Dementia incorporates a range of serious cognitive and non-cognitive changes including memory loss. People with dementia are vulnerable to getting lost and may require additional support to walkabout safely outdoors. Through a review of the research literature on wandering and getting lost, the thesis examines this complex and contested phenomenon and constructs a 'problem theory.' The evidence-base regarding assessment is examined and a new method of assessment proposed. The value of interventions, including electronic tracking, to promote safe walking outdoors is considered. The thesis is reported in three sections. The first section presents a review and a pilot study of electronic tracking with dementia carers. The study elicited understanding of usage, impact and acceptability and highlighted the need for intervention development to be based on sound research evidence of the phenomenon and its assessment. The second section examines the phenomenon through a review and an observational study of dementia-related police missing-person reports. The study examined incidence, consequences and the risk factors for harm. Results suggest getting lost is a low-frequency event. While harm was rare, the study indicates that the risks increase with age, going missing in winter and length of time missing. An assessment of safety needs to inform decisions about intervention. The third section reports the development of a new method of assessment based on a clear theoretical framework and includes a review and content validity study. The review highlighted the limited attention paid to assessment, including safety, as a means of supporting people with dementia to walkabout outdoors. The study indicated a need for a flexible and inclusive assessment process that seeks to balance safety concerns with quality of life. Further research is needed to understand this complex phenomenon. Identifying the predictors of harm is an important research priority, necessary to support assessment and intervention
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:572757 |
| Date | January 2012 |
| Creators | Bantry White, Eleanor |
| Publisher | University of Oxford |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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