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There is increasing recognition of animal-assisted interventions as a promising area of practice within health and social care for people living with dementia. However, much of the research focuses on benefits for those living in care homes and not in their own homes. The Dementia Dog Project is an innovative project that aims to support people with dementia to engage with dogs and to promote the use of dogs in dementia care in the community. The pilot project introduced a dementia assistance dog to four couples where one person had a diagnosis of dementia. The aim of this paper is to explore the mechanisms that can successfully expose the benefits of integrating dogs into dementia care by drawing on the findings of a realistic evaluation of the pilot phase of the Dementia Dog Project (2013–2015). A realistic evaluation, with its focus on context, mechanisms and outcomes illuminates why an approach may work in some situations but not in others. This makes it especially appropriate to the unique, complex experience of living with dementia and the early development stage of the programme. The analysis triangulated data from a range of primary and secondary sources including interviews with the project team, case reports, team meeting notes and transcripts of interviews with participants. The findings identified three mechanisms that help to unlock the most positive outcomes for both the participants and the dogs. These were (1) the human–animal bond, (2) relationship dynamics and (3) responsibility of caring. The findings presented within this paper provide essential information to inform and advance the planning for the use of assistance dogs for people with dementia. [ABSTRACT FROM AUTHOR]

As working lives extend and there is better recognition of early-onset dementias, employers need to consider dementia as a workplace concern. With suitable support, people living with dementia can continue employment – although, this is not appropriate for all. The requirement for employers to support employees living with dementia has human rights and legal foundations. This article considers whether employers consider dementia as a workplace concern; and the policies and/or practices available to support employees living with dementia. Thus, it develops understanding of whether employers are meeting their human rights/legislative obligations. A sequential mixed-methods approach was employed, with data collection undertaken in Scotland (United Kingdom). An online survey was sent to employers across Scotland, with 331 participating. Thirty employer interviews were conducted, with the survey results informing the interview approach. The survey and interview data were analyzed separately and then combined and presented thematically. The themes identified were (1) Dementia as a workplace concern, (2) Support for employees living with dementia and (3) Employer policy development and awareness raising. The findings demonstrate dementia awareness, but this knowledge is not applied to employment situations. There was little evidence suggesting that the rights of employees living with dementia are consistently upheld. This research sends out strong messages about the rights and legal position of person living with dementia which cannot be ignored. The continuing potential of employees living with dementia and their legal rights are not consistently recognized. This highlights the need for robust training interventions for employers. [ABSTRACT FROM AUTHOR]

Purpose: This paper reports on an action research study that aimed to collaboratively develop a complementary therapy care intervention to augment palliative care choices available to nursing home residents with advanced dementia. Design/methodology/approach: An action research design was adopted that consisted of a series of action cycles involving collaborative exploration, problem-solving planning, development and evidence gathering. A combination of mixed methods was used when gaining data at the different stages, including face to face delivered questionnaires, observational notes, focus groups, and the objective measure of the Neuropsychiatric Inventory adapted for Nursing Homes (NPI-NH). Findings: Care home staff and relatives considered the use of Complementary Therapy to be a helpful intervention promoting that it can reduce a sense of loneliness and provide companionship for residents experiencing distress. Analysis of NPI-NH scores showed a reduction in presenting neuropsychiatric behaviours associated with stress and distress. Research limitations/implications: Differing levels of participant group engagement may affect this study's findings as it was noted that care home staff provided a fuller contribution to the project in comparison to relatives. Practical implications: Implementation guidance is needed when implementing complementary therapy within the nursing home practice to promote consistency and successful integration of an intervention that is not provided as routine care. Originality/value: The findings of this study are encouraging and demonstrate the acceptability of complementary therapies to residents with advanced dementia, where positive impacts on otherwise difficult to address dementia symptoms related to stress and distress are highlighted. [ABSTRACT FROM AUTHOR]

This article reports case study research which addresses the gap in knowledge about dementia in the workplace. Receiving a diagnosis of dementia whilst still in employment may have negative consequences for a person's identity, further compounded by loss of employment. This study is the first to explore the employment-related experiences of people with dementia and their employers to determine the potential for continued employment post-diagnosis. Sixteen case studies centred on a person with dementia who was still in employment or had left in the previous 18 months. Each involved interviews with the person with dementia, a family member and a workplace representative. This triangulation of the data promoted rigour, allowing the experiences to be viewed through a variety of lenses to build a clear picture of each situation. Thematic analysis was carried out and three themes were developed: (a) dementia as experienced in the workplace; (b) work keeps me well; and (c) wider impact of dementia in the workplace. These findings have the potential to initiate changes to policy and practice related to supporting employees with dementia. The implications of this research are multifaceted and need to be considered in terms of the individuals’ wellbeing, organisational support, as well as the wider theoretical, economic and societal consequences of supporting an employee with dementia. [ABSTRACT FROM AUTHOR]

Purpose -- Recent changes affecting state pension age, and earlier diagnosis, will result in more people with dementia in employment. The purpose of this paper is to establish the nature of support that would enable/ enables people with dementia or mild cognitive impairment to continue employment post diagnosis. Design/methodology/approach -- An integrative review was carried out supported by information derived from a thematic analysis of data from interviews with seven relatives supporting a younger person with dementia and one person with dementia. Findings -- Six papers were identified for inclusion in the review. Findings from the published papers and interviews indicated that work is a significant issue for people with dementia highlighting problems with job retention, work performance and the impact of diagnosis. Research limitations/implications -- The review highlighted a dearth of high-quality research in the area. Although employment was not the main focus of the interviews, the extracts highlight some of the challenges that face people who develop dementia while of working age, their families, and employers. Practical implications -- Vocational rehabilitation is primarily carried out by allied health professionals; however, there is a lack of research evidence relating to people with dementia in the workplace. Further research is needed in order to inform future practice. Social implications -- Loss of employment deprives families of financial security and employers of a skilled employee. Originality/value -- This is the first review to focus on dementia in employment, providing a starting point on which to base future research in this area. [ABSTRACT FROM AUTHOR]

Background The negative health impacts of prolonged caregiving are widely reported. However, there is a paucity of evidence concerning the impacts of a lifetime of caring on older parents of offspring with learning disabilities. Design and Methods An exploratory postal survey including the Medical Outcome Study (Short Form) 36 version 2 (SF-36v2) was completed by 100 older parent carers. The reported survey is part of a larger mixed method study including in-depth interviews. Results The majority of respondents (n = 91) reported caring for 50 h or more per week with multiple caregiving duties. While the SF-36v2 reported physical health of older parent carers to be similar to UK norms, their mental health was significantly reduced. Implications for practice These important findings highlight the vulnerability of ageing parents of offspring with learning disabilities. This previously underreported situation warrants further investigation and urgent attention from health and social care agencies and professionals. [ABSTRACT FROM AUTHOR]

This article reports a study exploring what older people believe would enable them to adjust to and gain maximum benefit from wearing a hearing aid. A mixed methods approach was employed during 2006 involving interviews with key stakeholders, a survey across three Scottish health board areas and focus groups. Nine key stakeholders from six national and local organisations were interviewed about the needs of older people being fitted with hearing aids. In total, 240 older people belonging to three different types of hearing impaired older people were surveyed: long-term users of hearing aids, new hearing aid users, and those on a waiting list from urban and rural areas (response rate = 24%). A series of eight follow-up focus groups with 31 audiology patients was held. Health professionals appeared to neglect appropriate provision of information and overly rely on technological interventions. Of 154 older people already fitted with hearing aids, only 52% of hearing aid users reported receiving enough practical help post fitting and only 41% reported receiving enough support. Approximately 40% reported not feeling confident in the use of their aids or their controls. Older people wanted more information than they received both before and after hearing aid fitting. Information provision and attention to the psychosocial aspects of care are key to enabling older people to adjust and optimise hearing aid benefit. [ABSTRACT FROM AUTHOR]

Accessible Summary This article reports on interviews with eight older parent carers who cared for their children with learning disabilities., The aim of this study was to understand parent carers' experiences of caregiving and their views on the future., The findings revealed the following:, Parents lacked support, Parents did not receive enough information and practical resources, Some parents continued caring despite poor mental and/or physical health, All parents were concerned about their child's future, Most parents said that they were unable to think about their future and their needs, Summary This article reports on the results of a qualitative study (in-depth interviews) carried out in the United Kingdom as part of a larger (two-phased) study investigating the experiences, health and future perspectives of older parent carers (six mothers and two fathers) of offspring with learning disabilities over a prolonged period of time. The objectives of this article are twofold: (i) to present a conceptual framework, grounded in the experiences of older parent carers who participated in this research and; (ii) to come to a more in-depth understanding of older parent carers' experiences of caregiving, and views on their own future. A detailed analysis of the data revealed important issues with regard to prolonged caregiving. Overall, older parent carers felt that they lacked support, information and practical resources throughout their caregiving career. Some parents continued in their caregiving role despite their deteriorating mental and/or physical health as there appeared to be no alternative, and most parent carers expressed that they were unable to think ahead to their own future and needs owing to the absence of suitable care alternatives. The findings suggest that there is an urgent need to review how individuals with learning disabilities and parent carers are supported throughout their lifespan. [ABSTRACT FROM AUTHOR]

SCHOFIELD I, TOLSON D and FLEMING V. Nursing Inquiry 2012; 19: 165-176 [Epub ahead of print] How nurses understand and care for older people with delirium in the acute hospital: a Critical Discourse Analysis Delirium is a common presentation of deteriorating health in older people. It is potentially deleterious in terms of patient experience and clinical outcomes. Much of what is known about delirium is through positivist research, which forms the evidence base for disease-based classification systems and clinical guidelines. There is little systematic study of nurses' day-to-day practice of nursing patients with delirium. The aim was to uncover the kinds of knowledge that informs nurses' care and to explicate the basis of that knowledge. Critical Discourse Analysis is underpinned by the premise that powerful interests within society mediate how social practices are constructed. Links were made between the grammatical and lexical features of nurses' language about care in interviews and naturalistic settings, and the healthcare context. Care focused on the continuous surveillance of patients with delirium by nurses themselves or vicariously through other patients, and containment. Nurses influenced by major discourses of risk reduction and safety, constructed patients with delirium as risk objects. The philosophy of person-centred and dignified care advocated in nursing literature and government policy is an emerging discourse, though little evident in the data. The current dominant discourses on safety must give space to discourses of dignity and compassion. [ABSTRACT FROM AUTHOR]

T olson D and S chofield I. Nursing Inquiry 2012; 19: 63-70 Football reminiscence for men with dementia: lessons from a realistic evaluation A major challenge of studies of non pharmacological dementia interventions is the likely modest intervention effect size and difficulties collecting data from individuals with behavioural, psychological and communicative symptoms. The reported Realist Evaluation is built around sets of contextually comparable case studies of Football Focussed Reminiscence for men with dementia. The study aim was to evaluate benefits of football related reminiscence for individuals and family carers. Four case studies were constructed; two community groups, one nursing home groups and individual sessions within their family home. Data was collected as field notes from non-participation observation of reminiscence sessions, notes of conversations with people with dementia, audio recorded interviews with family members, facilitators and dementia link workers. The analysis was framed around identification and extraction of data pertaining to Context-Mechanism-Outcome configurations within each data set, and patterns and threads were compared across the cases. An important finding was that anticipation of pleasure in tandem with a sense of continuity appeared to be important mechanisms triggering optimal benefit. The paper explores design considerations, project delivery experiences and the contribution that innovative theory driven research adds to the study of complex interventions including those with behavioural and communicative symptoms of dementia. [ABSTRACT FROM AUTHOR]