scholarly journals Investigating what works to support family carers of people with dementia: a rapid realist review

2016 ◽  
Author(s):  
M. Parkinson ◽  
S.M. Carr ◽  
R. Rushmer ◽  
C. Abley
Keyword(s):  
Realist Review ◽  
Family Carers ◽  
What Works ◽  
People With Dementia ◽  
Support Family ◽  
Rapid Realist Review

scholarly journals 72 Adult Safeguarding, Abuse of Vulnerable Adults and Mandatory Reporting: A Rapid Realist Review of the Literature

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Sarah Donnelly
Keyword(s):  
Older People ◽  
Realist Review ◽  
Mandatory Reporting ◽  
Professional Judgment ◽  
Policy And Practice ◽  
Institutional Settings ◽  
What Works ◽  
The Individual ◽  
Vulnerable Adults ◽  
Rapid Realist Review

Abstract Background The continuing evolution of adult safeguarding legislation, policy and practice in relation to the abuse of vulnerable adults reflects a growing awareness of the nature and extent of such abuse in Ireland. The Adult Safeguarding Bill, 2017 represents a progressive step in safeguarding older people and vulnerable adults. The intention of the Bill is to put in place additional protections for adults, in particular, for those who may be unable to protect themselves, such as older people or those lacking capacity. Part 3 provides for mandatory reporting by specified/named persons/professionals. This paper sets out to critically analyse the concept of mandatory reporting within adult safeguarding using international comparators as case studies. Methods A rapid realist review of adult safeguarding reporting typologies and systems in five key jurisdictions: Australia, Canada, England, Northern Ireland and Scotland, were explored to answer the question: ‘what works, for whom and in what circumstances?’ [1] Results Jurisdictions differ as to who the mandated reporters are, the scope and powers of mandatory reporting, and the types of abuse subject to reporting. Of significance is that the debate on mandatory reporting has increasingly focused on institutional settings, rather than more broadly across services. Key concepts identified are those of protection, empowerment and proportionality. Adult safeguarding legislation must therefore ensure that interventionist and compulsory measures to protect do not excessively restrict the rights of the individual. Conclusion Mandatory reporting may offer professionals increased powers to prevent and reduce the abuse of adults and older people, but this could also change the dynamic of relationships within families, and between families and professionals. Ultimately, the success of any legal approach will rest with professional judgment in balancing autonomy with protection.

scholarly journals Undertaking a Collaborative Rapid Realist Review to Investigate What Works in the Successful Implementation of a Frail Older Person’s Pathway

2018 ◽  
Vol 15 (2) ◽  
pp. 199 ◽  
Author(s):  
Éidín Ní Shé ◽  
Fiona Keogan ◽  
Eilish McAuliffe ◽  
Diarmuid O’Shea ◽  
Mary McCarthy ◽  
...  
Keyword(s):  
Research Question ◽  
Realist Review ◽  
Successful Implementation ◽  
Role Clarity ◽  
Acute Setting ◽  
What Works ◽  
Final Sample ◽  
Wide Range ◽  
Rapid Realist Review ◽  
Support Research

We addressed the research question “what factors enable the successful development and implementation of a frail older person’s pathway within the acute setting”. A rapid realist review (RRR) was conducted by adopting the RAMESES standards. We began with a sample of 232 articles via database searches supplemented with 94 additional records including inputs from a twitter chat and a hospital site visit. Our final sample consisted of 18 documents. Following review and consensus by an expert panel we identified a conceptual model of context-mechanism-(resources)-outcomes. There was overall agreement frailty should be identified at the front door of the acute hospital. Significant challenges identified related to organisational boundaries both within the acute setting and externally, the need to shift outcomes to patient orientated ones, to support staff to sustain the pathway by providing ongoing education and by providing role clarity. RRRs can support research such as the systematic approach to improving care for frail older adults (SAFE) study by producing accounts of what works based on a wide range of sources and innovative engagement with stakeholders. It is evident from our provisional model that numerous factors need to combine and interact to enable and sustain a successful frail older person’s pathway.

scholarly journals The experiences of grandchildren who provide care for a grandparent with dementia: A systematic review

Dementia ◽  
2020 ◽  
pp. 147130122098024
Author(s):  
Sophie Venters ◽  
Christina J Jones
Keyword(s):  
Family Relationships ◽  
Family System ◽  
Quality Criteria ◽  
Family Carers ◽  
Inclusion Criteria ◽  
Multiple Impacts ◽  
Current Review ◽  
People With Dementia ◽  
Positive Aspects Of Caregiving ◽  
Support Family

Much of the research exploring the experiences of family caregivers of people with dementia has focussed on spouses and adult children. It is hypothesised that other family members at different life stages and with different family roles may experience and perceive the caregiving role differently. The objective of the current review was to explore the experiences of grandchildren who provide care to a grandparent with dementia. A systematic search of four databases identified 12 studies which met the inclusion criteria. An assessment of quality was completed for each of the included studies. Grandchildren described dementia-related changes, changes to their role and relationship with their grandparent, multiple impacts of caregiving, influences of other family relationships on caregiving and positive aspects of caregiving. Many of the included studies met most of the quality criteria for the respective methodological design; however, there was some variation in quality and sample across included studies. The review indicates that assessments and interventions to incorporate grandchildren and the wider family system may help to support family carers to continue to provide care for grandparents with dementia. The research and clinical implications and limitations of the review are also considered.

scholarly journals Care Planning: What Works, for Whom, and in What Circumstances? A Rapid Realist Review

2018 ◽  
Vol 28 (14) ◽  
pp. 2250-2266 ◽  
Author(s):  
Sarah Brown ◽  
Monique Lhussier ◽  
Sonia M. Dalkin ◽  
Simon Eaton
Keyword(s):  
Health Care ◽  
Care Setting ◽  
Review Process ◽  
Realist Review ◽  
Care Planning ◽  
Empirical Testing ◽  
Long Term Conditions ◽  
What Works ◽  
Rapid Realist Review

Care planning has been described as a “better conversation” that helps people with long-term conditions to be in control of planning their care. Each person with long-term conditions faces individual challenges and each health care setting is fundamentally different, so there is a need for empirical testing of the specific mechanisms through which care planning may lead to health improvements. A rapid realist review was conducted to unearth underpinning mechanisms leading to outcomes in particular contexts. These are expressed in the form of realist theories, which are developed and refined through the review process. Fifty-one full text studies were included in the review. Seven program theories were iteratively tested and refined. A detailed description of what care planning is and what it should look like in practice has been achieved in the form of realist theories.

scholarly journals What are the mechanisms that support healthcare professionals to adopt assisted decision-making practice? A rapid realist review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Carmel Davies ◽  
Francesco Fattori ◽  
Deirdre O’Donnell ◽  
Sarah Donnelly ◽  
Éidín Ní Shé ◽  
...  
Keyword(s):  
Decision Making ◽  
Healthcare Professionals ◽  
Social Care ◽  
Expert Panel ◽  
Realist Review ◽  
Unique Contribution ◽  
Persons With Disabilities ◽  
People With Dementia ◽  
Health And Social Care ◽  
Rapid Realist Review

Abstract Background The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) establishes a right to legal capacity for all people, including those with support needs. People with disabilities have a legal right to be given the appropriate supports to make informed decisions in all aspects of their lives, including health. In Ireland, the Assisted Decision-Making (Capacity) Act (2015) ratifies the Convention and has established a legal framework for Assisted Decision Making (ADM). The main provisions of the Act are not yet implemented. Codes of Practice to guide health and social care professionals are currently being developed. Internationally, concerns are expressed that ADM implementation is poorly understood. Using realist synthesis, this study aims to identify Programme Theory (PT) that will inform ADM implementation in healthcare. Methods A Rapid Realist Review using collaborative methods was chosen to appraise relevant literature and engage knowledge users from Irish health and social care. The review was led by an expert panel of relevant stakeholders that developed the research question which asks, ‘what mechanisms enable healthcare professionals to adopt ADM into practice?’ To ensure the PT was inclusive of local contextual influences, five reference panels were conducted with healthcare professionals, family carers and people with dementia. PT was refined and tested iteratively through knowledge synthesis informed by forty-seven primary studies, reference panel discussions and expert panel refinement and consensus. Results The review has developed an explanatory PT on ADM implementation in healthcare practice. The review identified four implementation domains as significant. These are Personalisation of Health & ADM Service Provision, Culture & Leadership, Environmental & Social Re-structuring and Education, Training & Enablement. Each domain is presented as an explanatory PT statement using realist convention that identifies context, mechanism and outcome configurations. Conclusions This realist review makes a unique contribution to this field. The PT can be applied by policymakers to inform intervention development and implementation strategy. It informs the imminent policy and practice developments in Ireland and has relevance for other worldwide healthcare systems dealing with similar legislative changes in line with UNCRPD.

Mandatory reporting and adult safeguarding: a rapid realist review

2019 ◽  
Vol 21 (5) ◽  
pp. 241-251 ◽  
Author(s):  
Sarah Donnelly
Keyword(s):  
Design Methodology ◽  
Realist Review ◽  
Realist Evaluation ◽  
Mandatory Reporting ◽  
Policy And Practice ◽  
Content Type ◽  
What Works ◽  
Reporting Systems ◽  
Practical Implications ◽  
Rapid Realist Review

Purpose The purpose of this paper is to critically analyse the concept of mandatory reporting in adult safeguarding in the jurisdictions of Australia, Canada, England, Northern Ireland and Scotland. Design/methodology/approach A rapid realist evaluation of the literature on this topic was carried out in order to answer the question: "what works, for whom and in what circumstances?” Particular attention was paid to Context(s), Mechanism(s) and Outcome(s) configurations of adult safeguarding reporting systems and processes. Findings The evaluation found a range of arguments for and against mandatory reporting and international variations on the scope and powers of mandatory reporting. Research limitations/implications This review was undertaken in late 2018 so subsequent policy and practice developments will be missing from the evaluation. The evaluation focussed on five jurisdictions therefore, the findings are not necessarily translatable to other contexts. Practical implications Some jurisdictions have introduced mandatory reporting and others are considering doing so. The potential advantages and challenges of introducing mandatory reporting are highlighted. Social implications The introduction of mandatory reporting may offer professionals increased powers to prevent and reduce the abuse of adults, but this could also change the dynamic of relationships within families, and between families and professionals. Originality/value This paper provides an accessible discussion of mandatory reporting across Ireland and internationally which to date has been lacking from the literature.

Cancer treatment decisions for people living with dementia: experiences of family carers

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711545
Author(s):  
Catherine Hynes ◽  
Caroline Mitchell ◽  
Lynda Wyld
Keyword(s):  
Cancer Treatment ◽  
Healthcare Professionals ◽  
Cancer Recurrence ◽  
Treatment Decisions ◽  
Support Needs ◽  
Family Carers ◽  
Structured Interviews ◽  
Power Of Attorney ◽  
Cancer Data ◽  
People With Dementia

BackgroundDementia and cancer are both diseases associated with older age. The National Cancer Data Audit in England found that 4.4% of people diagnosed with cancer also had cognitive impairment. Decisions about cancer treatment can be very complex when someone already has dementia. Often someone’s closest relative may be asked to make decisions on their behalf. Little is known about the psychosocial impact that this has on carers, or what their support needs are during this time.AimTo explore the experiences of family carers who have been involved in making cancer treatment decisions on behalf of a relative with dementia, in particular identifying challenges and support needs.MethodThe authors are conducting semi-structured interviews with carers of people with dementia who have been involved in making decisions about cancer treatment on their behalf. Data is being thematically analysed using an inductive approach. Two researchers will independently verify themes.ResultsThe authors expect to have completed 14–18 interviews and will report their preliminary findings. Family carers experience many difficulties in the context of cancer and dementia, including lack of support when coping with the aftereffects of cancer treatment, lack of awareness among healthcare professionals regarding the authority granted by a lasting power of attorney and the anxiety created by feeling responsible for identifying cancer recurrence.ConclusionThis study will highlight that supporting someone with dementia through cancer treatment, and having to make decisions about it on their behalf, creates unique challenges for carers. Currently there is a significant lack of support for those facing this distressing experience.

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