Championing Dementia Education: Adapting an Effective Scottish Dementia Education Program for Canadian Acute Health Care Providers.

With increasing numbers of persons living with dementia and their higher rates of hospitalizations, it is necessary to ensure they receive appropriate and effective acute care; yet, acute care environments are often harmful for persons with dementia. There is a lack of dementia education for acute health care providers in Canada. Scotland presently delivers a dementia education program for health care providers, known as the Scottish National Dementia Champions Programme. The objective of this Policy and Practice Note is to present the collaborative work of Scottish experts and Canadian stakeholders to adapt the Dementia Champions Programme for use in Canada. This work to date includes: (a) an environmental scan of Canadian dementia education for acute health care providers; (b) key informant interviews; and, (c) findings from a two-day planning meeting. The results of this collaborative work can and are being used to inform the next steps to develop and pilot a Canadian dementia education program.

Development of a bereavement intervention for spousal carers of persons with dementia: The Reclaiming Yourself tool.

A dearth of supportive interventions exists for bereaved spouses who were carers of persons with dementia, despite an identified need for such supports. The purpose of the current work was to develop and evaluate a supportive writing intervention for this population that was informed by the experiences of spouses who were bereaved and was specific to the unique context of dementia. Following development of the Reclaiming Yourself tool, a mixed methods design was utilized to assess its effects on grief, depressive symptoms, and balance between restoration and loss. Fifteen participants residing in Saskatchewan and Manitoba were provided the writing intervention and visited three times approximately four weeks apart, completing quantitative measures (for grief, depressive symptoms, and finding balance) at each visit and an exit interview about the intervention. Paired-sample t-tests illustrated trivial effect sizes and no significant differences in grief, depressive symptoms, or balance orientation, with overall means suggesting low levels of depressive symptoms and grief, and a slight orientation towards restoration. Thematic analysis illustrated benefits from the tool, with participants reporting that it provided a structured approach to grief, was a catalyst for emotional expression, and facilitated reflection. The format and timing of the intervention was not ideal for all participants. Although Reclaiming Yourself did not affect quantitatively measured grief, depressive symptoms, and balance, carers accrued benefits from the tool that align with beneficial processes observed in other writing interventions. While more research on the effectiveness of this tool is needed, such interventions are valuable to support the well-being of carers who are bereaved following the death of a spouse with dementia.

Qualitative exploration of emotional and social changes from diagnosis to bereavement for spousal caregivers of persons with dementia.

OBJECTIVES: To understand how bereaved spousal caregivers of persons with dementia perceive and respond to changes over the course of their spouse's disease, from diagnosis into bereavement. DESIGN: Qualitative interview study with convenience sampling and thematic analysis approach. PARTICIPANTS: Participants included eight women and two men (n=10) who had been spousal caregivers for a person with dementia prior to his/her death. Participants were older adults who self-reported good health and were bereaved longer than a year. SETTING: Data collected in a small Canadian prairie city between fall 2014 and winter 2015. FINDINGS: Two overarching themes were developed as important components of participants' caregiving journey: emotional reactions to change and variation in social connectedness throughout the caregiving and bereavement journey. Four key sub-themes developed through the analysis of emotional reactions to events: memorable grief overshadows persistent grief, a progressive feeling of hopelessness and overwhelmed, relief is common but hidden and gratitude is a milestone in a constructive bereavement. Three key variations of social connectedness throughout the caregiving and bereavement journey were developed: the importance of social inclusion throughout a caregiving and bereavement journey, the repeated loss of companionship and withdrawing from social interactions is contingent on needs. CONCLUSIONS: The findings suggest that emotional changes throughout caregiving and bereavement are not linear. The need for support from family, friends and new social supports is influential in enabling the caregiver to move forward during caregiving and bereavement.

The bereavement experience of spousal caregivers to persons with dementia: Reclaiming self.

Spouses of persons living with dementia both anticipate future loss and grieve for multiple losses occurring with caregiving and this ultimately influences their bereavement experience. Little research has been conducted regarding the bereavement experience in the caregiving journey with dementia and what does exist is mostly quantitative in nature. The purpose of this study is to describe the bereavement experience of spousal caregivers ( n = 10) utilizing Thorne's interpretive description. Thematic analysis revealed the features and facilitators of the bereavement process for spousal caregivers to persons with dementia. The unique contribution of this study to the dementia literature is the finding that the overall process of reclaiming self is significant to the bereavement journey. Future work should investigate identity as understood by spousal caregivers to persons with dementia, and further explore the processes, facilitators, and barriers to healthy bereavement in this population.

A needs assessment on addressing environmental health issues within reproductive health service provision: Considerations for continuing education and support.

BACKGROUND: This needs assessment was initially undertaken to explore the beliefs and knowledge of nurses and physicians about the impact of environmental toxicants on maternal and infant health, as well as to describe current practice and needs related to addressing environmental health issues (EHI). METHODS: One hundred and thirty-five nurses (n = 99) and physicians (n = 36) working in Saskatchewan completed an online survey. Survey questions were designed to determine how physicians and nurses think about and incorporate environmental health issues into their practice and means of increasing their capacity to do so. RESULTS: Although participants considered it important to address EHIs with patients, in actual practice they do so with only moderate frequency. Participants reported low levels of knowledge about EHIs' impact on health, and low levels of confidence discussing them with patients. Participants requested additional information on EHIs, especially in the form of online resources. CONCLUSION: The results suggests that while nurses and physicians consider EHIs important to address with patients, more education, support, and resources would increase their capacity to do so effectively. Based on the findings, considerations and recommendations for continuing education in this area have been provided.