People with dementia are hospitalized for a variety of reasons. The combination of dementia with additional health conditions creates a unique challenge to caregivers in acute care settings. There is a dearth of information available to provide guidance to the nursing staff caring for these patients. This integrated review of the literature examined the experiences of hospitalization from the perspective of the older adult with dementia, the family caregiver, and the patient care staff. Results showed a limited body of literature that addressed hospital experiences of people with dementia and those of family and professional caregivers. Additionally, few studies addressing this topic have been conducted in the United States. The primary finding from this study is that better communication is needed between nursing staff, patients, and their family caregivers. Nurses should carry out detailed assessments of cognition and pain in all elderly patients, and strive to provide appropriate palliative and end-of-life care. Dementia- specific training for all staff members may help to promote a better understanding of patients with dementia. Lastly, further research into the experiences of hospitalized dementia patients is needed, with a focus on acute care settings within the United States.

Traumatic brain injury/acquired brain injury (TBI/ABI) is considered a major cause of death and disability in the United States (Blennow et al., 2016). Most often, TBI/ABI affects memory, concentration, judgment, and executive functioning skills. As a result, individuals with moderate–severe TBI/ABI often experience physical and cognitive deficits, long-term disability, and decreased quality of life (Whiteneck et al., 2016). Unaddressed cognitive deficits can result in difficulties with patient performance of meaningful and prioritized occupations and activities (Giles, 2018). Occupational therapy has a role in addressing the cognitive dysfunction that results from moderate–severe TBI/ABI. Occupational therapy practitioners’ (OTPs) role in cognitive rehabilitation based on a neurofunctional approach is to maximize patients’ safety and engagement in meaningful, purposeful activities of daily living and instrumental activities of daily living. Despite the role that OTPs play in addressing cognitive dysfunction, cognition has slowly been marginalized from occupational therapy’s repertoire due to unclear boundaries with other health care disciplines, including speech-language pathology and neuropsychology (Giles et al., 2020). Education is needed to ensure that OTPs understand evaluation and intervention methods based in both functional cognition and the neurofunctional approach. The proposed training program, Hierarchy to Success: A Framework of Functional Cognitive Strategies and Caregiver Education, is provided to OTP participants via an asynchronous, online training format utilizing Blackboard course sites. The training program seeks to address many of these challenges through an evidence-based, theory-driven educational training program. The program aims at increasing OTPs’ knowledge, confidence, and competence in using neurofunctional evaluation and intervention strategies to address cognitive deficits that result from TBI/ABI. / 2023-09-16T00:00:00Z

Informal caregiving is growing in demand and is far from a uniform experience. Some caregivers report burdensome effects, while others attest to a wide range of benefits associated with their role. In the context of informal caregivers of persons affected by chronic neurological conditions (CNCs), psychological resilience is increasingly being explored as a protective factor that may account for variability in the caregiver experience; however, multiple sclerosis (MS) caregivers are noticeably absent from this body of work. To synthesize current evidence concerning resilience conceptualizations, assessments, and health correlates within this population, this thesis included a systematic review of resilience in CNC informal caregivers in which MS caregivers were unrepresented. Following this review, a qualitative study was conducted in informal MS caregivers to ascertain MS caregivers’ conceptualizations and unique lived experiences of resilience. Twenty-four semi-structured interviews of Canadian MS informal caregivers were conducted. Informed by the socioecological model of resilience in caring relationships, transcripts were analyzed using flexible thematic analysis. In support of the conceptual ambiguity of resilience, caregivers did not concur on a single resilience conceptualization. Emergent themes contributed to the creation of a cyclical model of resilience that incorporates adversity in the form of continuous loss and obstructed health-related self-care, individual and community resources, and multilevel adaptive pathways. We use our model to prompt future research directions and inform the development of effective resilience-enhancing interventions for MS caregivers.

<p> This study applies an IPE approach to examine the economic conditions, motivations and interests which have driven the Canadian government and two sending countries, Mexico and the Philippines, to accept the terms and conditions of a regulatory framework encouraging short-term labour migration between them. The features of program development which underpin the Seasonal Agricultural Workers Program (SAWP) and the Live-in Caregiver Program (LCP) have not been compared side by side. Nor have the two programs been compared for the relationship that has developed over the years between the Canadian government and the two sending governments of Mexico and the Philippines. The study's core research question asks how the process of regulating cross-border labour migration works and how it is coordinated between two or more governments that form part of a migration system.</p> <p> An important research finding that emerges from the comparison is the categorization of different types of migration systems. I argue that the SAWP and LCP differ in how they are administered because relations between the various actors differ. Furthermore, what defines these relationships is the set of geopolitical and economic interests that each government carries when it negotiates the regulation of cross-border labour migration. Findings suggest that the geopolitical and economic imperative which has driven the SAWP's development is not the same for the LCP.</p> / Thesis / Doctor of Philosophy (PhD)

The purpose of this study was to measure the impact of caregiver-student collaborative learning classes on an urban community. The study examined whether the self-efficacy of the caregivers increased with helping their children with school work due to the caregiver-student classes. The study also examined whether providing access to a resource not normally provided within this particular community led to increased self-efficacy within caregivers. The research questions that guided the study were as follows: How do collaborative caregiver-student classes that focus on collaborative strategies impact the self-efficacy of the caregivers in helping their children with school work? How does increasing access to educational services impact the self-efficacy of the caregivers who participate in collaborative caregiver-student classes? The researcher collected data through classroom observations, reflections from participants, and an initial focus group and closing individual interview. Classes were taught by a co-teacher selected by the researcher with the input of the principal. Four total sessions were held, three of which included the teaching of collaborative learning strategies, and the last of which was an individual interview. Overall, data indicated increased self-efficacy within caregivers. The caregiver roles within the neighborhood proved not to always be between an adult and child, but rather cousins and siblings who may have been close in age. Families within the neighborhood exchanged care in different ways according to their culture, work demands, and family dynamic. This program led to strengthened relationships between home and school, as well as enhanced self-efficacy and stronger relationships between caregivers and students.

Individuals in the final stages of life are often cared for by informal caregivers whose interpretation of the patient’s signs, symptoms and treatment needs and options may be incongruent with that of healthcare providers (Docherty et al., 2008). Nurses need to fully understand the scope of this disparity. The purpose of this study was to determine how Black caregivers interpreted signs, symptoms, and treatments for symptom relief during the last months of their loved one’s life. The effect on caregiver decision making was explored. This project is a secondary analysis of preexisting qualitative data. Transcripts from 5 focus groups encompassed 53 participants. All participants were Black and informal caregivers or decision makers for a loved one at their loved one’s end of life. Eighty-seven percent of caregivers were female, and a majority had a high school education. The mean age was 66. Transcripts were coded for themes independently by two researchers. To allow for the most open interpretation, no a priori set of codes was utilized. 3 main categories of signs, 4 main categories of symptoms, 4 themes of the interpretation of signs and symptoms, 4 main categories of treatments and interventions, 5 themes of the interpretation of treatments, and 3 themes describing the effect of signs, symptoms, and treatments on decision making were identified. Case examples of the caregiver interpretation process are included. Health care providers need to provide time, clear and simplified language, and additional explanation in communication. Further research combining health literacy measures and qualitative data on interpretations should be conducted.

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