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Adults with Down's Syndrome are at risk of developing Alzheimer's disease in later life. This paper gives an overview of the current research in the area and discusses the implications it raises for individuals, carers and service providers. Information on the link between Down's Syndrome and Alzheimer's disease and prevalence rates are given. The clinical symptoms of Alzheimer's disease and a stage model documenting the progression of the disease are presented. Attention is drawn to the problems inherent in assessing and diagnosing Alzheimer's disease in a person with a pre‐existing learning disability. The importance of a thorough assessment procedure and guidelines for assessment methods are highlighted. The paper also discusses the management of Alzheimer's disease and focuses on care management practices and recommendations for service provision. Guidelines for supporting individuals include maintaining skills, adopting a person‐centred approach, implementing psychosocial interventions and multidisciplinary care management. Finally, high prevalence rates of Alzheimer's disease in adults with Down's Syndrome and increasing life spans are highlighted as a particular concern, and recommendations for the future include increasing education and awareness, implementing screening services, improving assessment methods and developing appropriate services.

The purpose of the paper is to explore why it was considered useful and how it was possible to conduct a participatory action research (PAR) in a health‐care service experiencing conflictual dynamics (which affected service quality) and on the challenges this entailed. Specific attention is given to the action researchers’ role.

A methodological reflection is developed starting from theoretical considerations and a case study. In response to the committee group's request concerning the need to better understand and manage the criticalities and conflict episodes faced by a service for sufferers of Alzheimer's disease, the authors proposed and realized a PAR. The PAR is described considering: the process, some outcomes, the functions and actions performed by the action researchers, and the dilemmas and challenges they faced.

The case study revealed it was fundamental for the action researchers to perform a constant mediating function when conducting a PAR in an organization experiencing conflictual dynamics. How this function was carried out is described. Furthermore, the dilemmas, challenges and risks faced by the action researchers in proposing this PAR are addressed.

In this PAR the main limitations and open issues concern both the possibility of assessing outcomes and processes in a medium to long time frame and the cyclical turnover of patients and caregivers, raising the question of legacy.

In analyzing a specific case, the authors focus upon both the indicators that allowed them to assess usefulness, feasibility and sustainability of the PAR in a conflictual context and the functions assumed, actions realized, and challenges faced by the action researchers.

The provision of information and advice for older people arranging their own care is a policy objective. The purpose of this paper is to explore the range and scope of web-based information about care coordination activities for older people in the non-statutory sector in England.

Non-statutory organisations were identified through a structured internet search. Services were screened to identify those providing at least one care coordination activity. A postal survey of services was conducted in 2014 and results compared with the initial findings of the web search.

Almost 300 services were identified, most of which were provided by three organisations: Age UK; Alzheimer’s Society; and the British Red Cross. Brokerage was the most frequently reported care coordination activity; the majority of services focussed on help to stay at home; and carers and older people (including those with dementia) were the target groups most often identified. Comparison of the two information sources revealed a significant agreement between two care coordination’s activities: compiling support plans and monitoring and review.

Findings are based on a purposive sample of organisations and therefore care must be exercised in generalising from them.

This study is one of the first to systematically explore the nature and extent of information about care coordination activities provided by the non-statutory sector in England. It was conducted when policy advocated both an increased role for the non-statutory sector and an increase in self-directed support.

Hospitals and health‐care facilities are among the most complex, costly, and challenging buildings to design, construct and manage. To become a health facilities manager of a hospital or other medical centre in the USA, one requires knowledge not only of how to manage people, but also of how to deal with government agencies and all kinds of regulations and inspections. The hospital facility must cope with the idea of being open 25 hours a day, and having staff to control 365 days a year.

In 1906 a German doctor, Louis Alzheimer, first recognized the brain abnormalities that are characteristic of Alzheimer's disease. These abnormalities include clumps of dead brain cells (plaque) and tangled nerve fibers. In subsequent years more research was done on the causes and effects of Alzheimer's. Primarily found in people over age 65, the disease creates a loss of memory to the extent that the patient cannot engage in day‐to‐day activities. Current memories are the most affected; childhood memories are often left intact.

This study investigated, by way of interview (n=45), the needs of those caring for a person with dementia and their satisfaction with current services in the Caerphilly County Borough of South Wales. Carers reported having the most difficulty coping with the demands on their time and the emotional strain associated with caring. Carers requested more information regarding available services, the diagnosis of dementia and the legal and financial aspects of caring. They also mentioned the need for a night‐sitter service, a 24‐hour helpline, more support groups and more visits from social workers and community psychiatric nurses (CPNs). On the whole, the carers were satisfied with the services provided, although their use of these services was not extensive. However, issues around lack of support, quality and availability of homes and hospitals and poor communications were identified as areas of concern. The findings were welcomed by strategic planners and the information is being used as a basis for developing and improving specific carer support services.

This purpose of this paper is to provide details of a project to involve people with dementia in reviewing pieces of work being undertaken by Alzheimer's Society staff. Service User Review Panels (SURPs) were developed as a way to orientate participation around the requirements of service users with dementia.

SURPs took account of the specific communication and other needs highlighted in the literature on involving people with dementia. The underlying principles of SURPs concerned the quality of the relationship between the facilitator and the participants, the process of consent, the types of communication used, and the establishment of ownership. These principles were evaluated using observation of meetings, focus groups with panel members, and semi structured interviews with participating staff.

During the pilot, SURPs fed into the work of the organisation in a number of ways including helping to set organisational priorities, and reviewing the content of tools, materials and policies. They also created increased opportunities for contact between staff and people with dementia. This paper details three examples that illustrate some of the processes involved, the issues that arose, and the learning that resulted. It concludes by outlining some of the factors of success and some of the limitations of SURPs.

These findings might be of use to researchers and practitioners wanting to involve people with dementia in their work or their organisation.

A case study methodology was applied as a major component of a mixed-methods approach to the evaluation of a mobile dementia education and support service in the Bega Valley Shire, New South Wales, Australia. In-depth interviews with people with dementia (PWD), their carers, programme staff, family members and service providers and document analysis including analysis of client case notes and client database were used.

The strengths of the case study approach included: (i) simultaneous evaluation of programme process and worth, (ii) eliciting the theory of change and addressing the problem of attribution, (iii) demonstrating the impact of the programme on earlier steps identified along the causal pathway (iv) understanding the complexity of confounding factors, (v) eliciting the critical role of the social, cultural and political context, (vi) understanding the importance of influences contributing to differences in programme impact for different participants and (vii) providing insight into how programme participants experience the value of the programme including unintended benefits.

The broader case of the collective experience of dementia and as part of this experience, the impact of a mobile programme of support and education, in a predominately rural area grew from the investigation of the programme experience of ‘individual cases’ of carers and PWD. Investigation of living conditions, relationships, service interactions through observation and increased depth of interviews with service providers and family members would have provided valuable perspectives and thicker description of the case for increased understanding of the case and strength of the evaluation.

Services for people with dementia in the UK have developed piecemeal in the context of wider agency agendas. Health and social care agencies located in rural areas face particular challenges if they are to be able to support people with dementia within their communities. This article describes a piece of work carried out in three rural counties in East Anglia designed to map services across the statutory, voluntary and private sectors, and to describe the ways in which national policy is being interpreted to meet local need. Examples of innovative practice, as well as gaps in service design and delivery, were identified through an examination of local policy documents and qualitative interviews with strategic managers, frontline managers and practitioners, and local carers of people with dementia. The findings confirm that services for older people with dementia are under‐developed in comparison with services for older people generally, and in comparison with mental health services for working age adults. There are particular gaps with respect to rarer types of dementia, services for people with learning difficulties, and services for people from minority ethnic groups. Historically, a lack of strategic planning has meant that service development has been patchy and unco‐ordinated. Carers have been affected by a shortage of joined‐up information, high eligibility criteria and a change to short‐term working by practitioners. Nevertheless, the potential for developing community‐based and inclusive services for people with dementia is apparent, and the adaptability required of rural areas may, subject to further evaluation, provide a template for service development elsewhere.

The purpose of this article is to discuss the policy developments of integration and personalisation within the context of Primary Care, specifically an innovative Memory Service provided within a General Practice. It examines how these policies work together in this context to deliver a high quality service that is responsive to individual needs in an area of care: memory disorder or dementia, which has often relied heavily on secondary care services.

The article is a case study analysis of integration and personalisation in Primary Care, allowing for examination and elaboration of both concepts as applied in this setting; and their contribution to a better quality care Memory Service. The analysis is produced by independent researchers (MC and NM), background and facts by service personnel (IG, NG and DJ).

The innovative Memory Service operates as a person‐centred facility, integrating into the surgery, expertise that would traditionally be locked into secondary care health services. It makes maximum use of locally available knowledge of the patient, their family and formal and informal sources of support and therapy through links which cross agency boundaries. These links are identified and utilised in tailored support for individuals by the practice‐based Dementia Advisor. Outcomes include improved dynamics of identification, diagnosis and after care, high satisfaction amongst patients and families and reduced utilisation and expenditure of other healthcare facilities.

Personalisation and integration can be united in the development of innovative and improved Memory Services centred in Primary Care.

Maintaining a focus on the needs of people within their social contexts (being person‐centred) is a powerful means of driving better integrated care in Primary Care for people living with dementia and related disorders.

This is the first examination of personalisation and integration as coupled concepts to lead the improvement of care, specifically a Memory Service, in Primary Care.