Dyadic construction of dementia: meta-ethnography and behaviour-process synthesis

Bosco, Alessandro; Schneider, Justine; Coleston-Shields, Donna Maria; Sousa, Lídia; Orrell, Martin

doi:10.1080/13607863.2018.1450836

Cited by 12 publications

(9 citation statements)

References 33 publications

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“…In effect, positive dyadic coping is significantly associated with relationship satisfaction, regardless of partner's socio-demographic and cultural characteristics or relationship duration [46]. In line with this, authors of a recent meta-ethnography on dyadic construction of dementia further ascertained that dyad-set goals leading to a "co-responsibility and ownership" of the dementia experience promoted positive interaction, [47] while "hostile/ambivalent coping", "protective buffering", and "overprotection" were retained negative dyadic coping styles [48]. For these reasons, a dyadic approach in early-stage, community-based dementia care (e.g., dual support groups, dyadic counselling, cognitive stimulation, skill training, and multi-dyad memory notebooks), has shown to be well accepted and to improve communication, interpersonal relationships, and quality of life among both caregivers and care-recipients [49].…”

Section: Dyadic Approach To Care In the Elderly With Cognitive Declinementioning

confidence: 80%

Improving Dignity of Care in Community-Dwelling Elderly Patients with Cognitive Decline and Their Caregivers. The Role of Dignity Therapy

Ounalli

Mamo

Testoni

et al. 2020

Behavioral Sciences

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Demographic changes have placed age-related mental health disorders at the forefront of public health challenges over the next three decades worldwide. Within the context of cognitive impairment and neurocognitive disorders among elderly people, the fragmentation of the self is associated with existential suffering, loss of meaning and dignity for the patient, as well as with a significant burden for the caregiver. Psychosocial interventions are part of a person-centered approach to cognitive impairment (including early stage dementia and dementia). Dignity therapy (DT) is a therapeutic intervention that has been shown to be effective in reducing existential distress, mood, and anxiety symptoms and improving dignity in persons with cancer and other terminal conditions in palliative care settings. The aims of this paper were: (i) To briefly summarize key issues and challenges related to care in gerontology considering specifically frail elderly/elderly with cognitive decline and their caregivers; and (ii) to provide a narrative review of the recent knowledge and evidence on DT in the elderly population with cognitive impairment. We searched the electronic data base (CINAHL, SCOPUS, PSycInfo, and PubMed studies) for studies regarding the application of DT in the elderly. Additionally, given the caregiver’s role as a custodian of diachronic unity of the cared-for and the need to help caregivers to cope with their own existential distress and anticipatory grief, we also propose a DT-dyadic approach addressing the needs of the family as a whole.

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Section: Dyadic Approach To Care In the Elderly With Cognitive Declinementioning

confidence: 80%

Improving Dignity of Care in Community-Dwelling Elderly Patients with Cognitive Decline and Their Caregivers. The Role of Dignity Therapy

Ounalli

Mamo

Testoni

et al. 2020

Behavioral Sciences

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“…Bosco et al (2019) described how relational processes influence the coping strategies that each member of the care dyad enacts when dealing with adverse events. For example, when the dyad is confronted with a situation (be it challenging or of everyday concerns) the members of the dyad engage in an inter-dependant process, depending on their respective role in the relationship, to appraise and manage the situation.…”

Section: Introductionmentioning

confidence: 99%

Narrative inquiry on case studies of crisis in dementia

Bosco

Schneider

Coleston-Shields

et al. 2020

QAOA

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Purpose This study aims to explore the coping styles that can be inferred from the discourse of dyads with dementia, and how these appear to impact on care management. Design/methodology/approach This was a case study approach. Participants were recruited from two teams managing crisis in dementia in the UK. The authors conducted multiple qualitative interviews with people with dementia and their family carers over the course of one month. The analysis was first performed through thematic analysis. Data were further analysed through narrative inquiry to create a story line, or play in our case, for our findings. Findings Five dyads were interviewed and a total of 16 interviews were conducted. Three dyads were husband–wife and two were daughter–mother relationships. The mean age was 67.4 years for carers and 79.8 years for people with dementia. In these cases, the carer assumed responsibility for managing the episode and was more likely to seek formal help if a pre-existing plan was in place. Otherwise, when a crisis arose, dyads preferred to avoid involving professionals. Practical implications Psychosocial interventions should aim to identify and replace unhelpful strategies used by dyads to manage crisis episodes. Originality/value To the best of the authors’ knowledge, this is the first study using qualitative interviews of dyads to inquire into their experience of mental health crisis.

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“…Many of the previous studies exclusively assessing family caregiver variables or only indirectly including patients’ characteristics (Cheng, 2017; Roland & Chappell, 2015). Very few studies embrace dyadic and relational variables to understand how the change in cognitive function affects their life and their relationship from both sides (Bosco et al, 2018; Ducharme et al, 2013). Bosco et al (2018) pointed out that positive interactions and relationships between family caregivers and PWCI help sustain PWCI’s positive self-identity.…”

Section: Introductionmentioning

confidence: 99%

“…Very few studies embrace dyadic and relational variables to understand how the change in cognitive function affects their life and their relationship from both sides (Bosco et al, 2018; Ducharme et al, 2013). Bosco et al (2018) pointed out that positive interactions and relationships between family caregivers and PWCI help sustain PWCI’s positive self-identity. Unbalanced power distribution between the dyads and a lack of shared goals can impair their coping and cause significant stress.…”

Section: Introductionmentioning

confidence: 99%

Living With Cognitive Impairment in China: Exploring Dyadic Experiences Through a Person-Centered Care Lens

et al. 2020

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China has experienced a substantial increase in the number of older adults with dementia and milder forms of cognitive impairment. Being spouses of Persons with cognitive impairment (PWCI) and living with them for several decades does not necessarily mean that it is easier for them to provide person-centered care and maintain a valued and healthy relationship. The current study explored how elements of PCC, as operationalized by the Senses Framework, operate or fail to operate in the dyadic experiences of PWCI and their spousal care partners within the socio-cultural context of China. Our findings suggest that PWCI and their spouses experience the six senses through the person-centeredness in their daily interactions with each other. It also indicated successes and challenges to being person-centered early in the disease and identified their unmet needs as well as barriers and facilitators to improve their well-being.

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Dyadic construction of dementia: meta-ethnography and behaviour-process synthesis

Abstract: Our findings suggest that unequal power distribution within dyads, can cause significant stress, when coping strategies are impaired. We discussed implications for family carers, people with dementia, and health professionals deriving from greater understanding of dyadic dynamics to care.

Cited by 12 publications

References 33 publications

Improving Dignity of Care in Community-Dwelling Elderly Patients with Cognitive Decline and Their Caregivers. The Role of Dignity Therapy

Improving Dignity of Care in Community-Dwelling Elderly Patients with Cognitive Decline and Their Caregivers. The Role of Dignity Therapy

Narrative inquiry on case studies of crisis in dementia

Living With Cognitive Impairment in China: Exploring Dyadic Experiences Through a Person-Centered Care Lens

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