Dissertations / Theses on the topic 'Dementia services'
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Norman, Rachel Louise. "Acute nursing care for people with dementia : what happens when a person with dementia is admitted to hospital for acute care?" Thesis, University of the West of England, Bristol, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.289797.
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Netten, Ann Penelope. "Residential care and senile dementia : the effect of the physical and social environment of homes for elderly people on residents suffering from senile dementia." Thesis, University of Kent, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.236247.
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Keen, Justin Robert. "A systems approach to modelling services for people with dementia." Thesis, City University London, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.245863.
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Parker, Ethna Therese. "Dementia is a disease, not a person : exploring the experiences of people with dementia, carers and mental health practitioners on dementia and dementia services via a qualitative evaluation of a community-based memory service." Thesis, Durham University, 2015. http://etheses.dur.ac.uk/10987/.
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This thesis presents a case-based qualitative evaluation of a community-based memory service for people with dementia and carers, informed by an advisory group including people with dementia and carers. Drawing on theoretical frameworks of critical and narrative gerontology, interviews with service users, carers and community mental health team staff generated rich accounts of experiences of using and delivering the memory service. Data from people with dementia and carers were analysed thematically and built on work by Willis et al. (2009) to generate quality indicators for dementia care. Analysis of data from CMHT staff drew on a framework of collective leadership devised for use in the NHS by the Center for Creative Leadership and The King's Fund (2014a). Findings reveal rich insights into: i) the everyday challenges faced by people with dementia and carers, ii) the positive contributions they can bring to the evaluation and development of services for people with dementia and carers and iii) the important role of collective leadership in the provision of high quality services for people with dementia. The thesis extends the current knowledge base relating to people with dementia and carers by developing particular understandings of how they can contribute to the evaluation and development of memory services.
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Anderson, Karen Ann, and Ann Watschke-Dixon. "Dementia and elder abuse in domestic settings." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2241.
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America's growing elder population affects every segment of the social, political and economic landscape. This population has generated public concern and debate reagarding the problems faced by this often-vulnerable group, including the issue of elder abuse. This research project examined associations between dementia and elder abuse in domestic settings utilizing secondary data obtained from Adult Protective Services of San Bernardino County.
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Messner, Suzanne Elayne. "Levels of aggression and alcohol use in populations with dementia." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1999. http://www.kutztown.edu/library/services/remote_access.asp.
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Thesis (M.A.)--Kutztown University of Pennsylvania, 1999.Source: Masters Abstracts International, Volume: 45-06, page: 2777. Typescript. Abstract precedes thesis as 2 preliminary leaves. Includes bibliographical references (leaves 46-59).
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Merrick, K. "Dementia : constructing a relational perspective." Thesis, Canterbury Christ Church University, 2012. http://create.canterbury.ac.uk/11319/.
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Section A is a review of literature which has explored the experience of dementia in the context of couple relationships. Four key themes thought to be central to this experience were identified and highlight the impact of dementia upon couple relationships, and how aspects of relationships may influence the experience of dementia. Limitations and gaps in our understanding are highlighted. Most significantly, the existent literature focuses upon care partners’ perceptions and excludes people with dementia. Therefore, it is argued that a relational understanding of the experience of dementia, in the context of couple relationships, remains unknown. The review concludes with a rationale for why further research is needed and how people with dementia could be included. Section B describes a qualitative study, using interpretative phenomenological analysis, to investigate couples’ experiences of dementia. Seven couples were interviewed and five master themes (‘foundations’, ‘altered structures’, ‘self-restoration’, ‘flexible scaffolding’ and ‘reflective capacity’) emerged from analysis of the data. These themes offer an understanding of the experience of dementia from a relational perspective and depict the ways in which couples construct their experience in order to make sense of dementia, and the processes that they adopt in order to adjust to dementia. The findings of this study are supported by existing empirical and theoretical literature and have implications for future research and clinical practice.
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Adams, Trevor. "Developing partnerships between people with dementia, their informal family carers and community psychiatric nurses." Thesis, University of Surrey, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.390581.
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Douglas, Jane E. "Living with and beyond dementia : a phenomenological investigation of young people's lived experience with dementia and the transition from pre-diagnosis through diagnosis and beyond to living well with dementia." Thesis, Edinburgh Napier University, 2017. http://researchrepository.napier.ac.uk/Output/1032617.
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Younger People with Dementia (YPwD) are those who receive a diagnosis of dementia under the age of 65. In Scotland the number of people with dementia who meet this definition is approximately 3200 (Alzheimer Scotland, 2017). The purpose of this study was to explore the human experience of living with dementia at a younger age and to consider interpretations of well-being as defined by the subjective experience of the participants. At the start of this study there was limited quality research available which explored the lives and experiences of YPwD. At that time there was some recognition within professional groups and practitioners that YPwD would benefit from age appropriate services. This study used an Interpretive Phenomenological design to explore the experiences of YPwD and used in-depth qualitative interviews with eight people who were diagnosed with dementia under the age of 65, to capture their journey through pre-diagnosis, diagnosis and beyond. Interpretive Phenomenological Analysis was utilised for the primary analysis. A secondary analysis was then conducted with the initial findings using Self-determination Theory, Basic Psychological Needs Theory, autonomy, competence and relatedness to identify areas of well-being. The study identified four superordinate themes situated within a four phase transition pathway, which identified how a diagnosis of dementia impacted on the person and the process they underwent following diagnosis. These are:pre-diagnosis phase, living in a changing world, awareness of the changing self, discombobulation; diagnostic phase, anger and relief, the fragmented self, consideration; post diagnostic phase, the challenge of learning to livewith dementia as a younger person, the evolving self, assimilation; and the phase living well beyond dementia, consolidated self, consolidation. The study highlighted that while having a diagnosis of dementia at a younger age is a challenging and devastating experience, it is possible to live a good and productive life beyond the diagnosis of dementia. The secondary analysis using Self-determination Theory, Basic Psychological Needs Theory identified that where the basic psychological needs were supported, this enabled participants to embrace their lives living with and beyond dementia with improved wellbeing. The findings suggest that the basic psychological needs were thwarted in the pre-diagnostic phase and during and immediately after diagnosis, creating feelings of ill-being. The study acknowledges the strong sense of identity around the younger person with dementia and suggests that this group perceive their dementia, and the support they need to live with the condition to be a different experience to that of older people. The ability of a number of the participants to live an active life within a supported community cannot be underestimated, and suggests that this area of care and support needs to be evaluated in light of the changing needs of people living with dementia, particularly those who are diagnosed at such an early part of their lifecycle.
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Du, Preez Janice. "Adult day services: experiences of occupational participation by people with early dementia and their carers." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2019. https://ro.ecu.edu.au/theses/2186.
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Background issue:
Reduced opportunities for occupational participation by adults with dementia impact their quality of life and wellbeing. It also affects the health and wellbeing of carers with whom they live. Adult day services were identified as possibly providing opportunities for meaningful activity engagement. However, there is a paucity of research on the occupational participation needs of individuals with early stage dementia who use adult day services and their carers.
Aim and significance:
This study aimed to identify the occupational participation (engagement in everyday activities that are individually meaningful) experiences of people with early stage dementia and their primary carers, whilst in the home, and during adult day service attendance. Furthermore, this study explored how carers ’perceptions on any impact the adult day service attendance had upon the persons with early stage dementia. An important inclusion was the perspectives of people with dementia and recognition of the contribution they can make to research. Lastly, understanding how the occupational participation experiences of these two groups are affected by adult day service utilisation provided insights on how adult day services and related policies can enhance the health and wellbeing of people with early stage dementia and their carers. Understanding how changes in habits, roles and routines affect occupational participation experiences of these two populations in the home, and during adult day service attendance is fundamental to enabling successful ageing-in-place.
Method:
Qualitative research methods were selected as the most suitable and trustworthy approach to investigate the lived experiences and perceptions of vulnerable individuals with early stage dementia and their carers. Issues such as rigour and of transferability were addressed throughout the collection and interpretation of data. A semi-structured interview schedule was developed, drawing on the concepts in the Model of Human Occupation. A pilot study was conducted to pre-test the interview schedule and some adjustments were made. The final schedule was used in interviews conducted jointly with participants with dementia and their carers and individually, face-to-face with the primary carers. Interviews were conducted in a location of their choice, digitally (audio) recorded and transcribed verbatim. Field notes and an audit trail of procedures were maintained throughout.
Recruitment:
A purposive sample of 30 participants, comprising 15 community-dwelling individuals with early stage dementia and their carers (15), were recruited.
Materials:
Semi-structured joint and individual interviews, modelled on the theoretical framework of the Model of Human Occupation, were used with each of the 30 participants
Ethics:
Approval by the Edith Cowan University Human Research Ethics Committee was given. Research did not proceed prior to approval.
Analysis:
Analysis of the narrative data proceeded through an iterative approach that distilled data into themes.
Findings:
Findings from this study revealed that occupational participation that is, engaging in meaningful activities, during adult day service attendance positively impacts attendees by enhancing their sense of mastery, purpose and validation, and relieves their boredom. Attendees’ experiences were further enhanced by newly formed friendships with peers with whom they felt comfortable, understood and therefore safe. Carers perceived the benefits of adult day service attendance for attendees as providing opportunities for socialisation and that the co-operation social and built adult day service environment promoted attendee’s occupational participation. Whilst carers welcomed the respite adult day service attendance brings, they had to weigh the stressors of preparing their attendee for adult day service attendance against the benefits of respite time. An integrated model of service delivery and support for people with dementia, their primary carers and adult day services is proposed.
Conclusion:
Adult day services provide opportunities that encourage occupational participation and this contributes to enhanced wellbeing for people with early stage dementia. Recommendations for future research are given, and inter alia include a closer working nexus between the service recipients, service providers and policy makers. Research outcomes may inform recommendations for future programming in community-based adult day services.
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Siushansian, Jennifer A. "Factors affecting the use of formal services among informal caregivers of community-dwelling seniors with dementia." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/mq30825.pdf.
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Lett, Judy. "Utilization and evaluation of formal support services among informal caregivers of non-institutionalized elderly with dementia." Thesis, McGill University, 1994. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=55508.
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This study explored the utilization and evaluation of formal support services among caregivers of the elderly who suffer from dementia. Data for the analyses were obtained from the Canadian Study on Health and Aging, funded by Health and Welfare Canada (1991-92). The sample consisted of 327 informal caregivers of non-institutionalized elderly with dementia.Results indicated that formal support service users cared for demented elderly who had greater ADL/IADL functional limitations, reported more burden, tended to be husbands, tended not to live with the care recipient, reported less informal support, and tended to live in the Prairie region. They also tended to perceive their health to be better than a year ago. Service users' reports indicated that utilization of in-home services was considerably greater than that of out-of-home services. Out-of-home respite and caregiver support groups had the largest number of barriers to use. The most common barriers identified for all services included cost and perceived lack of effectiveness.
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Skovdahl, Kirsti. "Krävande beteenden i samband med demens : förekomst och olika förhållningssätt /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-875-0/.
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Archibald, Carole. "'Half of them are dying on their feet but they still have strength for that' : sexuality, dementia and residential care work : a disregarded and neglected area of study." Thesis, University of Stirling, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.249717.
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Beanblossom, Kathryn M. "EXPLORING THE EXPERIENCES AND PERCEPTIONS OF PERSONS DIAGNOSED WITH EARLY ONSET DEMENTIA AND THEIR PRIMARY CAREGIVERS." Miami University / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=miami1366835742.
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Hamal, Pragya. "Evidenced-Based Support Services for Informal Caregivers of Individuals with Dementia in the United States, India, and Nepal." Bowling Green State University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1403796240.
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McCabe, Louise Frances Mary. "Policy transfer and policy translation : day care for people with dementia in Kerala, India." Thesis, University of Stirling, 2003. http://hdl.handle.net/1893/21547.
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This thesis explores and explains the development of day care for people with dementia in Kerala, India. The development process is framed within the context of social globalisation. The central aim of the thesis is to further build theory on how and why social policy from one context is transferred and utilised in the development of social policy in another. The theoretical constructs of policy transfer and policy translation are used to explore the development process. Policy transfer is an existing concept within policy and politics literature. Theory on the concept of policy translation is built up within the thesis using theories of literary translation. Exploration of these processes provides an explanation of the development of day care. Policy transfer and policy translation are found to take place between the UK and Kerala. Policy ideas and information from the UK are transferred and then used within the implementation of day care in Kerala. A two-part research design explores firstly policy transfer and then policy translation. Policy transfer is examined within an analytical framework developed from existing models of policy transfer. Policy translation is investigated through a comparative analysis of day care for people with dementia between the UK and Kerala. The differences between day care in the two contexts represent the changes caused by the processes of policy transfer and policy translation. The main findings of the thesis are that policy transfer and policy translation have taken place within the development of day care in Kerala. The two concepts are found to complement each other. The theoretical construct of policy translation provides additional detail and clarity on the process of policy development to that provided by policy transfer. Policy transfer and policy translation can be described as mechanisms by which social globalisation is taking place and in turn globalisation promotes these processes. The thesis concludes that the theoretical constructs of policy transfer and policy translation as developed here could be used within other research to explore the processes of globalisation.
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McColgan, Gillian Margaret. "'They come here to tangle' : an ethnographic study of relationships of people with dementia." Thesis, University of Stirling, 2001. http://hdl.handle.net/1893/1526.
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This is a sociological ethnography of nine people with dementia living in a private nursing home in central Scotland. It seeks to find an alternative way to view people in this situation, in a field that has been dominated by the medical modeL. By placing the people before the disease of dementia, they can be studied within the same framework as any people. For this study this framework is everyday life sociology with a focus on symbolic interactionism, ethnomethodology and dramaturgy. Additionally, by gaining the subjective perspective, we can get close to understanding meaning for these people. The ethnographic methods I use consist of participant observation and interviews. For analysis I employ NUDIST to structure the data and the thesis. The settng, Lavender Wing of Deer View Grange Nursing Home, provides context for the study. This is a culture of surveillance and routines, which can be restrictive, infantilizing and disabling for residents. Despite this culture research findings are of socially active participants. By examining relationships through an interactional framework three thematic areas developed concerned with emotions, interactions and classification. These thematic spheres demonstrate the emotional self, the interactional self and the generalized self of research informants. The emotional is concerned with the most inner and intimate self, often engaging in backstage intimacies and in thought. Significant others share with the interactional self, in frontstage performances, which are more ritualistic. The generalized self interacts with the generalized other, most often consisting of everyone in Lavender Wing and is concerned with classification and boundarydefinition. Within these spheres the described relationships are fluid and change according to the situation, and how participating actors define it. To engage in intimacies, rituals and form, and to shift between them requires social competence and active participation. People in this study demonstrate these. Despite restrictions they offer resistance to the environment and to dementia. They often make profound and metaphorical statements, to which this ethnography gives voice. Keywords Everyday life; interaction; nursing home culture; people with dementia; resistance; self and others; social competence; surveillance.
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Huei-Ru, Lin. "The Effects of Dementia and Long-Term Care Services on the Deterioration of Care-needs Levels of the Elderly in Japan." 京都大学 (Kyoto University), 2015. http://hdl.handle.net/2433/202678.
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Bromley, Leslie Andrew. "How do carers of people with an intellectual disability with dementia experience their role and the support they receive through services?" Thesis, University of Exeter, 2014. http://hdl.handle.net/10871/16367.
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Background: People with an intellectual disability often require carers to provide assistance in their basic living needs and to help them achieve the best quality of life possible. The increased prevalence of dementia in people with an intellectual disability over recent years has prioritised the importance of research into the impact this has had on people with an intellectual disability with dementia, their carers, and their support services. There has been a lack of qualitative studies investigating the experiences of carers for people with an intellectual disability and dementia and their perceptions of services that support them to carry out their role. These carers fulfil an important need within the community and this study explored family and paid carers’ experiences of caring for people who have an intellectual disability with dementia. Method: This paper describes a qualitative study that used semistructured interviews to investigate both paid and family carer’s experiences of caring for people with an intellectual disability with dementia. Face-to-face interviews were conducted with 12 carers and the resulting data were analysed using thematic analysis. Results: The analysis generated 9 meta-themes including a carer’s identity, transitions in the carer experience, self-care, difficulties in caring, changes to services, recommendations for change, barriers to accessing carer support, sources of support and resources, and sharing carers’ best practice. Conclusions: The implications of the results are discussed and recommendations for future research are provided.
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Pavlů, Dominik. "Business Plan - Private Nursing Facilities." Master's thesis, Vysoké učení technické v Brně. Fakulta podnikatelská, 2016. http://www.nusl.cz/ntk/nusl-255786.
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Gibson, Allison K. "Examining the Experiences of Caregivers During the Diagnosis of Alzheimer’s Disease and Related Dementias." The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1275071723.
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Douglas, Natalie Franko. "Supporting Speech-Language Pathologist Evidence-Based Practice Use: A Mixed-Methods Study in Skilled Nursing Facilities within the Promoting Action on Research Implementation in Health Services Framework." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4663.
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As the management of dementia is a significant public health concern, efforts to increase access to effective treatments to a greater number of residents with dementia in skilled nursing facilities (SNFs) are warranted. The treatment addressed in this study, non-electronic external memory aids, is an evidence-based practice that has been found to increase positive communicative interactions and decrease negative behavioral problems of residents with dementia in SNFs.
Although use of memory aids is recommended, there are significant barriers such as lack of time and resources that inhibit the use of effective treatments in typical clinical settings. To address such barriers to evidence-based practice (EBP) implementation, the Promoting Action on Research in Health Services (PARIHS) framework is available. The PARIHS framework accounts for elements outside of the clinician knowledge base that may impact EBP delivery such as perceptions of the specific EBP and the specific context in which the EBP will be delivered. Organizational variables such as culture, leadership priorities, and resource availability are considered. Although the PARIHS framework has been used to successfully study and support EBP uptake in other areas of health care such as nursing, this framework has not to date been used in the field of Speech-Language Pathology, the clinician group of interest in this study.
This study utilized a transformative, mixed-methods design within the PARIHS framework to investigate potential impacts of Speech-Language Pathologists' (SLPs) and Facility Rehabilitation Directors' (FRDs) perceptions of the evidence and organizational context on the use of non-electronic external memory aids in SNFs. The project explored differences between FRDs' and SLPs' perceptions of such variables, as well as the relationship between those variables and the SLPs' reported percentage of use of non-electronic external memory aids. Qualitative methods through semi-structured interviewing of SLPs further provided contextualized and detailed data regarding facilitators and barriers to the use of memory aids in SNFs.
Results of the study indicated that there were statistically significant differences between SLP and FRD groups in terms of perceptions of the organizational context in the SNF, with the FRDs viewing the organizational context more favorably. There were no significant quantitative differences between SLPs and FRDs in terms of perception of the evidence for the practice of non-electronic external memory aids. Both groups demonstrated relatively favorable perceptions of the practice (3.8 on a 5-point scale with 5 being strongly favorable). Each additional point regarding favorable perceptions of SLPs in terms of the evidence for non-electronic external memory aids were associated with a 24% increase in percentage of use of the practice. Perceptions of the organizational context in the SNF were not significantly associated with higher percentages of SLP use of the practice; however, issues of organizational context were heavily present in the qualitative data. Analysis of the interview data yielded a total of 318 codes and 191/318 (60%) of those codes addressed issues of organizational context. Qualitatively, the most common codes related to issues of lack of necessary staff to both implement and sustain the use of non-electronic external memory aids. Further, lack of physical materials and time to create memory aids was also a frequently reported barrier in the interview data. There was not mention of local performance data or systems for which to evaluate performance in relationship to non-electronic external memory aid usage in the interview data.
Results of this study may contribute to the acceleration of a successful, systematic uptake of non-electronic external memory aids for residents with dementia in SNFs by considering SLPs' perceptions of evidence and by engaging the end organizational context. This project may also serve as a model to contribute to the successful implementation of other EBP for patients with cognitive-communicative impairments.
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Nordberg, Gunilla. "Formal and informal care in an urban and a rural elderly population : who? when? what? /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-253-8/.
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Jakobsson, Sara, and Elinor Larsson. "Närståendes upplevelse av hälso- och sjukvård för demensdrabbade : En litteraturöversikt." Thesis, Malmö universitet, Fakulteten för hälsa och samhälle (HS), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-40455.
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Bakgrund: Demens är en sjukdom som inte tillhör det normala åldrandet och påverkar inte bara den som drabbas av en demenssjukdom men också alla i dess närhet. En stor del av den vård som sker av en demensdrabbad person sker i hemmet av en närståendevårdare. För att ge en optimal vård är det viktigt att kommunicera med de närstående och inkludera dem i vården såväl hemma som inneliggande på sjukhus eller på vårdboende. Syfte: Syftet med denna kvalitativa litteraturstudie var att belysa hur närståendevårdare till personer med demensdiagnos upplever vårdkontakten genom sjukdomsförloppet. Metod: Kvalitativ litteraturöversikt Resultat: Närstående upplevde att de inte fick de stöd de efterfrågade från hälso- och sjukvårdspersonal under sjukdomsförloppet. Hälso- och sjukvårdspersonal förnekade de observationer närstående hade gjort av den demensdrabbade personen vilket förlängde diagnosprocessen. Efter diagnos och under sjukdomsförloppet upplevde närstående att det fanns både bristande information och kommunikationsproblematik med vården, men när kommunikationen och samarbetet fungerade väl mellan närstående, den demensdrabbade och sjukvården upplevdes det som en lättnad och minskad börda.Konklusion: En demensdiagnos påverkar inte enbart personen som är primärt drabbad men även personer i dennes närmaste sociala nätverk. Närstående till demensdrabbade personer behöver stöd från hälso- och sjukvårdspersonal såväl före som efter diagnos och i de beslut som behöver fattas under sjukdomsförloppet. Studiens resultat visar att närstående till personer med demensdiagnos upplever att stödet som ges från sjukvårdspersonal inte tillfredsställer de behov de närstående har i alla situationer.Background: Dementia is a disease that is not part of the normal ageing process and affects not only the person with the dementia diagnosis but also everyone close to that person. A big portion of the care surrounding the person with dementia is executed in their home by a relative. In order to provide optimal care, it is important to communicate with the relatives of the patient and include them in the care both at home, at the hospital and in a residential home setting.Aim: This literature review aims to review how relatives to persons with dementia experience contact with health care services through the course of the disease.Method: Qualitative literature reviewResults: Relatives felt they did not receive the support they asked for and needed from the health care services through the course of the disease. Health care personnel rejected the observations made by relatives which caused the process of getting a diagnosis to extend. After the diagnosis and through the course of the disease the relatives experienced a lack of information and communication with the health care services, however when the communication and cooperation worked between the health care, the relatives and the person with the dementia this resulted in feelings of relief and a reduced caregiver burden.Conclusion: A dementia diagnosis naturally affects the person who gets the diagnosis primarily but also has an impact on the people close to the person. Relatives need support from the health care services both before the diagnosis and after as well as in the decision making through the course of the disease. The results of this review establish that the relatives of people with dementia experience a lack of support in relation to the support they need in every step of the disease.
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Bosnjakovic, Amela, and Halane Ahmed Nuure. "Levnadsberättelser inom särskilda boenden för dementa : En kvalitativ studie om omvårdnadspersonals syn på levandsberättelser." Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-24607.
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Demens är en rad symtom som orsakas av hjärnskador och kan förklaras på olika sätt beroende på vilka delar av patientens hjärna som har blivit skadade. Patientens minne, förmågan att planera och genomföra sitt vardagsarbete försämras. Dementa människor drabbas av funktionsnedsättningar som innebär att patienten har språksvårigheter, sämre orienteringsförmåga och svårt att uppfatta tiden. Personens kognitiva förmågor blir också sämre som leder till nedstämdhet, oro och beteendeförändringar hos drabbade personer. Demenssjukdom resulterar i att personen med demens inte klarar av sin tillvaro som innebär att hen behöver stöd från vårdpersonalen och anhöriga, det vill säga att personen är beroende av stöd från sin omgivning. Syftet med studien är att beskriva omvårdnadspersonalens upplevelser av och berättelser om att använda levandsberättelse som verktyg vid omvårdnad för demensdrabbade personer som flyttar till särskilda boende. Den valda metoden för arbetet var intervjuer med personal som arbetar på demensboenden där vi bland annat frågade om hur de använder levnadsberättelser och hur de fungerar i praktiken. Efter intervjuerna kunde författarna konstatera att personalen som arbetar med dementa i särskilda boende har stor hjälp av levnadsberättelserna. Detta innebär att om patienten, till exempel, på något sätt är orolig under dagen och repeterar samma fråga hela tiden så kan personalen gå genom kopplingar med levnadsberättelsen och ge svar till den demenssjuke. Det brukar hjälpa personen att blir lugnare en stund och var nöjd med sin tillvaro. Undersköterskorna som intervjuades bekräftade att det skulle bli svårt för vårdpersonalen att vårda dementa personer utan levandsberättelse.Dementia is a series of symptoms caused by brain damages and can be explained in different ways depending on which parts of the patient’s brain are damaged. The patient’s memory and ability to plan and carry out his or her daily work worsens. People who suffer from dementia often have language difficulties, poor orientation and difficulties of perceiving time. The person’s cognitive ability also becomes impaired which is leads to depression, anxiety and behavioural changes in dementia affected people. Dementia disease results in the persons with dementia not being able to cope with their existence, which means that they need support from the nursing staff and relatives. The purpose of the study is to investigate how the nursing staff who work in special accommodations for people with dementia use life stories as a tool in order to help their residents, but also their experiences with using life stories in practice. The chosen method for the study was interviews with nursing staff who work in special accommodations, who about how they use life stories in their work and their experiences with it. After the interviews, the authors were able to state that the nursing staff who work with dementia in special accommodations have great help from using life stories in their work. This means that if the patient, for example, somehow is anxious during the day and repeats same question all the time, then the care staff can go through the connections with the patient’s life story and give answers to the dementia patient. This usually helps the person to calm down for a while and feel content. Nurses who were interviewed confirmed that it would be difficult for the nursing staff to take care of the demented people in the best possible way without a life story.
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Williams, Caroline Myferi. "The referral journey : an examination of key patient, carer and GP factors affecting the referral of patients with a dementia to mental health services for older people." Thesis, University of Surrey, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310721.
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Monahan, Ann Corneille. "Day care for people with dementia--the importance of communicating a safe and uncritical environment to clients and facilitating stimulating activity." Thesis, University of Stirling, 2005. http://hdl.handle.net/1893/270.
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Exploratory case studies investigated the day care benefit from the multiple perspectives of the person with dementia, caregiver, and day care worker. The routines, daily processes, and factors promoting benefit were reported. The day care client was also queried to explore their ability to contribute useful information about their care environment. The adult day care is primarily a social occasion for its clients, who enjoy the benefits of companionship and interaction. Day cares were differentiated by the environmental features: worker:client ratio, size, suitability of the site for intended purpose, quality of client-worker relationships, and quality of the activities offered. The quality of each of these features is an important component in the day care environment. All components at their highest quality are not necessary for the environment to be beneficial. The most important factors contributing to day care quality were workers who (1) communicated safety to the client through a relaxed, uncritical environment, and (2) facilitated client stimulation through activity and personal interaction, satisfying the clients’ basic needs to be safe and occupied. This evaluation was comprised of: two sets of case studies. Each evaluation was concurrently conducted and consistently designed. Participant observation and survey were the primary methods of data collection. Informed consent was sought from day care clients with dementia, family caregivers, and day care workers.
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Tsang, Yin-mei, and 曾燕薇. "A study of stress in the caregivers of the demented elderly." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1992. http://hub.hku.hk/bib/B31249371.
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Trosic, Branka. "Att tolka dementa : Vårdpersonalens egna berättelser." Thesis, Karlstad University, Karlstad University, Karlstad University, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-5129.
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Tidigare forskning pekar på försämrad kommunikationsförmåga som ett av de mest uppmärksammade symtomen vid demenssjukdom. För att förmedla ett budskap till sin omgivning använder dementa som alla andra människor både verbala och icke-verbala signaler. Med tiden försämras deras verbala uttrycksätt och de börjar istället att i allt högre grad använda sig av de icke-verbala signalerna, som till exempel ansiktsuttryck, kroppsspråk, gester, paraspråk och liknande. Eftersom dementas olika kommunikativa uttryckssätt ibland kan vara väldigt svåra att tolka av andra i deras närhet, är det av stor betydelse att ta reda på de förutsättningar som påverkar detta. Syftet med denna studie är att utifrån vårdpersonalens berättelser belysa vilka faktorer som påverkar deras tolkning av dementas olika kommunikativa uttryckssätt under omvårdnadsmötet. För att svara på detta syfte har jag använt mig av fokusgruppsintervjuer som metod för att samla in data, vilken sedan analyserades med hjälp av kvalitativ innehållsanalys. Resultatet visar att de faktorer som påverkar vårdpersonalens tolkning av dementas olika kommunikativa uttryckssätt är (1) kunskap, (2) yrkeskompetens och (3) institutionella aspekter som psykosocial miljö och tid. Den föreliggande studiens resultat kommer förhoppningsvis att bidra till en bättre kommunikation mellan dementa och vårdpersonal.
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Zad, Carina, and Annika Andreasson. "Rätten att bestämma över sitt liv : En studie hur biståndshandläggare hanterar äldre demenssjukas självbestämmanderätt och hjälpbehov." Thesis, Linnéuniversitetet, Institutionen för socialt arbete (SA), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-54048.
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The aim of this study was to analyze how social workers in an elder administration in Sweden handle empowerment and needs for people with dementia and what ethical dilemmas the social workers could experience with these clients. The result is based on qualitative interviews where eight social workers had the opportunity to describe their work with elder people with dementia. Five main subjects were identified in the interviews: empowerment, strategies, dilemmas, force and knowledge and understanding in the organization. The analysis of these themes helps us to understand how the social workers in their profession handle different situations and dilemmas which can arise in their daily work. The conclusion from the result and the analysis was that the most frequent dilemmas for the social workers in their work with people with dementia was the clients unwillingness to receive help, relatives’ and other professions’ ignorance about empowerment and also when relatives wanted to make decisions for the clients. The result showed that the social workers used extensive motivational work for the clients with dementia in order to handle their empowerment and needs. The social workers requested that the relatives and the staff who work with elder people should have more knowledge about the empowerment for the clients.Syftet med studien var att förstå hur biståndshandläggare i en äldreförvaltning i Sverige hanterar äldre demenssjukas självbestämmanderätt och hjälpbehov samt vilka etiska dilemman de kan ha i arbetet med dessa brukare. Empirin bygger på kvalitativa intervjuer där åtta biståndshandläggare haft möjlighet att med egna ord beskriva hur ärendehanteringar med äldre demenssjuka brukare kan se ut. Fem huvudteman identifierades i intervjuerna vilka var: självbestämmande, strategier, dilemman, tvång samt olika kunskaper och förståelse i organisationen. Analysen av dessa teman bidrar till att förstå hur handläggarna i sin yrkesroll hanterar situationer och dilemman som kan uppstå i deras praktiska vardag. Slutsatsen utifrån resultat och analys är att de främsta dilemman som biståndshandläggarna möter i arbetet med demenssjuka brukare är brukarnas ovilja att ta emot hjälp, oförståelse om självbestämmanderätten hos anhöriga och övriga professioner samt när anhöriga vill ta beslut åt brukarna. Utifrån empirin kunde vi se att biståndshandläggarna använde sig av omfattande motiveringsarbete med de demenssjuka brukarna för att hantera deras självbestämmanderätt och hjälpbehov. Något som handläggarna efterfrågade var mer kunskap om självbestämmanderätten bland äldreförvaltningens hemtjänstpersonal och anhöriga till brukarna.
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Larsson, Kristina. "According to need? : Predicting use of formal and informal care in a Swedish urban elderly population." Doctoral thesis, Stockholm : Dept. of Social Work [Institutionen för socialt arbete], Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-109.
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Loh, Poh Kooi. "Innovations in health for older people in Western Australia." University of Western Australia. School of Medicine and Pharmacology, 2009. http://theses.library.uwa.edu.au/adt-WU2010.0051.
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Australia and many other developed communities are ageing rapidly, placing a strain on the delivery of health services. This thesis examines the use of innovative health services management coupled with information and communication technology (ICT) to more efficiently deliver services to disabled older people in the hospital, community and residential care. The hypothesis explored is that ICT can provide clinical services to older people in poorly serviced communities and groups, thus extending the influence and capabilities of specialist health care professionals. The relevance of these studies is predominantly for those people who live outside the metropolitan regions, particularly in remote and rural communities, and also for those frail older people, who because of disability, are unable to travel to specialist health services. There are a series of studies presented in this thesis which have all been published. They have demonstrated that in a community and rural setting, ICT use in the assessment and management of geriatric syndromes such as dementia is valid and practical. This included the validation of commonly used assessment tools via Telehealth. A Telehealth protocol for assessment of Alzheimer's Dementia (AD) was developed and published. The use of ICT to link health services clinical and administrative data for determining stroke outcomes and disability has been evaluated and a resource utilization prediction model developed. Finally, in residential care a survey and a qualitative study of poor uptake of ICT services in hostels and nursing homes revealed insights into ICT perception by the older people in care facilities and their professional staff. The implications and future development of these studies have been discussed, especially barriers to increased uptake of ICT, cost comparisons and the potential of future technologies such as video conferencing mobile phones.
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Cai, Yongyong, and 蔡雍咏. "Intervention service programmes for family caregivers of a relative with dementia: a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48422381.
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Background: With the aging of the global population, the prevalence and incidence of Alzheimer’s disease or related dementia are increasing. Most mild or moderate dementia clients are taken care of at home by informal caregivers, which leave a heavy burden to the caregivers. Researchers have found out that with good intervention services and programmes for the caregivers, their burden, emotional distress and even the care recipients’ symptoms and institutionalization rates would be improved.
Objectives: This project is to review these researches to evaluate whether the interventions are effective and/ or cost-effective and how the decision-makers could use the results for evidence-based policy.
Methods: A literature search was performed on randomized controlled trials in education, information/ support intervention programmes published from October 2005 to July 2012. Electronic databases (EBSCO, PubMed and CNKI) were searched until July 2012. The Consolidated Standards of Reporting Trials (CONSORT) checklist for reporting randomized controlled trials was used as the guideline to evaluate the quality of identified papers.
Results: 16 papers (15 studies) were included in this review and classified into three groups, as home-based, individual-based and group-based interventions. This review found that the intervention programmes had various outcomes and showed some evidence of effectiveness. Most of the papers had good quality. The home-based programmes showed cost-effectiveness in the identified studies.
Conclusion: There was some evidence that the home- and group-based interventions were effective and the home-based interventions could be cost-effective. Further studies are recommended and a meta-analysis on the studies and more researches on economic analysis are needed. A community-based long-term dementia management should be built up for better outcomes.published_or_final_version
Public Health
Master
Master of Public Health
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Santos, Janici Therezinha. "Interpretações de enfermeiros sobre o cuidado à demência no contexto hospitalar." Pontifícia Universidade Católica de São Paulo, 2007. https://tede2.pucsp.br/handle/handle/12526.
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Previous issue date: 2007-10-22This research is aimed at investigating the interpretation of a nurse team in the context of the dementia care in hospitals. The world aging is a present phenomenon which is very debated by health professionals and researchers. The fast aging process observed in the developing countries as Brazil has not been supported by policies adequate to this population. It is known that chronic degenerative diseases along with aging cause staying for long days in a hospital. Families are broken-up when looking for a way out from the dependence that the elderly might present. It is necessary to choose family caregivers and others to give special attention to the elderly. Dementia is among the diseases which makes the patient very dependent as it develops. In the hospitals the elderly is admitted in medical-surgical clinic wards and stays among other patients who belong to different age groups and present several pathologies. It is up to the nurse, who is the nearest and most present professional for being longer with the patient and his family, to get institutional resources and adequate information so as to provide quality and decent assistance. Thinking just about the patient is not enough due to the fact that the family, as well as the family caregiver, also need support, mainly psychological, while they are escorting the elderly during the hospital admission. The nurse interpretations show what this work context is, which involves the elderly/family dependence disease problem. The professional nurse often works under overburden stress and in several occasions he/she needs institutional support and structure to give quality assistance. Also there are evidences concerning the conflict and afflicting situations which affect the families and family caregivers who reveal several aspects while dealing with so many difficulties related to the disease. Many of them do whatever is possible to stay with the patient, many are as old as the patient and need professional help. This research is aimed at showing the interpretations and, therefore, contributing to inform a certain reality, which may be one among many others, found in hospitals. Acknowledging the nurse value in searching information and decency in treating these elderly and families or family caregivers. Looking for ways and stimulating the team learning process so as to show that the care is in the Nurse s hand. This can not transferred to someone else!
A presente pesquisa objetiva estudar as interpretações de uma equipe de enfermeiros no universo do cuidado em relação à demência no contexto hospitalar. O envelhecimento mundial é um fenômeno presente, muito discutido por profissionais de saúde e estudiosos do assunto. O rápido processo de envelhecimento observado nos países em desenvolvimento, como o Brasil, ainda não tem sido respaldado com políticas adequadas a esta população. Sabe-se que as doenças crônico-degenerativas que acompanham o envelhecimento acabam desencadeando longos dias de internação nos hospitais. Famílias desestruturam-se em busca de saídas para a situação de dependência que o idoso internado pode apresentar. Faz-se necessário a escolha de cuidadores familiares e outros para dar atenção especial ao idoso. Entre estas doenças estão as demências, que à medida que evolui deixam o paciente altamente dependente. Nos hospitais, o idoso dementado é internado nos setores de clínica médico-cirúrgica e permanece, em meio a outros pacientes com faixa etária e patologias diversas. Cabe ao enfermeiro, como profissional mais próximo e mais presente por estar mais tempo ao lado do paciente e família, obter recursos institucionais e conhecimentos adequados para dar assistência com qualidade e dignidade. Não vale pensar somente no paciente, pois a família, bem como o cuidador familiar também necessitam de suporte, principalmente psicológico, enquanto estiver acompanhando o idoso no processo de internação. As interpretações dos enfermeiros mostram qual o universo deste trabalho, o qual envolve a problemática da doença-dependência-família-idoso. O profissional enfermeiro geralmente atua com sobrecarga de estresse, necessitando muitas vezes de estrutura e suporte institucional para dar continuidade à assistência com mais qualidade. Evidenciam também as situações de conflitos e angústias de famílias e cuidadores familiares, que, em meio a tantas complicações da doença, revelam vários perfis e muitos fazem o que estão ao seu alcance para continuar ao lado do paciente, muitos ainda são tão idosos quanto seus pacientes, necessitando de ajuda profissional. A pesquisa propõe mostrar as interpretações e, assim, contribuir para o conhecimento de uma determinada realidade hospitalar que pode ser uma entre tantas outras. Reconhecer o valor do enfermeiro na busca por conhecimento e dignidade no tratamento a estes idosos e familiares ou cuidadores familiares. Buscar saídas e estimular o aprendizado pela equipe com o intuito de mostrar que o cuidado está nas mãos do Enfermeiro. Isso não se transfere!
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Parajuli, Jyotsana. "EFFECT OF AN INTERGENERATIONAL SERVICE LEARNING PROGRAM ON STUDENTS’ ATTITUDES TOWARD PEOPLE WITH DEMENTIA." Miami University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=miami1438263576.
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Edwards, Angela Catherine. "An Evaluation of a Specialist Multi-Agency Home Care Support Service for Older People with Dementia." Thesis, University of Nottingham, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.517848.
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Erickson-Taube, Christina Marie. "Special care units: Recreational activities for patients with Alzheimer's disease." CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2843.
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The purpose of this study was to evaluate the recreational activities provided in special care units located in the Inland Empire. The population that this study sought to assist was patients diagnosed with Alzheimer's disease and living in an Alzheimer's special care unit.
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IVANCIC-RIBOU, CHRISTINE. "Devenir des dements seniles dans un service de long sejour." Aix-Marseille 2, 1989. http://www.theses.fr/1989AIX20192.
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Harvey, C. Froggatt S. Lightowler B. and Hodge A., C. Harvey, S. Froggatt, Bryan Lightowler, and A. Hodge. "The ambulance service advanced practitioner's role in supporting care homes: a qualitative study of care staff experiences." Mark Allen Group, 2020. http://hdl.handle.net/10454/18604.
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NoThe demand from care homes on NHS services continues to rise, with little evidence of ambulance service contribution in this area. The Yorkshire Ambulance Service provides an advanced practitioner model to support care homes in Sheffield, as an alternative to calling 999. This study investigated the experiences and needs of the care home staff who use the ambulance service advanced practitioner model. This qualitative study conducted semi-structured, face-to-face interviews with 19 staff members from 10 different care home settings. Thematic analysis using a combination of NVivo and manual coding was undertaken. The three key themes from the interviews were variations in service demand, the service user’s expectations and experience, and benefits to residents. Participants reported that good community services reduced the need to call 999, empowering carers to support residents to remain in the community. Care homes require comprehensive services that meet their needs. The advanced practitioner model provided by the ambulance service supports this, preventing unnecessary 999 calls and fitting with other community service provision.
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Hautz, Oliver R. "WHO AM I AND WHO ARE YOU? EXPLORING STUDENTS CONSTRUCTIONS OF PEOPLE WITH DEMENTIA DURING A CREATIVE ARTS PROJECT." Miami University / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=miami1379669602.
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Herrera, Pérez Eder Guillermo. "Perfil clínico epidemiológico de la enfermedad de Alzheimer en el servicio de neurología del Hospital Nacional Daniel Alcides Carrión." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2011. https://hdl.handle.net/20.500.12672/455.
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Introducción: El envejecimiento poblacional obliga a tomar en consideración la salud geriátrica como una prioridad emergente en salud pública. La enfermedad de Alzheimer es la principal causa de demencia la que, a su vez, es la principal causa de discapacidad en el adulto mayor, lo cual se traduce en un enorme costo social y económico. Por tal motivo, se considera de gran relevancia la realización de estudios de investigación que develen los factores asociados al desarrollo de la enfermedad de Alzheimer para orientar las políticas de salud e intentar reducir el gran avance de la enfermedad a nivel mundial.
Objetivo: Identificar el perfil clínico-epidemiológico de los pacientes con enfermedad de Alzheimer diagnosticados en los consultorios del servicio de neurología del Hospital Nacional Daniel Alcides Carrión.
Materiales y métodos: Se realizó un estudio observacional, descriptivo, de corte transversal del tipo serie de casos clínicos en el área de archivos de historias clínicas del Hospital Nacional Daniel Alcides Carrión, donde se revisaron historias clínicas de los pacientes con enfermedad de Alzheimer diagnosticados en los consultorios del servicio de neurología del Hospital Nacional Daniel Alcides Carrión. Los casos fueron localizados mediante la base de datos electrónica de la oficina de estadística del hospital y las hojas HIS correspondientes a la atención en consultorios externos del servicio de neurología durante el año 2010. Los datos fueron recolectados en una ficha electrónica de Microsoft Office Excel versión 2007, para su posterior transferencia y procesamiento en SPSS versión 15.0. Los estadísticos para el análisis incluyen el porcentaje para variables cualitativas, y la media, mediana, rango y desviación estándar para las variables cuantitativas.
Resultados: Después de la revisión de las historias clínicas, 20 pacientes fueron considerados elegibles para ser incluidos en el estudio. La edad promedio de los sujetos fue de 80,35 (desviación estándar [DE] 9,172, rango 56-92) años, con una mayoría de mujeres (16 casos, 80%), residentes en Lima Metropolitana y el Callao en todos los casos en quienes se registró el dato (19/19). Se identificaron trastornos de la glucemia en el 50% de casos (8 casos de 16 pacientes en quienes se realizó la prueba) y anemia en el 47,1% (8/17). Se prescribió memantina en el 85% casos (17/20), en tanto que el en tanto que el 55% de los casos recibió algún tipo de antipsicótico (11/20).
Conclusión: El perfil más frecuente del enfermo con enfermedad de Alzheimer corresponde a una mujer adulta mayor casada. Si bien la diabetes y la hipercolesterolemia se han reportado como factores de riesgo para enfermedad de Alzheimer, su presencia no ha sido notable en los casos observados, a diferencia de lo observado con la enfermedad hipertensiva. La anemia y la hiperuricemia constituyen hallazgos que merecen una mayor profundización en los estudios sucesivos.
-- Palabras clave (DECS): Enfermedad de Alzheimer, Factores de riesgo, Historia Clínica del Paciente.Tesis
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Ellames, Lorraine. "Dementia care training for residential care workers : building residential care workers' own views into a conceptual model." Thesis, University of Sussex, 2018. http://sro.sussex.ac.uk/id/eprint/76639/.
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This thesis is the result of research that investigated the views of residential care workers (RCWs) working with people with dementia about their perceptions of training for their dementia care role with older people. Using a constructivist ontology and an interpretivist epistemology, the research investigates how care workers perceive their training and how they feel it can be applied to their working environment. RCWs were asked what they saw as the specific needs of residents with dementia, what training they had received, how useful they perceived the training to be, and what training they felt was still needed. Previous studies had put forward topics for inclusion into dementia care training, but very little research had asked RCWs themselves about their dementia training needs. Nineteen semi-structured interviews were carried out across three care home organisations during the summer of 2013 in the East of England. Findings from thematic analysis showed that the care workers interviewed had very limited or no dementia training or assessment they could remember, and that training had generally been a negative experience. Dementia care trainers were not considered helpful or knowledgeable enough and RCWs identified that their learning needs had not been taken into consideration. The learning environment was viewed as unsuitable, usually a lounge or a bedroom where it was very cramped and RCWs were pulled out of training when there were limited staff numbers. Many challenges specific to caring with people with dementia were also identified: challenging behaviour, lack of time and resources, poor teamwork and communication and lack of organisational support all inhibited the development of person-centred care and training transfer into practice. A conceptual model of the training and learning cycle is proposed as a way forward for dementia training. This model illustrates the training process from course creation through to satisfactory completion. Learning into practice is measured by care workers' knowledge, confidence, and competence. This assessment is a two-way process between the learner and the mentor to ensure RCWs feel fully supported and recognised. Although this conceptual model has not been tested empirically, such a process is seen as a possible next step.
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Pettersson, Mats, and Martin Holm. "Äldreomsorg på vinst och förlust-Råder det kommunala skillnader i utförande av särskilt boende?" Thesis, Linköpings universitet, Nationalekonomi, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-129883.
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Det svenska välfärdssamhället har sedan länge värnat om alla likas rätt att få sina levnadsbehov tillgodosedda. I de fall där äldre blivit inkapabla att själva ta hand om sina behov kan plats till särskilt boende sökas där den äldre får assistans i sin livsföring. Biståndsansökningar till dessa boenden hanteras av kommunala tjänstemän och ska enligt lag hanteras lika för alla, oavsett kommunal utförare.Studien undersöker och analyserar huruvida det råder skillnader mellan större kommuner i Sverige vad gäller planering av- och placering till särskilt boende.Slutsatsen är att skillnader föreligger då vissa kommunerna utformat en reaktiv strategi där en uppbyggnad av ej verkställda beslut rättas till i efterhand och som inte tar hänsyn till behov utan endast ålder. De kommuner som lyckats väga in hälsa och behov i sin planering och i förväg försökt skatta den framtida efterfrågan på särskilt boende har lyckats bättre. Studiens resultat är att det råder kommunala skillnader kopplade till planering och placering till särskilda boendeThe swedish welfare state has a history of equal rights for living needs. In cases whereolder people become incapable to take care of their needs, there are specialaccommodations where the elderly can receive all forms of assistance. Theapplication to these special accommodations are managed by the municipal officialsand must be handled equal by law, regardless of local performers.This study examines and analyzes whether there are differences between the largermunicipalities in Sweden in terms of planning and placement to specialaccommodations.The conclusion is that differences exist because some municipalities have designed areactive strategy in which a buildup of unexecuted decisions has to be correctedretrospectively and does not take needs but age into to account. The municipalitiesthat managed to weigh health and needs in their planning and tried to estimate thefuture in advance regarding demand for special accommodations has been moresuccessful. The result of this study is that there are municipal differences in planningand placement for special accommodations
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Novo, Ana Lúcia Marques de Souza. "Gestão gerontológica domiciliar: a fragilidade do crepúsculo de uma flor." Pontifícia Universidade Católica de São Paulo, 2008. https://tede2.pucsp.br/handle/handle/12557.
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Previous issue date: 2008-09-29Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
This study intends to understand how features related to elderly dementia care develop, if grounded on a Homely Gerontology Management (Gestão Gerontológica Domiciliar - GGD). Professional experience incited me to write this study on GGD s building process, within elderly dementia care organization, involving also the family, caregivers and the environment. Research was carried through in the field of private homely care, in São Paulo, along with a team of professionals responsible for the care of an elderly patient with dementia. In a qualitative approach, I employed the participant observation of the care organization, as well as a semi-structured interview with some of the team s members. The study shows that the care organization to dementia subjects yields dynamic features and demands to be constantly re-structured. GGD is part of this complex functioning group and, in this study, seven approaches are described and detailed: 1) clinic evolution s monitoring; 2) the patient s emotional and psychic suffering aspects care; 3) family orientation; 4) recruiting, selection, training and development of professionals involved in elderly care; 5) orientation and management of home employees; 6) environmental adequacy; 7) financial management. The obtained knowledge does not intend to cover all the questions in the field. However, it was presented as a possible therapeutic in care actions carried out in the private health system, and which, therefore, forces us to reflect upon the extension of such experience to the public sphere, in lack of care projects to elderly subjects in fragile situation
O estudo pretende compreender como se desenvolvem os aspectos que abrangem o cuidado no atendimento a idosos com demência, quando parte de um programa de Gestão Gerontológica Domiciliar (GGD). A experiência profissional incitou-me a escrever este estudo sobre o processo de construção da GGD, na organização do cuidado a idosos com demência, familiares, cuidadores envolvidos e o ambiente. A pesquisa foi feita no campo da assistência domiciliar privada, na cidade de São Paulo, com uma equipe de profissionais envolvidos no cuidado a uma idosa com demência. Em abordagem qualitativa, utilizei a observação participante da organização do cuidado e entrevista semi-estruturada com alguns membros da equipe. O estudo constatou que a organização do cuidado nas situações demenciais tem caráter dinâmico e requer constante reestruturação. A GGD faz parte desse grupo de atuação complexa e, nesta pesquisa, estão descritas e detalhadas sete frentes: 1) acompanhamento da evolução clínica; 2) cuidados com os aspectos emocionais e o sofrimento psíquico do paciente; 3) orientação familiar; 4) recrutamento, seleção, treinamento e desenvolvimento dos profissionais envolvidos no atendimento ao idoso; 5) orientação e administração de funcionários domésticos; 6) adequação ambiental; 7) administração financeira. O conhecimento adquirido não pretende ser proposta que abrange a totalidade dos fatores desse cenário. No entanto, apresentou-se como terapêutica possível nas ações de cuidado que ocorrem no sistema privado, e que, consequentemente, nos leva a refletir sobre a extensão da experiência à esfera pública, que tem carência de planos de atendimento aos idosos em situação de fragilidade
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Litherland, R., and Andrea Capstick. "Involving people with dementia in service development and evaluation." 2014. http://hdl.handle.net/10454/7106.
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Hsieh, Meng-Lun, and 謝孟倫. "Use of Rehabilitation Services among Newly Diagnosed Dementia Patients and its influencing factors." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/qfp939.
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碩士國立陽明大學
醫務管理研究所
105
The increasing number of people with dementia is one of the most challenging problems for the worldwide healthcare system . In Taiwan , the estimation of prevalence of dementia will increase to 4.65% of the population , approximately 8.5 million people will suffer from dementia in 2061. Because dementia becomes the mainly causation of disability of elders , the World Health Organization lists dementia as a crucial issue of public health problem. Current evidence-based guidelines for the treatment of dementia recommend a wide variety of medication and non-pharmacological treatment options . However there are no pharmacological treatments demonstrated to cure the dementia and there are no any preventive strategies either. Rehabilitation is an important non-pharmacological treatment options for dementia. Rehabilitation combines multiple therapies including physiotherapy , occupational therapy , psychological therapy and speech therapy .Moreover in Taiwan , the expense of rehabilitation therapies is covered by the NHI program and over 99% of people are enrolled in the NHI program. In the total of 5,129 patients are diagnosed with dementia between 2005 and 2010 . 66.5% of patients received the rehabilitation therapies .the proportion of patients was the highest (97.5%) centered on psychic-related rehabilitation (97.5%) , comparing to other intervention is a huge gap . Both patients and the medical providers’ characteristics were investigated to determine their influence on rehabilitation receipt. including “ patient’s gender” ,“ past admission ” , “OPD visits in the last year” , “ provider’s specialty “ , “provider’s gender ”, “provider’s age ” , “accreditation level “ , “ past year of patient volume” , which significantly affect patient’s decision of receiving rehabilitation or not . Although 66.5% dementia patients receive rehabilitation therapy , they only take single therapy rather than multidisciplinary treatment. The results of this study also suggest that patient’s health status is an important factor influencing patient to receive rehabilitation therapy . Medical provider is also an important role for the patients to receive rehabilitation services . In the future , health care system should improve access of mobile rehabilitation in communities . and should provide full information of dementia disease , and the related welfare policy for the patients during diagnostic stage .
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Balsinha, Maria da Conceição Sousa. "Users and health professionals' perspectives regarding Portuguese primary care services: a focus on dementia." Doctoral thesis, 2022. http://hdl.handle.net/10362/135509.
Full textAbstract:
Dementia is one of the major causes of disability amongst older age people
worldwide, challenging governments to integrate a part of dementia care into
primary care. However, research suggests that dementia is under-managed in
primary care. Multifactorial barriers to dementia management have been identified, and the role of GPs in dementia care is still somewhat controversial.
The goals for clinical care change over the course of dementia and the typical
physician-patient dyad often expands to a triadic relationship (the person with
dementia, the family carer and the GP) as cognition declines. Evidence about triadic interactions suggests that the quality of interactions in consultations about dementia is unsatisfactory from the perspectives of both carers and physicians.
In the Portuguese National Health Service, family doctors and practice nurses are
the first contact point for the majority of persons with dementia and their family
carers, but most of these professionals do not have specific training in the area. The Portuguese Dementia Strategy has not yet been implemented, there are no
dementia care pathways in place in primary care, and social support for persons with dementia remains limited.
To our knowledge, only a few studies addressed the barriers to dementia care
from different perspectives (i.e., patients, carers, GPs and other primary care
professionals), and no studies were conducted involving primary care teams and the users of their services. Additionally, since consultation analysis has been used in primary care for a variety of purposes, but to our knowledge, not yet considering dementia triads.
The general aim of this thesis is to contribute to the understanding of how
dementia care is delivered in primary care. Specific objectives are: 1) to describe the
experiences and perspectives of GPs, persons with dementia and their family carers about the current role of GPs in providing dementia care and the issues that impact on this role; 2) to explore dementia care in the context of triadic consultations; and 3) to explore the obstacles and barriers to the implementation of the Portuguese Dementia Strategy by primary care teams, from the perspectives of service users and professionals.
Using a qualitative approach, this work includes three studies involving primary
care centres within the Lisbon metropolitan area, in which purposive sampling was used to recruit the participants. An ad-hoc quality framework for dementia care delivery in primary care guided the three studies. In two of them, semi-structured face-to-face interviews were conducted with 10 GPs, 8 practice nurses, 4 social workers, 8 persons with dementia and 10 family carers. In the third study, triadic consultations involving the same GPs, persons with dementia and their family carers were recorded and analysed. The framework approach, the thematic analysis and data triangulation were components of the data analysis. Our findings suggest that GPs were alone within primary care teams in providing dementia care. Moreover, liaison with dementia specialists (neurologists, psychiatrists) was poor. General practitioners’ contribution to dementia management was very limited, mostly relying on specialists to manage clinical symptoms and specific medication. The GPs assessed the impact of dementia on daily life to some extent, but failed to notice the comorbidities related to dementia. The exception were patients with advanced stages of dementia, given that specialists no longer followed them up. Importantly, the GPs had to address different subjects in consultations, which may have conditioned their more specific engagement in dementia care, strictly speaking.
The patients seemed to also have a limited access to dementia services because
of undefined roles and poor coordination of health professionals, the lack of social workers and the inadequacy of community services for persons with dementia. Their psychosocial needs seemed to be overlooked, since most professionals and carers had limited views on those needs. The patients may have had additional difficulties in expressing themselves, given the lack of person-centredness of GPs’ enquiries and patterns of disabling communication within the triad.
Finally, carers tended to assume the role of informants in most consultations, and
their needs were poorly assessed. Therefore, strategies for improving family carers’ assessments are needed.
Overall, we need enhanced competence in dementia, nurse-led systematic care
of persons with dementia and their carers, and more extensive community support. The analysis of triadic consultations may provide potential process measures for assessing the quality of clinical practice and consultation training in general practice, but this requires further study.
Our findings strongly suggest that Portuguese primary care teams are not yet
prepared to comply with policy expectations regarding the management of
dementia.
49
Lin, Huey-Jane, and 林惠珍. "Factors Affecting Caregivers of Person with Dementia to Use Institutional Long-Term Care Services." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/73603961425612941371.
Full textAbstract:
碩士南華大學
企業管理學系非營利事業管理碩士班
103
Based on Andersen’s behavior model of health service use, this study aims to investigate factors affecting caregivers of person with dementia who are now staying in nursing homes and long-term care institutions to choose institutional long-term care services, and to explore the relationships among predisposing factors, enabling factors, need factors and the utilization of institutional long-term care services. This study uses a cross-sectional survey with structured questionnaire. The sample includes 113 residents in one long-term care institution in Yunlin County and two nursing homes in Tainan City. The major findings of this study are as following: (1) Both predisposing factors and need factors are more important predictors for using institutional long-term care services. (2) The analyses of multiple logistic regressions controlling other variables indicate that predisposing factors such as age and education level of elders with dementia, education level and care responsibility recognition of caregivers; enabling factors such as the perception of quality of institutional care services; need factors such as physical disability and emotion-behavior disturbance of elders with dementia and care and emotion loading and economic burden of caregivers are the most important predictors of institutional care service utilization. (3)However, the caregivers of institutional residents with dementia received few assistance from formal community care services when they cared elders with dementia at home. Based on these findings, this study suggests that the government should develop various community care resources to support the disabled elders and their caregivers to mitigate their living burdens. More information, guidance and community resources regarding dementia care should be provided to assist elders with dementia staying at home for a longer time that the purpose of aging in place can be achieved.
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Wang, Ming Chiu, and 王明秋. "An investigation of needs for community services for patients with dementia and family caregiver." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/psxh44.
Full textAbstract:
碩士長庚大學
護理學系
104
As the aging of the population, dementia has great impact on the health of the older persons who suffered from the disease and also created huge burden for family caregivers. The purpose of this study was to understand the needs for community services of older person with dementia and their family caregivers. Andersen’s health behavioral model was modified to service as the theoretical model for this study, in order to explore related factors of needs for community services. These factors include pre-disposing factors (characteristics of the persons with dementia and family caregiver); enabling factors (the knowledge of the family caregivers of the community resources; competence of family caregiver in handing behavioral problems of the patient; and family caregiver’s preparedness) and needs factors (cognitive and physical function, quality of relationship, hours of care provided, and disturbance caused by behavioral problems of family caregivers). Secondary data analysis of the pre-test of a clinical trial (N=128) on family caregiver training program was implemented. Measures including service needs, knowledge, Mini-mental state examination (MMSE), Clinical Dementia Rating Scale (CDR), family caregiver competence, and preparedness were used to measure the related factors. This study found that older persons with dementia who live alone, with higher behavioral problems, with female family caregivers, and with younger family caregivers (<45 years old), reported higher needs for community services. Those with helps from friends and relatives reported higher needs for community services. Family caregivers with more knowledge of the community resources had higher preparedness and better competence in handing behavioral problems. Higher family caregiver preparedness was found to associate with better competence in handing behavioral problems. Family caregivers had more disturbance caused by behavioral problems of the older persons reported higher need for community service. This study can provide a reference for development of community service and related policy.