In 2050, global estimates indicate that 139 million people will have dementia. Responsible for 60% to 80% of dementia cases, Alzheimer’s disease is the fifth leading cause of death in American adults aged 65 plus and one of the top ten leading causes of death in the United States (U.S.) overall. The clinical manifestations of Alzheimer’s disease expand the nature of the problem from the individual to caregivers. More than 11 million people living in the U.S. provide informal, unpaid care for a loved one with dementia. In recent years, this care equated to an average of nearly 17 billion hours of work. Research shows increased levels of stress, depression, other urgent health issues, and ultimately death, in Alzheimer’s/dementia caregivers compared to non-carers, especially in women. As such, caregivers inadvertently become “invisible second patients,” often neglecting their own health, while focusing on the needs of the care recipient. Enhancing the quality of life and protecting the health and well-being of caregivers is not only essential for their own livelihood, but that of the person living with the condition, as well as communities, healthcare systems and societies, globally. YouTube is a ubiquitous and powerful communications vehicle that is well-positioned to help achieve this goal. With billions of video views occurring daily across 100 plus countries and 92% of viewers asserting that they access information and gain knowledge through the social media platform, it is clear that YouTube appeals to viewers of all backgrounds and literacy levels. There is a substantial amount of research characterizing the content of YouTube videos related to various health topics and caregiving with respect to conditions other than Alzheimer’s; however, studies describing YouTube videos about Alzheimer’s and related care provision are rare. This study intends to fill critical lacunae in the scientific literature by examining the sources, speakers, formats, length and content of the most widely viewed YouTube videos surrounding Alzheimer’s/dementia caregivers through a cross-sectional, descriptive analysis. On October 9, 2022, a clean web browser and YouTube search history were used to locate and select the videos for the study by way of the search term, “alzheimer,” where the YouTube filter was set to sort by view count. After exclusions, a sample of N= 100 of the most highly viewed videos, collectively viewed N= 146,950,160 times, was identified for coding. The results indicated that the average video duration was 11.68 (SD = 16.54) minutes (range = 0.13–87.45 minutes). Most videos (n= 47) were one to four plus minutes in length. More than half (n= 54) of the videos examined originated in the U.S. Videos with Multiple (combination of) Sources comprised the source type found in highest frequency (n= 52) and corresponding cumulative views (>68%), whereas only n= 1 video was posted by a Government Source, securing a mere 0.47% of the views. Compared to other formats, videos with Multiple Formats were found in greatest frequency (n= 85) and number of views (~93%). Videos where the primary speaker was a Layperson (n= 51) garnered the most views (~77%) versus other speaker types. The results also revealed content most and least likely to be covered and viewed. The highest coverage and views for topics related to Alzheimer’s dementia outweighed those of caregiving as follows: Alzheimer's Awareness (n= 99 videos), 99.89% of cumulative views; overall Assessment, detection, diagnosis and/or screening (n= 93), ~97% of views; Warning signs (n= 86), ~94% of views; Symptoms (n= 87), 94% of views; versus Alzheimer’s dementia family/informal caregivers (n= 45), ~34 % of views and caregiver involvement (n= 42), ~32% of views. In addition, overall attention to caregiver burden and maintenance of caregiver health and well-being was weak and that of advocacy efforts (plans, policies, legislation, proceedings, etc.) for the health, well-being and quality of life of carers and people living with Alzheimer’s was essentially non-existent. Contact information (n= 97) was regularly provided to potentially aid in viewer mobilization (~80% views); however, it was rarely connected to entities providing caregiver-specific supports and assistance. Three quarters of the videos (83% of the views) did not have citations. Questionable information was found in approximately one quarter of the videos (with >20% of cumulative views). Examples of questionable information included unproven available treatments such as intermittent fasting, diet modification and supplements, herbs and coconut oil to potentially halt or reverse the deleterious effects of the condition. Strategies and recommendations were presented relevant to a longer-term research agenda; policies and legislation to advance Alzheimer’s/caregiving initiatives; collaborative approaches to care and educational programs; and training for video producers and viewers about respective, optimal dissemination and evaluation of credible and authoritative health information on YouTube. YouTube is a welcome, familiar and accessible communications vehicle that should be leveraged to better understand, advocate for and deliver medically accurate, on-demand critical supports, skill-building and educational programs to carers for people living with Alzheimer’s everywhere, who are overwhelmed, pressed for time and in dire need of assistance. YouTube represents an efficient, cost-effective means through which to improve the health outcomes and quality of life of caregivers, as well as their loved ones with Alzheimer’s.

This comparative research explores the work experiences of dementia care workers in nursing homes. The aim of this study is to understand concepts central to care and to gain insights from the care workers‟ perspectives. A comparative framework and symbolic interactionist approach is used to analyse data collected using ethnographic methods from 59 dementia care workers in Canada, Scotland, and the United States. The fieldwork settings are institutionalised; dominated by for-profit ownership; and provide care for a resident population with high cognitive and physical needs. The comparative findings underscore the importance of work conditions that provide care workers with sufficient resources to do their job and enough time to complete their work. The absence of these critical components creates stressful work conditions for the care workers. The lack of time, staff and supplies such as towels, wash cloths, and continence products do not allow the residents‟ choices in their care and disregard their dignity and rights. The inability to deliver care for the residents according to the guaranteed government care standards often result in the violation of human rights for the care workers and residents. The care workers are unable to supply the quality of care they know the residents need and are capable of providing given better circumstances. There are frequently not enough care workers, resources, or time to meet the level of care that relevant standards mandate or the care workers know is possible. The analysis reveals that care workers struggle to provide more than basic physical care and are seldom able to meet essential social care needs for the residents. Unwritten rules are implemented in each setting that include separating people with dementia, placing these residents out of view of the public, not allowing the residents access to go outside, and not providing them with engaging and meaningful interactions. While policies are frequently developed with good intentions, many are counter-productive without dementia knowledge. This comparative research reveals care practices and routines share strong similarities across the fieldwork sites while the care worker characteristics as a workforce vary the most between countries. Some differences involve the training required, average age, pay and mode of dress or appearances. Too often researchers frame stress issues for care workers as problems with attitudes, motivation, training and incentives. Yet, the broader social structures and conditions that set the context in which these problems have their origins are commonly ignored. Good working conditions for care workers are precursors to good care for the residents. This thesis concludes with recommendations for practice, research and policy development.

The purpose of the study was to develop a behavioral nursing intervention strategy for specific deficits in grooming performance of elders with dementia. A quasi-experimental two-group design using switching replications with removed intervention was employed. Three residents with severe cognitive impairments and three residents with mild cognitive impairments were chosen from a special dementia care unit of a long-term care facility. Three residents among six residents were randomly selected to receive the behavioral intervention early. Baseline and post-intervention assistance was provided by nurse aides. Each resident was asked to wash hands, brush teeth, wash face, and comb hair in a sequence. Ten intervention sessions were conducted by the trained intervener for two consecutive weeks. The intervention consisted systematic prompting and social reinforcement. A total of 21 sessions were collected in the morning using videotape recordings. Interobserver agreement for the instruments designed by the investigator was measured by the trained observers. Data were analyzed in two phases. First, the quantitative data were analyzed to determine the independent functional behaviors of individuals, and the change in the intensity of nursing effort associated with grooming of elders with dementia. Data were examined by individual graphic display throughout the three phases (baseline, nursing intervention, post-intervention). Second, the qualitative data were analyzed to determine the antecedents, consequences, and resident responses associated with grooming, the caregiver problem behaviors, and resident problem behaviors associated with grooming performance. The results show that the functional behaviors of even severely demented elders can be promoted, indicating the effectiveness of nursing care strategies on the ADL task of grooming. The data in this research suggest that maintaining or improving functional ability is possible with a behavioral nursing intervention, which was a highly structured and systematic approach that involved modifying the environmental and behavioral context, through strategies such as prompting and social reinforcement, when necessary. Furthermore, through the qualitative analysis, the functional relationships between antecedents, consequences, and behaviors of demented elders allowed the investigator to analyze the caregiver problem behaviors and resident behavior problems associated with grooming.

Bibliography: leaves 347-361. Presents results of 2 longitudinal studies investigating the oral health of older adults with dementia, using questionnaires and clinical inspections at baseline and one year. Groups studied were nursing home residents and those living in the community, with moderate to severe dementia or no dementia diagnosis. Caries experience was related to dementias severity and not to specific dementia diagnoses. Coronal and root caries experience was higher in dementia participants with moderate-severe dementia, the socio-economically disadvantaged, more functionally dependent, taking neuroleptic medications with high anticholinergic adverse effects, with eating and swallowing problems, were not attending the dentist, who needed assistance and were behaviourally difficult during oral hygiene care and whose carers were burdened.

Bibliography: leaves 347-361. / 403 leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Presents results of 2 longitudinal studies investigating the oral health of older adults with dementia, using questionnaires and clinical inspections at baseline and one year. Groups studied were nursing home residents and those living in the community, with moderate to severe dementia or no dementia diagnosis. Caries experience was related to dementias severity and not to specific dementia diagnoses. Coronal and root caries experience was higher in dementia participants with moderate-severe dementia, the socio-economically disadvantaged, more functionally dependent, taking neuroleptic medications with high anticholinergic adverse effects, with eating and swallowing problems, were not attending the dentist, who needed assistance and were behaviourally difficult during oral hygiene care and whose carers were burdened. / Thesis (Ph.D.)--University of Adelaide, Dept. of Dentistry, 2001

Syftet med den här uppsatsen är att undersöka om ett experimenterande med etnopoetisk transkribering av den i fältarbetet skapade etnografin kan ge fördjupade insikter i musikens funktion och betydelse inom demensvården. Det sju dagar långa fältarbetet på ett demensboende gav upphov till ljud- och videoupptagningar, intervjuer med personalen, samt fältanteckningar och -dagbok. Etnografin presenteras i två empirisk- analytiska kapitel, av vilka det första undersöker formellt organiserade musiksituationer, medan det andra undersöker informella musiksituationer på demensboendet. Den etnopoetiska transkriberingen eftersträvar att i text så noggrant som möjligt återge tal och sång, liksom även de minsta detaljer i mänsklig kommunikation, så som prosodi, gestik, koreografi och andra paralingvistiska element. Som svar på fem ställda frågor konkluderar undersökningen att den etnopoetiska transkriberingen tydliggör: 1) hur spegling, upprepning och turtagning strukturerar samspelet mellan vårdtagare och personal; 2) den sociala interaktionen mellan forskaren, personer med demenssjukdom och deras personal; 3) hur musik förekommer i situationer som inte vid första anblicken uppfattas som musik; 4) demenspatienter (som agerande subjekt); 5) den kommunikativa musikkompetensen hos personer med demenssjukdom, de anhöriga och personalen. / The aim of this paper is to investigate if an experiment with ethnopoetic transcription of the ethnography created in a field study can convey profound insights into the functions and meanings of music in dementia care. The seven days fieldwork, resulting in sound- and video recordings, interviews, field notes and diaries, was conducted in a nursing home. The ethnography is presented in two empirical-analytical chapters, the first of which investigates formally organized music situations, whereas the second scrutinizes informal music situations in the nursing home. The ethnopoetic transcript aspires to meticulously render speech and singing in text, as well as minute details of interaction, such as prosody, gestures, choreography and other paralinguistic elements of communication. In response to a set of five questions, the investigation concludes that the ethnopoetic transcription makes evident: 1) how mirroring, repetition and turn-taking structure the interaction between patients and nursing staff; 2) the social interaction between the researcher, the patients and the nursing staff; 3) how music actually happens in situations that at first sight may be considered non-music situations; 4) dementia patients (as acting subjects); 5) the communicative music-competence of dementia patients, their relatives and the nursing staff.

This thesis considers whether the concept of resilience is applicable to people ageing with dementia; and, if so, what the implications are for social work practice. It begins with an exploration of the literature on dementia, resilience and social work. Using a symbolic interactionist approach it then details how the interactions of people with dementia and their social workers can potentially influence the realisation of resilience in practice. I collected data over a two year period. During this period six dyads comprising a person with dementia and social worker provided rich verbal accounts of their respective experiences. Using narrative analysis the stories of each person with dementia were explored to reveal threats to identity and possible resilience strategies. A resilience lens was applied to the verbal accounts of social workers in order to reveal opportunities and challenges to using resilience in practice. The findings indicate that identity continues to be of importance to people who are ageing with dementia. The preservation of identity could therefore be re-framed as the outcome of a resilience process. Each person could potentially acquire resources over their life which could help to mitigate threats to identity. This is referred to as the resilience reserve. This thesis details the potential domains of such a reserve. Further, it contains details of possible resilience strategies that a person with dementia might employ within stories of self. These strategies are placed within the context of protective and vulnerability factors in order that a resilience framework can emerge. This thesis argues for a re-framing of theories of what social work is. This, combined with a definition of resilience, and the development of a resilience practice framework could promote and realise the resilience of the person ageing with dementia.

Aims/Objectives: The objectives of this thesis were to examine and discuss the existing information and communication technology (ICT) tools used in the healthcare sector for older adults with dementia, the benefits and challenges of using these ICT tools from the perspective of older adults with dementia and their health care providers. Research methods: Data was collected using semi-structured interviews with older adults with dementia and health care providers and managers at a nursing home in Nigeria. All interviews were audio recorded with the consent of the research participants and then transcribed verbatim. All interview transcripts were analyzed using qualitative content analysis using the deductive approach. The coding scheme used for data analysis was derived from an existing framework called the Human-Organization-Technology fit (HOT) Framework. In addition, existing literature were reviewed on the use of ICT tools by older adults with dementia, their caregivers and their health care providers. Empirical findings: A total of six participants were interviewed for this study: two older adults with dementia, two nurses and two managers (one senior manager and one manager from the medical team). One older adult was 72 years old and was diagnosed with dementia one year ago. The other older adult was 70 years old and was diagnosed with dementia two years ago. The nurses that I interviewed have been working at this nursing home for 3 and 4 years respectively. The mangers that I interviewed have also been working at this nursing home for 3 and 4 years respectively. Two ICT tools are currently being used at this nursing home: 1) a GPS tracker and 2) a device that assists older adults with their daily activities. Eight themes emerged from the interviews: system quality, service quality, user satisfaction (perceived usefulness), system use, user expectation, organization structure, organization environment and net benefits. Conclusion and Future research: This study demonstrated that older adults with dementia and their caregivers (i.e. nurses) perceived the GPS tracker and the ADL assistant as userfriendly and helpful for supporting the daily activities. Most of the existing research on ICT tools used for dementia care have been conducted in North America and Europe. Therefore, there is a need for more research in Africa.

This research examines narratives about the quality of everyday life with dementia. The aim of the study is to compare and contrast differing perspectives about the impact of ageing and dementia upon the lives of older people with dementia. A total of 50 interviews with six older people with dementia and ten family and paid carers were conducted over a two-year period. Narrative analysis was used to examine the content and structure of their accounts to understand their perspectives on what matters most to people living with dementia. This in-depth analysis enabled an exploration of different social concepts and narrative constructions that people draw upon in making sense of their experiences of caring and living with dementia. The analysis demonstrated that older people incorporate ageing and dementia into a continuing sense of self. Positive constructions of living with dementia involve the ability to lead a meaningful life that supports pre-existing social roles and relationships and active engagement within the family and community. The emphasis is on living an ordinary life while responding to the challenges associated with cognitive impairment and social stigma. For family and paid carers, perceptions of a meaningful life depend on how the identity of the older person with dementia is positioned relative to past social roles and relationships. Positive constructions assume continuity as opposed to focusing on disruption in the person’s identity and life. Carer perspectives are also influenced by how the person is perceived to conform to social standards of normality. The narratives of older people with dementia reflect their active struggle to find meaning in terms of realising their sense of self within a social world that largely defines them as different and out of the ordinary. The narratives of carers resonate with emotional difficulty, reflecting their struggle to make sense of a life that is not represented as essentially normal. These findings show that, for all, finding meaning in everyday life depends upon making sense of that life as normal and ordinary.

PDSE are common (19.6%) in the local stroke population. Both premorbid factors as well as stroke-related factors contribute to the development of PRSD and PSDE. The application of different diagnostic criteria for PSDE will affect the frequency and the associated radiological characteristics. As regards the screening methods of PSDE, a more specific instrument should supplement the IQCODE or MDRS-IP in a two-stage screening procedure. / PSD is also common (16--17%) among local stroke survivors. Both psychosocial factors and the location of cerebrovascular lesions play an important role in the development of PSD. PSD in local Chinese seems to have a favorable short-term outcome in comparison with their Caucasian counterparts. With regard to the screening of PSD in Chinese, we found that both the GDS and HADS depression subscale have a satisfactory response rate and accuracy in detecting PSD. However, due to the relative low frequency of PSD in the local stroke population, a more specific instrument should supplement the GDS in a two-stage screening procedure. Finally, the familiarity of the rater with the subjects based on a preexisting therapeutic relationship did not influence the accuracy of screening for PSD in Chinese patients. / There has been a paucity of data on the frequency, clinical correlates and methods of screening of poststroke dementia (PSDE) and depression (PSD) in Chinese populations. The objective of this thesis is to examine the prevalence, diagnostic criteria and clinical correlates of PSDE and PSD in Chinese stroke patients in Hong Kong. A series of studies were all carried out; the author of the thesis had interviewed all the subjects 1--3 months after their index stroke and made the diagnosis of dementia and depression according to the DSM-IV criteria. / Tang Wai Kwong. / "July 2005." / Adviser: Gabor S. Ungvari. / Source: Dissertation Abstracts International, Volume: 67-01, Section: B, page: 0177. / Thesis (M.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 136-191). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / School code: 1307.