Promoting well‐being and independence for people with dementia

Abstract

This paper reviews the research evidence relating to non-pharmacological interventions with people with dementia aiming to improve well-being and independence. There have been a number of attempts to improve the person's level of independent functioning through programmes training and supporting self-care skills, mobility, continence, orientation and participation in activities. Well-being has been less often directly addressed, although recently studies have begun to specifically target aspects of it. Increased independence does not necessarily lead to greater well-being, and it is clear that the greatest potential for increasing function is in tackling the excess disability which many care giving situations in effect impose on the person with dementia. In carrying out research in this area, the limitations of randomized controlled trials are evident, and there is much to be said for the reporting of series of carefully controlled single-case studies in addition to group studies. Further development of methods of measuring well-being in people with dementia is also required.

Access technology and dementia care: Influences on residents’ everyday lives in a secure unit

“…As dementia diseases are progressive and as yet without cure, well-being is often the main goal in dementia care (7,8). Therefore, for caregivers of people with dementia, the focus is often on adaptation of the environment and on individualized support in everyday life, rather than on remediation of impairments (9,10).…”

“…In particular, social and ethical concerns are raised as people with dementia may put themselves at risk when they wander off (4,26). Wandering is problematic for people with dementia, and especially for caregivers, who may anticipate the consequences of getting lost, and who might react by restricting the autonomy of the person with dementia to assure his or her security (3,7). As wandering is a major cause of hospital admission for people with dementia (27) and is relatively common (28), engineers and medical staff have created tracking devices mostly via an electronic transmitter attached to a patient's clothes for determining his or her position (5).…”

Preserving Identity and Planning for Advance Care (PIPAC): preliminary outcomes from a patient-centered intervention for individuals with mild dementia

“…Lawrence, Samsi, Banerjee, Morgan, & Murray, 2011). Even when individuals are unaware of changes in their cognitive abilities, decreased functional status and elimination of social roles can be a source of significant distress (Woods, 1999). Furthermore, illness onset is often fraught with existential issues and pressing family decisions about future care needs (Chochinov, 2004;Chochinov, 2012).…”

Behavioural difficulties and cued recall of adaptive behaviour in dementia: Experimental and clinical evidence

“…At this stage of the research enterprise, work at the micro-level is vital and there is a growing trend in this direction (Woods, 1999). The goal would be to identify specific severe clinical problems suffered by people with dementia and those who care for them, and then use or develop existing knowledge to devise scientifically validated ways to ameliorate those problems.…”