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1 – 10 of over 2000Jonathan Parker, Bridget Penhale, Jill Manthorpe and Greta Bradley
This paper explores the importance of seeking the views of service users with dementia. This is fundamental to raising quality standards in the management of dementia care, and…
Abstract
This paper explores the importance of seeking the views of service users with dementia. This is fundamental to raising quality standards in the management of dementia care, and demands commitment to on‐going high quality training for social care staff. Contemporary research and policy developments are debated in this context.
Marjan Ghazirad, Olivia Hewitt and Sarah Walden
The use of anti-dementia medication in people with intellectual disabilities has been controversial and requires additional research to assess the efficacy of such medications. An…
Abstract
Purpose
The use of anti-dementia medication in people with intellectual disabilities has been controversial and requires additional research to assess the efficacy of such medications. An essential part of this treatment (both in terms of research and clinical practice) is having robust outcome measures to assess the efficacy of these medications for individuals. Currently there is no consensus in the UK regarding which outcome measures, in conjunction with clinical judgement, are effective in informing clinicians’ decision-making regarding anti-dementia medication management and this paper aims to present useful outcome measures.
Design/methodology/approach
A comprehensive literature search was conducted to identify relevant outcome measures. Outcome measures focused on aspects of patients’ presentation such as cognition, activities of daily living, neuropsychiatric presentation or the impact of their presentation (either on themselves, or on others). These outcome measures were critically appraised to ascertain their suitability in informing clinician’s decisions regarding management of anti-dementia medication. The focus of this appraisal was on good quality measures that are practical and accessible and can be easily used within clinical NHS services.
Findings
This paper provides advice for clinicians on using appropriate outcome measures, depending on patients’ presentations and the symptoms of dementia being targeted, that can be used alongside their clinical assessment to enhance their anti-dementia medication management. Two case studies are presented to illustrate the use of such outcome measures.
Originality/value
The case for using a range of assessments that are both broad in focus, and those specifically selected to measure the areas of functioning targeted by the anti-dementia medication, is presented.
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Mental health problems in old age have attracted policy attention in the UK over the past decade. An important issue is how to improve services for people who have both mental…
Abstract
Mental health problems in old age have attracted policy attention in the UK over the past decade. An important issue is how to improve services for people who have both mental health and other problems. This article sets out some of the challenges facing planners and commissioners in developing integrated services for older adults, by using the case study of people with dementia and incontinence problems. It uses integrated service models and observations from the EVIDEM‐C study to suggest some incremental actions that would help develop the long‐term strategy for integrated services.
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Vee Prasher and Anthony Fernando
Dementia in older persons with learning disabilities is a growing concern for all those involved in their care. There is at present no effective treatment, but the importance of…
Abstract
Dementia in older persons with learning disabilities is a growing concern for all those involved in their care. There is at present no effective treatment, but the importance of current drug treatments is reviewed. Developments in drug treatments for dementia remain an active area of ongoing research.
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Alisoun Milne and Heather Wilkinson
This paper presents the findings of two research projects focusing on sharing a diagnosis of dementia. The first paper analyses the attitudes of GPs towards early diagnosis and…
Abstract
This paper presents the findings of two research projects focusing on sharing a diagnosis of dementia. The first paper analyses the attitudes of GPs towards early diagnosis and the second explores the user experience of receiving a diagnosis (Milne et al, 2000; Pratt & Wilkinson, 2001). The authors draw upon these ‐ as well as wider research ‐ in suggesting ways that diagnostic practice can be improved by taking account of the user perspective. The findings are relevant to all those professionals working in a primary care context.
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Modern dementia care is increasingly turning to technology to address a wide range of issues. Such developments are argued to improve quality of life, as, for example…
Abstract
Modern dementia care is increasingly turning to technology to address a wide range of issues. Such developments are argued to improve quality of life, as, for example, technological interventions that reduce risks and increase safety can enable people with dementia to stay in their own homes for longer. However, all interventions in dementia care must strike a balance between doing what is perceived to be for the best and preserving the personhood of people with dementia. Technological interventions run a particularly high risk of crossing the line into doing things to people with dementia, rather than with them. Doing things for people with dementia is also problematic if it takes away their ability to do things for themselves. These issues are examined with reference to electronic tagging, assistive or ‘smart’ technology and interventions to address the psychosocial needs of people with dementia.
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Viniti Seabrooke and Alisoun Milne
The number of older Asians in the UK is increasing placing greater numbers at risk of developing dementia. The emerging need to address early diagnosis is especially prominent in…
Abstract
The number of older Asians in the UK is increasing placing greater numbers at risk of developing dementia. The emerging need to address early diagnosis is especially prominent in areas where Asian communities are long established. This was the specific focus of a Dementia Collaborative Project in North West Kent. The project, working through a primary care practice, aimed to raise awareness of dementia and to facilitate early intervention and access to specialist dementia services. Using an evaluation methodology adopted by the Collaborative and working through a multiagency steering group, the pilot project successfully identified an appropriate primary care practice, established a link with a specially trained Asian nurse and devised a set of project materials. By inviting older Asian patients with memory problems to make an appointment with the nurse, and enclosing a culturally relevant information leaflet, older people were encouraged to come forward. Although the number of individual patients identified was small, the project outcomes include: significantly increased referral rates from black and minority ethnic communities to specialist services and greater awareness of dementia‐related issues in both primary care and Asian care services. Overall, the evaluation suggests that by engaging with a committed primary care practice it is possible to engage a hitherto marginal group of older people in early intervention in dementia and raise awareness about its benefits. That this approach underpins the development of a larger scale five year project in the same area additionally endorses its relevance for the mainstream population.
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Lesley Thoms, Adelola Idowu, Arjun Nehra and Asit Biswas
There is high incidence of dementia in individuals with Down’s syndrome. Much of the emphasis has been on Alzheimer’s disease as being most prevalent; however, it is apparent that…
Abstract
Purpose
There is high incidence of dementia in individuals with Down’s syndrome. Much of the emphasis has been on Alzheimer’s disease as being most prevalent; however, it is apparent that other dementia types are also likely, to which this patient cohort may be predisposed. Specifically, this paper aims to highlight the potential for subcortical dementias in Down’s syndrome, suggesting a role for broader cognitive screening in aging individuals.
Design/methodology/approach
This paper describes a case of a female with Down’s syndrome and mild intellectual disability who presented with early signs of distinctive cognitive impairment and radiological calcification of the basal ganglia.
Findings
An active 42-year-old lady, who was mostly independent of activities of daily living and in part-time employment, presented with a three-year history of progressive cognitive deficit, characteristic of subcortical decline. She had no personal or known family history of mental illness, epilepsy or dementia. Routine blood tests showed chronic renal impairment, mild hypocalcaemia and vitamin D deficiency, managed by her GP. CT scan showed only bilateral basal ganglia calcification.
Originality/value
There is a widespread appreciation for the link between Down’s syndrome and Alzheimer’s disease but lesser consideration of the possibility of subcortical dementias. Given the differential nature and presentation of the two dementias, this case report highlights a need for clinicians to consider both to effectively manage these patients in the longer-term. Screening is discussed as a potential means of achieving this.
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Shelley Peacock, Meridith Burles, Alexandra Hodson, Maha Kumaran, Rhoda MacRae, Cindy Peternelj-Taylor and Lorraine Holtslander
The number of prisoners over 55 years is increasing and many are at risk of developing dementia. This has generated new responsibilities for prisons to provide health and social…
Abstract
Purpose
The number of prisoners over 55 years is increasing and many are at risk of developing dementia. This has generated new responsibilities for prisons to provide health and social care for older persons. The purpose of this paper is to synthesize the existing research literature regarding the phenomenon of the health and social care needs of older persons living with dementia in correctional settings.
Design/methodology/approach
Using an integrative review method based on Whittemore and Knafl, the inclusion criteria for the review are: articles written in English; a focus on some form of dementia and/or older persons with discussion of dementia; to be set in a correctional context (correctional facility, prison and jail); be derived from a published peer-reviewed journal or unpublished dissertation/thesis; and be a qualitative, quantitative or mixed methods study. Based on those criteria, a search strategy was developed and executed by a health sciences librarian in the following databases: Medline, CINAHL, Embase, PsychINFO, Proquest Nursing and Allied Health and Web of Science; searches were completed up to April 2019. After data were extracted from included studies, synthesis of findings involved an iterative process where thematic analysis was facilitated by Braun and Clarke’s approach.
Findings
Eight studies met the inclusion criteria. Key findings of the eight studies include recognition of dementia as a concern for correctional populations, dementia-related screening and programming for older persons and recommendations for improved screening and care practices. Most significant is the paucity of research available on this topic. Implications for research are discussed.
Originality/value
This paper identified and synthesizes the limited existing international research on the health and social care needs of older persons with dementia living in correctional settings. Although existing research is scant, this review highlights the need for increased awareness of dementia as a concern among older persons living in correctional settings. As well, the review findings emphasize that enhanced screening and interventions, particularly tailored approaches, are imperative to support those living with dementia in correctional settings.
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