Quality in residential care from the perspective of people living with dementia: The importance of personhood

Milte, Rachel; Shulver, Wendy; Killington, Maggie; Bradley, Clare; Ratcliffe, Julie; Crotty, Maria

doi:10.1016/j.archger.2015.11.007

Cited by 88 publications

(140 citation statements)

References 12 publications

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“…Enjoyment can be experienced during activity participation (Nyman & Szymczynska, ; Roland & Chappell, ), when looking forward to an activity (Roland & Chappell, ) or enjoyment of the outcome of an activity (Bishop & Purcell, ). Activities may be enjoyed for various reasons such as being a hobby (Bishop & Purcell, ), a means of relaxation (Bishop & Purcell, ; Han et al, ) or a connection to personal identity (Carless, ; Han et al, ; Milte et al, ). In a study examining “meaningful activity” in RACFs, people with dementia as well as care staff commonly identified enjoyment as a measure for whether an activity was meaningful (Harmer & Orrell, ).…”

Section: Resultsmentioning

confidence: 99%

“…Harmer and Orrell () suggest that pure engagement entails deep involvement in the activity, implying that engagement requires more than simply being physically present during an activity. In one study, family members of RACF residents with dementia suggested that for activities to be engaging they need to be at a level of difficulty that requires the individual to concentrate on what they are doing but without being unachievable (Milte et al, ). An example of an activity for RACF residents that is not typically considered meaningful is falling asleep in front of the television (Morley, Philpot, Gill, & Berg‐Weger, ).…”

Section: Resultsmentioning

confidence: 99%

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Enjoyable, engaging and individualised: A concept analysis of meaningful activity for older adults with dementia

Tierney

Beattie

2020

Int J Older People Nursing

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Aim:The term "meaningful activity" is widely used in policy, practice and the research literature. However, definition and use of the term is unclear and inconsistent. A concept analysis was conducted to explore the fundamental attributes that make an activity meaningful for older adults with dementia and propose a conceptual model for understanding "meaningful activity" in this population. Methods: This study followed Walker and Avant's method of concept analysis. Searches were conducted in the Scopus, MEDLINE, CINAHL, PubMed, Academic Search Elite and Web of Science databases for literature using the term "meaningful activity." Papers published before 1996 were excluded. Results: Twenty-nine papers concerned with "meaningful activity" were analysed. This analysis identified five attributes that make activities meaningful for people with dementia: (a) enjoyable; (b) suited to the individual's skills, abilities and preferences; (c) related to personally relevant goals; (d) engaging; and (e) related to an aspect of identity. The conceptual model illustrates how individual and opportunity factors influence participation in "meaningful activity" and the consequences of this participation as discussed in the existing literature. Conclusion: The findings of this concept analysis provide insight into what characteristics make an activity meaningful. Specific activities that are meaningful are different for each person and participation in personally 'meaningful activities' has the potential to positively impact the lives of people with dementia. Implications for practice: This understanding of 'meaningful activity' can be used by those involved in research, planning or delivery of services and care for people with dementia to encourage and support participation in activities that are meaningful to individuals. K E Y W O R D S concept analysis, dementia, meaningful activity, older adults, person-centred care

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Enjoyable, engaging and individualised: A concept analysis of meaningful activity for older adults with dementia

Tierney

Beattie

2020

Int J Older People Nursing

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“…Supporting personhood has been identified as a foundation for quality care for people living with dementia [40]. Person-centred care centres on relationships with others and the theory that warm and compassionate care interactions should increase well-being, while disrespectful and disengaged care interactions are thought to lead to decreased well-being and increased agitation [14].…”

Section: Resultsmentioning

confidence: 99%

Advancing aged care: a systematic review of economic evaluations of workforce structures and care processes in a residential care setting

Easton

Milte

Crotty

et al. 2016

Cost Eff Resour Alloc

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Long-term care for older people is provided in both residential and non-residential settings, with residential settings tending to cater for individuals with higher care needs. Evidence relating to the costs and effectiveness of different workforce structures and care processes is important to facilitate the future planning of residential aged care services to promote high quality care and to enhance the quality of life of individuals living in residential care. A systematic review conducted up to December 2015 identified 19 studies containing an economic component; seven included a complete economic evaluation and 12 contained a cost analysis only. Key findings include the potential to create cost savings from a societal perspective through enhanced staffing levels and quality improvement interventions within residential aged care facilities, while integrated care models, including the integration of health disciplines and the integration between residents and care staff, were shown to have limited cost-saving potential. Six of the 19 identified studies examined dementia-specific structures and processes, in which person-centred interventions demonstrated the potential to reduce agitation and improve residents’ quality of life. Importantly, this review highlights methodological limitations in the existing evidence and an urgent need for future research to identify appropriate and meaningful outcome measures that can be used at a service planning level.

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“…For example, in Definition 1, the defining attributes of ‘dementia friendly’ are empowerment, aspiration, self-confidence, contribution, participation, and meaningful activities [8]. These attributes may imply that the purposes of becoming dementia friendly are to acknowledge the ‘personhood’ of PWD [12], and to sustain their sense of meaning in life. In Definition 2, the essential attributes of ‘dementia-friendly’ include way-finding ability, a sense of safety, accessibility to local facilities, social acceptance, and understanding of dementia [10].…”

Section: Communities Working Towards Becoming Dementia Friendlymentioning

confidence: 99%

‘Dementia-friendly communities’ and being dementia friendly in healthcare settings

Lin

2017

Current Opinion in Psychiatry

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Purpose of review This review discusses the concept of ‘dementia-friendly communities’ and summarizes the latest research and practice around such communities. This review also highlights important topic areas to be considered to promote dementia friendliness in healthcare settings. Recent findings Definitions of ‘dementia-friendly communities’ reflect the contemporary thinking of living with dementia (e.g., dementia as a disability, equal human rights, a sense of meaning). Existing research has covered a wide range of topic areas relevant to ‘dementia-friendly communities’. However, these studies remain qualitative and exploratory by nature and do not evaluate how dementia-friendly communities impact health and quality of life of people living with dementia and their caregivers. In healthcare settings, being dementia friendly can mean the inclusion of people with dementia in treatment discussion and decision-making, as well as the provision of first, adequate and appropriate service to people with dementia at an equivalent standard of any patient, second, person-centered care, and third, a physical environment following dementia-friendly design guidelines. Summary Research incorporating more robust study designs to evaluate dementia-friendly communities is needed. Being dementia-friendly in healthcare settings requires improvement in multiple areas – some may be achieved by environmental modifications while others may be improved by staff education.

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Quality in residential care from the perspective of people living with dementia: The importance of personhood

Cited by 88 publications

References 12 publications

Enjoyable, engaging and individualised: A concept analysis of meaningful activity for older adults with dementia

Enjoyable, engaging and individualised: A concept analysis of meaningful activity for older adults with dementia

Advancing aged care: a systematic review of economic evaluations of workforce structures and care processes in a residential care setting

‘Dementia-friendly communities’ and being dementia friendly in healthcare settings

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