The proportion of individuals with dementia is increasing in all kinds of institutions. Specialised day hospitals are now being developed as an alternative to long term care for the demented. Twelve day hospital wards, with 312 individuals suffering from dementia, were included in a study aiming to assess functional abilities and frequencies of participation in different activities. Eighty-nine per cent of the day hospital patients could be classified as having a dementia disease. Seventy-eight per cent of the population were dependent on some kind of help from a caregiver in the performance of ADL activities. The most common occupations that could be seen in the programmes were physical activities, entertainment, and personal care activities. The activities were often undertaken as large group activities, often including more than ten patients. The functional abilities that characterise the population are comparable with those of the population living in pensioners' service blocks with full board.
In a population-based study 219 family members of cognitively impaired elderly (casegroup) and 255 family members of cognitively healthy elderly (control-group) were interviewed about their situation as a caregiver to an old person. Twenty-six family members in the case-group reported abusive behavior in the care of the elderly at home. These family members are compared with 154 family members in the control-group, reporting other coping strategies than abusive. In the abusive group most of the elderly were in a mild stage of dementia, and the family members reported more strain in the care situation. The family members were older, judged their health as deteriorated, and were mostly living together with the dependent elderly.
Based on an analysis of extracts from 11 free-form written texts and 13 focused interviews with Finnish husbands who had given care to their demented wives, this study was aimed at finding out how husbands signify their action as spousal caregivers. The data were approached qualitatively from a social constructionistic point of view. Husbands' written material described their action of caregiving mainly in a passive voice that echoed duty and responsive agency. Analysis of the interview talk revealed a wider spectrum of voices and more agentive talk about caregiving. The results of the study challenge interpretations of men as either ineffective or capable caregivers and highlight, instead, the contextual nature of the way that men construct their agencies, depending upon the purposes and audiences of their narration.
BACKGROUND: Developed countries are experiencing a dramatic increase in the proportion of elderly persons, as well as a progressive aging of the elderly population itself. Knowledge regarding the amount of formal and informal care and its interaction at population-based level is limited. OBJECTIVES: To describe the amount of formal and informal care for non-demented and demented persons living at home in a population-based sample. METHODS: The population consisted of all inhabitants, 75 + years, living in a rural community (n = 740). They were clinically examined by physicians and interviewed by nurses. Dementia severity was measured according to Washington University Clinical Dementia Rating Scale (CDR). Informal and formal care was examined with the RUD (Resource Utilization in Dementia) instrument. RESULTS: The amount of informal care was much greater than formal care and also greater among demented than non-demented. There was a relationship between the severity of the cognitive decline and the amount of informal care while this pattern was weaker regarding formal care. Tobit regression analyses showed a clear association between the number of hours of informal and formal care and cognitive decline although this pattern was much stronger for informal than formal care. CONCLUSIONS: Informal care substitutes rather than compliments formal care and highlights the importance of future studies in order to truly estimate the amount of informal and formal care and the interaction between them. This knowledge will be of importance when planning the use of limited resources, and when supporting informal carers in their effort to care for their intimates.
This exploratory study examines the ethical justification that cancer care and dementia care nurses gave for active voluntary euthanasia. A convenient sample of 319 nurses working in seven countries was interviewed using a structured interview guide. The great majority of the nurses could not ethically justify active voluntary euthanasia. Even if the law changed, only 96 of the total sample viewed active voluntary euthanasia as ethical. For those nurses who could ethically justify active voluntary euthanasia, the majority did so because of the patients' suffering.
Appreciative inquiry (AI) studies have proven to be useful in developing nursing knowledge and changing nursing practice. However, few AI studies have examined the meaning of participation over time among collaborating healthcare providers. Our aim was to explore and illuminate healthcare providers' participation over time in a Norwegian nursing home to develop new knowledge and practice, focusing on sensory gardens.
Twenty healthcare providers participated in the 3 year AI study. Data were collected in fieldwork, interviews, and interventions. Saldañas' longitudinal analysis was applied.
The collaboration between the researcher and participants created insight of a relational room, which was named "the room of closeness". Participants' search for new arenas to apply the meaning of the room of closeness was found when focusing on the sensory garden. Their desire for joint development created a bottom-up perspective, the hallmark of successful AI.
Knowledge of participants' experiences may contribute to developing AI as a useful and transferable method, especially regarding co-creating participation, and may have implications for research and society. AI's strength-based approach may, however, lead to the neglect of data that are associated with problems, and complicate the assessment of success. Further research is therefore needed to develop AI.
Appreciative inquiry (AI) studies have proven to be useful in developing nursing knowledge and changing nursing practice. However, few AI studies have examined the meaning of participation over time among collaborating healthcare providers. Our aim was to explore and illuminate healthcare providers' participation over time in a Norwegian nursing home to develop new knowledge and practice, focusing on sensory gardens.
Twenty healthcare providers participated in the 3 year AI study. Data were collected in fieldwork, interviews, and interventions. Saldañas' longitudinal analysis was applied.
The collaboration between the researcher and participants created insight of a relational room, which was named "the room of closeness". Participants' search for new arenas to apply the meaning of the room of closeness was found when focusing on the sensory garden. Their desire for joint development created a bottom-up perspective, the hallmark of successful AI.
Knowledge of participants' experiences may contribute to developing AI as a useful and transferable method, especially regarding co-creating participation, and may have implications for research and society. AI's strength-based approach may, however, lead to the neglect of data that are associated with problems, and complicate the assessment of success. Further research is therefore needed to develop AI.
With the aim to evaluate the Swedish version of the Caregiver Reaction Assessment Scale (CRA), informal caregivers (n = 209) to individuals with a malignant disease, dementia or a physical impairment were recruited. The CRA was developed in the USA and is a self-rating questionnaire consisting of five subscales, measuring family members' reactions to the experience of caring for a relative with mental or physical illnesses. Data were analysed using psychometric and qualitative methods. Findings indicated good internal consistency, and a factor analysis confirmed the structure with five subscales; however, an overlap of items between the subscales was found. A content analysis of respondents' comments indicated that there were problems due to presuppositions inherent in the questions and with the meaning of words. Problems regarding inclusion/exclusion aspects in some concepts were also found. Two aspects of caregiver reactions were found to be missing or only partly covered: worrying and positive experiences. Results from this study suggest that the Swedish version is useful for assessment of caregiver reactions but needs further refinement.
This paper documents the use and interest in support strategies such as telephone support, newsletters, and computer services, among caregivers of all ages. Data obtained from telephone interviews with community living caregivers of persons with dementia (n = 148) showed substantial interest in the use of these types of services. Using a theoretical framework, this paper identifies caregiver and care-receiver characteristics associated with those interested in the utilization of these support strategies. The implications of these findings for program planning and future research are discussed.
