Psychological support for people with dementia: A preliminary study

Abstract

Aim/Purpose: Evidence suggests nonpharmacological therapies could improve quality of life in people with Alzheimer's disease (Olazaran et al., 2010). This study aimed to explore attitudes to, and acceptability of, psychological support for people with mild dementia, from their perspective. Design/Methodology: Semi-structured interviews were conducted with five people identified from secondary care services. Questions concerned the experience of being diagnosed, experience of support services and their opinion of alternative support options. Interviews were audio-recorded, transcribed and analysed using thematic analysis. Results/ Findings: Three main themes were identified: loss, coping mechanisms and support. Loss of physical abilities was associated with loss of identity and place in the community. Coping mechanisms included asserting control, and growth and development, including engaging in new activities or using humour. Individual needs and preferences were key to effective support. Social aspects of support and opportunities to talk about their feelings were valued by participants. Counselling, mindfulness and group-based activities, including walking and gardening, were viewed positively. Support from admiral nurses or specialist nurses tended to be viewed in terms of physical health needs, and most needed in later stages of dementia. Research Limitations: Limitations include the small sample size, potential inaccuracies acknowledged by participants regarding recollections of events and researcher bias in hoping that psychological support would be well received. Conclusions/Implications: Talking therapies and psychosocial interventions are acceptable sources of support. Person-centred support which considers personal preferences and abilities can support people to live well with dementia.

Relational counselling as a psychosocial intervention for dementia: Qualitative evidence from people living with dementia and family members

“…The findings in this study highlight the strong emotional impact of the diagnosis of dementia for both participant groups, particularly in response to the unknown trajectory of the dementia, the grief associated with actual and anticipated losses and a sense of helplessness or loss of self as someone living with dementia or caring for a relative with dementia. These current findings are consistent with previous literature that explores the perceptions of the emotional impact of a dementia diagnosis (Aminzadeh et al, 2007) and with the three key areas that people with dementia have highlighted as recommended focus for therapeutic interventions; loss of abilities/identity, coping mechanisms and support (Birtwell & Dubrow-Marshall, 2018). It appeared that change in the identity of people with dementia, as perceived by the caregivers, was associated with caregivers' reported change in sense of their own identity and their perception of the dyadic relationship, in line with previous literature that the onset and progression of dementia is likely to result in a change in the interpersonal relationship (Hayes et al, 2009;Noyes et al, 2009).…”

“…Sabat and Harré (1992) argued that identity can be created through talk and social interaction, subsequently reducing the social isolation of the person with dementia (Jones, 1995). Furthermore, such interventions can support an individual's sense of self, increase selfacceptance and can have positive effects on depression, anxiety and caregiver burden (Birtwell & Dubrow-Marshall, 2018;Elvish et al, 2014;Mittelman et al, 2007).…”

“…Previous research has argued that identifying important aspects of psychotherapeutic interventions from participant perspectives will improve treatment and provide understanding of barriers and facilitators to engagement in the counselling process (Birtwell & Dubrow-Marshall, 2018;Berg et al, 2008). To deliver effective counselling to people with dementia and their caregivers, it is vital to consider the individuals' lived experiences and perspectives, and by doing this, services can subsequently be tailored accordingly (Elvish et al, 2014).…”

“…Therefore, delivering psychotherapeutic interventions that address one's lived experience, for example working through feelings of loss, isolation, role change, the challenge of symptoms and being understood within this process could improve the quality of life of those living with dementia (Scholl & Sabat, 2008). Previous research has highlighted the need for emotional and practical support post-diagnosis (Kelly & Innes, 2016) and the importance of post-diagnostic counselling for people with dementia to facilitate working through the impact of and acceptance of their diagnosis (Birtwell & Dubrow-Marshall, 2018). A recent systematic review (Shoesmith et al, 2020) found that psychotherapeutic interventions can lead to meaningful change for both people with dementia and their caregivers, although highlighted that considerably more evidence has considered caregivers.…”

Effectiveness of counselling and psychotherapeutic interventions for people with dementia and their families: a systematic review

“…People with dementia have highlighted three specific target areas that should be focused on within psychotherapeutic interventions (Birtwell and Dubrow-Marshall, 2018). Loss of both abilities and a sense of identity are common amongst people with dementia.…”