language with quantitative and qualitative study designs. The participants were patients with intellectual disability and health professionals who had worked with them or had experience in palliative care. RESULTS 22 studies met the selection criteria. The barriers identified were under referral to palliative care, reduced access, communication, and limited knowledge and experience by health professionals. CONCLUSION Patients with intellectual disability do not get referred to PC frequently. Health professionals and caregivers do not recognize when it is necessary to make a referral, and they need to improve their communication abilities. Also, health care workers need more training in PC, pain management, anticipation of death, and use of opioids. More research and education on the palliative care needs and care for patients with intellectual disabilities is needed.
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Affiliation(s)
- Josselyn Velepucha-Iniguez
- Department of Health Sciences (J.V.I., P.B.S.), Universidad Técnica Particular de Loja (UTPL), Loja, Ecuador.
| | - Patricia Bonilla Sierra
- Department of Health Sciences (J.V.I., P.B.S.), Universidad Técnica Particular de Loja (UTPL), Loja, Ecuador
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation and Integrative Medicine (E.B.), The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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De Leo D, Congregalli B, Guarino A, Zammarrelli J, Valle A, Paoloni S, Cipolletta S. Communicating Unexpected and Violent Death: The Experiences of Police Officers and Health Care Professionals. Int J Environ Res Public Health 2022; 19:11030. [PMID: 36078746 PMCID: PMC9518522 DOI: 10.3390/ijerph191711030] [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] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/31/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The notification of unexpected and violent death represents a challenging experience for police officers and health workers. These professionals are exposed to very intense emotions during this task. AIM We aimed to investigate the degree of preparation, and the emotions and attitudes of police officers and health professionals while communicating such a death. METHOD An ad hoc online questionnaire was created and disseminated through Qualtrics software. The participants were recruited through the institutional channels of Police, the College of Physicians, the ONG De Leo Fund and the Department of General Psychology of the University of Padua. In this qualitative study, thematic content analysis was used to examine the responses. RESULTS A total of 155 individuals participated in the study (44 females, 111 males): 102 individuals were police officers, 23 were doctors and were 30 nurses. Five main themes were identified: (1) how the communication took place; (2) the experiences during the communication; (3) the difficulties encountered; (4) coping strategies, and (5) forms of support. Most communications were performed in person, and most represented an intense emotional experience for the notifiers. There is a generalised lack of specific preparation and training for this practice. The recipient's characteristics (culture of origin, language, age, health conditions, psychological vulnerability) may add to the difficulties of the notification process. Professionals unload their tension by practicing sport, relying on their hobbies or interacting socially. The presence of other colleagues during and after the death notification is usually able to alleviate the burden of the communication. CONCLUSIONS Communication modalities can have a profound impact on the recipients and intensify the trauma of the loss; however, they also have the possibility of mitigating it. The notification of a violent and unexpected death remains a difficult and challenging task for the notifier, which is potentially stressful and emotionally charged. The topic is of great relevance and more research should be promoted in this area.
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Affiliation(s)
- Diego De Leo
- Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, QLD 4122, Australia
- Slovene Center for Suicide Research, Primorska University, 6000 Koper, Slovenia
- De Leo Fund, 35137 Padua, Italy
| | | | | | | | - Anna Valle
- Autonomous Syndicate of Police (SAP), 00184 Rome, Italy
| | | | - Sabrina Cipolletta
- Department of General Psychology, University of Padua, 35100 Padua, Italy
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Lam CKK, Bernal J, Finlayson J, Todd S, Taggart L, Boaz A, Tuffrey-Wijne I. Maximising engagement and participation of intellectual disability staff in research: Insights from conducting a UK-wide survey. J Intellect Disabil 2021; 25:554-566. [PMID: 32394781 PMCID: PMC8649423 DOI: 10.1177/1744629520924141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/12/2020] [Indexed: 06/11/2023]
Abstract
AIM This article explores ways of maximising engagement of intellectual disability staff as research participants, research advisers and research implementers. METHOD The authors describe and reflect on a three-phased strategy in recruiting front-line staff (n = 690) working for intellectual disability service providers (n = 25) to participate in a UK-wide anonymous online survey about death, dying and bereavement. RESULTS Important elements in engaging participants were: involving stakeholders at all stages of the research process, which includes: building relationships with participating organisations; enlisting organisational management support at all levels; an attractive and well laid-out collection tool; a well-structured recruitment strategy; time and flexibility; and a varied and targeted dissemination strategy. However, the recruitment method had limitations, in particular around representativeness, bias and generalisability. CONCLUSIONS Staff in intellectual disability services can be enthusiastic and invaluable research participants. Active engagement between researchers, participating organisations and stakeholder groups is key to ensuring involvement of intellectual disability staff with research.
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Affiliation(s)
| | | | | | | | | | - Annette Boaz
- Kingston University and St George’s, University of London,
UK
| | - Irene Tuffrey-Wijne
- Irene Tuffrey-Wijne, Faculty of Health, Social Care
and Education, Kingston University and St George’s, University of London, 6th Floor Hunter
Wing, Cranmer Terrace, London SW17 0RE, UK.
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Voss H, Loxton A, Anderson J, Watson J. "It was one of those complicated cases": health practitioners' perspectives and practices of providing end-of-life care for people with profound intellectual and multiple disability. BMC Palliat Care 2021; 20:177. [PMID: 34772382 PMCID: PMC8586595 DOI: 10.1186/s12904-021-00873-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/21/2021] [Indexed: 11/18/2022] Open
Abstract
Background Due to developments in health and social care, people with profound intellectual and multiple disability (PIMD) are living longer than ever before, meaning they are increasingly experiencing life-threatening health conditions requiring palliative care. Little is known about providing end-of-life care for people with PIMD. The aim of this study was to explore health practitioners’ perspectives and practices relating to end-of-life decision-making and planning for people with PIMD. Methods Seven in-depth semi-structured interviews were conducted with health practitioners employed in a range of hospital and community services throughout Melbourne, Australia. Questions were designed to gather information about their experience, perceptions, and attitudes relating to people with PIMD during and at the end of their life. Each interview, ranging from 40 to 60 min in length, was audio recorded and transcribed. Inductive thematic analysis was used to analyse the data. Results Four main themes emerged: limited participation, bias, dignity, and quality of death. Health practitioners indicated that people with PIMD are frequently excluded from participating in decision-making related to end-of-life care. Participants discussed reasons for this exclusion including challenges with communication and cognition. Participants reported a need for additional support and guidance in providing care for people with PIMD at the end of life. Professional and family bias played a role in end-of-life decision-making for people with PIMD. Participants reported a disproportional focus by palliative care practitioners on physical as opposed to emotional and spiritual well-being for patients with PIMD at the end of life. Finally, participants reported that people with PIMD generally did not die in specialised palliative care settings, but in segregated supported living environments. Conclusions Due to negative perceptions of a person with PIMD’s decision-making capacity, people with PIMD are likely to be assessed as unable to express choice and preference regarding end-of-life care and are offered limited opportunity to be involved in their own end-of-life care. This research provides guidance for the development of training and professional development relating to people with PIMD at the end of life. It is hoped that this will increase the accessibility of end-of-life services for people with PIMD, ensuring that a respectful and dignified death can be a reality for all humankind regardless of disability. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-021-00873-5.
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Affiliation(s)
- Hille Voss
- Netherlands Institute for Health Services Research (Nivel), Otterstraat 118, Utrecht, 3513 CR, The Netherlands.
| | - April Loxton
- Deakin University's School of Health and Social Development, Faculty of Health, 221 Burwood Hwy, Burwood, Melbourne, VIC, 3125, Australia
| | - Julie Anderson
- Deakin University's School of Health and Social Development, Faculty of Health, 221 Burwood Hwy, Burwood, Melbourne, VIC, 3125, Australia
| | - Joanne Watson
- Deakin University's School of Health and Social Development, Faculty of Health, 221 Burwood Hwy, Burwood, Melbourne, VIC, 3125, Australia
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Todd S, Bernal J, Worth R, Shearn J, Brearley S, McCarron M, Hunt K. Hidden lives and deaths: the last months of life of people with intellectual disabilities living in long-term, generic care settings in the UK. J Appl Res Intellect Disabil 2021; 34:1489-1498. [PMID: 34031949 DOI: 10.1111/jar.12891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/15/2021] [Accepted: 03/12/2021] [Indexed: 11/27/2022]
Abstract
RATIONALE This paper concerns mortality and needs for end-of-life care in a population of adults with ID living in generic care homes. METHODS Various sampling strategies were used to identify a difficult to find a population of people with ID in generic care homes. Demographic and health data were obtained for 132 people with ID. This included the Surprise Question. At T2, 12 months later, data were obtained on the survival of this sample. FINDINGS The average age was 68.6 years, and the majority were women (55.3%). Their health was typically rated as good or better. Responses to the Surprise Question indicated that 23.3% respondents might need EoLC. At T2, 18.0% of this population had died. The average of death was 72.2 years. The majority died within the care setting (62.9%). IMPLICATIONS The implications for end-of-life care and mortality research are discussed.
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9
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Hedayioglu J, Marsden S, Sackree A, Oliver D. Paid carers' understanding and experiences of meaningful involvement in bereavement for people with intellectual disability when a significant other is dying. J Appl Res Intellect Disabil 2021; 35:143-149. [PMID: 34240511 DOI: 10.1111/jar.12929] [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] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 06/09/2021] [Accepted: 06/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Wider communication about death and dying for those with intellectual disabilities has been highlighted as being of key importance. OBJECTIVE To gain the perspective of paid carers based in residential homes about meaningfully supporting individuals with intellectual disabilities in the bereavement process. METHODS Semi-structured interviews were conducted with paid carers working across two residential homes. RESULTS Four themes were identified: (a) challenges in having conversations about death and dying; (b) meaningful involvement of residents in the bereavement process; (c) the relationship between paid carers and residents (including the impact of a resident's death on paid carers); and (d) the support needs of paid carers. CONCLUSIONS The recommendations from previous research of meaningfully involving people with intellectual disabilities in the bereavement process have not filtered fully into practice. Paid carers still highlight the need for specialist support and advice to help them discuss and increase involvement in death and dying.
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Affiliation(s)
- Julie Hedayioglu
- Clinical Audit & Research, Kent Community NHS Foundation Trust, Kent, UK.,Centre for Health Services Studies, University of Kent, Kent, UK
| | - Sue Marsden
- Specialist Community Matron, Kent Community NHS Foundation Trust, West Malling, UK
| | | | - David Oliver
- Tizard Centre, University of Kent, Canterbury, UK
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Hussain R, Wark S, Janicki MP, Parmenter T, Knox M, Tabatabaei-Jafari H. Mental health of older people with mild and moderate intellectual disability in Australia. J Intellect Disabil Res 2021; 65:535-547. [PMID: 33786909 DOI: 10.1111/jir.12825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 11/30/2020] [Accepted: 02/08/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The progressive increase in life expectancy of people with intellectual disability (ID) has resulted in enhanced survival into old age and has also seen a growth in research on both lifelong and emerging ageing-related health issues. Health issues amongst provider-supported adults have been previously studied, but these studies have not always included older community-dwelling adults with ID. METHODS A study examining the extent of mental health of 391 community-dwelling adults with ID age 60 and older in both metropolitan and rural areas of two East Coast Australian states was undertaken using a cross-sectional survey. Examined were a range of demographic (age, sex, living arrangements, employment and socio-economic status) and life (co-morbidities, adverse life events and social support) factors. Data were parsed by two age groupings (60-65: n = 234 and >65: n = 157). RESULTS Findings revealed that older community-dwelling adults with ID have many of the same mental health disorders as do other ageing people, with the exception of significant psychiatric disorders often associated with older age. Over a third (35%: n = 137) reported some one or more mental health disorders. Age, sex, location (rural or urban), financial hardship, social support or type of living arrangement were not statistically significant as risk factors for poor mental health. However, employment status was a clear predictor. Stepwise regression models showed a strong association between mental ill-health and adverse life events and between mental ill-health and multiple physical co-morbidities. CONCLUSIONS The cross-sectional nature of the study limits causal inference. The cumulative effect of chronic health conditions and adverse life events cannot be prevented retrospectively. However, greater awareness amongst both health professionals and care staff that older adults with ID have a high likelihood of significant and/or repeated traumas and need better health care to limit physical co-morbidity may assist in providing support that is better tailored to individual needs in older age to reduce the burden of mental ill-health.
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Affiliation(s)
- R Hussain
- ANU Medical School, Australian National University, Australia
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - S Wark
- School of Rural Medicine, University of New England, Armidale, NSW, Australia
| | - M P Janicki
- Disability and Human Development, University of Illinois, Chicago, IL, USA
| | - T Parmenter
- Center for Disability Studies, Sydney Medical School, University of Sydney, NSW, Australia
| | - M Knox
- Center for Disability Studies, Sydney Medical School, University of Sydney, NSW, Australia
| | - H Tabatabaei-Jafari
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, ACT, Australia
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Foo B, Wiese M, Curryer B, Stancliffe RJ, Wilson NJ, Clayton JM. Specialist palliative care staff's varying experiences of talking with people with intellectual disability about their dying and death: A thematic analysis of in-depth interviews. Palliat Med 2021; 35:738-749. [PMID: 33730929 DOI: 10.1177/0269216321998207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/17/2022]
Abstract
BACKGROUND The cognitive and communication challenges experienced by people with intellectual disability present difficulties for health professionals, particularly in the face of illness and dying. AIM To explore the experiences of specialist palliative care staff in talking with people with intellectual disability about their dying and death, and factors that influence these conversations. DESIGN An inductive thematic analysis was conducted on data from a larger qualitative semi-structured interview study. SETTING/PARTICIPANTS Twenty palliative care staff from health services across Australia were interviewed. Participants were employed in multidisciplinary specialist palliative care teams and had provided palliative care to dying persons with intellectual disability. RESULTS Specialist palliative care staff did not consistently talk with people with intellectual disability about their dying and death. Conversations were influenced by (a) the perceived capacity of the person with intellectual disability, (b) experience and expertise of palliative care staff, (c) the relationship between palliative care staff and dying person and (d) values of palliative care staff and other caregivers (namely family members and paid carers). CONCLUSIONS Specialist palliative care staff experience difficulties in talking with people with intellectual disability about their dying. Development of communication guidelines, resources and training for palliative care teams are urgently required to improve palliative care for this patient group. A more comprehensive research agenda on the needs of people with intellectual disability and their caregivers in palliative care is needed, with a particular focus on strategies to effectively communicate about dying and death.
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Affiliation(s)
- Baby Foo
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Michele Wiese
- School of Psychology, Western Sydney University, Penrith, NSW, Australia
| | - Bernadette Curryer
- Centre for Disability Research and Policy, The University of Sydney, Sydney, NSW, Australia
| | - Roger J Stancliffe
- Centre for Disability Research and Policy, The University of Sydney, Sydney, NSW, Australia
| | - Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Hawkesbury, NSW, Australia
| | - Josephine M Clayton
- Centre for Learning & Research in Palliative Care, HammondCare, Greenwich Hospital, Sydney, Australia; Northern Clinical School, The University of Sydney, Sydney, NSW, Australia
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Kim MA, Yi J, Bradbury L, Han KM, Yang J, Lee J. A Photovoice Study: The life experiences of middle-aged adults with intellectual disabilities in Korea. J Appl Res Intellect Disabil 2021; 34:852-865. [PMID: 33686721 DOI: 10.1111/jar.12870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 01/14/2021] [Accepted: 01/25/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND As adults with intellectual disabilities approach older adulthood, they face unique physical and psychosocial challenges. This study explored the lived experiences of middle-aged adults with intellectual disabilities living in their community. METHOD Six sessions of Photovoice were conducted with a purposeful sample of six middle-aged adults with intellectual disabilities in South Korea. Participants were involved with the theme selection, taking photographs related to the themes, group discussion of photo stories and sharing Photovoice outcomes. RESULTS Thematic analysis yielded 11 subthemes under the five major themes selected by the participants: health, free time, time in the centre, family and my future in old age. CONCLUSIONS The study findings showed complex issues middle-aged adults with intellectual disabilities may face in later life, including bereavement and healthy lifestyle concerns. It is important to create a space for meaningful social support and social interactions without stigma.
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Affiliation(s)
- Min Ah Kim
- Department of Social Welfare, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jaehee Yi
- College of Social Work, University of Utah, Salt Lake City, UT, USA
| | - Laura Bradbury
- College of Social Work, University of Utah, Salt Lake City, UT, USA
| | - Ki-Myung Han
- Department of Gerontology, Graduate School of East-West Medical Science, Kyung Hee University, Gyeonggi, Republic of Korea
| | - Jieun Yang
- Therapy Center for Children with Emotional and Behavioral Issues, I-Zone in Seodaemun, Seoul, Republic of Korea
| | - Jinseung Lee
- Woori Daycare Center, Gyeonggi, Republic of Korea
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13
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Alathur S, Kottakkunnummal M, Chetty N. Social media and disaster management: influencing e-participation content on disabilities. TG 2021. [DOI: 10.1108/tg-07-2020-0155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to analyse the nature and forms of digital content that may influence e-participation for persons with disabilities (PWDs) during a flood disaster.
Design/methodology/approach
This paper undertakes a case study of the 2019 and 2020’s flood in Kerala, India. In-depth interviews with rehab workers during the flood are used in the study. Topic modelling and sentiment analysis are carried out using Twitter data. The native language responses from Facebook forums related to PWDs are analysed manually to construct taxonomy of problematic content
Findings
The results show that problematic content toward PWDs in the social media occurs during a flood. The extreme and exploitative content results in disability exclusion. Thus, e-participants fail to address the actual disability-specific requirements through social media during a disaster.
Research limitations/implications
The paper explores social media content toward PWDs. Implications of findings on citizens’ e-participation competency are delineated. Existing e-participation literature reports a low degree of disability e-participation in social media. Exploring disability e-participation helps to design more inclusive participation platforms. Further studies can explore the disability consciousness among e-participants for a more inclusive space.
Practical implications
The development of problematic content in the social media environment is alarming. Regulatory frameworks are also less adequate. Hence, policies for enabling inclusive participation that is not limited to the information technology infrastructure is needed.
Social implications
First, the citizens will get more insights for meaningful disability e-participation. Second, inclusive e-participation platform designs will help to reduce problematic content generation.
Originality/value
Disability e-participation requires regional studies. But there are fewer studies on disability e-participation from developing nations. The current study considered the regional context and complexities of disability e-participation. This paper gives policy recommendations for an inclusive e-participation.
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Stancliffe RJ, Wiese MY, Read S, Jeltes G, Barton R, Clayton JM. Does talking about end of life with adults with intellectual disability cause emotional discomfort or psychological harm? J Appl Res Intellect Disabil 2020; 34:659-669. [DOI: 10.1111/jar.12835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/20/2020] [Accepted: 10/29/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Roger J. Stancliffe
- Faculty of Medicine and Health Sydney School of Health Sciences Centre for Disability Research and Policy The University of Sydney Sydney NSW Australia
| | - Michele Y. Wiese
- School of Social Sciences and Psychology Western Sydney University Kingswood NSW Australia
| | - Sue Read
- School of Nursing and Midwifery Keele University Newcastle under Lyme UK
| | | | - Rebecca Barton
- Faculty of Medicine and Health Sydney School of Health Sciences Centre for Disability Research and Policy The University of Sydney Sydney NSW Australia
| | - Josephine M. Clayton
- Centre for Learning & Research in Palliative Care HammondCare Greenwich Hospital Sydney NSW Australia
- Northern Clinical School Faculty of Medicine and Health The University of Sydney Sydney NSW Australia
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De Leo D, Zammarrelli J, Viecelli Giannotti A, Donna S, Bertini S, Santini A, Anile C. Notification of Unexpected, Violent and Traumatic Death: A Systematic Review. Front Psychol 2020; 11:2229. [PMID: 33101106 PMCID: PMC7546769 DOI: 10.3389/fpsyg.2020.02229] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 08/10/2020] [Indexed: 11/25/2022] Open
Abstract
Background: The way the death of a person is communicated can have a profound impact on the bereavement process. The words and expressions that are used to give the tragic news, the characteristics of who communicates it, the physical setting in which the notification is given, the means used (e.g., in person, via phone call, etc.) are just some of the factors that can influence the way survivors face one of the most difficult moments in their lives. Aim: To review the literature on the topic of death notification to verify the state of the art related to this important procedure. Methods: A systematic review was conducted with PRISMA criteria on English-written materials produced from 1966 to 2019. Results: Out of the initial 3,166 titles considered, 60 articles were extracted for this review. A content analysis has revealed four main areas of interest: (1) protocols and guidelines; (2) emotional reactions of recipients and notifiers; (3) professional figures involved in the notification process; and, (4) types of death. Discussion: The communication of death represents a complex and stressful experience not only for those who receive it but also for those who give it. Alongside the acquisition of a necessary technique and execution methods, the process should involve the selection of notifiers based on personality characteristics and communication styles. Conclusion: Indications for the need of better training and protocols sensitive to different circumstances emerge. Adequate preparation can positively influence the quality of communication and the effects it produces, both on recipients and notifiers. In vocational training, more space should be devoted to this demanding task.
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Affiliation(s)
- Diego De Leo
- Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, QLD, Australia
- Slovene Center for Suicide Research, Primorska University, Koper, Slovenia
- De Leo Fund, Padua, Italy
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McKenzie K, Armitage B, Murray G, James I. The use of therapeutic untruths by staff supporting people with an intellectual disability who display behaviours that challenge. J Appl Res Intellect Disabil 2020; 34:28-35. [PMID: 32627289 DOI: 10.1111/jar.12780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 06/05/2020] [Accepted: 06/20/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Therapeutic untruths (TU) are used in dementia services to de-escalate distressing situations. The present authors explored the use of TU by care staff supporting people with an intellectual disability who displayed behaviours that challenged. METHOD Data were collected from 126 staff (female = 72.2%; mean age = 41.9 years, SD = 10.7) via an online survey in relation to three areas: responses to three scenarios, reported use of different forms of TU and ratings of perceived effectiveness of, and level of comfort using, each type. RESULTS 96% of participants reported using TU themselves and observing their colleagues doing likewise. Models that included perceived effectiveness of, and level of staff comfort with using, different TU were significant, although only perceived effectiveness significantly independently contributed to the model. CONCLUSION The use of TU was common, with levels consistent with those found in dementia services. The limitations and implications of the findings are discussed.
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Affiliation(s)
- Karen McKenzie
- City Campus, Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Bethan Armitage
- City Campus, Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - George Murray
- City Campus, Department of Psychology, Northumbria University, Newcastle upon Tyne, UK.,Morningside Derive, NHS Lothian, Edinburgh, UK
| | - Ian James
- Campus for Ageing and Vitality, CNTW NHS Trust, Newcastle upon Tyne, UK
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Tuffrey‐Wijne I, Finlayson J, Bernal J, Taggart L, Lam CKK, Todd S. Communicating about death and dying with adults with intellectual disabilities who are terminally ill or bereaved: A UK‐wide survey of intellectual disability support staff. J Appl Res Intellect Disabil 2020; 33:927-938. [DOI: 10.1111/jar.12714] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 01/21/2020] [Accepted: 01/31/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Irene Tuffrey‐Wijne
- Faculty of Health, Social Care and Education Kingston University & St George’s, University of London London UK
| | | | | | | | - Claire Kar Kei Lam
- Faculty of Health, Social Care and Education Kingston University & St George’s, University of London London UK
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18
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Ibañez-Masero O, Carmona-Rega IM, Ruiz-Fernández MD, Ortiz-Amo R, Cabrera-Troya J, Ortega-Galán ÁM. Communicating Health Information at the End of Life: The Caregivers' Perspectives. Int J Environ Res Public Health 2019; 16:E2469. [PMID: 31336698 PMCID: PMC6678674 DOI: 10.3390/ijerph16142469] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/04/2019] [Accepted: 07/10/2019] [Indexed: 12/02/2022]
Abstract
Health information and communication are key elements that allow patients and family members to make decisions about end-of-life care and guarantee a death with dignity. Objective: To understand caregivers' experiences regarding health information and communication during the illness and death of family members. Methods: This qualitative study was conducted in Andalusia based on the paradigm of hermeneutic phenomenology. Participants were caregivers who had accompanied a family member at the end of life for over 2 months and less than 2 years. Five nominal groups and five discussion groups were established, and 41 in-depth interviews with 123 participants were conducted. Atlas.ti 7.0 software was used to analyze the discourses. A comprehensive reading was carried out along with a second reading. The most relevant units of meaning were identified, and the categories were extracted. The categories were then grouped in dimensions and, finally, the contents of each dimension were interpreted and described given the appropriate clarifications. Results: Four dimensions of the dying process emerged: differences in caregivers' perceptions of information and communication, a conspiracy of silence, consequences of the absence or presence of information, and the need for a culture change. Conclusions: Poor management of health information and communication at the end of life increased the suffering and discomfort of patients and their families. The culture of denying and avoiding death is still present today. A change in education about death would better enable health professionals to care for patients at the end of life.
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Affiliation(s)
| | | | | | - Rocío Ortiz-Amo
- Department of Nursing, Physiotherapy, and Medicine, University of Almería, 04120 Almería, Spain
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Johansson M, Björne P, Runesson I, Ahlström G. Healthy Ageing in People with Intellectual Disabilities from Managers' Perspective: A Qualitative Study. Healthcare (Basel) 2017; 5:E45. [PMID: 28820435 DOI: 10.3390/healthcare5030045] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 07/28/2017] [Accepted: 08/04/2017] [Indexed: 11/17/2022] Open
Abstract
An increasing number of people with intellectual disability (ID) are reaching older ages today although they experience more health problems than the older population without ID. Leaders in intellectual disability services can greatly influence the conditions for a healthy ageing, and the aim of the present study was to explore healthy ageing in this group from the perspective of the leaders. Interviews with 20 leaders were subjected to qualitative content analysis. The findings gave rise to the overall theme ageing in dependence, which emerged from the following six categories: Supporting self-determination; Inaccessible activities after retirement; Signs of decline; Increased and specific needs for support and care; A non-question of gender; Aspects concerning the end of life and death. A prerequisite for healthy ageing in the case of people with ID is, according to the leaders, that they can live the life according to their preferences and make independent choices whilst at the same time receiving adequate support. With the shrinking of their social network after retirement, they become increasingly dependent on staff and leaders in the group home, who need to know what healthy ageing implies.
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Tuffrey‐Wijne I, Rose T, Grant R, Wijne A. Communicating about death and dying: Developing training for staff working in services for people with intellectual disabilities. J Appl Res Intellect Disabil 2017; 30:1099-1110. [DOI: 10.1111/jar.12382] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Irene Tuffrey‐Wijne
- Faculty of HealthSocial Care and EducationKingston University & St George's University of London London UK
| | - Tracey Rose
- Faculty of HealthSocial Care and EducationKingston University & St George's University of London London UK
- Kent Community Health NHS Foundation Trust Ashford UK
| | - Robert Grant
- Faculty of HealthSocial Care and EducationKingston University & St George's University of London London UK
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