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21 Search Results:

B. Relations/Communication > Keep communicating • Negative Communication - sensory impairment, Deal with loss of ability to participate in communication effectively and pleasurably, being misunderstood, by carer taking time/effort to optimise communication. Environment - not inappropriately restrictive, uncomfortable, alien, boring. Health/happiness - pain, disability, sensory impairment, psychiatric disorder, high level emotional distress. Quality of professional care - disrespectful, dehumanising, ill-coordinated, inadequate in amount/skill level. Quality of family care - conflictual, disrespectful, abusive, burden rather than cherished. Personhood - loss of self-worth, personal identity, loss of ability to work, loss of ability to love, loss of dignity. Deal with loss of ability to participate in communication effectively and pleasurably, being misunderstood, by carer taking time/effort to optimise communication.

K. Supporting Caregivers > Information • - singing, dancing, exercises etc. family members join the group 1 x monthly. They get to see their loved ones having fun and meet other carers to form ongoing relationships.

F. Enjoyment > 2. Any other • - being enabled to have fun and do life-enhancing activities and social interaction

J. Basic Comforts > For specific complaints • - decreased reading, comprehension, driving and cooking skills; - decreased tolerance and enjoyment of cultural activities, travel, entertainment, social interaction; - decreased flexibility in thinking, therefore poorer problem solving. - frustrations from memory difficulties, losing things, language problems, etc. - shift in relationship between me and my spouse - he is more care-giver than equal; a lot of our activities together are determined by my decreased abilities and decreased tolerance and energy - we have had to make more fun and enjoyment with less.

F. Enjoyment > 1. Sample narratives • . What improves quality of life: - being enabled to maintain independence to the degree possible; - being enabled to have fun and do life-enhancing activities and social interaction; - maintainance of a strong and positive self-image. CANADA PERSON WITH DEMENTIA

F. Enjoyment > 1. Sample narratives • Have moments to look forward to in the week. Have things person in dementia can do with carer and others. Generate manageable tasks. Create new social networks of families who are affected and who share problems and possibilities. Lots of humour, including people who support people with dementia, and willingness to do “off the wall” activities and create a failure-free environment. Give opportunities for physical expression of memories – eg show how things work (like work tools), dance to time-appropriate music, sporting activities (judo example – 94 year old blackbelt with dementia), gardening. All the above involve sensory stimulation and recall of past activities which can be revisited with success. D PROFESSIONAL

F. Enjoyment > Humor and laughter • Humour, and understanding that humour is more applicable when the person has dementia - compassionate but 'natural', 'everyday' humour. It works!

F. Enjoyment > Humor and laughter • Lessen anxiety by security and fun - enjoying life part of QOL.

F. Enjoyment > Humor and laughter • Lots of humour ie staff dressing up in themes.

B. Relations/Communication > 1. Sample narratives • Positive Communication - ability to engage in meaningful, reciprocal communication (conversation, gesture, touch) enabling pleasure and communication of needs/wants/comments. Environment - safe, comfortable, home-like, rich social network, access to nature, travel, physical and emotional, enriching, stimulating, not stultifying. Health/happiness - physical and mental health, freedom from pain, restricted mobility, expression, psychosis. Quality of professional care - respectful, competent, comprehensive, consistent, appropriately targetted, humane, well-coordinated, medical, psychiatric, nursing etc ie multi-disciplinary. Quality of family care - multiple generations involved, free from undue stress/conflict, availability of regular daily loving care and acceptance, respect and valued place within the family. Personhood - feeling valued, loved, maintenance of dignity, intact sense of identity and self-esteem, ability to carry out work of some kind, ability to love. Negative Communication - sensory impairment, loss of ability to participate in communication effectively and pleasurably, being misunderstood, carer failing to take time/effort to optimise communication. Environment – inappropriately restrictive, uncomfortable, alien, boring. Health/happiness - pain, disability, sensory impairment, psychiatric disorder, high level emotional distress. Quality of professional care - disrespectful, dehumanising, ill-coordinated, inadequate in amount/skill level. Quality of family care - conflictual, disrespectful, abusive, burden rather than cherished. Personhood - loss of self-worth, personal identity, loss of ability to work, loss of ability to love, loss of dignity. NEW ZEALAND PROFESSIONAL

D. Identity/Continuity > 1. Sample narratives • Positive Freedom of choice and choice taken seriously by others in decision making. Treated as an adult. Treated as person with ability to contribute to care and decision making. Autonomy within safety or ? security. Independence as long as possible. Trust in carers. To be treated as if able to continue with same interests and activities as before diagnosis eg continue with same hobbies, outings etc. When entry into rest home - family member carer must be taken very seriously. Cultural needs met - even when changing. Not to be 'labelled' as someone with particular stages. Individualised care. Family member carers gently changing roles - not an immediate "take over' of old roles. Fun introduced and continued. Physical contact but not in an overbearing way - especially if physical contact was not part of life. Negative A "take over' of the persons rights by the caring people. A medicalised approach with disease process being the most important. Too much over- protection by everyone! Infantalisation. Too rapid a change of roles by family members - increases the loss. All too serious theory. Being made to do activities that you don't want to or would never have done in their lives. Family members input being ignored. Withdrawal of former friends. In rest home care - lack of encouragement for friends and families to visit and be involved. I love grounded theory and congratulate you on choosing this methodology - inducted from us all. NEW ZEALAND PROFESSIONAL

K. Supporting Caregivers > 1. Sample narratives • Positive Humour, and understanding that humour is more applicable when the person has dementia - compassionate but 'natural', 'everyday' humour. It works! Acknowledgement that (as a carer) you are doing your best, that sometimes what you say is not what you mean and to not hold it against you forever. Maintaining physical activity and socialisation for both the carer and the person with dementia. As part of a group or individually. Accepting that the carer is the person who needs to do the care plan, that the health professional can not dictate this just because the person is in care. Ensuring that the person in care is kept looking neat, tidy "as if the person is generally cared about and not scruffy, uncoordinated or in another persons clothes". For HC givers to know about what goes on for the carer - health wise, financially and socially - over and about the carer role. Negative Honesty from HC professionals, a seeming inability to cope with appropriate emotional responses -1 put this point first as, from a carers point of view, I saw the course ahead as a set of hurdles and not a straight line. A genuine desire to be 'part of the loop' with the person, the carer and the whole family - the contact being seen only as a professional encounter. Not being addressed in a condescending way - go to the person and the carer, we are not contagious. The unwillingness of some personnel - such as police - to be involved with people with dementia whom the carer is wanting and trying desperately to keep the person in their own home. I know they are busy but it is very uncorporative. NEW ZEALAND CAREGIVER

F. Enjoyment > 1. Sample narratives • Positive Relaxed, unstructured routines except meals. Freedom to walk around in a safe environment. Showing love and acceptance. Supporting caregivers. Role modelling expected care. Plenty of food and fluids available. Music playing and a homely environment. Regular family support meetings. Close relationship with families of residents and involvement in careplanning. Spending time with clients, talking about their past, ie profession, travel, etc. Respecting family members who are grieving for the loss of their loved one to this illness. Lots of humour ie staff dressing up in themes. Engaging in short conversations with residents who don't actually make sense, chatting with them makes them feel respected and 'normal'. Negative Expecting individuals to 'behave themselves'. Tired caregivers trying to rush to achieve their workload. Poor training of caregivers. No available dementia training for caregivers. NEW ZEALAND PROFESSIONAL

D. Identity/Continuity > 1. Sample narratives • Positive Treated with dignity - accepted of who they are - in spite of their progression of disease. Knowing that someone cares and accepts them - who will take time to explore community and enable them to explore participation to enable them to participate within their community. Being heard and enabled to participate or just be as they want to - to have a choice, take time to develop relationships and stay there till no longer required - by client or caregiver. Work alongside them till able to adjust/accept that no longer able to manager on own safely - being aware of safety v autonomy. To have fun, a giggle, even if unable to verbally communicate can still enjoy things. Maintain interests/interactions, even adapt them so can still participate in family - continue with sense of belonging. They are still unique people - in spite of dementia. Safety in the home - awareness of needs there if other medical problems or sensory impairment. Treated as unique individual persons and adjust to their uniqueness, their physical, mental and spiritual dimensions. Negative. Over-stimulation, fatigue not noticed by caregivers or not understood. Doing things or made to do things they do not want to do and have no interest in. Inappropriate environment - where misinterprets things. Frequent changes of environment. People with dementia respond to the emotional context and if someone does not care pick it up quickly - or in a hurry then behaviour changes. Being controlled. People not taking time to adjust to the individuals (pwd) needs - expecting them to fit into a mould - when they have their past life stories. Social isolation and neglect. NEW ZEALAND PROFESSIONAL

D. Identity/Continuity > 1. Sample narratives • Positive Use of humour and laughter. Lessen anxiety by security and fun – enjoying life part of QOL. Involvement, control in own life - choice, empower. Lessen anxiety by acknowledging illness and needs - ie explain same concerns every day so that the feeling of confusion and anxiety lessened 'I told him yesterday, he won't remember if I tell him again so why bother'. Acknowledging person and individual life history - keep emphasising the individual in activities, conversation or choices that are offered (ie relevant to person). Support carers - respite, listening, asking what would be helpful, supportive environment where time can be spend with person with dementia (as opposed to general public where awareness is not yet the best). Public awareness of issues faced by people with dementia, especially regarding the person as an individual - acceptance, support, helpful and with interactions. Some risk taking to ensure choice and involvement in activities important to the person for as long as possible. Resources to enable greatest autonomy – ie technology to aid people to stay in own home as long as possible, ie smart house. Negative Disregard for person - ie talking about someone in front of them as if not there. Assumptions by people who do not know and fear ie loss of abilities in some area - loss of abilities in all areas (unable to communicate verbally - unable to feel or understand). Stigma, uncaring interactions and discrimination and discounting the person. NEW ZEALAND PROFESSIONAL

A. Choices > 1. Sample narratives • Positive Caring carer. Stay as long as possible in own home. Supportive family. Keep to routine (as it was) as much as possible. Allow the person to make decisions. Allow choice. Continue to be loved and cherished. Respect. To be themselves. Accept challenging behaviour. To allow independence for as long as able. To be an individual. To allow to express own feelings. To plan own path way. Listen to the music not the words. Allow risks. Support groups including PWD. Alzheimer's Society, community support workers. Conferences. Negative Over protection, taking away independence, overwatched, decisions made for me (pwd) eg food, time planning, what to wear, where to go. Treated like a child. Not treated like before. Having a stressful carer. Thinking about how the spouse of an older age is going to manage. Enjoying fun and laughter but not at time at the appropriate time and not being accepted for this. I've got a client who does this and family (not being accepted) are horrified. NEW ZEALAND PROFESSIONAL

L. Strengthening Services > 1. Sample narratives • Positive Better knowledge - people who provide care need to be informed and updated - attend conferences such as these 3 days - meet network, share and develop ideas. Sense of belonging and knowing who you are, feeling involved and valued - contribute to daily life. Let people make their own mistakes whilst being loved. Lots of fun and laughter. Negative Ignorance - people not knowing anything about dementia or what it means for the PWD. Withdrawal of services, cost cutting budget constraints. Non- treatment of other conditions affecting mood - mental state eg delerium, psychosis. NEW ZEALAND PROFESSIONAL

J. Basic Comforts > For specific complaints • Safety in the home - awareness of needs there if other medical problems or sensory impairment.

A. Choices > 1. Sample narratives • What has happened that has decreased my quality of life as a person with dementia - decreased reading, comprehension, driving and cooking skills; - decreased tolerance and enjoyment of cultural activities, travel, entertainment, social interaction; - decreased flexibility in thinking, therefore poorer problem solving. - frustrations from memory difficulties, losing things, language problems, etc. - shift in relationship between me and my spouse - he is more care-giver than equal; a lot of our activities together are determined by my decreased abilities and decreased tolerance and energy - we have had to make more fun and enjoyment with less. CANADA PERSON WITH DEMENTIA

E. Self Esteem > 1. Sample narratives • What practical help has been of use to me in maintaining or improving my quality of life as a person with dementia. - development and application of personal coping strategies to increase independence and control of my own life; - maintaining a sense of self-identity and value to others with peer support groups and social interactions and volunteer work; - doing fun and creative activities that give me a positive attitude and good feedback about myself. - maintaining the highest level of health and fitness. - coming to terms with my limitations; changing (reducing) expectations of myself and how much I can do; reducing the standards I used to set for myself - this leads to acceptance and serenity and more positive living. CANADA PERSON WITH DEMENTIA

K. Supporting Caregivers > 1. Sample narratives • Working directly with individuals affected by the disease, family carers, professional carers, students, nursing home staff etc. Support Group for early stage individual - we meet weekly, talk, share, coffee/cake, reminisce, talk about what it feels like, fears, joys, hopes etc. “Poetry writing”. Activity Group for these individuals - singing, dancing, exercises etc. family members join the group 1 x monthly. They get to see their loved ones having fun and meet other carers to form ongoing relationships. What has helped carers - providing respite by involving their family members with these activities; - getting reports from staff of all the positives of their family member. The workshop was very positive, confirming, stimulating. Very clearly tied things together, made new links. L CANADA PROFESSIONAL