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To better understand the social nature of dementia, it is important to understand its cultural significance and the role that it plays in re-articulating later life. In this new terrain of ageing it may be worth exploring how the idea of the fourth age can help us better understand the nature of dementia and the way in which its cultural role affects both social and health policies. The paper aims to discuss these issues.

Gilleard and Higgs (2010) argue that the fourth age now serves as a “cultural imaginary” of the deepest and darkest aspects of old age and that dementia figures prominently in fashioning it.

The scope for exploring dementia as a component of the cultural imaginary of the fourth age has already been demonstrated through the small but growing number of studies that have explored the fear of dementia.

An avenue for further exploration is the distinction between a fear of losing one's mind (as in the pre-modern meaning of dementia) and the fear of losing one's place (as in the loss of status associated with dependency). Arguably the former exercises a greater influence than the latter, and raises the question of distinguishing between narratives and practices that sustain the mind of the person with dementia and those that sustain the position of the person with dementia as fellow citizen or fellow countryman or woman.

Through a literature review, this article aims to identify the needs of those people with dementia who wish to remain at home, and those of their carers. It goes on to model a range of services that can be linked together to meet these needs comprehensively.

The purpose of this paper is to understand factors that affect viewing of television news programmes by people living with dementia, and to identify dementia-friendly design principles for television news programmes and factors for personalising object-based media broadcast.

Extensive public involvement comprising two discussion groups with people with dementia and family carers informed the study design and provided supplementary secondary data. Primary data collection comprised a focus group interview with people with dementia (n=4) and family carers (n=4). Past viewing experiences and perceived barriers and facilitators to viewing television were explored. Participants commented on an array of video clips comprising varying segments of fictional news programmes, plus control versions of each segment.

Four themes were identified: content (general comments, context, type of media and pace); presenter (body language, clothing and accent); background (location and studio appearance); and technical aspects (graphics, sound, colours, camera, transitions, general issues).

Limitations included a modest sample size which is offset by exemplary public involvement in informing the study design.

Measures ensured research involvement and participation was made accessible to people living with dementia.

Participants benefited from sharing views with peers and expressed enhanced wellbeing from knowing their participation could lead to improved television viewing, an important social occupation, for people with dementia in the future.

This study is the first to be published which focusses on dementia-friendly television news programmes.

The social exclusion of people with dementia is a problem. Older men with dementia in nursing homes are at considerable risk of social exclusion due to factors associated with age, gender, mental health status and this setting. It is not known whether older men in this situation experience it as social exclusion or not. Drawing on a detailed case study from a male participant involved in a larger study on social exclusion, this paper highlights and explores masculine experiences of, and responses to, nursing home life. In this single case study it was found that social exclusion was experienced in an economic, spatial and emotional sense, and the participant aligned himself with other men in the home and masculine behaviours, perhaps to deal with that. Implications for care home practice and research are discussed. The paper concludes that more attention needs to be paid to the influence of gender and, in particular, to the different needs and experiences of older men with dementia in receipt of care generally.

Dementia care is an important aspect affecting the quality of life of people living with dementia. There are many studies that test the efficacy of methods of care in order to support and even increase the quality of life of dementia patients (e.g. Gridley et al., 2016; Thyrian et al., 2017). A novel approach developed by Beville (2002) called Virtual Dementia Tour® (VDT®) also aims to improve the care of people living with dementia in their middle and late stages of deterioration. VDT® is now becoming popular internationally (see www.provdt.co.uk/) and it is sold to the general public as an evidence-based method through which people can experience what it is like to live with dementia, aiming to increase empathy and improve the delivery of care. The purpose of this paper is to explore the validity of the VDT® intervention.

The author explores the original research article upon which the VDT® was developed, highlighting critical points and reviewing these through a rigorous selection of references.

The supporting evidence base is consistently weak on closer scrutiny, and in combination with anecdotal evidence of distress related to the VDT® experience, this analysis suggests a need for caution in implementation.

Although high-quality standards of care from the national guidelines (National Institute for Health and Clinical Excellence, 2010) ensure that health services implement evidence-based interventions, it may be important to discern that which is empirically based from that which is not.

Government guidelines promote service user consultation without providing extensive advice on people in later dementia. “Seen as too difficult to involve, they are effectively excluded from […] influenc(ing) service provision”, especially institutional care residents (Clare and Cox, 2003, p. 936). This hard-to-reach group presents methodological challenges. The purpose of this paper is to explore innovative approaches, offering even those with fragmented or lost speech the opportunity to contribute to decisions about their care.

This specialist dementia home consultation included staff and every resident, irrespective of the level of their communication impairment. Consultation on potential colour schemes took the form of a ballot. Staff helped develop an unpatronising, person-centred approach. Visual aids supported communication, de-emphasising the spoken word and promoting inclusion.

The majority of residents appeared to express an opinion on the potential decor. Others chose a colour while not necessarily grasping the context. The approach engaged all except four.

Even people with moderate/advanced dementia may be enabled to participate in consultation. Further research needs to refine methodology to include everyone and clarify the interpretation of results.

Service providers may widen their expectations of inclusivity in consultation exercises.

This consultation is important to researchers and practitioners because it explores ways of communicating, which avoid privileging the spoken word, revealing seldom-recognised abilities in people with moderate/advanced dementia.

Uncertainty over ethical impact may hinder uptake of assistive technology (AT) in dementia. This study aims to examine whether AT contributes to person‐centred care, whether users can participate in research and to explore ethical dilemmas with users, family and professional carers.

People with dementia, at home or in residential care, and carers were allocated equipment and consulted about ethics. In a small, qualitative study, data were collected using semi‐structured interviews and vignettes and content‐analysed to establish themes.

AT in person‐centred dementia care requires meticulous assessment, reliability and availability in rapidly evolving situations. Users displayed insight, logic and empathy in ethical evaluation. They disliked remote monitoring and surveillance, whereas carers were pragmatic, prioritising safety.

This research provides further evidence that users with dementia can be included in research. It demonstrates a significant potential role for AT in dementia care, with an ethical checklist to help professionals evaluate ethical dilemmas.

AT potentially increases wellbeing, enabling users to remain longer at home, delaying or avoiding moves to or between homes.

Despite the longstanding use of music therapy with people with intellectual disabilities and the growing evidence base for using music therapy as a tool to aid behavioural and psychological symptoms of dementia in the general population, there is little work published which details the use of music therapy groups for people with intellectual disabilities who have a diagnosis of dementia. The purpose of this paper is to report a qualitative evaluation of staff views of a music therapy group for people with intellectual disabilities and dementia.

Carers of service users attending the group were interviewed either individually or through a focus group in order to ascertain their views about the music therapy group. The interview transcripts were then analysed using thematic analysis.

Two core themes and eight sub themes emerged from the data. These themes show that the group was felt to be pleasurable and enjoyable for the service users and that some tangible benefits of attending the group were observed by staff members. Notwithstanding the positive feedback, the results also suggested that more work is needed to inform carers of the goals and purpose of such groups. Further psycho-education for carers is suggested as a strategy to support future groups to run successfully.

There is little published research into the use of music therapy for people with intellectual disabilities who also have dementia. The current paper provides a starting point for future work in the area and further recommendations for future practice and research are considered.

The focus of interest in dementia in people with learning disabilities has been largely on epidemiology, prevalence, assessment and diagnosis. There has been less focus on care issues and interventions, with a paucity of research papers but a growing number of books and resource packs addressing these issues. Psychological and non‐pharmacological approaches are useful in services for people with learning disabilities and dementia, but must be delivered in line with a clear conceptual framework of dementia that aids staff in understanding what is happening to the person with dementia and the effect of their care and responses. This paper describes the most commonly used approaches, including developing an understanding of dementia, anxiety and stress reduction, life story work, reminiscence, reality orientation and validation techniques, helping peers to understand dementia, other therapeutic approaches, and understanding behaviour and dementia care mapping and their impact on the well‐being of people with learning disabilities and dementia and the people who support them.