Louise McCabe

Physical activity for people with dementia: a scoping study

BackgroundThis scoping study aimed to identify how physical activity may benefit people with dementia; how and/or if current service provide these benefits; and what support they need to do so.MethodsMethods included an evidence review using literature; mapping current service provision through a survey; and in-depth interviews with a sample of service providers.ResultsThe 26 studies included in the review indicated the potential effectiveness of physical activity for people with dementia, including improvements in cognition and mood, behaviour and physical condition. Mechanisms of action and the link with outcomes were poorly defined and implemented.The mapping survey and related interviews showed that service providers were delivering a range of services broadly consistent with the scientific evidence. They tended to take a holistic view of possible benefits, and focused on enjoyment and well-being, more than specific cognitive, physical and behavioural outcomes highlighted in literature. Service providers needed more evidence based information and resources to develop services and realise their potential.ConclusionDespite potential benefits demonstrated in literature and practice, there is a need for further research to optimise interventions and to consider some neglected issues including delivery at home and in communities; impacts for carers; physical activities through ADLs; and individual needs. Studies are needed which take a more holistic approach to the effects of physical activity, and outcomes should be broader and include mental health and wellbeing.

Caring for older people with an intellectual disability: A systematic review

This review critically evaluates the available research literature on aging among people with an intellectual disability. 42 papers meeting the review inclusion criteria are presented under three themes: studies with a service user perspective (13), studies of carers of older people with ID (14) and studies of service provision for older people with ID (15). User view specific findings relate to concerns about accommodation; experiences of services; and perceptions of aging; with a common underlying finding from all user focused themes that of unmet need. Carer specific findings relate to fear of the future; experiences of older carers; and planning for the future. Services themes reflect the debate over specialist or generalist services as people age; accommodation; retirement from day services; and staff training. Overall this review reveals a lack of robust research evidence concerning the lives of older people with ID and a need for more research that directly engages with older people with ID and their carers.

Dementia Studies Online: Reflections on the Opportunities and Drawbacks of eLearning

This paper explores the opportunities and drawbacks of eLearning from the viewpoints of educators and learners. A postgraduate dementia studies programme provides the basis for reflection on the use of a blended learning approach utilising web‐based learning. Those who register for the programme are employed in different health and social care settings and have varied roles, but all have a desire to improve their knowledge and skills within a field where continuing professional development is currently limited. The paper outlines the main debates around eLearning and describes the programme itself. It then focuses on three key themes. First the challenges for educators, in terms of cost and quality, in developing and delivering an online curriculum. Second the flexibility of the structure and learning methods for students. Third how student support was developed using the concept of a learning community. It concludes by summarising the strengths and challenges of this mode of learning for students and the key lessons learned by the educators.

The cultural and political context of the lives of people with dementia in Kerala, India

This article draws on available literature and empirical data to discuss the experiences of people with dementia in Kerala, India. India is currently undergoing considerable demographic change. The state of Kerala in the south-west of the country is demographically advanced in comparison with other parts of India and as such is experiencing demographic change and modernization ahead of other parts of the country. The proportion and numbers of older people in Kerala are increasing, which in turn is leading to a higher prevalence of dementia. This article reviews existing literature to describe the context for people with dementia in Kerala. It also draws on empirical data to further illustrate and explore their experiences. People with dementia in Kerala are disadvantaged, as the process of modernization is breaking down traditional forms of care ahead of any significant service provision to replace them. Recent development of services in Kerala aims to provide quality care for people with dementia to counteract these demographic changes.

Supporting User Participation in Local Policy Development: The Fife Dementia Strategy

This article reviews the consultation process during the development of a local dementia strategy. The processes of involvement by the range of stakeholders involved and how their different views shaped the strategy are considered. Particular attention is paid to the involvement of people with dementia as they are the recipients of the services to be shaped by the strategy and also form the group most difficult to reach. This article demonstrates the value of including a wide range of stakeholders in the development of local policy and the importance of involving people with dementia in policy development.

'What I want to do is get half a dozen of them and go and see Simon Cowell': Reflecting on participation and outcomes for people with dementia taking part in a creative musical project.

This paper presents the findings from an evaluation of a creative musical project led by Scottish Opera. The project included people with dementia and their carers in the development, writing, design and performance of a musical production about their experiences of love. The project involved professional singers, artists and choreographers from the opera company. Activities involved practice sessions and performances. People with dementia and their carers reflected on positive outcomes from the project including improved confidence; being part of a group; improved physical strength and people seeing them in a new way. Within the evaluation framework they also reported on how the project had been run and gave ideas for future development. Key elements in the success of this project were the involvement of professionals, the kudos of working with a national organisation and the performances that, while daunting, provided unique and rewarding experiences.

Effects and Costs of a Day Care Centre Program Designed for People with Dementia-A 24 Month Controlled Study

Background: Attending day care centres with programs specifically designed for patients with dementia is believed to postpone admittance to nursing home as well as increase quality of life and well-being for both patients and their family carers. Therefore, the Norwegian Ministry of Health and Care Services is presently offering funding to all municipalities that wish to establish day care centre programs for this group of patients. There is only limited knowledge on the effectiveness of day care centre programs designed for patients with dementia. Our research group aims to investigate to what degree attendance in day care centres with programs designed for people with dementia is effective to postpone admittance to nursing home care, to enhance quality of life for the patients and to relieve burden of care for the family carers. Methods/Design: The study is a quasi-experimental trial with a comparison group and a qualitative inquiry. Four hundred patients with dementia and their family caregivers will be included in the trial. Assessments will be made at baseline, after one and two years. Data collection will be made at three levels; at patient level with measures of cognition, depression, coping, quality of life, functioning in activities of daily living, neuropsychiatric symptoms and time of death; at family carer level with measures of depression, coping and burden; and at societal level with measures of nursing home admittance, hospital stays and use of other health and social care resources. For the qualitative analysis, 20 dyads of patients receiving a day care program and their family carers will be asked to participate. The main focus will be to explore how the day care centre programs affect both the patients and the family carers’ daily life. Five of these dyads will be followed closely throughout two years. Trial registration: Clinical Trial number NCT01943071.

Developing best practice guidelines for designing living environments for people with dementia and sight loss

ABSTRACT The paper considers a process of developing evidence-based design guidelines to be used in environments where people with dementia and sight loss are living. The research involved a systematically conducted literature review and a series of consultations with people affected by dementia and/or sight loss who lived or worked in care homes or in domestic settings. Findings from the literature and the consultations were used in an iterative process to develop the guidelines. The process is outlined, providing examples from the guidelines about lighting and colour and contrast. In discussing the research findings and the development process, the authors consider implications of the work including the weakness of the evidence base, the challenges of improving this and the need for innovative approaches to understanding the complexities of design for people with dementia and sight loss. They highlight the emphasis in the literature on independence for people with sight loss and the focus on control of people with dementia, arguing that this falls short of a genuinely person-centred approach, which recognises the active participation of people with dementia and sight loss.

Design of residential environments for people with dementia and sight loss: a structured literature review

A structured literature review concerning the design of living environments for people with dementia and sight loss was conducted. Following systematic searching, 33 items were included and quality was assessed. Findings are described covering colour and contrast, lighting, fixtures and fittings, entrances and exits, gardens, and outdoors. The discussion highlights the poor quality of evidence, combined nevertheless with useful suggestions for design; the tendency for the literature to be fragmented; and the need for improvements in terms of study focus, study quality, and an emphasis on independence and individual needs. The review was subsequently used to inform the development of design guidelines.

Keeping your brain active': the activities of people aged 50-65 years

The paper aims to construct a baseline of knowledge about current activities, attitudes and motivations of a sample of people aged 50–65 years in relation to ‘keeping ones brain active’, with a particular focus on activities suggested in the literature and in popular parlance to have positive effects.