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Groulx M, Freeman S, Gourlay K, Hemingway D, Rossnagel E, Chaudhury H, Nouri M. Monitoring and Evaluation of Dementia-Friendly Neighborhoods Using a Walkshed Approach: Protocol for a Scoping Review. JMIR Res Protoc 2024; 13:e50548. [PMID: 38170573 PMCID: PMC10794960 DOI: 10.2196/50548] [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: 07/04/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The number of people in society living with dementia is growing. In Canada, most people who live with dementia live at home, often in a neighborhood setting. Neighborhood environments can be a source of independence, social engagement, and well-being. They can also contain barriers that limit physical activity, social engagement, and well-being. A dementia-friendly neighborhood includes assets that support persons living with dementia and their caregivers in multiple life domains, including those that support walking within the neighborhood environment. OBJECTIVE The objectives for this scoping review are twofold. First, focusing on walkshed analysis, we aim to extend scholarly understandings of methodological practices used in the monitoring and evaluation of dementia-friendly neighborhoods. Second, we aim to provide clear and practical guidance for those working in planning, design, and public health fields to assess the neighborhood context in support of evidence-based action to improve the lives of persons living with dementia. METHODS The study design follows Arksey and O'Malley's scoping review framework and PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. We will conduct a search of peer-reviewed studies in 6 electronic databases to identify the use of Geographic Information System analysis to measure the walkshed of persons living with dementia in a community setting. As age is a primary risk factor associated with dementia, we will also include studies that focus more broadly on community-dwelling older adults aged 65 years and older. Data will be extracted, analyzed, and represented according to 3 domains. This includes study details, walkshed analysis methods, and criteria and indicators used to measure dementia-friendly neighborhoods. RESULTS The results of the study and the submission of a manuscript for peer review are expected in June 2024. The results of the review are expected to contribute to an understanding of methods for monitoring and evaluating dementia-friendly neighborhoods. Expected findings will include a detailed breakdown of current parameters and routines used to conduct walkshed analysis. Findings will also convey criteria that can be operationalized in a Geographic Information System as indicators to assess barriers and facilitators to walking in a neighborhood setting. CONCLUSIONS As far as we are aware, the proposed scoping review will be the first to provide comprehensive methodological or technical guidance for conducting walkshed analysis specific to persons living with dementia. Both the scalability and objective nature of walkshed analysis are likely to be of direct interest to public health practitioners, planners, and allied professionals. Clearly documenting methods used in walkshed analysis can spur increased collaboration across these disciplines to enable an evidence-informed approach to improving neighborhood environments for persons living with dementia. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/50548.
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Affiliation(s)
- Mark Groulx
- University of Northern British Columbia, Prince George, BC, Canada
| | - Shannon Freeman
- School of Nursing, University of Northern British Columbia, Prince George, BC, Canada
| | - Keone Gourlay
- School of Planning and Sustainability, University of Northern British Columbia, Prince George, BC, Canada
| | - Dawn Hemingway
- School of Social Work, University of Northern British Columbia, Prince George, BC, Canada
| | - Emma Rossnagel
- University of Northern British Columbia, Prince George, BC, Canada
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
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Bai YL, Shyu YIL, Huang HL, Chiu YC, Hsu WC. The enrichment process for family caregivers of persons living with dementia: A grounded theory approach. J Adv Nurs 2024; 80:252-263. [PMID: 37515365 DOI: 10.1111/jan.15809] [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: 11/17/2022] [Revised: 06/12/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023]
Abstract
AIM Many persons living with dementia (PLWD) reside in the community and are cared for by family members. The aim of this qualitative study was to gain an understanding the enrichment process for family caregivers of PLWD in Taiwan. DESIGN A grounded theory approach with face-to-face semi-structured interviews was conducted with family caregivers of PLWD in Taiwan. METHODS Interview data from 30 family caregivers of PLWD recruited from dementia clinics or support groups in Taiwan were obtained from the first wave of a larger study conducted from January 2018 to September 2021. Glaser's grounded theory approach with theoretical sampling was used to understand the enrichment process of family caregivers of PLWD. RESULTS Analysis indicated the core category that characterized the process of enrichment was 'holding together'. Caregivers were able to maintain their connection to the person with dementia through activities that deepened their relationship and strengthened their bond. 'Holding together' included four components: maintaining continuity, creative interactions, interacting with humour and sharing pleasurable activities. Through these components, family caregivers generated positive interactions and relationships with the person living with dementia and sustained their motivation for caregiving. Three modifying elements facilitated or impeded the process of holding together: 'previous daily interactions', 'caregiving beliefs' and 'filial piety'. CONCLUSION Through the enrichment process of 'holding together', family caregivers used different strategies to conduct pleasurable and meaningful activities with the person living with dementia to maintain and improve their relationship and enhance their happiness in life. IMPACT To facilitate the enrichment process, health care providers should encourage activities between family caregivers and PLWD that promote continuity, increase interactions, provide humour and foster pleasurable activities. REPORTING METHOD This study adhered to the COREQ guideline checklist. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Yu-Lin Bai
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- NTU BioMedical Park Hospital Zhubei Campus, Zhubei, Taiwan
| | - Yea-Ing L Shyu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Dementia Center, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Huei-Ling Huang
- Dementia Center, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Geriatric and Long-Term Care Research Center, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Yi-Chen Chiu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Dementia Center, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Wen-Chuin Hsu
- Dementia Center, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Hovsepian VE, Liu J, Schlak AE, Sadak T, Martsolf G, Bilazarian A, McHugh MD, Poghosyan L. Structural capabilities in primary care practices where nurse practitioners care for persons living with dementia. Int J Older People Nurs 2023; 18:e12556. [PMID: 37431711 PMCID: PMC10569265 DOI: 10.1111/opn.12556] [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: 07/19/2022] [Revised: 04/04/2023] [Accepted: 06/04/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Primary care structural capabilities (i.e., electronic health records, care coordination, community integration, and reminder systems) can address the multiple needs of persons living with dementia (PLWD). OBJECTIVES This study describes structural capabilities in primary care practices where nurse practitioners (NPs) provide care to PLWD and compares the presence of structural capabilities in practices with a high and low volume of PLWD. METHODS We conducted a secondary analysis of cross-sectional data from 293 NPs in 259 practices in California. Logistic regression models were used to determine the association between the volume of PLWD and the presence of structural capabilities. RESULTS NPs reported that 96% of practices had electronic health records, 61% had community integration, 55% had reminder systems and 35% had care coordination capabilities. Practices with a high volume of PLWD were less likely to have community integration compared to practices with a low volume of PLWD. CONCLUSION Many PLWD-serving practices do not have the essential infrastructure for providing optimal dementia care. Practice managers should focus on implementing the essential structural capabilities to address the complex needs of PLWD. IMPLICATIONS FOR PRACTICE Clinicians and practice administrations can use the findings of this study to improve the delivery of care in practices that provide care to PLWD.
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Affiliation(s)
| | | | | | - Tatiana Sadak
- University of Washington, Seattle, WA School of Nursing
| | - Grant Martsolf
- School of Nursing, University of Pittsburgh, Pittsburgh, PA
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Kay K, Metersky K, Smye V, McGrath C, Johnson K, Astell A, Sun W, Bartfay E. A scoping review to inform the development of dementia care competencies. Dementia (London) 2023:14713012231165568. [PMID: 36978250 DOI: 10.1177/14713012231165568] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Health professionals and care partners of persons living with dementia have expressed that learning needs related to dementia care are a priority. There are currently a variety of training programs available in Ontario (Canada) to address aspects of dementia care, but no commonly accepted description of the core knowledge, skills, and abilities, (i.e., competencies) that should underpin dementia-related training and education in the province. The aim of this study was to review current evidence to inform the later development of competency statements describing the knowledge, skills and actions required for dementia care among care providers ranging from laypersons to health professionals. We also sought to validate existing dementia care principles and align new concepts to provide a useful organizing framework for future competency development. We distinguished between micro-, meso- and macro-level concepts to clarify the competencies required by individuals situated in different locations across the healthcare system, linking competency development in dementia care to broader system transformation. This review precedes the co-development of a holistic competency framework to guide approaches to dementia care training in Ontario.
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Affiliation(s)
- Kelly Kay
- Ontario Institute for Studies in Education, 7938University of Toronto, Toronto, ON, Canada
- Provincial Geriatrics Leadership Ontario, Toronto, ON, Canada
| | - Kateryna Metersky
- Daphne Cockwell School of Nursing, 7984Toronto Metropolitan University, Toronto, ON, Canada
| | - Victoria Smye
- Arthur Labatt Family School of Nursing, 6221Western University, London, ON, Canada
| | - Colleen McGrath
- School of Occupational Therapy, 6221Western University, London, ON, Canada
| | | | - Arlene Astell
- Department of Occupational Sciences and Occupational Therapy, 7938University of Toronto, Toronto, ON, Canada
- School of Psychology and Clinical Language Sciences, 6816University of Reading, Reading, UK
- DATE Lab, KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Winnie Sun
- Faculty of Health Sciences, 85458Ontario Tech University, Oshawa, ON, Canada
| | - Emma Bartfay
- Faculty of Health Sciences, 85458Ontario Tech University, Oshawa, ON, Canada
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Sun T, Jia R, Clarke JA, Zhu M, Dobbs D, Di Y, Dong X, Meng H. Perceived and unmet needs for health and social services among families coping with dementia in China: A descriptive study. Dementia (London) 2022; 21:1699-1713. [PMID: 35533235 DOI: 10.1177/14713012221094979] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To describe the perceived and unmet needs for health and social services and their relative importance among families coping with dementia in urban China. METHODS We used data from a cross-sectional survey conducted between 2018 and 2019 in two cities in eastern China. Trained staff conducted structured interviews of family caregivers of people living with dementia at home to obtain individual characteristics as well as types of service needs of families coping with dementia. Service needs and utilization in 24 types of services across five domains (daily living, medical/nursing, rehabilitation, mental health, and other) were examined. Descriptive statistics were used to describe characteristics of the dyads and the ranking of services based on the percentage of respondents with perceived/unmet needs. RESULTS A total of 170 (87.6%) family caregivers completed the interviews. The mean age of the care recipient was 77.2 years (range: 60-102) and 65.3% were female. The mean age of family caregivers was 58.4 years (range: 28-90), and 57.1% were female. The top five services used by the care recipients were: primary care, medication management, housekeeping, activities of daily living assistance, and adult day service. The five services with the most unmet needs were: legal assistance (42.7%), hospice care (44.7%), respiratory secretion management (expectoration) (57.6%), life enrichment activities (65.4%), and companion care (67.0%). Except for transportation and dressing/grooming, working and nonworking caregivers reported similar relative importance of service needs. CONCLUSIONS The findings suggest that people living with dementia and their family require a wide range of services and supports to live in the community. Future research and policy efforts should target the unmet needs of families to improve dementia care in the community and promote aging-in-place.
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Affiliation(s)
- Tongda Sun
- Institute of Health Service Research, 200642Ningbo College of Health Sciences, Ningbo, China
| | - Rangcheng Jia
- Institute of Health Service Research, 200642Ningbo College of Health Sciences, Ningbo, China
| | - Jodie-Ann Clarke
- College of Public Health, 27117University of South Florida, Tampa, FL, USA
| | - Mingze Zhu
- College of Public Health, 27117University of South Florida, Tampa, FL, USA
| | - Debra Dobbs
- School of Aging Studies, College of Behavioral & Community Sciences, 27117University of South Florida, Tampa FL, USA
| | - Yuntong Di
- College of Public Health, 27117University of South Florida, Tampa, FL, USA
| | - Xiaoxin Dong
- Institute of Health Service Research, 200642Ningbo College of Health Sciences, Ningbo, China
| | - Hongdao Meng
- School of Aging Studies, College of Behavioral & Community Sciences, 27117University of South Florida, Tampa FL, USA
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Muñoz J, Mehrabi S, Li Y, Basharat A, Middleton LE, Cao S, Barnett-Cowan M, Boger J. Immersive Virtual Reality Exergames for Persons Living With Dementia: User-Centered Design Study as a Multistakeholder Team During the COVID-19 Pandemic. JMIR Serious Games 2022; 10:e29987. [PMID: 35044320 PMCID: PMC8772876 DOI: 10.2196/29987] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/24/2021] [Accepted: 09/24/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Advancements in supporting personalized health care and well-being using virtual reality (VR) have created opportunities to use immersive games to support a healthy lifestyle for persons living with dementia and mild cognitive impairment (MCI). Collaboratively designing exercise video games (exergames) as a multistakeholder team is fundamental to creating games that are attractive, effective, and accessible. OBJECTIVE This research extensively explores the use of human-centered design methods that involve persons living with dementia in long-term care facilitates, exercise professionals, content developers, game designers, and researchers in the creation of VR exergames targeting physical activity promotion for persons living with dementia/MCI. METHODS Conceptualization, collaborative design, and playtesting activities were carried out to design VR exergames to engage persons living with dementia in exercises to promote upper limb flexibility, strength, and aerobic endurance. We involved a total of 7 persons living with dementia/MCI, 5 exercise professionals, 5 community-dwelling older adults, a VR company for content creation, and a multidisciplinary research team with game designers, engineers, and kinesiology experts. RESULTS An immersive VR exergame called Seas the Day was jointly designed and developed and it is freely available to be played in state-of-the-art VR headsets (Oculus Quest 1, 2). A model for the triadic interaction (health care institution, industry partner, academia) is also presented to illustrate how different stakeholders contribute to the design of VR exergames that consider/complement complex needs, preferences, and motivators of an underrepresented group of end users. CONCLUSIONS This study provides evidence that a collaborative multistakeholder design results in more tailored and context-aware VR games for persons living with dementia. The insights and lessons learned from this research can be used by others to co-design games, including remote engagement techniques that were used during the COVID-19 pandemic.
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Affiliation(s)
- John Muñoz
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Samira Mehrabi
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Yirou Li
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Aysha Basharat
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Laura E Middleton
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Shi Cao
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Michael Barnett-Cowan
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Jennifer Boger
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
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Jonas-Simpson C, Mitchell G, Dupuis S, Donovan L, Kontos P. Free to be: Experiences of arts-based relational caring in a community living and thriving with dementia. Dementia (London) 2021; 21:61-76. [PMID: 34166151 PMCID: PMC8739588 DOI: 10.1177/14713012211027016] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM To present findings about experiences of relational caring at an arts-based academy for persons living with dementia. BACKGROUND There is a compelling call and need for connection and relationships in communities living with dementia. This study shares what is possible when a creative arts-based academy for persons living with dementia grounded in relational inquiry and caring focuses on relationships through the medium of the arts. DESIGN A qualitative phenomenological methodology (informed by van Manen) was used to answer the research question, "What is it like to experience relational caring at an arts-based academy for persons living with dementia?" We address two research objectives: (1) to explore how relationships are experienced when a relational caring philosophy underpins practice, including arts-based engagements; and (2) to understand the meaning of relationships that bring quality to day-to-day living. METHODS Twenty-five participants were recruited from the Academy and interviewed in one-to-one in-depth interviews or small groups. Participants included five persons living with dementia, eight family members, four staff, five artists, one personal support worker, and two volunteers. Participants were asked to describe their experiences of relational caring or relationships in the Academy space. FINDINGS Three thematic patterns emerged, which address the research objectives.Relational caring is experienced when:freedom and fluid engagement inspire a connected spontaneous liveliness;embracing difference invites discovery and generous inclusivity; andmutual affection brings forth trust and genuine expression. CONCLUSIONS Findings contribute to the growing body of knowledge about both relational caring and arts-based practices that call forth a different ethic of care-one that is relational, inclusive, and intentional. Findings also shed light on what is possible when a relational caring philosophy underpins arts-based practices-everyone thrives.
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Affiliation(s)
| | | | | | - Lesley Donovan
- St. Michael's Hospital, 508783Unity Health Toronto, Toronto, ON, Canada
| | - Pia Kontos
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Chelberg GR, Neuhaus M, Mothershaw A, Mahoney R, Caffery LJ. Mobile apps for dementia awareness, support, and prevention - review and evaluation. Disabil Rehabil 2021; 44:4909-4920. [PMID: 34034601 DOI: 10.1080/09638288.2021.1914755] [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] [Indexed: 10/21/2022]
Abstract
PURPOSE This review aimed to document the characteristics and appraise the quality of dementia applications (apps) to support persons living with dementia and their caregivers. MATERIALS AND METHODS Systematic searches of the Australian-based Google Play Store, Apple App Store, and relevant websites sought apps with dementia or Alzheimer's information, support for caregivers and persons living with dementia, or prevention content. Apps were screened and subsequently appraised via the mobile application review system (MARS). RESULTS The majority of the final 75 dementia apps were free to download, but were only available on a single platform. Persons involved in caregiving were the primary audience. App content focused on dementia information, practical caregiving, and communication tips. Language options in addition to English were limited and few apps offered ongoing support. MARS appraisal identified few apps with good "Overall Quality" scores. Apps that were more comprehensive trended towards higher MARS scores. CONCLUSIONS A composite lack of standardised quality indicators and commercial drivers of the marketplace present significant barriers for consumers seeking meaningful dementia information and support. Persons living with dementia and their caregivers would significantly benefit from social and organisational services that assist with navigating the app marketplace.Implications for rehabilitationThere is significant opportunity for quality digital innovations, including apps, to support home-based, independent dementia care.A composite lack of standardised quality indicators and commercial drivers of the app marketplace present significant barriers for persons living with dementia and their caregivers who seek apps with dementia information and support.Social and organisational services can support the dementia community through assistance with navigating the app marketplace for quality dementia information and support.
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Affiliation(s)
- Georgina R Chelberg
- Centre for Online Health - Centre for Health Services Research, The University of Queensland, Brisbane, Australia.,Australian E-Health Research Centre (AEHRC), Commonwealth Scientific and Industrial Research Organisation (CSIRO), Canberra, Australia
| | - Maike Neuhaus
- Centre for Online Health - Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Adam Mothershaw
- Centre for Online Health - Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Ray Mahoney
- Australian E-Health Research Centre (AEHRC), Commonwealth Scientific and Industrial Research Organisation (CSIRO), Canberra, Australia.,School of Public Health, The University of Queensland, Brisbane, Australia
| | - Liam J Caffery
- Centre for Online Health - Centre for Health Services Research, The University of Queensland, Brisbane, Australia
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Berendonk C, Blix BH, Hoben M, Clandinin DJ, Roach PM, Compton RM, Cave MT, Caine V. A Narrative Care approach for persons living with dementia in institutional care settings. Int J Older People Nurs 2019; 15:e12278. [PMID: 31577388 DOI: 10.1111/opn.12278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 02/27/2019] [Revised: 07/26/2019] [Accepted: 08/29/2019] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES We will provide insights in the theoretical background and key concepts of a Narrative Care approach, such as narrative cultures, narrative curiosity, narrative co-composition and narrative reflective practice. BACKGROUND Care understood as narrative practice underscores the importance of experiences and how these shape identities. Important to the quality of care in institutional care settings is the ability of care providers to cope with complexities and uncertainties in older adults' stories, which can be realised by attending to ways that foster and co-compose evolving and forward-looking narratives. Recognising these ongoing co-compositions means that persons living in institutional care settings and care providers live, tell, retell and relive their experiences. A change in the current institutional culture is necessary to implement care as narrative practice. To support such a change, approaches are needed that foster a focus on experiences and relationships and make relational ethics central to care. METHODS The proposed Narrative Care approach is the result of an iterative development process involving a literature review, interviews with, and observations of, care providers, dialogues with an advisory committee, and consultation with experts. MAIN CONTRIBUTIONS The proposed Narrative Care approach aims to help care providers (a) to recognise the importance of curiosity in a person's verbal and embodied narratives-especially for those living with dementia; (b) to take note of individual experiences in all of their complexity and uncertainty; (c) to respect these narratives; (d) to open up spaces to co-compose new narratives; and (e) to allow care providers to engage in narrative reflective practices that shape who they are and are becoming. CONCLUSION The introduced approach responds to the need of implementing strategies to think and work narratively in institutional care settings. IMPLICATIONS FOR PRACTICE Narrative Care has the potential to reshape task-oriented, technical notions of care. Concepts such as embodied narratives, relational ethics, narrative co-composition and narrative reflective practice must be integrated in the education of all care providers.
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Affiliation(s)
| | - Bodil H Blix
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Matthias Hoben
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - D Jean Clandinin
- Faculty of Education, University of Alberta, Edmonton, AB, Canada.,Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
| | - Pamela M Roach
- Brain and Mental Health Research Clinics, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Roslyn M Compton
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - Marie T Cave
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Vera Caine
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Johnson C, Kelch J, Johnson R. Dementia at the End of Life and Family Partners: A Symbolic Interactionist Perspective on Communication. Behav Sci (Basel) 2017; 7:E42. [PMID: 28698488 DOI: 10.3390/bs7030042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 07/04/2017] [Accepted: 07/04/2017] [Indexed: 11/30/2022] Open
Abstract
People with dementia are not dying; they are experiencing changes in the brain. This paper utilizes a symbolic interaction theoretical perspective to outline communicative alternatives to polypharmacy. There is a growing interest in sociological interventions to untangle the “disordered discourses” associated with dementia. Such practices challenge common stigmas attached to dementia as an “ongoing funeral” or “death certificate.” Changing the expectations, attitudes and communication patterns of family care partners can positively impact them and the person living with dementia at the end of life. This paper delineates multiple non-verbal communication interventions (e.g., the trip back in time, dementia citizenship and sensory engagement modalities) to explore techniques to engage persons with advanced dementia.
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