Behavioural Changes in Dementia and their Impact on Professional Caregivers: A Grounded Theory Approach

Appleton, Katie; Pereira, Antonina

doi:10.1177/1471301217714654

Cited by 7 publications

(3 citation statements)

References 29 publications

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“…The present study revealed that sensor information was perceived to enhance continuity in care and improve the staff's understanding of the individual with dementia and their needs, since it contributed to the information collected over time. An enhanced understanding of needs has been shown to strengthen the relationship between the nursing staff and the individual with dementia [ 36 ], which has been identified as one of the most influential factors in caregiving satisfaction [ 37 ] and shown to affect the well-being of individuals with dementia [ 38 ]. Based on the present findings, we suggest that information from an EDA sensor can contribute to an improved assessment process with enhanced recognition and understanding of an individual's needs, which, in turn, can improve nursing staff's work satisfaction [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Using Measurements of Electrodermal Activity in the Assessment of Problematic Behaviour in Dementia

Melander

Kikhia

Olsson

et al. 2018

Dement Geriatr Cogn Disord Extra

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Background: A major and complex challenge when trying to support individuals with dementia is meeting the needs of those who experience changes in behaviour and mood. Aim: To explore how a sensor measuring electrodermal activity (EDA) impacts assistant nurses’ structured assessments of problematic behaviours amongst people with dementia and their choices of care interventions. Methods: Fourteen individuals with dementia wore a sensor that measured EDA. The information from the sensor was presented to assistant nurses during structured assessments of problematic behaviours. The evaluation process included scorings with the instrument NPI-NH (Neuropsychiatric Inventory-Nursing Home version), the care interventions suggested by assistant nurses to decrease problematic behaviours, and the assistant nurses’ experiences obtained by focus group interviews. Results: The information from the sensor measuring EDA was perceived to make behavioural patterns more visual and clear, which enhanced assistant nurses’ understanding of time-related patterns of behaviours. In turn, this enhancement facilitated timely care interventions to prevent the patterns and decrease the levels of problematic behaviour. Conclusion: With the addition of information from the sensor, nursing staff could target causes and triggers in a better way, making care interventions more specific and directed towards certain times throughout the day to prevent patterns of problematic behaviours.

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Section: Discussionmentioning

confidence: 99%

The Impact of Using Measurements of Electrodermal Activity in the Assessment of Problematic Behaviour in Dementia

Melander

Kikhia

Olsson

et al. 2018

Dement Geriatr Cogn Disord Extra

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“…The variability may be related to the varying level of adherence to the intervention by the individual caregivers, which might reflect the difficulties for caregivers working in SCU to change their accustomed behaviour in their daily work. Caregiver training should focus on more intense and in-depth training to increase the understanding of behavioural change across the development of dementia [ 35 ]. Genuine professional knowledge concerning the fundamental needs in persons with dementia is recognized as crucial in caregivers for dyadic interactions in dementia care [ 36 , 37 ], which means that health care professionals need to recognize the perspectives of both parts since the PwD needs to rely on the other’s contributions in the interaction [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Behaviour-directed interventions for problematic person transfer situations in two dementia care dyads: a single-case design study

2022

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Background Persons with dementia living in nursing homes need assistance with moving and transfers; however, caregivers assisting persons with dementia in their daily person transfers report strain-related and complicated transfer-related behavioural problems. The reciprocity of complex dyadic transfer-related behaviours is affected by environmental factors, the health status of the person with dementia and the caregiver’s skills and knowledge. The aim of this study was to explore tailored interventions guided by a functional behaviour analysis for problematic person transfer situations in two dementia care dyads. Methods This study was a quasi-experimental single-case study with an A-B design. Tailored interventions were developed in a five-step model for functional behavioural analysis. The study was conducted in a dementia special care unit at a nursing home, and the inclusion criteria were caregivers’ experiences of physical strain and/or resistiveness to care, which led to complex transfer-related behaviour. Two care dyads were included. Transfer situations were video-recorded and evaluated with the Dyadic Interaction in Dementia Transfer Assessment Scale, Pain Assessment in Advanced Dementia Scale, and Resistiveness to Care Scale for Dementia of the Alzheimer’s Type. The caregiver experience was evaluated with study-specific items addressing caregiver self-efficacy, catastrophizing thoughts, perceived control, and perceived physical strain. Scorings were graphically displayed. The graphs were inspected visually to identify changes in trend, level, latency, and variability. Nonoverlap of all pairs (NAP), including 90% confidence intervals (CIs), was calculated to complement the visual inspection. Results Verbal and nonverbal discomfort decreased in care dyad 1, which mirrored the caregiver changes in adapting their actions to the needs of the person with dementia. High variability was seen in both the intervention and the baseline phases in care dyad 2. In both care dyads, caregiver transfer-related behaviour improved. Conclusions The results indicate that the transfer-related behaviours of the care dyad might be improved through a behaviour-directed intervention tailored to meet the care dyad´s needs. The small number of cases and observations limits the generalizability, and the results should be interpreted in consideration of the piloting approach of the study.

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“…The variability may be related to the varying level of adherence to the intervention by the individual caregivers, which might re ect the di culties for caregivers working in SCU to change their accustomed behaviour in their daily work. Caregiver training should focus on more intense and in-depth training to increase the understanding of behavioural change across the development of dementia (Appleton & Pereira, 2019). Genuine professional knowledge concerning the fundamental needs in persons with dementia is recognized as crucial in caregivers for dyadic interactions in dementia care (Jakobsen & Sørlie, 2010;Manthorpe et al, 2010), which means that health care professionals need to recognize the perspectives of both parts since the PwD needs to rely on the other's contributions in the interaction (Lichtner et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Behaviour-directed Interventions for Problematic Person Transfer Situations in Two Dementia Care Dyads: A Single-case Design Study

Lagerlund¹,

Thunborg²,

Sandborgh³

2021

Preprint

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Background:Persons with dementia living in nursing homes need assistance with moving and transfers; however, caregivers assisting persons with dementia in their daily person transfers report strain-related and complicated transfer-related behavioural problems. The reciprocity of complex dyadic transfer-related behaviours is affected by environmental factors, the health status of the person with dementia and the caregiver’s skills and knowledge. The aim of this study was to explore tailored interventions guided by a functional behaviour analysis for problematic person transfer situations in two dementia care dyads.Methods:This study was a quasi-experimental single-case study with an A-B design. Tailored interventions were developed in a five-step model for functional behavioural analysis. The study was conducted in a dementia special care unit at a nursing home, and the inclusion criteria were caregivers’ experiences of physical strain and/or resistiveness to care, which led to complex transfer-related behaviour. Two care dyads were included. Transfer situations were video-recorded and evaluated with the Dyadic Interaction in Dementia Transfer Assessment Scale, Pain Assessment in Advanced Dementia Scale, and Resistiveness to Care Scale for Dementia of the Alzheimer’s Type. The caregiver experience was evaluated with study-specific items addressing caregiver self-efficacy, catastrophizing thoughts, perceived control, and perceived physical strain. Scorings were graphically displayed. The graphs were inspected visually to identify changes in trend, level, latency, and variability. Nonoverlap of all pairs (NAP), including 90% confidence intervals (CIs), was calculated to complement the visual inspection.Results:Verbal and nonverbal discomfort decreased in care dyad 1, which mirrored the caregiver changes in adapting their actions to the needs of the person with dementia. High variability was seen in both the intervention and the baseline phases in care dyad 2. In both care dyads, caregiver transfer-related behaviour improved significantly.Conclusions:The results indicate that the transfer-related behaviours of the care dyad might be improved through a behaviour-directed intervention tailored to meet the care dyad´s needs. The study is a replication of a previous study in a new clinical setting, which in turn strengthens the generalizability for a functional behavioural analysis-guided intervention for problematic transfer situations in dementia care dyads.

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Behavioural Changes in Dementia and their Impact on Professional Caregivers: A Grounded Theory Approach

Cited by 7 publications

References 29 publications

The Impact of Using Measurements of Electrodermal Activity in the Assessment of Problematic Behaviour in Dementia

The Impact of Using Measurements of Electrodermal Activity in the Assessment of Problematic Behaviour in Dementia

Behaviour-directed interventions for problematic person transfer situations in two dementia care dyads: a single-case design study

Behaviour-directed Interventions for Problematic Person Transfer Situations in Two Dementia Care Dyads: A Single-case Design Study

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