Dementia care is an immediate and growing issue that affects everyone. People are living longer increasing the likelihood that they may be diagnosed with dementia. Friends and family are become caregivers but are often unprepared for the role. The purpose of this project was to develop a 15-minute dementia care module to assist caregivers with the home care of dementia patients. A pamphlet was created to reinforce the module information and to provide a quick reference for dementia support. The self-efficacy theory, along with the review of best practice guidelines and evidence from literature, informed the development of the module. The Simple Measure of Gobbledygook (SMOG) and the Flesch Reading Ease scales were used to ensure that the written materials were at an appropriate reading level for the targeted group. A single group evaluation was used to determine whether caregivers would be able to understand and use the information. A total of 5 lay dementia caregivers volunteered to evaluate the dementia module and related pamphlet. They volunteered to provide feedback using Appraisal of Guidelines for Research and Evaluation (AGREE) tool. Four out of the 5 caregivers strongly agreed or agreed that the module met the designated criteria. All participants stated that the information presented in the module/pamphlet was applicable to their circumstance as dementia caregivers, that the information would assist to provide better care for their loved one, and that they would recommend the dementia module to other caregivers. This project will have a positive impact on social change by providing dementia caregivers with strategies and information to deliver quality dementia care for their loved ones.

Background: Dementia friendly initiatives share similarities with the age-friendly movement in a focus on active engagement and creating a good quality of life for older adults. Dementia friendly initiatives offer a welcoming optimistic narrative in dementia studies by embracing dignity, empowerment, and autonomy to enable well-being throughout the dementia trajectory. Purpose: The purpose of this review is to explore the current science of dementia friendly initiatives, identify gaps, and inform future research. Method: Quantitative, qualitative, and conceptual/theoretical peer-reviewed dementia friendly research literature were evaluated for their current evidence base and theoretical underpinnings. Results: The dementia friendly initiatives research base is primarily qualitative and descriptive focused on environmental design, dementia awareness and education, and the development of dementia friendly communities. Person-centered care principles appear in dementia friendly initiatives centered in care settings. Strong interdisciplinary collaboration is present. Research is needed to determine the effect of dementia friendly initiatives on stakeholder-driven and community-based outcomes. Due to the contextual nature of dementia, the perspective of persons with dementia should be included as dementia friendly initiatives are implemented. Theory-based studies are needed to confirm dementia friendly initiative components and support rigorous evaluation. Dementia friendly initiatives broaden the lens from which dementia is viewed.

Yes / Promoting the health and well-being of couples where one partner has dementia is an overlooked area of care practice. Most postdiagnostic services currently lack a couple-centered approach and have a limited focus on the couple relationship. To help address this situation, we developed a tablet-based self-management guide (DemPower) focused on helping couples enhance their well-being and relationship quality. The aim of this study is to investigate the feasibility and acceptability of the DemPower app. A nonrandomized feasibility design was used to evaluate the DemPower intervention over 3 months among couples where a partner had a diagnosis of dementia. The study recruited 25 couples in the United Kingdom and 19 couples in Sweden. Outcome measures were obtained at baseline and postintervention. The study process and interventions were evaluated at various stages. The study was completed by 48% (21/44) of couples where one partner had dementia, of whom 86% (18/21) of couples accessed all parts of the DemPower app. Each couple spent an average of 8 hours (SD 3.35 hours) using the app during the study period. In total, 90% (19/21) of couples reported that all sections of DemPower were useful in addressing various aspects of daily life and helped to focus on how they interacted in their relationship. Of the 4 core subjects on which the DemPower app was structured, home and neighborhood received the highest number of visits. Couples used activity sections more often than the core subject pages. The perception of DemPower's utility varied with each couple's lived experience of dementia, geographic location, relationship dynamics, and opportunities for social interaction. A 5.2-point increase in the dementia quality of life score for people with dementia and a marginal increase in the Mutuality scale (+1.23 points) for caregiver spouses were found. Design and navigational challenges were reported in the DemPower app. The findings suggest that the DemPower app is a useful resource for couples where one partner has dementia and that the implementation of the app requires the support of memory clinics to reach couples at early diagnosis. ISRCTN Registry ISRCTN10122979; http://www.isrctn.com/ISRCTN10122979. / Economic and Social Research Council (ESRC) and National Institute for Health Research (NIHR). This research is part of Work Programme 6 of the ESRC/NIHR Neighborhoods and Dementia mixed methods study (reference ES/L001772/1)

Thesis (Ph. D.)--UCLA, 2009. / Vita. Description based on print version record. Includes bibliographical references (leaves 295-309).

Agitated behaviours in dementia elderly predispose to negative outcomes. Music intervention is an evidence-based intervention that could help to ease the situation. The integrative and systematic review studies provide evidence that music intervention is effective in reducing agitated behaviours in dementia elderly. The assessment of the implementation potential, the feasibility and transferability demonstrate the music intervention can be implemented in local setting. An evidence-based guideline based on the reviewed papers is developed to use in local HK hospitals or nursing homes. With the help of an effective communication plan to the stakeholders, it is believed that the intervention can be smoothly implemented. Further evaluation helps to review the potentials for sustaining the intervention in the long run. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Thesis (Ph. D.)--University of Texas at Austin, 2007. / Vita. Includes bibliographical references.

Thesis (Ph.D.)--Drexel University, 2009. / Includes abstract and vita. Includes bibliographical references (leaves 74-85).

There is little data regarding the prevalence of dementia in South Africa. Estimating such prevalence is problematic as the most commonly used cognitive screening tests are inappropriate for use in non-western populations. For this reason researchers have explored the use of informant questionnaires where relatives provide information on cognitive functioning over the last year. In the South African context Lenger, de Villiers & Louw (1996) conducted a dementia case-ascertainment study in a Xhosa-speaking community near Cape Town using a well-known informant questionnaire, the DECO, and concurrent clinical assessment. Reflecting on the discrepancies between DECO scores and clinical diagnosis, the researchers conducted interviews to explore beliefs and expectations regarding the elderly and cognitive decline. The aims of the current research were to gather comparative data from Bothasig, an English-speaking community, in order to explore areas of commonality and difference in perceptions and attributions regarding cognitive decline in the elderly. The study found that a significant percentage of informants from both Bothasig and Langa consider forgetfulness to be normal in old age. Different discourses around illness in the elderly were identified incorporating a range of medicalised and folk attributions. The discussion showed that informant perceptions within the Langa community may increase the likelihood that observational data provided in informant questionnaires may be confounded by cultural perceptions regarding the elderly. In addition, certain items on the DECO were found to be unsuitable for use across groups and modifications were proposed. The data was analyzed using both quantitative methods and phenomenological discourse analysis. The discussion concluded with metatheoretical reflections on the tension between etic and emic perspectives in cross-cultural research.

Background: Semantic dementia occurs as part of the frontotemporal dementia spectrum of conditions and presents with a progressive and striking receptive and expressive communication disorder. Studies thus far have generally concentrated on quantitative assessment of cognition and behaviour and there is a paucity of research examining conversation skills in everyday life, despite people with this condition and their family carers identifying this as the primary focus of their difficulties. There is also a gap in the literature in examining the first-hand experiences of people with semantic dementia and their family carers, in terms of how they live day to day with this condition. There is currently no evidence based advice for management of everyday communication issues in semantic dementia. Aims: This thesis used a multiple case study design to explore everyday conversation at home with five individuals with semantic dementia and their spouses and in one case study, also a daughter. Individuals ranged from early semantic dementia to the advanced stages of this condition. Each case study used an innovative combination of conversation analysis of video and audio data alongside biographical interviewing in a longitudinal design. A total of 74 home visits gathered 45 hours of interview data and 12 hours of video data. Information derived from these strands was then used to design an individually tailored intervention which focussed on the specific everyday conversation issues in each situation. This included aspects of life story work and interaction-focused therapy. Findings: A range of challenges and skills were present in the everyday conversations of these individuals with semantic dementia and their family carers. Some of this variability arose from differences in the severity of the semantic dementia across individuals in the study. However, differences were also apparent in how individuals with semantic dementia and their family carers adapted to the condition. Interaction-focussed therapy was delivered in one case study, with measureable changes in post-therapy conversations at home. Life story work was delivered in all cases using a variety of formats. Analysis of outcomes highlighted that the work could be conceptualised under various points of connection: including interactional connections, emotional connections, building new connections, practical care connections and future connections. Cognitive, psychological and social factors impacted on the life story work. Creativity in practice was important to enhance not just information exchange but foster interaction using verbal, paralinguistic and embodied behaviours. Conclusion: The study contributes to knowledge by providing in-depth understanding of the changes in everyday conversation for those living with semantic dementia and their family carers, as well as exploring interventions directly relevant for clinical practice. In this study both interaction-focussed therapy and life story work offered promise to support and enhance adaptation to changes in interaction for all concerned. Aspects of both interventions, grounded in the study data, were proposed in an exploratory model to underpin ‘interaction-focussed life story work’ in semantic dementia, i.e. life story practice with a central aim to enhance strategies for interaction in everyday life.

The use of antipsychotic medications in older adults with dementia increases risk of mortality; therefore, it is critical that nurses use nonpharmacological interventions in dementia care. The nurses' role is integral to implementation of treatment strategies to dementia patients and efforts to improve care in patients with dementia using a nonpharmacological approach are necessary. Therefore, guidelines outlining nonpharmacologic dementia care management will enable nurses to provide a wider spectrum of care to dementia patients. The purpose of this project was to make recommendations for the development and implementation of interdisciplinary practice guidelines to standardize care in the organizational setting. An integrative literature review was conducted using the Fineout-Overholt, Melnyk, Stillwell, and Williamson's analytical approach to reviewing evidence using 7 levels for evaluating the hierarchy of evidence. Inclusion criteria were limited to studies from January 2010 to October 2017 in English with full text. A total of 16 studies were reviewed and categorized according to 1 of the 7 hierarchical levels. Findings were summarized at each appropriate level and included systematic review or meta-analysis, randomized controlled trials, controlled trial without randomization, case-control or cohort studies, qualitative or descriptive studies and expert opinion or consensus. Non-pharmacological approaches including music therapy, cognitive-behavioral therapy, distraction, horticultural therapy, ear acupressure, and cognitive stimulation were all shown to be effective in dementia care. Social change based on this project targets improving nurses' knowledge of nonpharmacological interventions in dementia care.