scholarly journals Understanding the person with dementia: a clinicophilosophical case discussion

2013 ◽  
Vol 19 (5) ◽  
pp. 337-343 ◽  
Author(s):  
Julian C. Hughes ◽  
Aileen Beatty
Keyword(s):  
Clinical Practice ◽  
Mental Health Professionals ◽  
Case Vignette ◽  
Case Discussion ◽  
Broad View ◽  
People With Dementia ◽  
Person With Dementia ◽  
Conceptual Underpinning ◽  
Embodied Agent ◽  
Practical Implications

SummaryThis article examines the notion of personhood and shows how it offers a robust conceptual underpinning to person-centred care. We use a fictitious case vignette to clarify the nature of personhood. Mental health professionals need a broad view of personhood, which we feel is best captured by regarding the person as a 'situated embodied agent'. Using this characterisation, we aim to demonstrate how it can underpin the notion of person-centred care and show the practical implications of this in connection with our fictitious case. The broad view supports a specific approach to people with dementia, but also shows the challenges that face the implementation of good-quality dementia care. Discussion of this case shows both the relevance of philosophy to clinical practice and the ways in which clinical practice can enrich the debates of philosophy.

Recovery and dementia: promoting choice and challenging controversy

2017 ◽  
Vol 21 (5) ◽  
pp. 297-303 ◽  
Author(s):  
Laura Louise Hammond ◽  
Conrad Debney
Keyword(s):  
Mental Health ◽  
Design Methodology ◽  
Positive Attitude ◽  
Content Type ◽  
People With Dementia ◽  
The World ◽  
Key Concepts ◽  
Mental Health Difficulties ◽  
Person With Dementia ◽  
Practical Implications

Purpose The purpose of this paper is to provide a viewpoint about why people with dementia should be able to choose Recovery and how this approach might be experienced by them. Design/methodology/approach This paper addresses some key challenges to accepting Recovery as an approach for people with dementia by making comparisons with people with mental health difficulties. It then discusses key concepts of Recovery using the connectedness, hope, identity, meaning and empowerment framework and how each one might be experienced by the person with dementia. Findings The challenges which cause concerns about the applicability of Recovery to people with dementia are shared by people with mental health difficulties, therefore Recovery should be perceived as an approach suitable for anyone regardless of their diagnosis. Recovery for people with dementia could mean: connecting to the self, others and the world to promote feelings of purposefulness; having hope for the here and now; preserving one’s identity; finding meaning in retaining skills and incorporating dementia into one’s life; and, feeling empowered by keeping one’s mind working, adopting a positive attitude, having control and making decisions. Practical implications People with dementia can choose to access Recovery, and commonly voiced concerns can be answered and supported with evidence. Originality/value This is one of the only papers written to provide an understanding of how Recovery might be experienced by people living with dementia, and directly answers some concerns.

scholarly journals Organising and evaluating a Balint group for trainees in psychiatry

2003 ◽  
Vol 27 (11) ◽  
pp. 434-436 ◽  
Author(s):  
Gearoid Fitzgerald ◽  
Michael D. Hunter
Keyword(s):  
Clinical Practice ◽  
Discussion Group ◽  
Case Vignette ◽  
Group Method ◽  
Clinical Implications ◽  
Case Discussion ◽  
Written Responses ◽  
Before And After ◽  
One Year ◽  
Balint Group

Aims and MethodWe describe the Balint case discussion group method and how it can be applied to training psychiatrists. In a group that we ran, the performance of members on a clinical task before and after a year in the group was investigated. Written responses to a case vignette were appraised blindly by psychotherapists who were also examiners for the Royal College of Psychiatrists.ResultsThere were eight members in the Balint group, which met weekly for one year. We found that members' performance on the clinical task improved significantly following the year spent in the Balint group.Clinical ImplicationsA Balint group, as part of an introduction to psychotherapy for psychiatrists, may represent a step towards achieving comprehensive training that is relevant to ordinary clinical practice.

What Gives a Diagnostic Label Value? Common Use Over Informativeness

2019 ◽  
Author(s):  
Babak Hemmatian ◽  
Sze Yu Yu Chan ◽  
Steven A. Sloman
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Causal Relation ◽  
Causal Beliefs ◽  
Diagnostic Categories ◽  
Diagnostic Labels ◽  
Diagnostic Label ◽  
The Impact ◽  
Practical Implications

A label’s entrenchment, its degree of use by members of a community, affects its perceived explanatory value even if the label provides no substantive information (Hemmatian & Sloman, 2018). In three experiments, we show that laypersons and mental health professionals see entrenched psychiatric and non-psychiatric diagnostic labels as better explanations than non-entrenched labels even if they are circular. Using scenarios involving experts who discuss unfamiliar diagnostic categories, we show that this preference is not due to violations of conversational norms, lack of reflectiveness or attentiveness, and the characters’ familiarity or unfamiliarity with the label. In Experiment 1, whether a label provided novel symptom information or not had no impact on lay responses, while its entrenchment enhanced ratings of explanation quality. The effect persisted in Experiment 2 for causally incoherent categories and regardless of direct provision of mechanistic information. The effect of entrenchment was partly related to induced causal beliefs about the category, even when participants were informed there is no causal relation. Most participants in both experiments did not report any effect of entrenchment and the effect was present for those who did not. In Experiment 3, mental health professionals showed the effect using diagnoses that were mere shorthands for symptoms, despite a tendency to rate all explanations as unsatisfactory. The data suggest that bringing experts’ attention to the manipulation eliminates the effect. We discuss practical implications for mental health disciplines and potential ways to mitigate the impact of entrenchment.

Cultural competency training for psychiatry residents and mental health professionals: A systematic review

2020 ◽  
pp. 002076402098161
Author(s):  
Vyjayanthi N Venkataramu ◽  
Bhavika Vajawat ◽  
Bharathram Sathur Raghuraman ◽  
SK Chaturvedi
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Cultural Competence ◽  
Cultural Competency ◽  
Mental Health Professionals ◽  
Case Vignette ◽  
Training Methods ◽  
Psychiatry Residents ◽  
Competency Training ◽  
Cultural Competency Training

Introduction: Cultural competence is a prerequisite skill for a psychiatrist. There is a dearth of information on the methods used for training of cultural competence and their outcomes. This study aims to explore and determine the existing methods used for cultural competency training (CCT) for psychiatry residents and how useful these training methods are. Method: A systematic review methodology based on PRISMA guidelines was adopted for this study. The literature search reviewed databases of PubMed and MesH, using keywords ‘psychiatry resident’, ‘psychiatry’, ‘psychiatrist’, ‘mental health’, and ‘mental health professional’. In the end,14 articles qualified for the detailed review. The level of evidence and quality of the studies were evaluated and recorded. Results: The methods of cultural competence training identified were grouped as, active/passive/mixed; group training/individual training. These included documentaries or non-feature films based teaching, secondary consultation and cross consultation models, case vignette discussions, Objective Structured Clinical Examination (OSCE), behavioral simulation, video demonstration, cultural discussion in rounds, and traditional clinical teaching. The studies covered participants from different cultural backgrounds, mainly urban and predominantly university/institution based. Conclusion: There is limited literature in the area to conclude one method to be better than the other with respect to CCT in psychiatry residents. However, this review identified a variety of training methods, which can be used and pave way for research on their effectiveness. Training and evaluation of psychiatry residents in the area of cultural competence should be done routinely during their training to enable them to practice in the multi ethic societies.

scholarly journals ‘Getting back to normality seems as big of a step as going into lockdown’: the impact of the COVID-19 pandemic on people with early to middle stage dementia

2021 ◽  
Author(s):  
Catherine V Talbot ◽  
Pam Briggs
Keyword(s):  
Well Being ◽  
Cognitive Stimulation ◽  
Social Worlds ◽  
Middle Stage ◽  
People With Dementia ◽  
The Social ◽  
Function Loss ◽  
The Government ◽  
Person With Dementia ◽  
The Impact

Abstract People with dementia can experience shrinkage of their social worlds, leading to a loss of independence, control and reduced well-being. We used ‘the shrinking world’ theory to examine how the COVID 19 pandemic has impacted the lives of people with early to middle stage dementia and what longer-term impacts may result. Interviews were conducted with 19 people with dementia and a thematic analysis generated five themes: the forgotten person with dementia, confusion over government guidance, deterioration of cognitive function, loss of meaning and social isolation, safety of the lockdown bubble. The findings suggest that the pandemic has accelerated the ‘shrinking world’ effect and created tension in how people with dementia perceive the outside world. Participants felt safe and secure in lockdown but also missed the social interaction, cognitive stimulation and meaningful activities that took place outdoors. As time in lockdown continued, these individuals experienced a loss of confidence and were anxious about their ability to re-engage in the everyday practises that allow them to participate in society. We recommend ways in which the government, communities and organisations might counteract some of the harms posed by this shrinking world.

scholarly journals Non-Pharmacologic Interventions for Caregivers of People With Dementia in Latin America: A Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 275-276
Author(s):  
Jose Aravena ◽  
Jean Gajardo ◽  
Laura Gitlin
Keyword(s):  
Quality Of Life ◽  
Latin America ◽  
Depressive Symptoms ◽  
Latin American ◽  
Randomized Clinical Trials ◽  
Social Inequalities ◽  
Neuropsychiatric Symptoms ◽  
People With Dementia ◽  
Person With Dementia

Abstract In a scenario of increasing longevity and social inequalities, Latin-America is an important contributor to the worldwide dementia burden. Caregivers’ health is fundamental to maintain the person with dementia quality of life. However, caregiving is a culturally sensible role that requires tailored solutions. The aim is to synthesize the evidence about non-pharmacologic interventions targeted to caregivers of people with dementia in Latin-American contexts. A comprehensive review of interventions in caregivers and persons with dementia in Latin-American countries was conducted using MEDLINE, Embase, PsycINFO, and Scopus with studies published until January 27th, 2020. Randomized clinical trials of non-pharmacologic interventions targeted to caregivers of people with dementia or dyads where included. Qualitative synthesis of the evidence was presented and analyzed. Overall, 9 pilot RCT were included for the final analysis (6 Brazil, 1 Colombia, 1 Mexico, 1 Perú). The biggest study recruited 69 caregivers and the smallest 13 dyads, with follow-up range of 3-6 months. 5 control groups received at least some other non-standard care type of intervention. 8 were targeted exclusively to caregivers (4 group intervention, 3 individual, and 1 combined) and 1 multicomponent intervention. Most frequent measured outcomes were caregiver’s burden, anxiety, depressive symptoms, and quality of life, and person with dementia neuropsychiatric symptoms. Individual interventions report better results in caregiver parameters such as burden and depressive symptoms and person with dementia neuropsychiatric symptoms. Group interventions presented mixed results. Nevertheless, the quality of evidence was low. There is a critical need to study interventions for caregivers in Latin-American contexts.

scholarly journals Wayfinding in People with Alzheimer’s Disease: Perspective Taking and Architectural Cognition—A Vision Paper on Future Dementia Care Research Opportunities

2021 ◽  
Vol 13 (3) ◽  
pp. 1084
Author(s):  
Saskia Kuliga ◽  
Martin Berwig ◽  
Martina Roes
Keyword(s):  
Perspective Taking ◽  
Spatial Orientation ◽  
Environmental Design ◽  
Spatial Disorientation ◽  
Planning And Design ◽  
People With Dementia ◽  
Starting Point ◽  
Planning Processes ◽  
Person With Dementia ◽  
Underlying Processes

Based on a targeted literature review, this vision paper emphasizes the importance of dementia-sensitive built space. The article specifically focuses on supporting spatial orientation and wayfinding for people living with dementia. First, we discuss types of wayfinding challenges, underlying processes, and consequences of spatial disorientation in the context of dementia of the Alzheimer’s type. Second, we focus on current efforts aimed at planning and evaluating dementia-sensitive built space, i.e., environmental design principles, interventions, evaluation tools, strategies, and planning processes. Third, we use our findings as a starting point for developing an interdisciplinary research vision aimed at encouraging further debates and research about: (1) the perspective of a person with dementia, specifically in the context of wayfinding and spatial orientation, and (2) how this perspective supplements planning and design processes of dementia-sensitive built space. We conclude that more closely considering the perspective of people with dementia supports the development of demographically sustainable future cities and care institutions.

scholarly journals What Are the Benefits of Pet Ownership and Care Among People With Mild-to-Moderate Dementia? Findings From the IDEAL programme

2020 ◽  
pp. 073346482096261
Author(s):  
Carol Opdebeeck ◽  
Michael A. Katsaris ◽  
Anthony Martyr ◽  
Ruth A. Lamont ◽  
James A. Pickett ◽  
...  
Keyword(s):  
Positive Outcomes ◽  
Pet Ownership ◽  
Active Life ◽  
People With Dementia ◽  
Moderate Dementia ◽  
Self Reports ◽  
Key Factor ◽  
Person With Dementia ◽  
The Ideal

Pet ownership has been associated with positive outcomes in many populations, yet the associations with physical and psychological wellbeing in people with dementia remain unclear. The current study used baseline data from 1,542 people living at home with mild-to-moderate dementia from the Improving the experience of Dementia and Enhancing Active Life (IDEAL) programme. Regression analyses investigated associations of pet ownership and pet care with self-reports of walking, loneliness, depression, and quality of life (QoL). After adjusting for covariates, having any pet was associated with higher likelihood of walking over 3 hr in the last week. Those with a dog and who were involved in its care were less likely to be lonely than those with no dog. Having any pet but no involvement in its care was associated with increased depression and decreased QoL compared with those without a pet. The key factor in the associations was involvement in the care of the pet by the person with dementia.

scholarly journals Clinical practice guidelines and principles of care for people with dementia: a protocol for undertaking a Delphi technique to identify the recommendations relevant to primary care nurses in the delivery of person-centred dementia care

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e044843
Author(s):  
Caroline Gibson ◽  
Dianne Goeman ◽  
Mark William Yates ◽  
Dimity Pond
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Dementia Care ◽  
Care Nurse ◽  
Primary Care Nurse ◽  
People With Dementia ◽  
Primary Care Nurses

IntroductionNationally and internationally it is well recognised that dementia is poorly recognised and suboptimally managed in the primary care setting. There are multiple and complex reasons for this gap in care, including a lack of knowledge, high care demands and inadequate time for the general practitioner alone to manage dementia with its multiple physical, psychological and social dimensions. The primary care nurse potentially has a role in assisting the general practitioner in the provision of evidence-based dementia care. Although dementia-care guidelines for general practitioners exist, evidence on resources to support the primary care nurse in dementia care provision is scarce. The ‘Australian Clinical Practice Guidelines and Principles of Care for People with Dementia’ provides 109 recommendations for the diagnosis and management of dementia. This protocol describes a Delphi study to identify which of the 109 recommendations contained in these multidisciplinary guidelines are relevant to the primary care nurse in the delivery of person-centred dementia care in the general practice setting.Methods and analysisUsing a Delphi consensus online survey, an expert panel will grade each of the recommendations written in the ‘Clinical Practice Guidelines and Principles of Care for People with Dementia’ as high-to-low relevance with respect to the role of the primary care nurse in general practice. To optimise reliability of results, quality indicators will be used in the data collection and reporting of the study. Invited panel members will include Australian primary care nurses working in general practice, primary care nursing researchers and representatives of the Australian Primary Health Care Nurses Association, the peak professional body for nurses working in primary healthcare.Ethics and disseminationThis study has been approved by The University of Newcastle Human Research Ethics Committee (HREC) (H-2019-0029).Findings will be published in a peer-reviewed journal and presented at scientific conferences.

scholarly journals Pilot Randomised Evaluation of Singing in Dementia (PRESIDE): protocol for a two-arm, parallel-group randomised controlled feasibility study with waiting-list control

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Becky Dowson ◽  
Justine Schneider ◽  
Boliang Guo ◽  
Philip M. Bath ◽  
Orii McDermott ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Waiting List ◽  
Community Group ◽  
People With Dementia ◽  
Parallel Group ◽  
Randomised Controlled ◽  
Person With Dementia

Abstract Background As the number of people living with dementia grows, so does the need to provide them with adequate psychosocial support. Many people with dementia live at home with family carers, who also require social and emotional support to cope with their role. Community group singing has received attention for its potential to support people with dementia and their carers. It is postulated that singing can improve cognitive function, strengthen the bonds between care partners and help to establish social support networks. However, there is a lack of rigorous evidence of singing’s benefits for this population. This study aims to test the feasibility of a randomised controlled trial of community singing in dementia, to pave the way for a larger, conclusive study. Methods The PRESIDE study is designed as a two-arm, parallel-group randomised trial with a waiting list control. Dyads consisting of a person with dementia (n = 80) and their carer (n = 80) will be recruited. Each dyad will be randomised either to attend 10 weeks of community group singing sessions straight away or to wait for 3 months before attending the sessions. The singing sessions will be led by experienced professional musicians and will last about 90 min, including time for socialising. The primary outcome of this study is the attainment of feasibility criteria around recruitment, retention and the acceptability of the waiting list control. Secondary outcomes include the quality of life, mood, cognition, and musical engagement of the person with dementia, and quality of life, mood, and experiences/challenges of the carer. These data will be collected during home visits at baseline, and 3 and 6 months post-baseline. Discussion Despite growing public interest in the positive effects of singing, and encouraging findings from qualitative and non-randomised quantitative studies, there is a lack of rigorous evidence. This is the first randomised controlled trial of community group singing for people with dementia in Europe, to our knowledge. If the results favour a full trial, conclusively demonstrating the effectiveness of group singing could positively affect the opportunities available to community-dwelling people with dementia and their carers. Trial registration Unique identification number in ISRCTN registry: ISRCTN10201482. Date registered: 12 May 2020

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