Why we need dementia care nursing.
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Aged↗
Biomedical subjects
J Keady
Publications and source records attributed to J Keady.
Telephone helplines for people with dementia.
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Adult↗
Rewards and gratifications among family caregivers: towards a refined model of caring and coping.
Supplemented by a case illustration, findings from a study in Wales are reported for the first time from the application of two new instruments for measuring rewards and stresses among family caregivers. The paper takes as its starting point a critique of models of caregiving which emphasize instrumental and pathological dimensions. Findings suggest that caregivers report the existence of pervasive rewards and gratifications, as well as stresses, as part of the caregiving experience, and that these stem from varying sources. The role of rewards and satisfactions in stress-coping models is briefly discussed, and implications for changed practice and policy thinking are reviewed.
Activities of Daily Living↗
The concept of serious mental illness: modern myths and grim realities.
Current mental health practice and legislation is influenced significantly by the ill-defined concept of serious mental illness (SMI). Although the concept of SMI originally appeared to include a consideration of a range of forms of mental illness, including dementias, by custom and practice the term has come to mean, often, only people with a psychotic diagnosis. This paper reviews the influence of the term SMI, considering the way older people, younger people and other subgroups within the 'adult' population have been marginalized by the narrow definition of the concept. The paper concludes with a consideration of some of the ethical implications of mental health nurses focusing on an ill-defined 'illness' grouping, and the impact that such a narrow focus might have on the ambition to establish 'health for all by the year 2000'.
Adolescent↗
Behavioural and Instrumental Stressors in Dementia (BISID): refocussing the assessment of caregiver need in dementia.
The importance of supporting family carers of people with dementia is well accepted and is likely to remain one of the primary areas of intervention for mental health practitioners. This article argues for a holistic assessment of need prior to designing intervention strategies. Such an assessment should include both objective and subjective stressors. Following discussion of a relevant theoretical approach to assessment, a new index for measuring behavioural and instrumental stressors is presented.
Caregivers↗
The Strategy for Action on Farmers' Emotions (SAFE): working to address the mental health needs of the farming community.
Within the United Kingdom farmers are considered to be the fourth highest occupation group at risk of committing suicide. However, the mental health needs of the farming community are currently poorly understood or addressed by mental health nurses and community mental health teams. This is unacceptable both in terms of the presented level of risk, and in the direction of the most recent mental health review, which suggests that mental health nurses have unique skills in identifying and responding to suicidal behaviour. By building upon the practice of the first author, this paper outlines the Strategy for Action on Farmers' Emotions (SAFE), which develops a comprehensive strategy to respond to the mental health needs of the farming community. Where it is applicable, it is vital that these needs are brought from the margins to the mainstream of policy and service provision. This paper suggests that this position will only be achieved once an increased understanding of farming life and culture is gained.
Agriculture↗
The experience of dementia: a review of the literature and implications for nursing practice.
This paper explores the early experience of dementia when the veil of uncertainty that surrounds the diagnosis of this condition is lifted. Consideration will also be given to the impact of dementia on carers and the service demands that are created. In the UK alone there are estimated to be 636,000 people living with dementia, with this figure rising to just under 900,000 by the year 2021. In the USA the projected number of people with Alzheimer's disease is expected to be 9,000,000 by the year 2040 Despite a wealth of social and gerontological research on the impact of dementia upon family carers, service responses and policy initiatives are fragmented because dementia is excluded from some important recent initiatives, such as the Mental Health Task Force. Current services and interventions focus predominantly on the later stages of dementia, when a meaningful perspective of the person with dementia is difficult to obtain. Nursing has a relatively long history of caring for people with dementia and their family carers. The paper will also consider the contribution of nursing and nursing research to the field and explore additional avenues for service intervention and education.
Cost of Illness↗
Developing a typology of family care: implications for nurses and other service providers.
The meanings attributed to the concept of care are considered. It is argued that whilst nursing has paid considerable attention to care in a professional (nursing) context, it has virtually ignored care as it is defined and construed by family carers. A new typology of family care is described which builds on the limited existing conceptual work in this area. It is further suggested that interventions which are intended to assist carers form a continuum ranging from services which are facilitative to those which are actually obstructive. In the light of these discussions, the implications of the new typology for nurses working with family carers are addressed briefly.
Caregivers↗
Younger-onset Alzheimer's disease: learning from the experience of one spouse carer.
There are estimated to be 17,000 younger sufferers of dementia currently living in the UK. At present, individualized service and practice initiatives for younger sufferers and their carers remain fragmented and poorly developed. This is despite potential additional caregiving stressors caused by the age of onset, such as financial difficulties due to disruption in the work pattern, children still living at home, and the sufferer's decreased life expectancy. Drawing on an individual carer's personal case history, this article details a spouse carer's individual experience of her husband's decline through the stages of younger-onset Alzheimer's disease. Pointers for policy and practice for younger sufferers and their carers are drawn from this case history and a role for the community psychiatric nurse is outlined.
Adaptation, Psychological↗
A stitch in time. Facilitating proactive interventions with dementia caregivers: the role of community practitioners.
The role of family caregivers in supporting people with dementia in the community is beyond question. Yet, all too often, the needs of such carers are overlooked by community practitioners. This paper describes the results of a study in Wales examining the experiences of dementia caregivers with Community Practitioners. Four themes are identified which encapsulate the various difficulties carers faced. These revolve around a lack of communication, information and support. Recommentations to improve the current situation are made.
Aged↗
Younger onset dementia: developing a longitudinal model as the basis for a research agenda and as a guide to interventions with sufferers and carers.
With the current emphasis on community care, the importance of dementia as an area for the interventions of community practitioners, especially nurses, cannot be overemphasized. However, despite being the subject of increasing research over recent times, a comprehensive model of the dementia experience from either the sufferer's or carer's perspective has yet to be developed. This is particularly noticeable in the case of people suffering from dementia below the age of 65. This situation is exacerbated by the lack of representative epidemiological studies which relate to the incidence or prevalence of younger onset dementia. In this paper, the current epidemiological literature on younger onset dementia is considered and the findings from previous work are used to suggest prevalence figures for Wales. A longitudinal model of the dementia experience from a sufferer's perspective is then presented as the basis for a research agenda. It is also suggested that this model, subject to empirical testing and refinement, could be used as a guide to interventions for practitioners working with the sufferers and their carers.
Caregivers↗
The carer-led assessment process (CLASP): a framework for the assessment of need in dementia caregivers.
The initial and on-going assessment of individuals with dementia may not always fully reflect the expert knowledge of the caring situation that carers possess. In the absence of such knowledge a comprehensive and responsive assessment is unlikely to be achieved. This paper describes the development of a carer-led assessment process (CLASP) which it is suggested provides a flexible framework for the assessment of need in carers of dementia sufferers.
Activities of Daily Living↗
Supporting families over the life course: mapping temporality.
BACKGROUND: The present paper addresses a rather neglected dimension of family caregiving, its temporality. Many accounts of caregiving assume a state of stasis, and therefore, overlook factors which shape the evolving experience of family caregiving over the life course. METHODS: The paper begins by offering some reflections on theoretical and methodological issues identified by life-course researchers. RESULTS: Based both on theoretical propositions and a growing body of empirical evidence, this paper offers a heuristic for thinking about caregiving stages applied to families supporting people with intellectual disability. CONCLUSIONS: This heuristic is used to suggest further avenues of research and development.
Caregivers↗
Living alone with dementia.
In the UK there is estimated to be 154,000 people with dementia who live on their own. People with dementia aged over 85 years make up half of this figure. People with dementia who live on their own are more prone to the risk of self-neglect, injury and exploitation. District health authorities need to identify and monitor the number of people with dementia who live on their own. Nursing interventions need to take centre stage on assessment, relationship building and networking responsibilities.
Aged↗
Role of the nurse in the early stages of Alzheimer's disease.
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Adaptation, Psychological↗
Implications for nursing of the Alzheimer's Disease Society report.
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Alzheimer Disease↗
CAMI: a basis for assessment and support with family carers.
This article describes the development of a new index for assessing the coping strategies employed by family (informal) carers. It considers the nature of coping and suggests ways that professional interventions can augment the coping repertoires that carers employ.
Adaptation, Psychological↗
FADE: a strategy for action in the mild stage of dementia.
This article introduces the Framework for Action in Dementia (FADE), a new strategy aimed at the mild stage of dementia. It suggests that empowering people with dementia from the onset of their illness is a crucial role for nurse practitioners.
Dementia↗