Evaluating and Modifying the Communication Environment for People With Dementia

Brush, Jennifer; Sanford, Jon A.; Fleder, Hannah; Bruce, Carrie; Calkins, Margaret P.

doi:10.1044/gero16.2.32

Cited by 17 publications

(16 citation statements)

References 16 publications

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“…It is also prevalent in the SLP literature Ilott et al, 2013;Van der Meer et al, 2017) .The fourth theme is Creating the right environment. This echoes guidance from the National Collaborating Centre for Mental Health (2007) in the United Kingdom, which advocates caring environments for PWD that are more home-like in character, and is also frequently found in SLP literature (Bruce et al, 2013;Brush et al, 2011).…”

Section: Training Needs Of Nurses and Care Staffmentioning

confidence: 51%

Equipping Nurses and Care Staff to Manage Mealtime Difficulties in People With Dementia: A Systematic Scoping Review of Training Needs and Interventions

Faraday

Salis

Barrett

2019

Am J Speech Lang Pathol

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Purpose Mealtime difficulties are prevalent in dementia, posing major challenges to people with dementia (PWD), carers, and clinical services. Speech-language pathologists have a recognized role in providing training to carers of PWD who have mealtime difficulties. The aims of this study are (a) to identify the training needs of nurses and care staff with regard to managing mealtime difficulties in PWD, (b) to describe existing training interventions on this topic, and (c) to investigate the extent to which these interventions are relevant to the needs of nurses and care staff. Method A systematic search was carried out to identify studies relevant to the aims of the review. Data were extracted and then synthesized using thematic analysis and a synthesis matrix. Study quality was appraised using a validated appraisal tool. Results Various themes were identified in relation to the training needs of nurses and other care staff who manage mealtime difficulties in PWD. These were as follows: person-centered care; dealing with uncertainty; strategies, skills, and knowledge; and creating the right environment. Existing training interventions were described and compared against the training needs. The review found some correspondence between interventions and staff needs, but also some gaps. Conclusions Training interventions on this topic should be more systematically developed and better reported to facilitate effective implementation. Evidence to date indicates that training should do more to help staff deal with uncertainty. Further research assessing the benefits of speech-language pathologists' involvement in the development of training interventions is recommended because of this profession's specialist skills and knowledge with regard to both dysphagia and communication.

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Section: Training Needs Of Nurses and Care Staffmentioning

confidence: 51%

Equipping Nurses and Care Staff to Manage Mealtime Difficulties in People With Dementia: A Systematic Scoping Review of Training Needs and Interventions

Faraday

Salis

Barrett

2019

Am J Speech Lang Pathol

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“…The SLP acted upon the person-centered assessment to recognize that laundry was an activity these two particular elders would enjoy. 15 In this example, the SLP practices at the top the license as the nursing assistants act as extenders of the skilled service. 12 Montessori-based services provide another pathway toward employing both the skill and the person-centeredness that are profession requires.…”

Section: Skilled Servicesmentioning

confidence: 99%

Person-Centered, Skilled Services Using a Montessori Approach for Persons with Dementia

2018

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The current mandate for person-centered care throughout the health care system, and especially in the nursing home industry, requires that speech-language pathologists ensure that the services they provide to elders with dementia are skilled, person centered, and relevant to positive overall health outcomes. Guidelines developed by the Association Montessori International Advisory Board for Montessori for Aging and Dementia are one avenue toward such skilled and person-centered services. The purpose of this article is to provide clinicians with practical strategies for guiding their assessment, goal writing, and intervention plans to meet the expectations of a person-centered approach to services for elders with dementia, using the Montessori approach as a philosophical guide.

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“…The noisy and fast-paced atmosphere of acute hospitals, and particularly emergency departments, can be very disorienting for people living with dementia (Borbasi, Jones, Lockwood, & Emden, 2006;Cowdell, 2010;Cunningham, 2006; Dementia Services Development Centre (DSDC), 2012; Hung et al, 2017;Nolan, 2007;Timmons et al, 2016;Waller & Masterson, 2015). Very often, time spent in an ED can result in responsive behaviours (Brush, Sanford, Fleder, Bruce, & Calkins, 2011;Cunningham, 2006). Stimuli in the environment which others, such as staff, may perceive as acceptable, can reduce the person living with dementia's capacity to cope with the care environment and the severity of cognitive impairment may appear greater (Dewing, 2009).…”

Section: Introductionmentioning

confidence: 99%

“…Importantly, the influence of the sensory stimulations arising from each of the factors outlined above can be used strategically in a therapeutic way to manage some of the responsive behaviours sometimes prevalent in people living with dementia (Brush et al, 2011;Dewing, 2009;Grey, Pierce, Cahill, & Dyer, 2015;Van Vracem et al, 2016) and enable rather than disable people living with dementia (Pollock & Fuggle, 2013). There are often barriers however to improving the hospital environment and providing best-practice care to people living with dementia; for example, rigid interpretation of health and safety and infection control regulations (Judd, 2008), as well as staffing levels and workload time resources (Tropea, LoGiudice, Liew, Roberts, & Brand, 2017).…”

Section: Introductionmentioning

confidence: 99%

Assessing the impact of dementia inclusive environmental adjustment in the emergency department

et al. 2019

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Objectives Acute hospitals, in particular the emergency department, can be disorienting for people living with dementia. As part of a larger project to improve care for people living with dementia, dementia-inclusive modifications were made to two emergency department bays in a large acute care hospital in Ireland. Modifications to spatial configuration included noise reduction, altered lighting and the addition of an orientation aid and fixed seating for relatives. Method A mixed methods approach was employed with both service user and service provider perspectives explored (survey of service providers ( n = 16) and interviews with family carers ( n = 10) at one time point and interviews with service providers ( n = 8 and n = 5) and key stakeholders ( n = 3) as well as audit data (at two time points) to evaluate the impact of the modifications made to the emergency department. Results Orientation and navigation within the modified bays were improved though technical issues with the orientation aid were highlighted. Further user information on the functionality of the adjustable lighting would be required to maximise its benefits. This lighting and use of calming colours, together with the addition of noise-reduction bay screens, served to reduce sensory stimulation. The provision of adequate space and seating for family carers was extremely beneficial. The removal of unnecessary equipment and use of new structures to store relevant clinical equipment were other positive changes implemented. A number of challenges in the design development of the modified bays were highlighted, as well as ongoing broader environmental challenges within the emergency department environment. Conclusion The findings suggest that the modified bays contributed positively to the experience of people living with dementia and their families in the emergency department.

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Evaluating and Modifying the Communication Environment for People With Dementia

Cited by 17 publications

References 16 publications

Equipping Nurses and Care Staff to Manage Mealtime Difficulties in People With Dementia: A Systematic Scoping Review of Training Needs and Interventions

Equipping Nurses and Care Staff to Manage Mealtime Difficulties in People With Dementia: A Systematic Scoping Review of Training Needs and Interventions

Person-Centered, Skilled Services Using a Montessori Approach for Persons with Dementia

Assessing the impact of dementia inclusive environmental adjustment in the emergency department

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