PubMed · 7624720
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R R Walter. 1995. Codependency? Nonsense.. https://pubmed.ncbi.nlm.nih.gov/7624720/
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BackgroundDementia with Lewy bodies (DLB) is a common degenerative dementia, but no studies investigate bereaved caregiver experiences.ObjectiveTo investigate the experiences of caregivers three months after the death of persons with DLB using a mixed-methods approach.MethodsDyads of individuals with moderate-advanced DLB and their primary informal caregivers were followed prospectively every 6 months until the person with DLB died. Caregivers completed a study visit with questionnaires and a semi-structured interview ∼3 months later. Spearman correlation coefficients and Wilcoxon rank-sum tests evaluated the relationships of post-death measures with pre-death patient and caregiver variables. Thematic analysis was used to analyze the interviews.ResultsSeventy-three caregivers completed visits (mean 3.5 months post-death). Most of the caregivers were women (82.2%) and spouses (76.7%) or adult children (17.8%). Over 40% had scores indicating risk for clinical depression. Post-death caregiver experiences (depression, quality of life, grief, resilience) correlated with pre-death caregiver experiences. Post-death experiences did not associate with patient characteristics, disease-related symptoms, or healthcare services used in the last 6 months of life. Trajectories for caregiver measures from pre- to post-death visits varied widely. Interview themes included grief and sadness, anger, guilt and regret, relief, appreciation/gratitude, and adjusting to a new normal.ConclusionsThe finding that pre-death caregiving experiences have the strongest association with post-death experiences emphasizes the critical importance of accessible and evidence-based caregiver support before and after the death of a person with DLB. Research is needed to develop interventions for current and bereaved caregivers of individuals with DLB.Trial registration informationNCT04829656 (submitted 2021-03-22).
This prospective study regarding the quality of care and treatment on an unlocked psychiatric ward had two purposes. Firstly, to examine selected elements of care and treatment by continuously registering these elements during the patients' admission and to examine by questionnaire the patients' satisfaction with these elements at the time of their discharge. Secondly to test this method as a means of conducting quality assurance on psychiatric wards. The study took place at the Copenhagen County Hospital Herlev, Psychiatric Department Y, Denmark. Twenty-eight patients admitted to the psychiatric ward between March 1, and May 31, 1993 were included in the study and follow-up at their discharge. We found the method to be very good at uncovering strengths and weaknesses of the practices of our daily clinical work.
It is now 20 years since the Portage Home Teaching model of early intervention was introduced into the UK. In this paper, an overview of the Portage Model and rationale is provided, achievements over the past two decades are noted and related research and evaluation studies are reviewed. A number of areas for future development are also highlighted. These include: issues of quality control; the multi-cultural dimension of Portage; multi-agency collaboration; professional training needs of Portage personnel; and influencing central government policy relating to families who have a young child with special needs.