Building Resilience Mild Cognitive Impairment and Early-Stage Dementia Innovative Approaches to Intervention and Outcome Evaluation Read more
Racism Reported By Direct Care Workers in Long-Term Care Settings This article focuses on reports of racism experienced by direct care workers (DCWs). These DCWs provide the majority of hands-on care to older residents/ clients that need help with activities of daily living such as bathing and dressing in long-term care (LTC) settings. Interviews were conducted with 644 DCWs working in three types of LTC settings. Proportionate random sampling techniques were used to select 49 LTC agencies from a five-county area in northeast Ohio. The DCWs included nurse assistants in nursing homes, resident assistants in assisted living facilities, and home care aides in home health agencies. Analyses reported include frequencies, chi-square tests, and analysis of variance. Hearing racial and ethnic remarks, particularly from residents/clients, was widely reported by DCWs. Despite this, DCWs were likely to believe that remarks from residents/clients were not intended to hurt their feelings. Although DCWs heard fewer racial/ethnic remarks from family members or other staff, they were likely to believe that such remarks were intended to hurt their feelings. At the organizational level, DCW reports of hearing racial/ethnic remarks in nursing homes were more frequent than those in other LTC settings. Further, DCWs in organizations in which racial differences between them and the residents/clients that they served was very large reported hearing significantly more racial/ethnic remarks. These findings have important implications for addressing racism in LTC agencies with anti-discrimination policies and programs. Read more
Applying a Strength-Based Intervetion for Dyads with Mild to Moderate Memory Loss Two Case Examples Managing and coping with the symptoms of dementia and memory loss is associated with negative psychosocial outcomes for both persons with dementia and their family caregivers. Research has indicated beneficial results in using dementia-management interventions to impact positively on mental health outcomes for caregivers and address cognitive and functional issues for persons with dementia. However, most intervention programmes to date have primarily worked with each care partner separately, rather than implementing a single intervention protocol that targets both members of the caregiving dyad. This article provides a description of a newly designed intervention that includes both care partners. Using a Strength-Based Approach, the dyadic intervention identifies and builds upon both care partners’ current abilities to address their specific care needs. Two case examples are presented to illustrate the flexibility and advantages of using a Strength-Based Approach. The discussion highlights the extent to which core intervention skills can be tailored to fit a range of care needs. Read more
Acceptability and Feasibility Results of a Strength-Based Skills Training Program for Dementia Caregiving Dyads Purpose: The current article provides an in-depth description of a dyadic intervention for individuals with dementia and their family caregivers. Using a strength-based approach, caregiving dyads received skills training across 5 key areas: (a) education regarding dementia and memory loss, (b) effective communication, (c) managing memory loss, (d) staying active, and (e) recognizing emotions and behaviors. Results of the acceptability and feasibility of the intervention protocols are also presented. Design and Methods: Caregiving dyads were randomly assigned to participate in the intervention. Participants in the treatment condition were asked to complete a series of evaluation questions after each intervention session and an overall evaluation of the program. Data were also collected from the intervention specialists who implemented the protocols. Results: Overall, the evaluation data indicated that the content and process of the intervention were viewed as highly acceptable and feasible by both participants and intervention specialists. Implications: This article highlights the merit of using a strength-based approach for working with caregiving dyads with dementia and how a single intervention protocol can be used to address the goals of both care partners. Furthermore, the intervention program was found to be highly acceptable and feasible, which is an important aspect of developing dyadic protocols. Read more
Stress Process Model for Individuals with Dementia Purpose: Individuals with dementia (IWDs) face particular challenges in managing and coping with their illness. The experience of dementia may be affected by the etiology, stage, and severity of symptoms, preexisting and related chronic conditions, and available informal and formal supportive services. Although several studies have examined particular features of IWD’s illness experience, few draw upon a conceptual model that outlines the global illness experience and the resulting stressors that commence with symptom onset, proliferate over time, and continue through the later stages of cognitive loss. Building on the work of Pearlin and colleagues (1990, Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30, 583–594), this article proposes a stress process model (SPM) for IWDs that conceptualizes and examines the illness experience of IWDs. Implications: The proposed SPM for IWDs serves as a guide to (a) consider and understand the short- and long-term complexities of the illness experience for IWDs, (b) investigate specific hypotheses by outlining key stressors in the illness experience and by positing relationships among stressors and outcomes, and (c) help inform the development of interventions to prevent or reduce the negative stressors and enhance the positive experiences of living with a dementing illness. Read more
Impact of Arts Participation on Health Outcomes for Older Adults The objective of this study was to present findings from a literature review on the documented health benefits of arts programs for older adults. A systematic literature review was conducted to examine research publications on participatory arts programs for older adults and their reported impact on health outcomes. A total of 2,205 articles were found. Of these, 11 were eligible for inclusion. The review describes the effects of participation in art programs on a variety of health outcomes. The small number of empirical studies documenting the health impact and limitations in their design prohibit broad generalizations, however, findings suggest there are physical and mental health benefits for older adults from arts participation. Read more
Strengthening the Direct Care Workforce Preliminary Recommendations from a National Panel of Experts in Long-Term Care Read more
How Well Do Family Caregivers Know Their Relatives’ Care Values and Preferences Purpose: This study examines the psychometric properties of the Values and Preferences Scale (VPS) and compares the responses of 267 persons with cognitive impairment with the responses of their family caregivers to determine the accuracy of the caregivers’ perceptions of their relatives’ care values and preferences. Design and Methods: Exploratory factor analyses examined whether a consistent factor structure could be found for the VPS for both persons with cognitive impairment (PWCIs) and family caregivers. Analyses also determined whether family caregivers were accurate in their perceptions of their relative’s care preferences. Results: Results indicated that the VPS was best divided into four factors or subscales (i.e., Burden, Safety/Quality of Care, Autonomy, and Social Interactions) all of which were found to have adequate internal consistency for persons with cognitive impairment and family caregivers. Caregivers generally had a good sense of what preferences were most important to their relatives (i.e., issues of safety and quality of care), but often underestimated the importance of certain values and preferences. Implications: These findings support previous work suggesting that practitioners consider incorporating an assessment of val Read more
Predictors of Quality of Life for Individuals with Dementia Implications for Intervention Although a growing number of investigations examine the lived experience of individuals with dementia (IWDs), few draw upon a conceptual model to explore inter-relationships among background characteristics, stressors, and outcomes (Menne, 2006). This study is guided by a conceptual model that draws upon the broader stress literature to examine predictors of IWD quality of life. Relying primarily on IWD self-reported data (n = 211), multivariate ordinary least squares regression analysis was used to determine the predictors of IWDs’ quality of life. Results indicate that IWDs who report poorer quality of life are more likely to be African-American, have a non-spousal caregiver, have more depressive symptoms, be less involved in daily decision-making, and have more negative strain with their caregiver. These findings are discussed in the context of current and practical interventions that address the strengths and needs of IWDs and their family caregivers. Read more
