Finding the fundamental needs behind resistance to care: Using the Fundamentals of Care Practice Process.

A person living with Alzheimer's disease (PA) can experience difficulty during bodily care and therefore may show resistance to care behaviours (RTCBs). Nurses must take a clinical approach to planning care that meets the person's needs. Therefore, it is necessary to identify training strategies for bedside nurses and nursing students. AIMS AND OBJECTIVES: To describe and discuss how the FOC practice process (FOC-PP) can help nurses understand PAs who show RTCBs during bodily care. BACKGROUND: Resistance to care behaviour phenomenon and the importance of bodily care as fundamental care are described. The FOC-PP enables nurses to apply the FOC framework in their practice. DESIGN: This discursive paper is based on the literature of the FOC framework and PP. METHOD: A clinical scenario that develops through the five stages of the FOC-PP. RESULTS: The scenario centres on Mrs. Emily Morgan, 81, who lives in a nursing home and is not receiving the bodily care that she needs. Camille, a nursing student, and her supervisor Florence collaborate with Mrs. Morgan's family to improve the quality of her care. Three particular aspects of nursing practice based on the FOC-PP are described: the critical thinking process, relational process and pedagogical process. CONCLUSION: The FOC-PP promotes holistic care centred on the person and his or her needs and encourages the nurse to use his or her skills and knowledge. All these dimensions are fundamental for high-quality nursing care. RELEVANCE TO CLINICAL PRACTICE: Mrs. Morgan's scenario enables us to perceive that the FOC-PP is very useful for nursing students and bedside nurses. However, given the amount of specific and diverse knowledge required by the FOC-PP, it is necessary to identify avenues for teaching them. Using clinical scenarios could facilitate the integration of the FOC-PP, with taking into account the specific characteristics of individual clients.

Nonpharmacological Strategies Used By Family Caregivers of Persons With Alzheimer's Disease and Related Dementias as Presented in Blogs.

Individuals with Alzheimer's disease and related dementias (ADRD) may exhibit behavioral and psychological symptoms of dementia that can increase the strain experienced by their family caregivers. This strain correlates with increased stress and reduced quality of life for the family caregiver and individual with ADRD. More information is needed regarding the ways in which caregivers manage the caregiving experience in their efforts to reduce strain and maintain or improve quality of life. Many individuals, including dementia caregivers, use web blogs as online journals to share their lived experiences. The current study used blogs written by family caregivers of persons with ADRD to explore strategies used to support their care recipients. Using a qualitative thematic analysis, six themes related to the strategies used by caregivers were identified: Modifying the Physical and Personal Environment; Engaging the Person With ADRD; Seeking Outside Assistance; Using Complementary Therapies; Planning and Organization; and Reminiscing and Traditions. The current findings extend our understanding of strategies for caregiving that are used by and acceptable to family caregivers of persons with ADRD. This information can be used to develop or modify nursing-related interventions and services aimed at improving caregiver strain and quality of life. [Journal of Gerontological Nursing, 45(7), 25-35.].

Saúde do idoso com doença de Alzheimer: revisão integrativa / The health of elderly people bearing alzheimer's disease: an integrative review / Salud mayor con la enfermedad de alzheimer: revisión integradora

Objetivo: Verificar o conhecimento produzido pelos pesquisadores a respeito da saúde do idoso com doença de Alzheimer (DA). Métodos: Revisão integrativa da literatura com levantamento bibliográfico realizado nas bases de dados Biblioteca Virtual em Saúde (BVS), Medical Literature Analysis and Retrieval System Online (MEDLINE) e nos bancos de dados do Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes). Resultados: Observou-se a incipiência de artigos científicos publicados sobre a DA com enfoque na saúde da pessoa idosa. Conclusão: Verificou-se a necessidade de pesquisas para investigar a saúde do idoso em virtude da DA que possibilitem aporte teórico na elaboração de políticas públicas de saúde mais abrangentes para os cuidados aos idosos

Objective: The study's purpose has been to verify the knowledge produced by the researchers with regards to the health of elderly people bearing Alzheimer's disease. Methods: It is an integrative review of the literature where the bibliographical survey was carried out in the following databases: Biblioteca Virtual em Saúde, MEDLINE and Portal de Periódicos Capes. Results: It was observed an incipient number of published scientific articles concerning the Alzheimer's disease with a focus on the elderly' health. Conclusion: It was verified the need for carrying out researches aiming to address the lack of scientific resource in order to investigate the elderly's health facing the Alzheimer's disease, and also to provide a theoretical contribution regarding the elaboration of comprehensive public health policies for the care of elderly people

Meta: Compruebe el conocimiento producido por los investigadores acerca de la salud de las personas mayores con la enfermedad de Alzheimer. Métodos: Integradora de la literatura con la literatura que tuvo lugar en la Biblioteca Virtual en Salud, MEDLINE y bases de datos del Portal Capes Periódico. Resultados: Había una escasez de artículos científicos publicados sobre la Enfermedad de Alzheimer centrándose en la salud de las personas de edad. Conclusión: Hay una necesidad de investigación para investigar la salud de las personas mayores en la cara de la enfermedad de Alzheimer permitiendo contribución teórica en el desarrollo de políticas más integrales de salud pública para el cuidado de los ancianos

The Long Journey of Alzheimer's Disease.

The growing elderly population is creating record numbers of individuals with Alzheimer's disease (AD) and other dementias. Nursing has an unprecedented opportunity to rethink how we care for adults with dementia, reduce the burden of caregivers, and preserve the personhood of patients. This article reviews AD and dementia pathophysiology, history, screening, stigma, treatments and interventions, and caregiver support. A nurse's journey with her mother with AD imparts the meaning of patient dignity.

Family caregiver support groups: spiritual reflections' impact on stress management.

OBJECTIVES: Caregiving for people with neurodegenerative disease (e.g. Alzheimer's disease (AD); frontotemporal dementia (FTD)) is provided primarily by the family care system. Caregiving is taxing and much of the caregiving research is guided by a stress/adaptation theoretical perspective. Within this theoretical model, the role of spirituality in rendering meaning to the caregiver role remains unexplored. We conducted a qualitative analysis of expressions of spirituality and its meaningfulness during the caregiving journey within the context of an online video conferencing support group intervention program. METHODS: Eighteen AD and six FTD caregivers participated in the Caring for Others evidence-based program consisting of 10 weekly virtual online support group sessions facilitated by experienced gerontological social workers. RESULTS: Content analysis of the video-recorded group interactions yielded recurrent themes of caregivers' spiritual reflections and their associations with managing caregiver stress responses. CONCLUSION: The findings inform professional observations of the importance of spiritual beliefs in understanding how caregivers ascribe both positive and negative meanings to critical life events and their management.

Alzheimer's Disease Caregivers' Health and Important Resources: Next Steps in Intervention Research.

In this issue of Psychosomatic Medicine, Mausbach and colleagues report that Alzheimer's disease caregivers who engage in more pleasant leisure activities had lower blood pressure for 5 years compared with those who engage in fewer leisure activities. This novel finding suggests that something as simple as taking more walks in the park or more time for reading books could protect the physical health of caregivers. In this editorial, we review possible mechanisms linking pleasant leisure activities with lower blood pressure in caregivers and discuss potential barriers that prevent caregivers from engaging in pleasant leisure activities. One possibility is that caregivers may not give themselves "permission" to take time away from caregiving, or feel guilty or selfish for doing so. Another impediment may be lack of outside assistance or support that would be needed to take time for leisure activities. Primary health care providers may play an important role in helping caregivers overcome these obstacles. In addition, public policy innovations are needed to meet the increasing societal demands on the psychological and medical consequences of caregiver burden.

Effects of Spiritual Group Therapy on Caregiver Strain in Home Caregivers of the Elderly with Alzheimer's Disease.

INTRODUCTION: Care of patients with Alzheimer's disease is one of the most difficult types of care that exposes the caregiver to a high level of care strain. The present research aimed at determining the effect of spiritual care on caregiver strain of the elderly with Alzheimer's disease. METHODS: An experimental study was carried out on 100 caregivers who were selected by convenience sampling and randomly divided into intervention, control one and control two groups. Group spiritual therapy was performed on the intervention group for five weeks, Control one participate in the group sessions without any particular interventions, and control two received no interventions. Data was collected through a demographic questionnaire and Robinson's (1983) Caregiver Strain Index, and analyzed using the Chi-square, Fisher's Exact test, one-way analysis of variance and paired t-test. Statistical significance level was considered as 0.05. RESULTS: In the intervention group mean of the posttest care strain score 32.43±2.73 was significantly lower than pretest 37.16±1.26 (P<0.001). The mean posttest score of care strain was significantly lower in the intervention group compared to the two other groups (P<0.001). CONCLUSION: Spiritual care can reduce care strain in home caregivers of the elderly with Alzheimer's disease.

Implementing living room theatre activities for people with dementia on nursing home wards: a process evaluation study.

OBJECTIVES: A new communication method, the 'Veder Method', was implemented in the Netherlands. This method uses theatrical stimuli in combination with proven person-centred communication methods. Care staff was trained to apply the Veder Method in a 'living room theatre activity' for people with dementia. This study evaluates the implementation of the Veder Method on psychogeriatric nursing home wards. METHODS: Facilitators and barriers to train staff and implement the Veder Method in psychogeriatric nursing homes were identified by conducting semi-structured interviews with 12 stakeholders who were involved in the implementation, and five focus groups with 35 trained care staff. The interviews and focus groups were transcribed verbatim, and two independent researchers analysed the content of the transcripts. The Implementation Process Evaluation (IPE) Framework was used to categorize the data and the 7s-model to contextualize the qualitative findings. RESULTS: A structured overview of facilitators and barriers in different stages of the implementation process is presented. Positive reactions in residents and more reciprocity in caregiver-resident contact motivated trained care staff to work with the Veder Method. An action plan, executive support, the visibility of the method in the organization and a pioneer group that initiated implementation were essential for successful implementation. High work pressure for the care staff was a hindering factor. CONCLUSION: Respondents experienced the added value of the Veder Method. The facilitators and barriers to implementation we identified in this study can help to implement and disseminate the successful Veder Method and other person-centred communication methods in psychogeriatric nursing homes effectively.

Collaborative transdisciplinary team approach for dementia care.

Alzheimer's disease (AD) has high economic impact and places significant burden on patients, caregivers, providers and healthcare delivery systems, fostering the need for an evaluation of alternative approaches to healthcare delivery for dementia. Collaborative care models are team-based, multicomponent interventions that provide a pragmatic strategy to deliver integrated healthcare to patients and families across a wide range of populations and clinical settings. Healthcare reform and national plans for AD goals to integrate quality care, health promotion and preventive services, and reduce the impact of disease on patients and families reinforcing the need for a system-level evaluation of how to best meet the needs of patients and families. We review collaborative care models for AD and offer evidence for improved patient- and family-centered outcomes, quality indicators of care and potential cost savings.

Who is that stranger in the mirror? The mirror experience for elderly patients with dementia.

Use of the mirror is an everyday phenomenon for most individuals. There seems to be limited evidence-based studies that address mirror viewing and the appropriate use of mirrors for patients with dementia. Using a case study, the purpose of this study is to begin a dialogue with the nursing community on practical nursing interventions and the need for research in this area.

Children of heroes: Alzheimer's disease--a path toward healing and wholeness for caregivers.

Conventional wisdom postulates that Alzheimer's steals personhood and destroys our opportunities to heal, reconcile, and deepen our relationships with persons who have this disease. In this article, children of Alzheimer's Heroes who have answered the call to love, challenge this conventional wisdom. With clarity, confidence, and courage, we bear witness to the mythic power of Alzheimer's and express gratitude for the surprising gifts that have transformed our lives.