Objectives: This project investigated experiences of caregivers of people living with dementia during COVID-19. We recorded caregivers' perceptions of care before, during, and moving forward from COVID-19, emphasizing positive experiences, coping strategies, creative care adaptation, strengths demonstrated, and benefits of providing care. Methods: Allied health professionals conducted semi-structured interviews with 26 informal caregivers of people living with dementia. We categorized and thematically analyzed responses as before, during or moving forward from COVID-19. Results: A range of themes were derived from the data. Pre-pandemic care: (1) focusing on the person living with dementia and (2) working together. During-pandemic care: (1) respecting personhood; (2) connecting with virtues and values; (3) improving relationships; (4) seeking and receiving support; (5) prioritizing self-care; (6) being protective and proactive; (7) making practical changes. Moving forward from COVID-19: (1) strengthening commitment to the person living with dementia, (2) looking after my own needs, and (3) considering practical requirements. Conclusions: Participants reported positive caregiving experiences in all timeframes, focusing more on their own needs and experiences during and moving forward from COVID-19. This research may highlight informal caregivers' challenges and needs.Clinical implications: Enforced isolation produced deeper connections for some caregivers. Caregivers benefit from resources facilitating adaptive care.
BackgroundHealthcare professionals’ attitudes to older people, and especially those living with dementia, may contribute to unsatisfactory healthcare. Despite repeated calls to address increasing need, training an adequate geriatric workforce remains an international concern. Of particular concern are the attitudes and knowledge healthcare workers may hold about people living with dementia. Students’ knowledge of dementia has been found to be low at the beginning of their university education and has shown limited improvement throughout their coursework; greater understanding of students’ attitudes to ageing and dementia, upon entry and throughout their degrees, may help inform targeted educational interventions to improve the healthcare delivered to older people.MethodsThis study measured knowledge of and attitudes toward dementia and ageing in an Australian university student sample (n = 183), comparing students from medical professional versus non-medical professional related fields at both undergraduate and postgraduate levels. We examined diagnostic and prognostic biases through age manipulation of a vignette describing a hypothetical patient (aged 42 or 72 years), who was experiencing symptoms that were consistent with DSM-5 criteria for both dementia and depression. Based on information provided in the vignette, student participants were asked to select a primary disorder that they would assign to the patient.ResultsShowed that while medical professional students held significantly more positive attitudes toward ageing than 'other' students, average attitudinal scores indicated neutrality. Medical professional students indicated a diagnostic bias toward the older vignette patient, who was more likely to be diagnosed with dementia than depression. A history of geriatric-specific training did not predict dementia knowledge; however, having prior contact with people with dementia predicted both dementia knowledge and more positive prognoses.ConclusionsOverall, findings indicated medical professional students held neutral attitudes towards older people and showed deficits in knowledge of dementia. Educational interventions that introduce students to people living with dementia may improve knowledge, skills, and attitudes. All university students would benefit from education about dementia and inclusivity to reduce stereotyping and stigma.
Most people living with dementia in the early-to-middle stages live in the community or in their own homes and engagement in enjoyable activities is fundamental to maintaining quality of life and autonomy. Horticulture-based activities are beneficial for the health and well-being for people living with dementia (“PLWD”) in residential care settings, yet evidence within community settings, where the majority live, has not been comprehensively synthesized. A mixed studies systematic review protocol was registered and a systematic search conducted to June 2022 across MEDLINE, COCHRANE, Web of Science, Embase, Psycnet, CINAHL, PsycINFO databases, using terms relating to dementia and horticulture. Original studies examining group or individual horticulture-based programs for community-dwelling PLWD were included. Forty-five articles were selected for full review, eight met inclusion criteria and were retained for data extraction. Evidence from three mixed methods, two quantitative, two qualitative, and one case study design, involving a total of 178 community dwelling PLWD, was narratively summarized. Findings revealed that involvement in horticulture-based activities led to positive impacts on engagement, social interactions, and mental and physical well-being in PLWD. No conclusive evidence was found from included studies for improvement in cognitive function. As most studies to date have concentrated on PLWD in long-term care settings, future research should evaluate the effect of these types of activities in a more rigorous intervention design in community settings.
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