In Norway, there is a focus on home-dwelling people with dementia receiving the opportunity to participate in organized meaningful activities. The aim of this study was to elucidate the experiences of home-dwelling persons with early-stage dementia who attend an activity center and participate in adapted physical and social activities delivered by nurses and volunteers.
The study adopted a qualitative approach, with individual interviews conducted among eight people diagnosed with early-stage dementia. The interview texts were analyzed using manifest and latent content analysis.
Four categories, ie, "appreciated activities", "praised nurses and volunteers", "being more active", and "being included in a fellowship", as well as the overall theme "participation in appreciated activities and a sense of feeling included in a fellowship may have a positive influence on health and well-being" emerged in the analysis. The informants appreciated the adapted physical and social activities and expressed their enjoyment and gratitude. They found the physical activities useful, and they felt themselves to be included in a fellowship through cheerful nurses and volunteers. The nurses were able to create a good atmosphere and spread joy in the center together with the volunteers. The informants felt themselves valued as the persons they were. These findings indicated that such activities may have had a positive influence on the informants' health and well-being.
In order to succeed with this kind of activity center, it is decisive that the nurses are able to tailor meaningful activities and create an environment where the persons with dementia can feel that they are respected and valued. The municipality health care service should implement such activity centers with specialist nurses in dementia care together with volunteers.
Cites: J Am Med Dir Assoc. 2006 Sep;7(7):426-3116979086
After more than a decade of concerted effort by policy-makers in Canada and elsewhere to encourage older adults to age at home, there is recognition that the ageing-in-place movement has had unintended negative consequences for family members who care for seniors. This paper outlines findings of a qualitative descriptive study to investigate the health and wellness and support needs of family caregivers to persons with dementia in the Canadian policy environment. Focus groups were conducted in 2010 with 23 caregivers and the health professionals who support them in three communities in the Southern Interior of British Columbia. Thematic analysis guided by the constant comparison technique revealed two overarching themes: (1) forgotten: abandoned to care alone and indefinitely captures the perceived consequences of caregivers' failed efforts to receive recognition and adequate services to support their care-giving and (2) unrealistic expectations for caregiver self-care relates to the burden of expectations for caregivers to look after themselves. Although understanding about the concepts of caregiver burden and burnout is now quite developed, the broader sociopolitical context giving rise to these negative consequences for caregivers to individuals with dementia has not improved. If anything, the Canadian homecare policy environment has placed caregivers in more desperate circumstances. A fundamental re-orientation towards caregivers and caregiver supports is necessary, beginning with viewing caregivers as a critical health human resource in a system that depends on their contributions in order to function. This re-orientation can create a space for providing caregivers with preventive supports, rather than resorting to costly patient care for caregivers who have reached the point of burnout and care recipients who have been institutionalised.
To identify the health-related needs of community-dwelling older adults with mild memory loss.
Qualitative study using semistructured, audiotaped, face-to-face interviews and focus groups.
A large community in Newfoundland.
Twenty-two adults between the ages of 58 and 80 years.
This needs assessment used a qualitative methodology of collecting and analyzing narrative data to develop an understanding of the issues, resources, and constraints of community-dwelling older adults with mild memory loss. Data were collected through semistructured, audiotaped, face-to-face interviews and focus groups. Transcripts of the interviews were analyzed using interpretive phenomenologic analysis.
Three constitutive patterns with relational themes and subthemes were identified: forgetting and remembering, normalizing yet questioning, and having limited knowledge of resources. Participants described many examples of how their daily lives were affected by forgetfulness. They had very little knowledge of resources that provided information or support. Most of the participants believed they could not discuss their memory problems with their family doctors.
It is important for older adults with mild memory loss to have access to resources that will assist them in understanding their condition and make them feel supported.
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The study aimed to explore how home help service staff described their role in improving the abilities of older people, in particular, older women with chronic pain who are dependent on formal care, to perform everyday activities. Three focus group interviews were conducted, and a qualitative inductive thematic content analysis was used. The analysis resulted in one theme: struggling to improve the care recipients' opportunities for independence but being inhibited by complex environmental factors. By encouraging the care recipients to perform everyday activities, the staff perceived themselves to both maintain and improve their care recipients' independence and quality of life. An important goal for society and health care professionals is to improve older people's abilities to "age in place" and to enable them to age independently while maintaining their quality of life. A key resource is home help service staff, and this resource should be utilized in the best possible way.
The aim of this Swedish study was to describe landlords' experiences of having tenants suffering from severe mental illness. Sixteen landlords working in private and public housing agencies participated in open in-depth interviews. Data were subjected to a thematic latent content analysis. The results showed that having tenants with severe mental illness entails being confronted with various difficult circumstances, ranging from mismanagement of apartments to sensitivity among neighbours as well as issues regarding provocative behaviour. It involved providing assistance that was far beyond their professional obligations and to be neglected by the community-based psychiatric service system when in need of help. In order to support landlords and to prevent evictions of individuals with severe mental illness, community-based psychiatric services need to be more pro-active in their attempts to achieve collaboration with the parties at hand.
This paper is a report of a study of the meaning of living alone from the perspective of older people with dementia.
Risks and problems experienced by older women living alone have been investigated mostly through quantitative research. Balancing their safety and autonomy is a serious international community care dilemma. Older people's perspectives have been muted in qualitative research on living alone with dementia.
Using an interpretive phenomenological approach and van Manen's method, 14 interviews were conducted in Ontario, Canada from January 2004 to April 2005 with eight older women diagnosed with Alzheimer disease or a related dementia.
The theme holding back time expressed the temporal meaning of living alone. Pharmacological treatments represented stored time, offering the opportunity to hold back future dreaded time. Past experience with others with dementia was a context for holding on to now and facing some risks of living alone with memory loss. The women acknowledged the limited time remaining for, and identified endpoints to, living alone.
Insight into the impact of past experience with others with dementia could inform nursing assessment and advocacy for health/social services that are sensitive to the potential emotional impact of mixing people with varied levels of dementia in the same programme.
People with advanced cancer are able to live for extended periods of time. Advanced cancer can cause functional limitations influencing the ability to manage occupations. Although studies have shown that people with advanced cancer experience occupational difficulties, there is only limited research that specifically explores how these occupational difficulties are managed.
To describe and explore how people with advanced cancer manage occupations when living at home.
A sub-sample of 73 participants from a larger occupational therapy project took part in the study. The participants were consecutively recruited from a Danish university hospital. Qualitative interviews were performed at the homes of the participants. Content analysis was applied to the data.
Managing occupations were manifested in two main categories; (1) Conditions influencing occupations in everyday life and (2) Self-developed strategies to manage occupations.
The findings suggest that people with advanced cancer should be supported to a greater extent in finding ways to manage familiar as well as new and more personally meaningful occupations to enhance quality of life.
The Icelandic old-age care system is universal and the official goal is to support older people live independently for as long as possible. The aim of this study is to analyse living conditions and use of formal and informal care of older people in Iceland.
The results are based on the new study ICEOLD, a telephone survey which included questions on social network, health, activities of daily living, and received support from the community and/or from relatives, neighbours, and friends.
Almost half of the sample (47%) receives some kind of care, with 27% of them receiving only informal care, which is understood to mean that informal care is of great importance and families are the main providers of help. For hypothetical future long-term care, older people wish to be cared for in their homes, but those already in need of assistance prefer to be cared for in institutions.
Caring relatives are the main providers of support to older people in their homes and it is important to provide them with suitable formal support when the care responsibility increases.
As the care system in Iceland is now under reconstruction, the important contribution of informal carers must be recognised and taken into account when planning the care of older people.
To study how selected indicators of socioeconomic status and urban-rural residency associate with medication use in form of number of daily medications, polypharmacy, and medication use according to Anatomic Therapeutic Classification (ATC) system.
Cross-sectional, population-based study among older community-dwelling Icelanders. Criteria for participation were: age =65 years, community-dwelling, and able to communicate verbally and to set up a time for a face-to-face interview. Information on medication use was obtained by interviews and by examining each person's medication record. Medications were categorised according to ATC system. A questionnaire and the physical and mental health summary scales of SF-36 Health Survey were used to assess potential influential factors associated with medication use.
On average, participants (n=186) used 3.9 medications, and the prevalence of polypharmacy was 41%. No indicators of socioeconomic status had significant association to any aspects of medication use. Compared to urban residents, rural residents had more diagnosed diseases, were less likely to live alone, were less likely to report having adequate income, and had fewer years of education. Controlling for these differences, urban people were more likely to use medication from the B and C categories. Moreover, older urban men, with worse physical health, and greater number of diagnosed diseases used more medications from the B category.
There are unexplained regional differences in medications use, from categories B and C, by older Icelanders. Further studies are needed on why urban residents used equal number of medications, or even more medications, compared to rural residents, despite better socioeconomic status and fewer diagnosed diseases.
Explore the needs and the degree of satisfaction of Francophone seniors living in a minority socio-linguistic urban community in regards to aging-in-place.
An ethnographic case study was conducted in an urban community in the province of New Brunswick between October 2010 and June 2011. Individual interviews were completed with leaders of different community organizations (n=9) and focus groups were held with socio-linguistic minority French-speaking older adults (n=19).
Francophone seniors explained their willingness to age-in-place; however, the lack of services and support in the community makes aging-in-place difficult. Despite this identified absence of services, leaders of various community organizations have no plans to review current services in order to facilitate better quality of life for seniors.
Aging-in-place for French-speaking seniors living in socio-linguistic minority communities requires concerted efforts from family members, the community and the government. The Ottawa Charter of Health clearly states housing as a prerequisite of health. Housing and social support are important determinants of health. Therefore, the development and implementation of a public policy with regard to seniors, and particularly those in a socio-linguistic minority, seems fundamental in the context of population aging.