Experience Of Dementia Care Research Articles

Intersecting social relations of care: a protocol for an ethnographic and interview study with South Asian people ageing in place with dementia

IntroductionPeople living at home with dementia are often cared for by family members, especially those from minority ethnic groups. Many people living with dementia from minority ethnic communities face barriers...

Carers and professionals' views on using virtual reality in dementia care: A qualitative study.

Virtual reality (VR) interventions provide immersive, interactive computer-simulated virtual environments. There is interest in their use for people with dementia as they may provide stimulating experiences and improve dementia symptoms and quality of life. However, as more insight is needed about carers' and clinical professionals' perspectives to understand how VR may be implemented successfully, we elicited their views on the benefits of, and challenges to, using VR in dementia care. We conducted five qualitative focus groups involving 25 healthcare professionals and informal carers with experience of dementia care. Participants received a demonstration of a VR headset and content and were then questioned following a topic guide asking for views on benefits of, and challenges to, using VR for dementia care. The main findings addressed the benefits of, and concerns about, the impact and implications of VR on wellbeing, ethics, implementation, caregivers and services. Overall, participants had a positive attitude toward VR and made several suggestions for its future use to enable enjoyable and immersive experiences. Examples included suggestions to personalise VR content to accommodate heterogenous profiles and stages of dementia, co-developing protocols to address health risks and side effects and further investigating shared experiences of VR with caregivers. Healthcare professionals and informal carers thought that VR had potential to enhance a holistic and personalised approach to dementia care. They suggested changes which could guide future implementation of VR interventions for dementia patients and their caregivers.

HIGHER STRESS AMONG ETHNIC MINORITY ADULT-CHILD CAREGIVERS COMPARED TO SPOUSAL CAREGIVERS IN DEMENTIA CARE

Abstract Ethnic minority family caregivers of persons with dementia (PWD) suffer from negative health conditions resulting from continuous care responsibility for PWD. While adult-child caregivers have additional family care and job responsibilities, cultural and linguistic needs in ethnic minority families further compound caregiving challenges. Little research examines ethnic minority caregivers’ health statuses. This study aimed to understand the emotional health status and dementia care experiences of minority caregivers, between spouses and adult-children. The study collected cross-sectional survey data on perceived stress and utilizations of caregiving resources: Alzheimer’s agencies, state-funded in-home supportive service, adult-day service, support groups, and caregiving education. Recruitment focused on diverse communities with special emphasis on minority caregivers who speak Spanish, Vietnamese, or Korean in California. Seventy-six caregivers participated in surveys in their respective language; 42% Korean, 38% Vietnamese, 20% Spanish; 49% spouses/partners vs 51% adult-children/grandchildren; 78% females; 55% PWD with Medicaid; Mean English Proficiency (EP) of 3/5(1.3). Sixty-four percent of adult-child caregivers were employed (full-time or part-time) compared to 5% of spousal caregivers (P<.05). Adult-child caregivers showed higher stress compared to spousal caregivers (P<.05) despite no differences in PWD’s activities of daily living (ADL) scores and instrumental ADL scores. Although EP of adult-child caregivers was higher than spousal caregivers (P<.05), both caregivers underutilized care resources and showed little awareness of Alzheimer’s agencies. Findings demonstrated higher caregiving stress of adult-child caregivers compared to spousal caregivers of PWD among minority groups. Tailored interventions with appropriate language and cultural aspects should consider the caregiver’s relationship to the PWD.

Challenges and opportunities in providing dementia care for Aboriginal and Torres Strait Islander peoples living in rural and remote areas.

Dementia rates within Australian Aboriginal and Torres Strait Islander populations are estimated to be three to five times higher than non-Indigenous populations. Geographical and cultural barriers demand creative ways of delivering culturally appropriate effective dementia care. Focus groups and interviews with people (N = 73) from three Aboriginal Medical Services and communities explored attitudes toward, and experiences of dementia care and services. A thematic analysis highlighted the juxtaposition between biomedical and culturally appropriate models of dementia care. Services at the cultural interface can be adapted to facilitate appropriate dementia care at a local level allowing people to stay on Country, supported by people within one's own Community.

Working in a gray area-Healthcare staff experiences of receiving consent when caring for persons with dementia.

Every person has the right to autonomy, and to be involved in decisions about their care. When persons with dementia have difficulties in expressing what they want, their autonomy is challenged. Staff should strive to involve the person in care decisions, to obtain consent and to avoid the use of coercion and restraints. However, care without consent exists and coercion and restraints are being used. In order to improve care, further knowledge is warranted. The purpose of this study was to explore staff's experiences of obtaining consent when caring for persons with dementia. In total 14 focus group interviews were conducted with staff with experience of dementia care who work in either home care or residential care in Sweden. An inductive qualitative content analysis was used to analyze the collected data. Three categories were generated describing staff experiences of consent in dementia care: the person as the decision-maker, the staff as the decision-makers, and the viability of the consent. Overall, staff found it difficult to know if they really had consent from the individual. Even if the person verbally gave consent, it was challenging to know if the person really understood what they had consented to. Common to all three categories was the significance of the relationship between the person with dementia and staff: getting to know the person, recognizing the person's response in terms of their facial expressions and body language as well as being able to explain and justify specific actions to the person. Staff need better conditions in dementia care, including training and time to reflect on how to obtain consent. A person-centered approach can be one way to develop care and ensure that persons with dementia are allowed autonomy and to share in making decisions.

Informal dementia care: The carer's lived experience at the divides between policy and practice.

Support for informal dementia care at a local community level is not working for most carers today. Carers looking after a person with dementia have long lamented the absence of an empowered named support and an effectively actioned care plan. Drawing on literary writing and social research, we argue in this article that these challenges have existed since dementia emerged as a major condition in the West during the 1980s. Based on this historical context, we ask: Why has this issue persisted over the last four decades? How have healthcare politics and policy initiatives responded to these requests? And what can we learn from this for the current, COVID-19 exacerbated crisis of care? This article focuses on the English context, to discuss these ongoing challenges in the light of a series of policy papers, and to ask what is hampering the implementation of such policy initiatives. In England, local authorities are responsible for dementia support. This article focuses on the situation in a county in the Midlands where one of us (AB) has been lobbying local government for over a decade. The discussion contextualises the lived experience of dementia care within the situation exacerbated by the COVID-19 pandemic, ensuing politics of crises and persistent emphasis on cure over care. We find that the absence on two points centrally challenges care: a joined-up approach between health and social care and adequate information on available care support services, accessible through an empowered named contact. To enhance the lived experience of dementia care, consistent provision of individual named support and professional care support, as and when required, should become essential to local implementation of the care policy.

Trust and inclusion during the Covid-19 pandemic: Perspectives from Black and South Asian people living with dementia and their carers in the UK.

IntroductionPeople from ethnic minority backgrounds living with dementia are more likely to be diagnosed later and have less access to health and social care support than their White counterparts in the United Kingdom (UK). Covid‐19 has exacerbated health inequalities and diminished trust from underserved communities in the government and health services. The wider aim of the study was to explore the impact of covid‐19 on Black and South‐Asian people living with dementia and their carers as well as exploring the experiences of dementia care. The present paper specifically explores their views on trust and mistrust using an ecological model.MethodSemi‐structured interviews were conducted with 11 family carers and four people living with dementia from South Asian or Black communities living in the community. Thematic analysis was used to analyse data.DesignAn exploratory qualiative design was used.ResultsFour main themes were developed exploring trust at the structural, organisational, community and individual level. At the structural level, participants discussed the inequity of Covid‐19, some lack of trust in the UK Government and confusion in its messaging, and the anxiety sometimes leading to curtailment of media usage. At the organisational level, there was some evidence of a perceived lack of person‐centred and culturally sensitive care from healthcare professionals, as well as concerns around care homes as places of safety. At the neighbourhood community level, participants discussed both a distrust as well as a strengthening of relationships and, at the individual level, factors such as knowledge of services, identity, and faith influenced their experience of the pandemic.ConclusionsPeople living with dementia need support at all levels and this study highlights how the pandemic impacted each level. Ways to improve trust in the Government and health professionals alongside culturally adapted health messaging should be explored. Alongside this, an examination of how cultural values and norms may influence help‐seeking responses to dementia and increase trust in services may be helpful post‐pandemic.

Multispecialty Interprofessional Team Memory Clinics: Enhancing Collaborative Practice and Health Care Providers' Experience of Dementia Care.

This study explored whether working within Multispecialty INterprofessional Team (MINT) memory clinics has an impact on health care professionals' perceptions of the challenges, attitudes, and level of collaboration associated with providing dementia care. Surveys were completed by MINT memory clinic members pre- and 6-months post-clinic launch. A total of 228 pre-and-post-training surveys were matched for analysis. After working in the MINT memory clinics for 6 months, there were significant reductions in mean ratings of the level of challenge associated with various aspects of dementia care, and significant increases in the frequency with which respondents experienced enthusiasm, inspiration, and pride in their work in dementia care and in ratings of the extent of collaboration for dementia care. This study provides some insights into the effect of collaborative, interprofessional approaches on health care professionals' perceptions of the challenges and attitudes associated with providing dementia care and level of collaboration with other health professionals.

Resilience and Service Needs Among African American Caregivers of People With Dementia: A Pilot Mixed-Methods Study

African American caregivers face unique challenges and strengths in addressing the needs of dementia care recipients. The purpose of the current study was to explore the roles of the familism and faith and service preferences and needs for African American dementia caregivers. Through collaborative partnerships among the research team, Alzheimer’s’ Association, Area Agency on Aging, and local churches, we obtained focus group and survey data (N=30) from African American dementia caregivers. Most caregivers were female (90%) and older than 51 years and had provided care more than 3 years. CGs showed strong cultural reasons (e.g., faith, duty, paying back) for providing care (range 0-40;M= 34.5; SD= 5.2). Focus groups data, which was audio taped, transcribed, and analyzed by three researchers using content analysis, revealed three major themes related to dementia care experiences and needs. First, caregivers explained positive aspects of caregiving for both the individual caregiver and family (growth in faith, sense of self -efficacy, feeling of gratefulness). Second, caregivers also described negative aspects that pose substantial challenges such as lack of services, lack of balance in life, family conflicts over care, and mistrust based on their previous experiences with existing health care systems. Third, caregivers described their knowledge of dementia and shared their self-care and coping strategies and a need for support group services. The findings show an urgent need to implement culturally responsive services, especially in undeserved areas and populations, for caregivers to maintain or improve their emotional well-being and quality of care as well as family relationships.

Living well with cognitive decline and dementia

Nursing and Residential CareVol. 21, No. 12 CommentLiving well with cognitive decline and dementiaAysha MendesAysha MendesFreelance journalist, specialising in health, psychology and nursingSearch for more papers by this authorAysha MendesPublished Online:18 Nov 2019https://doi.org/10.12968/nrec.2019.21.12.672AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View articleReferencesCare Quality Commission. Cracks in the pathway: people's experiences of dementia care as they move between care homes and hospitals. 2014. https://www.cqc.org.uk/publications/themed-inspection/cracks-pathway (accessed 7 November 2019) Google ScholarClare L, Nelis SM, Quinn C et al.. Improving the experience of dementia and enhancing active life—living well with dementia: study protocol for the IDEAL study. Health Qual Life Outcomes. 2014; 12(164). https://doi.org/10.1186/s12955-014-0164-6 Google ScholarDepartment of Health and Social Care. Living well with dementia: a national dementia strategy. 2009. https://tinyurl.com/y3k38e8p (accessed 21 October 2019) Google ScholarESRO. A good life with dementia. 2014. https://tinyurl.com/y6dl3xhp (accessed 7 November 2019) Google ScholarHackett RA, Steptoe A, Cadar D, Fancourt D. Social engagement before and after dementia diagnosis in the English Longitudinal Study of Ageing. PLoS One. 2019; 14(8):e0220195. https://doi.org/10.1371/journal.pone.0220195 Crossref, Google ScholarMarioni RE, Proust-Lima C, Amieva H et al.. Social activity, cognitive decline and dementia risk: a 20-year prospective cohort study. BMC Public Health. 2015; 15:1089. https://doi.org/10.1186/s12889-015-2426-6 Crossref, Google ScholarMendes A, Palmer SJ. Dementia and mental health: a blurry interface. Nurs Res Care. 2018; 20(6):274—276. https://doi.org/10.12968/nrec.2018.20.6.274 Link, Google ScholarMilne A. Depression in care homes. In: Chew-Graham CRay MG. Mental health and older people: a guide for primary care practitioners. Cham (Switzerland): Springer International Publishing; 2016:145—160. https://doi.org/10.1007/978-3-319-29492-6_13 Crossref, Google ScholarPrince M, Knapp M, Guerchet M et al.. Dementia UK: second edition—overview. 2014. http://eprints.lse.ac.uk/59437/1/Dementia_UK_Second_edition_-_Overview.pdf (accessed 7 November 2019) Google ScholarRegan M. The interface between dementia and mental health: an evidence review. 2016. https://www.mentalhealth.org.uk/sites/default/files/Dementia%20paper.pdf (accessed 7 November 2019) Google Scholar FiguresReferencesRelatedDetails 2 December 2019Volume 21Issue 12ISSN (print): 1465-9301ISSN (online): 2052-2932 Metrics History Published online 18 November 2019 Published in print 2 December 2019 Information© MA Healthcare LimitedPDF download

A qualitative study of the dementia-care experiences and educational needs of physiotherapists in the Republic of Ireland

ObjectivesGait disturbance and impaired balance lead to a greater risk of falls and hip fractures for people with dementia. Physiotherapists play an important role in multidisciplinary dementia care. This study aimed to explore physiotherapists’ experiences of dementia care and sought to identify their dementia-specific educational needs. DesignQualitative design, using focus group interviews. SettingPrimary care and secondary care physiotherapy services in the Republic of Ireland. ParticipantsSix focus groups with thirty-two physiotherapists, working in community care and hospital settings. ResultsPhysiotherapists described a significant dementia-related workload. Challenges to care included absence of a formal diagnosis, clinical uncertainty, scarcity of resources, physical working environment and the assessment of rehabilitation potential. Dementia care was enhanced by the involvement of family members and by collaboration with other allied healthcare professionals. Participants expressed a wish to receive further dementia training and clear evidence-based physiotherapy guidelines. Identified areas of educational need included enhanced communication techniques, use and interpretation of cognitive screening tools, sub-typing of dementia, and ethical issues in dementia care. ConclusionsOur findings indicate that physiotherapists remain challenged by complex aspects of dementia care. Tailored dementia training for physiotherapists should be developed, focusing on their educational needs. Delivery of training should incorporate interactive case-based activities and interprofessional education with other allied healthcare professionals.

Aboriginal community understandings of dementia and responses to dementia care

ObjectiveAboriginal people and Torres Strait Islanders are impacted by dementia at higher rates and at a younger age of onset than the broader Australia population. Public health strategies to support this population require a thorough understanding of how Aboriginal people perceive dementia and dementia care support needs. The aim of this study was to investigate Aboriginal community understandings of dementia and their responses to dementia care. Study designThis study is a community participatory action research partnership. MethodsThe mixed method study was undertaken in 2017 with members of a discrete Aboriginal community from rural Tasmania, Australia. Participants were older than 18 years, self-identified as an Aboriginal person and were living or had lived in the community studied. Data were derived from 50 participants who completed the 27-item Dementia Knowledge Assessment Scale (DKAS). Twelve of these participants also shared their dementia care experiences in individual interviews. ResultsThe DKAS results showed a low overall level of dementia knowledge, with a total mean score of 27.73 (scoring 51% on average) of a possible score of 54. The salient interview theme was the cultural obligation to care for family members living with dementia. Dementia care metaphors represented ways to protect family members living with dementia and maintain their ongoing connections to home and community. However, limited understandings of dementia affected their capacity to provide quality care. ConclusionThe findings contribute to public health scholarship involving Aboriginal community responses to dementia care. The study has resulted in important initiatives including a community-based dementia education program to ensure Aboriginal people impacted by dementia are provided with effective and culturally appropriate care.

A Scoping Review of Dementia Care Experiences in Migrant Aged Care Workforce.

In high-income countries, an increasing number of people living with dementia in residential aged care facilities are being cared for by an increasingly multicultural workforce. The purpose of this review was to investigate migrant aged care workers' dementia care experiences and to identify enablers and challenges that influence their retention. Utilizing Arksey and O' Malley's approach, PubMed, Scopus, CINAHL, Web of Science, and EMBASE were searched for peer-reviewed studies published from 2000 to November 2018. Selection criteria were studies with original research, focusing on dementia care among migrant aged care workers, and conducted in high-income countries. Seventeen articles were identified incorporating 13 (76.47%) qualitative, 1 (5.88%) quantitative, and 3 (17.65%) mixed method designs. A limited understanding of dementia and experiences of dementia care were reported among some migrant care workers in residential aged care facilities. The identified enablers to retention were the availability of organization support services; professional development opportunities; reciprocity and mutual respect between migrant care workers, care recipients, and coworkers; and good working conditions. Factors such as discrimination from care recipients and coworkers and limited understanding of workplace culture were identified as barriers to migrant care workforce retention. Migrant care workers are valuable contributors to the aged care workforce. It is important to consider their cultural perceptions of dementia in relation to care provision. In addition, their exposure to occupational psychosocial risk factors in conjunction with the challenges associated with resettlement and dementia care needs to be addressed.

Anticipatory anxiety about future dementia-related care needs: towards a dementia-friendly community.

Although a dementia-friendly community is a global goal, community-dwelling persons with dementia continue to have unmet care needs. The aim of this study was to explore the characteristics of persons who experience anxiety about the possibility of not receiving proper dementia care should they need it in the future. A questionnaire was mailed to all residents aged 65 years or older (n = 132 005) living in one Tokyo district. The questionnaire included an item that measured anxiety about the possibility of not receiving proper dementia care as well as items about sociodemographic variables, depressive symptoms, frailty, housebound status, socioeconomic status, social support, access to a general practitioner (GP), and experience of dementia care. Of the 74 171 participants who responded to the anxiety item, 58 481 (78.8%) reported anxiety about the possibility of not receiving proper dementia care should they need it in the future. Simultaneous multiple logistic regression analysis indicated that factors associated with this anticipatory anxiety were depressive symptoms, frailty or prefrailty, being female, not being currently socioeconomically disadvantaged, not having someone who can take you to the hospital when you do not feel well, being younger (65-74 years), being married, not trusting in neighbours, higher educational level (>9 years), not having someone to consult when you are in trouble, not working, having been socioeconomically disadvantaged in childhood, only greeting or less with neighbours, and not having the experience of dementia care. Having access to a GP, living alone, and going out less than once a week did not show a significant association. This large-scale study explored factors associated with anticipatory anxiety about the possibility of not receiving proper dementia care should it be needed in the future. Further studies concerning interventions to decrease such anxiety are needed.

Language and Culture in the Caregiving of People with Dementia in Care Homes - What Are the Implications for Well-Being? A Scoping Review with a Welsh Perspective.

The loss of language skills is one of the most challenging aspects of living with dementia. This is particularly true for bilingual individuals, who have difficulty in maintaining fluency in more than one language. Language and culture overlap greatly, with potential implications for the well-being of people with dementia (PWD) being cared for in their 'second' language or culture. Our aim was to review the available relevant literature, together with an examination of the potential effects of linguistic incongruity on healthcare in general for Welsh speakers in Wales. A literature search yielded 50 articles, which were analysed using the scoping review methodological framework. We found that the presence of cultural and linguistic congruity was beneficial for PWD living in care homes, and that their absence was detrimental. The absence of linguistic congruity is a strong predictor for decreased well-being in people in such settings, due to communication barriers between residents and carers, which result mainly from the loss of PWD's second language skills. Such barriers may lead to inappropriate care, e.g. being unable to obtain help to self-care, as well as social isolation. This review suggests that strategies need to be developed across the world to accommodate bilingual individuals requiring a care home for their dementia needs. There is a particular dearth of research regarding the influence of bilingualism on the experience of dementia care in those areas of the UK where the indigenous population are most likely to be bilingual (i.e. parts of Wales).

Dementia patient care in the diagnostic medical imaging department

IntroductionPeople with dementia have difficulties with memory, executive functions and behaviour which pose a challenge during diagnostic imaging. There is abundant literature on the radiographic diagnosis of dementia; however, there is little research on how to best to care for people with dementia during imaging procedures. The aim of this study is to explore the experiences of dementia care in imaging departments through the perspectives of people with dementia, carers, radiographers and student radiographers. MethodsThis was a cross-sectional qualitative study. Four people with dementia and six carers participated in individual semi-structured interviews; eight academic radiographers and 19 student radiographers participated in focus groups. Interviews and focus groups were transcribed and thematically analysed. ResultsParticipants described positive and negative experiences during imaging procedures. Common themes existed among people with dementia, carers and radiographers. Findings were (1) People with dementia and carers had negative experiences such as distress and pain; radiographers experienced stigma and violence. (2) Negative experiences during imaging were associated with disrespected personhood, poor communication, insufficient knowledge of dementia, inappropriate time management, overly stimulating physical environments and exclusion of carers. (3) Departmental protocols that contributed to negative experiences included lack of preparation, lack of dementia protocols, and the use of restraints. ConclusionPeople with dementia and their carers can experience poor care in imaging departments and radiographers can find it difficult working with people with dementia. Radiographers need training about dementia, imaging services can improve their procedures and environment, and work in greater partnership with carers.

Assessment of Caregiving Constructs: Toward a Personal, Familial, Group, and Cultural Construction of Dementia Care through the Eyes of Personal Construct Psychology.

Conditions that cause cognitive impairment and behavioural and personality changes, such as Alzheimer's disease (AD) and related dementia, have global impact across cultures. However, the experience of dementia care can vary between individuals, families, formal caregivers, and social groups from various cultures. Self-reported measures, caregiving stress models, and conceptual theories have been developed to address the physical, financial, psychological, and social factors associated with the experience of dementia care. Given the cross-cultural variability in the experience of dementia care, it is important for such methodologies to take individual and cultural construct systems into account. We contend that personal and group constructs associated with dementia care should be explored in both the formal and informal caregiving contexts. Therefore, in this paper we introduce the theory of Personal Construct Psychology (PCP) with its explicit philosophy, well-elaborated theory, and derived assessment methods as a potential constructivist research approach to examine the personal, familial, group, and cultural construct systems that determine the experience of dementia caregiving. These concepts and assessment procedures are illustrated in this paper through case study examples and scenarios from the context of dementia care with a focus on family home caregivers. This paper elaborates the assessment and therapeutic approaches of personal construct theory (PCT) to further expand alternatives for support services and program interventions and to amplify policies for dementia care within and across cultures.

Development and Implementation of Patient Reported Outcomes in an Interventional Radiology-Oncology Practice

People with dementia have difficulties with memory, executive functions and behaviour which pose a challenge during diagnostic imaging. There is abundant literature on the radiographic diagnosis of dementia; however, there is little research on how to best to care for people with dementia during imaging procedures. The aim of this study is to explore the experiences of dementia care in imaging departments through the perspectives of people with dementia, carers, radiographers and student radiographers.This was a cross-sectional qualitative study. Four people with dementia and six carers participated in individual semi-structured interviews; eight academic radiographers and 19 student radiographers participated in focus groups. Interviews and focus groups were transcribed and thematically analysed.Participants described positive and negative experiences during imaging procedures. Common themes existed among people with dementia, carers and radiographers. Findings were (1) People with dementia and carers had negative experiences such as distress and pain; radiographers experienced stigma and violence. (2) Negative experiences during imaging were associated with disrespected personhood, poor communication, insufficient knowledge of dementia, inappropriate time management, overly stimulating physical environments and exclusion of carers. (3) Departmental protocols that contributed to negative experiences included lack of preparation, lack of dementia protocols, and the use of restraints.People with dementia and their carers can experience poor care in imaging departments and radiographers can find it difficult working with people with dementia. Radiographers need training about dementia, imaging services can improve their procedures and environment, and work in greater partnership with carers.

Relationship-Centered Dementia Care: Insights from a Community-Based Culture Change Coalition.

This article reports on the work of a community-based culture change coalition affiliated with the Partnerships in Dementia Care Alliance, a research network committed to strengthening dementia care through supporting relationship-centered care approaches. Research to date emphasizes negative aspects of dementia care relationships. Drawing on data the culture change coalition collected as part of their culture change work using participatory action research guided by appreciative inquiry, this article examines what relationship qualities contributed to positive dementia care experiences and how positive relationships were created. Five types of care partners participated in the study through questionnaires, focus groups, and a mini appreciative inquiry summit. Data were analyzed collaboratively with culture change coalition members. Early in the analysis process, the aspiration statement "Relationships are at the heart of dementia care in [name of] County," was developed and informed further thematic analysis. Findings revealed several relationship characteristics including friendship, commonality of experience, developing trust and feeling appreciated, reciprocity, and taking time/making time for relationships. As this article illuminates, relationship-centered programs and policies have the potential to foster positive dementia care experiences among diverse care partners in community settings.

Care assistant experiences of dementia care in long-term nursing and residential care environments

Care assistants have a unique insight into the lives of service users and those factors which may impede or enhance the delivery of high quality dementia oriented care. To address the paucity of research in this area, the present study examined care assistant experiences of dementia care in British long-term residential and nursing environments. Semi-structured interviews were conducted with eight care assistants and transcripts were analysed using interpretive phenomenological analysis. Super-ordinate themes emerging from the data were psychological wellbeing of the care assistant, barriers to effective dementia care, the dementia reality and organisational issues within the care environment. The study revealed important deficiencies in understanding and varying levels of dementia training. Whilst person centred strategies were being implemented, task orientated care remained dominant. Furthermore, care assistants reported taking the perspectives of those with dementia into account, and actively using these to develop relationship centred care.