Fear of Incompetence in Family Caregivers and Dementia Care Transitions.

Research on interpersonal interaction dynamics in relationships between persons with dementia and their family caregivers has been limited. We examine the role of these dynamics in decisions to transition a family member from home care to congregate care, with a particular focus on the role of fear of incompetence. Fear of incompetence is the fear of being unable to interact, communicate in a meaningful way, or take care of a close family member with dementia. In this study (N = 350 family caregivers), perceived negative changes in the family member with dementia predicted increased perceived dependency, which predicted both increased caregiver burden and greater fear of incompetence in caregivers, which, in turn, predicted stronger care transition desire. Strategies should be aimed not only at reducing dependency of the care recipient but also teaching family caregivers interaction skills that decrease their fear of interactional incompetence and thus promote home care continuation.

Effects of dementia knowledge and dementia fear on comfort with people having dementia: Implications for dementia-friendly communities.

BACKGROUND AND OBJECTIVES: Advocates for dementia-friendly communities emphasize the need for the public to know about the dementias and to experience social comfort with people having dementia. This research tested a conceptual model of influences on social comfort, including two types of dementia knowledge and personal dementia fear. RESEARCH DESIGN AND METHODS: Data were collected from 645 Wisconsin residents through an online platform (Qualtrics®) and community outreach efforts. A hierarchical multiple regression was conducted and its results were mapped onto a figure representing the conceptual model of social comfort. RESULTS: Greater personhood-based knowledge (based on observations of the capabilities and perspectives of persons with dementia) and less personal dementia fear significantly predicted higher levels of social comfort, while biomedical knowledge did not. Although more personhood-based knowledge improved overall comfort regardless of the level of biomedical knowledge, people with higher levels of biomedical knowledge benefitted the most from having personhood-based knowledge. DISCUSSION AND IMPLICATIONS: These findings suggest that activities that promote personhood-based knowledge may enhance social comfort. These activities may be most effective for individuals who already have a high level of biomedical knowledge about people with dementia. Community members and professionals ought to strike a balance between biomedical knowledge and personhood-based knowledge, as the two together may be associated with higher levels of social comfort. This could benefit the promotion of dementia-friendly community initiatives.

Young Adults' Concerns and Coping Strategies Related to their Interactions with their Grandparents and Great-Grandparents with Dementia.

Young adults' concerns and coping strategies related to their face-to-face interactions with their grandparents/great-grandparents with dementia were explored through the lens of a solidarity-conflict conceptual framework. Participants indicated concerns about their inability to maintain the relational connection, not knowing what to say or how to behave, their lack of perspective-taking skills and emotion-regulation strategies, interacting with an ever-changing other, as well as concerns about other co-participants in the interaction. Participants' coping strategies were driven by two interaction motives: maintaining solidarity (e.g., desire to maintain and improve the interaction with the grandparent by seeking the other's company, loving the other, and maintaining the other's personhood) and dealing with conflict (e.g., dealing with self-focused concerns about lack of skills and knowledge by engaging in substitute avenues for communication and down-regulating negative affect). Implications for improving interactions between young adults and their grandparents/great-grandparents with dementia are discussed.

Diagnosis makes a difference: Perceptions of older persons with dementia symptoms.

Background/Study Context: Employing the stereotype content model and terror management theory, we examined whether stereotypes and feelings about persons with dementia vary depending on the type of dementia diagnosis and purported causes of the dementia. METHODS: Participants were randomly assigned to read one of four vignettes that depicted a man who consulted his doctor because of memory problems. All vignettes described the same symptoms and diagnostic tests, but each of four groups read a different result: all tests normal (Normal); Alzheimer's disease (AD); Wernicke-Korsakoff Syndrome (WKS) associated with alcohol abuse; and chronic traumatic encephalopathy (CTE) associated with head injuries from playing football in high school and college. Measures included a word fragment completion task, a stereotype content scale, and an emotions scale. RESULTS: Results showed no differences in the number of death-related words generated in the word fragment completion task and no differences in assessment of competence across the four groups. Those in the Normal, AD, and CTE groups evaluated the man as warmer than those in the WKS group. Participants in the AD condition showed more empathy than those in the WKS group. There were no differences in pity or fear but the CTE condition produced more envy and admiration and the WKS condition produced more contempt. CONCLUSION: These results suggest that different forms of dementia elicit varying emotional and cognitive responses.

Contact and perspective taking improve humanness standards and perceptions of humanness of older adults and people with dementia: a cross-sectional survey study.

BACKGROUND: No empirical work has systematically explored perceptions of humanness of people with dementia and of older adults and the variables that could improve these perceptions. We thus investigated the role of contact and perspective taking in improving perceptions of humanness of these social groups. To do so, we developed a new concept, humanness standards, defined as the amount of evidence of ability impairment needed to conclude that elderly people and those with dementia have lost personhood. METHODS: We used a cross-sectional survey design (n = 619) to assess participants' humanness standards and perceptions of uniquely human characteristics and human nature characteristics of two social groups (people with dementia and older adults). Half the participants (n = 311) completed a survey about people with dementia and half (n = 308) assessed older adults. RESULTS: People with dementia were perceived as possessing humanness characteristics to a lesser extent than were older adults. For both groups, contact predicted enhanced perceptions of humanness characteristics. Participants' degree of contact with individuals with dementia also predicted humanness standards, but only under low perspective-taking conditions. As predicted, for older adults, participants set the highest humanness impairment thresholds in the high contact/high perspective-taking condition. CONCLUSIONS: We conclude that while social programs that bring persons with dementia and other individuals in contact could change humanness standards and perceptions of humanness characteristics of people with dementia, in the case of elderly adults, the contact must be supplemented by variables that facilitate taking the perspective of the person.

Healthy aging persons and their brains: promoting resilience through creative engagement.

Creative engagement, as an expression of and a support for resilience, may have a neuroprotective effect among older adults, contributing to retention of cognitive capacity. Recent research on creative activities shows that they strengthen social networks and give persons a sense of control; both outcomes have been associated with brain health. The authors cite evidence suggesting that positive social interactions can nurture resilience and creative engagement among older persons, including those living with dementia. The motivational, attentional, affective, and social components of creative activities combine to offer older persons meaningful opportunities to express and strengthen their resilience, regardless of their cognitive status, despite the biopsychosocial challenges of aging. The article addresses implications for future research, clinical practice, and public policy, and suggests how gaps in current research on resilience and creativity might be addressed.

Continuity in the midst of change: behaviors of residents relocated from a nursing home environment to small households.

A time-sampling procedure was used to observe behaviors of 22 long-term-care residents with dementia (Mini-Mental State Exam median, 11.94; range 0-23) in public areas before and after relocation from a traditional nursing home environment to 2 small household units. Two trained observers noted the occurrence of 19 social behaviors (14 verbal, 5 nonverbal) in which the resident intentionally interacted with another person. Another 19 nonsocial behaviors (16 active, 3 passive) were also coded. Analysis by t tests of 6 groupings of behaviors showed no significant differences before and after relocation, with the exception of nonverbal social interactions. Overall, residents showed consistency in both social and nonsocial behaviors. Results are interpreted in light of personal, social, and environmental continuity despite the many changes associated with the relocation.

1918 influenza: a Winnebago County, Wisconsin perspective.

The population of Winnebago County in 1918 was approximately 62,000 residents. It consisted of towns supporting diverse manufacturers surrounded by farming country. For this study, records were revisited, and 1918 to 1920 influenza survivors were interviewed. A pharmacological investigation encompassing the various influenza treatments used in Wisconsin from 1918 to 1920 was documented. In 1918, over 180 individuals perished from influenza, and over 2000 cases were reported in Winnebago County, Wisconsin. Influenza returned in 1920, which some researchers refer to as the "fourth wave," claiming nearly 50 lives in Winnebago County, Wisconsin. This study also documents the 1920 influenza wave.