Exploring the factors influencing meaningful engagement of persons living with advanced dementia through the Namaste Care Program: a qualitative descriptive study

Abstract

Background: Meaningful engagement has been described as active participation based on a person’s interests, preferences, personhood, or perceived value. It has many benefits for persons living with dementia in long-term care (LTC) homes, including improvement in physical and cognitive function, and mental health. People with advanced dementia continue to need and benefit from inclusion and social contact in LTC, yet there is not a well-developed understanding of how to support this. A tailored intervention called Namaste Care has been shown to be an effective approach to meaningfully engage residents in LTC, decrease behavioral symptoms, and improve their comfort and quality of life. There is a need to consider how best to deliver this intervention. Objective: The aim of this study was to describe environmental, social, and sensory factors influencing meaningful engagement of persons with advanced dementia during Namaste Care implementation in LTC. Methods: In this qualitative descriptive study, focus groups and interviews were conducted with families, volunteers, staff, and managers at two LTC homes. Directed content analysis was conducted. The Comprehensive Process Model of Engagement was used as a coding framework. Results: With respect to environmental attributes, participants emphasized that a designated quiet space and a small group format were helpful for engagement. In terms of social attributes, participants emphasized Namaste Care staff capacity to deliver individualized care. Regarding sensorial factors, familiarity with the activities delivered in the program was emphasized. Conclusion: Findings reveal the need to offer small group programs that include adapted recreational and stimulating activities, such as Namaste Care, for residents at the end of life in LTC. Such programs facilitate meaningful engagement for persons with dementia as they focus on individual preferences, comfort, and inclusion while recognizing changing needs and abilities of residents.

What are best practices for involving family caregivers in interventions aimed at responsive behaviour stemming from unmet needs of people with dementia in nursing homes: a scoping review

“…Various techniques for managing the behaviour were used, for example, educating family or family participating in one-on-one activities with the resident 40. The interventions all aimed at collaboration and creating a partnership between family caregivers and staff,41–59 such as ongoing monitoring of case management, interaction and socialisation 40 45 46 48 50 52–56 59. Twelve of these studies involved interventions of family participation in preventing or reducing responsive behaviour 43 45 46 48 50 52 54–56 58 59.…”

“…The interventions all aimed at collaboration and creating a partnership between family caregivers and staff,41–59 such as ongoing monitoring of case management, interaction and socialisation 40 45 46 48 50 52–56 59. Twelve of these studies involved interventions of family participation in preventing or reducing responsive behaviour 43 45 46 48 50 52 54–56 58 59. In 13 studies, the intervention was designed to support meaningful activities 41 45–49 51–57 59…”

“…Twelve of these studies involved interventions of family participation in preventing or reducing responsive behaviour 43 45 46 48 50 52 54–56 58 59. In 13 studies, the intervention was designed to support meaningful activities 41 45–49 51–57 59…”

“…One of these offered family caregivers the opportunity to engage in activities they had chosen for their relatives during a visit 49. Three studies explored the Namaste Care Family programme that invited family to participate in a psychosocial intervention to increase the quality of life for people with advanced dementia 54 58 59. Another intervention included facilitating reminiscence by using three-dimensional printed objects 45.…”

“…The involvement of family caregivers mainly took the form of giving family caregivers an active role in conceptualising, creating and implementing person-centred activities for their relatives in cocreation with staff 42 44 49 50 52 53. Family caregivers were often asked to provide information about the relative, for example, about their hobbies, interests, occupations or the kind of music they like 42 44 52–54 59. Items brought in by family caregivers (ie, pictures and memorabilia) were then often used to develop activities for the residents or in creating a draft life story book 45 50 52 53 55 56.…”