Persons with dementia experience impairments in cognitive, behavioral, and functional ability, often leading to long-term care placement. The Enhancing Care Program was developed by the Alzheimer Society of Canada to assist organizations in improving care for this population. Although this program has been implemented in many facilities, the majority have been located in urban settings and there has been limited formal evaluation. Little is known about dementia care in rural facilities, or about how programs are implemented in rural settings. The Enhancing Care Program is based on eleven guidelines that outline best practices for caring for individuals with dementia. With the assistance of a facilitator from the Alzheimer Society, a multi-disciplinary team from the facility assesses their current ability to meet each guideline. In subsequent meetings, the team establishes specific, measurable goals to improve care in targeted areas. The two purposes of this study were to conduct a process evaluation of the Enhancing Care Program and to develop theory relating to the implementation of a program in two rural long-term care facilities. Observations were made over the course of seven months as teams worked through the guidelines and set goals. Focus group interviews consisting of team members took place at the end of the observation period. In addition, individual interviews were conducted with general staff, the facility managers, and the facilitator from the Alzheimer Society. Grounded theory methodology informed the research and analysis process. The theory that emerged, The Process of Building Effective Teams, explains the transition of the participants from collections of individuals to cohesive units that functioned as teams. Five key categories were developed in the theory: trust, respectful and open communication, transformational leadership, creating change collectively, and enhanced team culture. As part of the process evaluation of the Enhancing Care Program, 24 recommendations were made for program improvements.

Older adults living with dementia are marginalized in society through the socially constructed binaries of old/young, able/disabled and ultimately us/them. These are manifested in a culture dominated by approaches towards illnesses that favor clinically inclined models of care which entail the search for cures rather than attention to the care required by and for individuals. To heighten their vulnerability, from an individual perspective, the cognitive nature of dementia often prevents people living with it from having a voice in their representation. Person-centered care is a philosophy that recognizes the importance of who the individual is and where they are situated in an effort to create a more holistic care experience. The Lodge at Broadmead is a residential care facility that has operationalized an explicitly person-centered philosophy of care. The main objectives of this project were to gain an understanding of the lived experience and implementation of person-centered dementia care from the many different perspectives contained within this facility as well as the methodological barriers associated with including people living with dementia in this type of research. To this end, one-on-one interviews and focus groups were conducted with a total of 16 staff members and leadership at The Lodge at Broadmead as well as one resident. These were informed by a 4 month period of observation in the form of volunteer work. Three main themes emerged around the implementation of person-centred care at The Lodge at Broadmead: identity maintenance, facilitating relationships, and aligning values. These themes represent the most important theoretical links between the physical and social aspects of the environment, and person-centred care’s ultimate goal of maintenance and enhancement of personhood for the residents. Drawing from my own research experience, there were several methodological challenges in undertaking the research as well which were: the institutional necessity of consent by proxy, a rigid interview approach, and not enough time spent with the residents. / Graduate / 0336 / 0351 / kyle.plumb@gmail.com

Background: With the increasing older adult population, new graduate nurses will be providing care for patients with dementia more frequently and should be supported to care for this population during their transition period. Purpose: The purpose of this thesis was to explore the experiences of new graduate nurses providing care for patients with dementia in acute care environments. Methods: An interpretive descriptive qualitative study explored eleven Ontario new graduate nurses’ experiences providing dementia care in acute care environments. A thematic analysis was conducted. Findings: The thematic analysis resulted in three themes and several sub-themes: building of vision and values, clash of vision and values, and “make do with what you have”. Discussion and Conclusion: Facilitators to providing dementia care in acute care were supportive colleagues and early exposure to dementia care. The barriers identified were similar to the barriers experienced by nurses in the literature.

Older adults living with dementia are marginalized in society through the socially constructed binaries of old/young, able/disabled and ultimately us/them. These are manifested in a culture dominated by approaches towards illnesses that favor clinically inclined models of care which entail the search for cures rather than attention to the care required by and for individuals. To heighten their vulnerability, from an individual perspective, the cognitive nature of dementia often prevents people living with it from having a voice in their representation. Person-centered care is a philosophy that recognizes the importance of who the individual is and where they are situated in an effort to create a more holistic care experience. The Lodge at Broadmead is a residential care facility that has operationalized an explicitly person-centered philosophy of care. The main objectives of this project were to gain an understanding of the lived experience and implementation of person-centered dementia care from the many different perspectives contained within this facility as well as the methodological barriers associated with including people living with dementia in this type of research. To this end, one-on-one interviews and focus groups were conducted with a total of 16 staff members and leadership at The Lodge at Broadmead as well as one resident. These were informed by a 4 month period of observation in the form of volunteer work. Three main themes emerged around the implementation of person-centred care at The Lodge at Broadmead: identity maintenance, facilitating relationships, and aligning values. These themes represent the most important theoretical links between the physical and social aspects of the environment, and person-centred care’s ultimate goal of maintenance and enhancement of personhood for the residents. Drawing from my own research experience, there were several methodological challenges in undertaking the research as well which were: the institutional necessity of consent by proxy, a rigid interview approach, and not enough time spent with the residents. / Graduate / 0336 / 0351 / kyle.plumb@gmail.com

Caregivers of dementia patients who were referred to a community-based comprehensive assessment program for demented and/or chronically ill older adults by physicians or community agencies were studied for this thesis.

No description available.

No / Communication involves the exchange of information between at least two people, a giver and a receiver. If left unaddressed, communication difficulties may have a profound effect on quality of life and quality of care. Poor communication may result in high levels of anxiety and depression for the person living with dementia. Communication breakdown contributes to high rates of depression in spouses of people living with dementia and is a major problem for family and carers. Positive and supportive communication is essential to ensure good quality dementia care. A person-centred approach focuses on supporting a person to use and retain their skills and abilities. Person-centred communication involves a commitment to including the perspective of the person living with dementia, and an understanding of who the person is, their life history and preferences.

No / Dementia is a global concern. Although effort is being put toward finding a cure, many advances have been made in ensuring excellence in dementia care. In the United Kingdom, the concept of person-centered dementia care has transformed what is expected for individuals with dementia. Now embraced in national policy in the United Kingdom, it was pioneered by Thomas Kitwood and Kathleen Bredin and driven by a con-cern for the quality of care for indi-viduals with dementia in care homes. The purpose of the current article is to describe key concepts of Kitwood’s pioneering work in person-centered dementia care and to use them to inform current community-based supports and services for individuals with dementia in their own homes, whether alone or with family carers. / Full text is unavailable due to publisher copyright restrictions.

Yes / The full-text of this article will be released for public view at the end of the publisher embargo, 6 months from first publication.

The purpose of this study was to examine Residential Care Aides’ (RCAs) experiences of good quality dementia care provision. Informed by a political economy perspective, I sought to understand how RCAs conceptualize quality dementia care, whether such conceptualizations are reflected in their daily care practice and how the organizational care context impedes or facilitates such care provision. Drawing on a focused ethnographic approach, I utilized in-depth interviews, participant observation and the review of selected documents to contextualize RCAs’ experiences within the organizational care environment. Over a 12-month period, in-depth interviews with 29 staff (21 RCAs, 3 LPNs and 5 managers) and 239 hours of participant observation were conducted in four small-scale dementia units in two nursing homes in British Columbia, Canada. In-depth interviews yielded information-rich data about RCAs’ care experiences and their relationships with residents, while participant observation afforded the opportunity to strategically link RCAs’ actions and interactions with what was said, a feature missing from much of the previous research examining staff perceptions of quality dementia care. A select review of facility documents and provincial licensing regulations provided additional insight regarding the relevance of the larger structural context for RCAs’ care experiences. In general, RCAs conceptualized, and exhibited in their daily physical care provision, quality dementia care as that which focused on tangible care outcomes (i.e., keeping residents clean, comfortable, calm and happy), on their care approach (i.e., delivering care in a compassionate, patient and affectionate manner) and was guided by family ideology (i.e., invoking of family metaphors). Inherent in their care provision was a sense of role tension, as they sought to incorporate social interaction with task completion and their co-workers’ conflicting expectations. Study findings also illustrated how, in the face of continued disempowerment and organizational constraints, RCAs sought to provide quality dementia care by negotiating their peer and supervisory relationships and selectively breaking formal and informal policies/procedures. Salient to RCAs’ experiences of personhood was the limited recognition and appreciation they received from management and the manner in which work-life balance, staffing coverage, human resource management practices and limited information sharing further devalued them and their work. Study findings draw attention to the importance of: acknowledging the role of structural constraints in the pervasiveness of a task-oriented work culture; attending to (and facilitating) staff personhood; facilitating supportive peer and supervisory relationships and; fostering effective management practices as a means of potentially improving care quality. As such, the study sheds important light on what RCAs require within their work environments to help facilitate resident well-being, reinforcing the assertion that residents’ care conditions are inextricably linked to RCAs’ care work conditions. / Graduate / 0351