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1 – 10 of 265Caroline Duncan, Ewan Wilkinson, Sujeet Jaydeokar and Daniel James Acton
This study aims to evaluate the dementia assessment and diagnosis care provided to adults with intellectual disability. The authors selected recommendations from the National…
Abstract
Purpose
This study aims to evaluate the dementia assessment and diagnosis care provided to adults with intellectual disability. The authors selected recommendations from the National Institute for Health and Care Excellence (NICE) standards which could be evidenced in clinical notes and aimed to identify characteristics which may be associated with improved adherence to these recommendations.
Design/methodology/approach
The study population was adults with an intellectual disability who were diagnosed with dementia between January 2019 and December 2022 by a UK-based intellectual disability service. Data to demonstrate adherence to selected recommendations and demographic and clinical characteristics were extracted from electronic patient records.
Findings
The authors identified 41 individuals. A mean of six of the eight recommendations were adhered to. There was low adherence with structural imaging to support dementia subtype diagnosis (9 individuals, 22%). This may be linked with the low percentage of people diagnosed with vascular dementia (1 individual, 2%) despite a national figure of 20%. No demographic or clinical characteristics were associated with level of adherence recorded. The authors found incomplete recording of diagnostic clinical coding in electronic patient records. This may disadvantage this population, as they cannot be readily identified for post diagnostic support or resource allocation.
Originality/value
To the best of the authors’ knowledge, this is the first study to examine adherence to these NICE guidelines in this population.
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Anya Ahmed, Lorna Chesterton and Matthew J. Ford
The purpose of this paper is twofold: to explore the existing evidence around dementia services and interrogate the overarching UK policy development relating to service inclusion…
Abstract
Purpose
The purpose of this paper is twofold: to explore the existing evidence around dementia services and interrogate the overarching UK policy development relating to service inclusion of black and minoritised groups. The paper will go on to identify the implications for the dementia wellness pathway and make recommendations regarding how services can be more inclusive.
Design/methodology/approach
This paper examines the policy/practice landscape around dementia care provision and observes if lessons can be learnt to improve health outcomes for people living with dementia from black and minoritised communities.
Findings
A review of dementia policy demonstrates how opportunities to improve the awareness, diagnosis and post-diagnostic support for minoritised communities are being missed. The outcomes of this mean that individuals are denied vital treatment and support, which could enhance quality of life and delay the progression of dementia.
Practical implications
The authors’ premise is that not meeting the dementia support needs of less-heard communities has negative financial as well as social and health-related outcomes and has wider resonance and implications for all stages of the dementia wellness pathway. Moreover, there is a legal responsibility for public services to provide culturally sensitive, responsive, appropriate and available care, to all people, without discrimination.
Originality/value
This paper offers a valuable review of policy and practice around dementia care in the UK and makes recommendations to improve health outcomes for people living with dementia from black and minoritised communities.
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This study aims to evaluate the quality of information recorded in Behaviour Monitoring Charts (BMC) for Behaviours that Challenge (BtC) in dementia in an older adult inpatient…
Abstract
Purpose
This study aims to evaluate the quality of information recorded in Behaviour Monitoring Charts (BMC) for Behaviours that Challenge (BtC) in dementia in an older adult inpatient dementia service in the North of England (Aim I) and to understand staff perceptions and experiences of completing BMC for BtC in dementia (Aim II).
Design/methodology/approach
Descriptive statistics and graphs were used to analyse and interpret quantitative data gathered from BMC (Aim I) and Likert-scale survey responses (Aim II). Thematic analysis (Braun and Clarke, 2006) was used to analyse and interpret qualitative data collected from responses to open-ended survey questions and, separately, focus group discussions (Aim II).
Findings
Analysis of the BMCs revealed that some of the data recorded relating to antecedents, behaviours and consequences lacked richness and used vague language (i.e. gave reassurance), which limited its clinical utility. Overall, participants and respondents found BMC to be problematic. For them, completing BMCs were not viewed as worthwhile, the processes that followed their completion were unclear, and they left staff feeling disempowered in the systemic hierarchy of an inpatient setting.
Originality/value
Functional analysis of BMC helps identify and inform appropriately tailored interventions for BtC in dementia. Understanding how BMCs are used and how staff perceive BMC provides a unique opportunity to improve them. Improving BMC will support better functional analysis of BtC, thus allowing for more tailored interventions to meet the needs of people with dementia.
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Sarah Waller, Simon Chester Evans, Jennifer Bray and Teresa Atkinson
There is increasing interest in the UK in developing environments that support people who are neurodiverse. This paper aims to report on a project to develop a cognitively…
Abstract
Purpose
There is increasing interest in the UK in developing environments that support people who are neurodiverse. This paper aims to report on a project to develop a cognitively supportive environmental assessment tool to improve the design of health centres, where the majority of National Health Service consultations take place, for all users, including people living with dementia and those who are neurodiverse.
Design/methodology/approach
A three-stage process was used: a literature review; the development of a matrix of key design features for people living with dementia, autism and other neurodiverse conditions; and the development of an environmental assessment tool and guide for users, which included easy-to-read versions to maximise service user involvement.
Findings
The overarching concepts of dementia-friendly design can be adapted to create designs for everyone, including those who are neurodiverse.
Research limitations/implications
There is a paucity of research in environmental design for primary care from the patient’s perspective, and, more generally, further research on design for adults with learning disabilities and autism is needed.
Practical implications
The tools are free to download. With adaptation, they have potential applicability across health and care settings.
Originality/value
This project has confirmed that the principles of dementia-friendly design are applicable, with modifications, to a wider group of neurodiverse people. Critically, each person’s response to sensory stimuli is individual rather than determined by their condition.
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Jodi Brooke Patterson and Michelle Kimzey
The purpose of this paper is to determine the relationship between trait and situational empathy, and the effect of educational activities on empathy of nursing students towards…
Abstract
Purpose
The purpose of this paper is to determine the relationship between trait and situational empathy, and the effect of educational activities on empathy of nursing students towards people living with dementia.
Design/methodology/approach
This embedded mixed-methods study compared trait and situational empathy examined situational empathy pre/post didactic and experiential activities with nursing students and used qualitative data from focus group discussions to corroborate the quantitative data.
Findings
There was no significant difference between trait and situational empathy. Post intervention scores (situational) demonstrated improvements on empathic concern, shared affect, empathic imagination, helping motivation and cognitive empathy. Focus group discussions supported quantitative findings and also included distress.
Research limitations/implications
Limitations include lack of generalizability, single group threats and exclusion of stakeholder input. Single group threats include absence of a control group, familiarity with the CSES from pre-test to post-test and reactive measurements, as the students were observed by faculty while completing the Dementia Live activity. The perspective of stakeholders would strengthen the impact of the results on implementation.
Practical implications
Information gleaned from this study can help inform administrators in education and in practice. CliftonStrengths assessment and Dementia Live simulation activities can be used for administrators, faculty and students in schools of nursing as well as administrators and health-care workers.
Social implications
Information from this study can impact those living with dementia as well as their caregivers.
Originality/value
Most studies involving health-care students and empathy do not delineate between trait and situational empathy. This study is unique in that it measured both and sought a relationship between the two. Determining one's personal attributes such as trait empathy, can help students capitalize on their strengths and ultimately enhance patient care.
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Kelly Norwood and Mary Webster
Research ethics and integrity stipulates that research must be conducted with responsibility towards the research community and should benefit the intended population. This…
Abstract
Research ethics and integrity stipulates that research must be conducted with responsibility towards the research community and should benefit the intended population. This chapter will share insights from an ongoing research programme to reduce family conflict in the context of dementia care while discussing the accompanying ethical considerations. Research into dementia care has primarily focused on improving outcomes for the care dyad, leaving the influence and input of the wider family unit under investigated. Family conflict can detrimentally impact the quality of care provided and leave caregivers vulnerable to psychosocial difficulties. Family conflict occurs in the context of dementia care but there is little research on how to reduce, or prevent, such conflict occurring. In this research programme, a systematic review investigated the effectiveness of interventions that include the wider family unit to reduce family conflict; only one study was included which evidenced the lack of interventions in this area. A qualitative scoping review was then conducted to explore the lived experiences of caregiving families with experience of family conflict and reported solutions. It was found that conflict occurred due to factors including care decisions and role transitions which impacted relationships and affected care provision. Solutions to conflict were less often reported, indicating an important gap in the literature. Interviews with Alzheimer's Society staff and volunteers revealed that stigma and denial surrounding dementia were prevalent, and families were often reluctant to seek external help. This research programme is currently establishing public patient involvement (PPI) to develop the research methodology and interview questions for people with dementia (PWD) and their family caregivers to explore their lived experiences and potential solutions to family conflict. To conclude, this research programme will propose a family-focused intervention aimed at systemic family conflict for those caring for someone with dementia.
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Yunus Emre Ayhan, Muhammet Özmen, Nur Ozturk and Nilay Aksoy
Alzheimer’s disease (AD) is the primary cause of dementia in elderly people and needs extensive professional care. The aim of our study was to assess the level of knowledge among…
Abstract
Purpose
Alzheimer’s disease (AD) is the primary cause of dementia in elderly people and needs extensive professional care. The aim of our study was to assess the level of knowledge among primary health-care providers, primarily Family Physicians (FPs) and community pharmacists (CPs), about AD and its treatment.
Design/methodology/approach
A cross-sectional study using Google Forms sent by email or message to FPs and CPs in Istanbul in June–July 2023. Turkish modified the Alzheimer’s Disease Knowledge Scale (ADKS) and Alzheimer’s Medicines Knowledge Level Questionnaire (AMKLQ) were used in this study.
Findings
A total of 63 FPs with a mean age of 35.3 ± 7.8 and 138 CPs with a mean age of 38.6 ± 12.6 enrolled in the study. There was no statistically significant difference between FPs and CPs in terms of total ADKS score (19.82 ± 2.30 vs 19.23 ± 3.08, p = 0.136), but there was a significant difference in terms of total AMKLQ score (4.31 ± 1.40 vs 3.81 ± 1.49, p = 0.020). Health-care providers with Alzheimer’s training had a higher total AMKLQ score (OR =1.08 CI 95% [1.03–1.14], p = 0.012).
Originality/value
FPs’ knowledge of AD is on par with that of CPs. Nevertheless, it has been observed that FPs have more proficiency in delivering accurate responses to the AMKLQ and ADKS inquiries, which encompass crucial details regarding the treatment of AD. The sole determinant of the highest mean AMKLQ score was found to be professional education. Collectively, these arguments emphasize the need for primary health-care practitioners to obtain comprehensive and ongoing education regarding AD and its treatment.
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Catrin Hedd Jones, Diane Seddon, Katherine Algar-Skaife, Carol Maddock and Stephanie Green
This paper aims to share how the Centre for Ageing and Dementia Research co-designs research within a national programme of work to improve the lives of older adults and those…
Abstract
Purpose
This paper aims to share how the Centre for Ageing and Dementia Research co-designs research within a national programme of work to improve the lives of older adults and those affected by dementia. Through examples of this work, the authors identify the barriers and enablers to participatory approaches and lessons to inform future involvement activities.
Design/methodology/approach
This study reflects on implementing the UK National Standards for Public Involvement into practice. Of international relevance, the observations span the research process from research prioritisation and design to research implementation and knowledge exchange.
Findings
This study demonstrates the importance of using a relational approach, working toward a common purpose and engaging in meaningful dialogue. Only through offering choice and flexibility and actively learning from one another can co-design lead to synergistic relationships that benefit everyone.
Research limitations/implications
Key implications for researchers engaged in patient and public involvement are be receptive to other people’s views and acknowledge expertise of those with lived experience alongside those with academic expertise. Training, resources and time are required to effectively support involvement and meaningful relationships. A nominated contact person enables trust and mutual understanding to develop. This is an ongoing collective learning experience that should be embedded throughout the entire research process.
Originality/value
This paper demonstrates how the standards are implemented with people who are often excluded from research to influence a national programme of work.
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