Effectiveness of a grief intervention for caregivers of people with dementia

In this article, we report on the structure and effectiveness of a grief management coaching intervention with caregivers of individuals with dementia. The intervention was informed by Marwit and Meuser’s Caregiver Grief Model and considered levels of grief, sense of empowerment, coping, and resilience using five methods of delivery. Results indicate that the intervention had significant positive effects on caregivers’ levels of grief and increased their levels of empowerment, coping, and resilience. The intervention was found to be effective across caregivers’ characteristics as well as across five delivery modalities. Through description of this intervention, as well as outcome, this research contributes to the body of knowledge about caregivers’ disenfranchised grief and ways to effectively address it

Changing practice in dementia care in the community: developing and testing evidence-based interventions, from timely diagnosis to end of life (EVIDEM)

Background Dementia has an enormous impact on the lives of individuals and families, and on health and social services, and this will increase as the population ages. The needs of people with dementia and their carers for information and support are inadequately addressed at all key points in the illness trajectory. Methods The Unit is working specifically on an evaluation of the impact of the Mental Capacity Act 2005, and will develop practice guidance to enhance concordance with the Act. Phase One of the study has involved baseline interviews with practitioners across a wide range of services to establish knowledge and expectations of the Act, and to consider change processes when new policy and legislation are implemented. Findings Phase 1, involving baseline interviews with 115 practitioners, identified variable knowledge and understanding about the principles of the Act. Phase 2 is exploring everyday decision-making by people with memory problems and their carers

Exemplar models and support for older carers and carers of people with dementia: informing commissioning

In May 2017 NHS England commissioned a project to support its Commitment to Carers programme. The focus of the work was to scope exemplar models of support for older carers, and for carers of people with dementia (of any age). The work took place between May 2017 and March 2018, and included a consultation workshop in February 2018. A full report of the findings is available, but this brief summary has been prepared primarily to give feedback to the people who contributed to the project and shared their experience with us. Our conclusions and recommendations should inform the further development of NHS England’s Commitment to Carers, but more widely they also point to gaps in which new approaches might be further developed and tested, building on the experiences and exemplars discussed

My Home Life: promoting quality of life in care homes

A new report from JRF outlines the findings from the My Home Life project. My Home Life is a collaborative initiative between Age UK, City University, the Joseph Rowntree Foundation and Dementia UK promoting quality of life in care homes. This study found: - positive relationships in care homes enable staff to listen to older people, gain insights into individual needs and facilitate greater voice, choice and control; - relationship-centred care is at the heart of many examples of best practice; - care home managers play a pivotal role in promoting relationships between older people, staff and relatives; - care home providers and statutory agencies should consider how their attitudes, practices and policies can create pressure and unnecessary paperwork which ultimately reduce the capacity of care homes to respond to the needs of older people; and - negative stereotypes of care homes have an impact on the confidence of staff and managers

Silver Dreams Fund Learning and Evaluation Contract: Final report June 2014

This is a summary of the Final Report which presents the findings of the evaluation of the Big Lottery Fund's Silver Dreams Fund conducted by Ecorys.The Silver Dreams Fund was a £10 million programme which sought to address the gaps in provision by challenging organisations to come up with an innovative idea for a project that would "pioneer ways to help vulnerable older people deal more effectively with life-changing events".Our approach involved both formative and summative elements and was based upon a robust and evidence-based outcome evaluation framework. In addition, we have also undertaken an evaluation of the new programme management processes employed by the Big Lottery Fund which has been reported separately.In summary, the evaluation involved:- development of an evaluation framework and common indicators to measure outcomes;- provision of a package of self-evaluation support to projects;- programme level work to provide independent primary qualitative research and to validate findings from self-evaluations;- a range of learning activities; and- analysis and reporting

Information technologies that facilitate care coordination: provider and patient perspectives

Health information technology is a core infrastructure for the chronic care model, integrated care, and other organized care delivery models. From the provider perspective, health information exchange (HIE) helps aggregate and share information about a patient or population from several sources. HIE technologies include direct messages, transfer of care, and event notification services. From the patient perspective, personal health records, secure messaging, text messages, and other mHealth applications may coordinate patients and providers. Patient-reported outcomes and social media technologies enable patients to share health information with many stakeholders, including providers, caregivers, and other patients. An information architecture that integrates personal health record and mHealth applications, with HIEs that combine the electronic health records of multiple healthcare systems will create a rich, dynamic ecosystem for patient collaboration

Seeing the wood for the trees. Carer related research and knowledge: A scoping review

This NIHR-SSCR funded scoping review provides a comprehensive mapping of what is known about carers and caring, and aims to help inform policy, practice and research in relation to carers. The review was undertaken by searching 10 electronic bibliographic databases, supplemented by additional web searches to identify academic research, grey literature and wider knowledge. The analysis adopts a selective thematic approach covering: carer variables - the characteristics of different types of carer and different caring situations; types of care - the nature of needs of the cared for person and the features of the care situation; the impact of caring – resilience and coping, employment and health; and carer support and needs assessment. The final section highlights key messages identified from the review. It found that caring involves all sections and age groups of the population, with people are likely to experience one or more periods of caregiving over their lifetime. The uniqueness of each caring relationship is also highlighted. In relation to types of carers, knowledge about ‘hard to reach’ groups, such as BAME and LGBT carers, remains sparse. Older carers are also relatively invisible in policy and research terms. It found that much of the knowledge about carers identified in the review relates to their characteristics, their lived experience and the nature of their caregiving, with relatively less being known about the effectiveness of interventions to support them. The report concludes by offering suggestions for policy and practice. An appendix provides a bibliography of the 3,434 items identified in review, classified into 17 types of reference

The Role of Coping Humour in the Physical and Mental Health of Older Adults

Objectives - This study examined the associations among coping humor, other personal/social factors, and the health status of community-dwelling older adults. Method - Survey questionnaires were completed with 73 community dwelling older adults. Included were measures of coping humor, spirituality, self-efficacy, social support and physical and mental health status. Results - Correlations across all variables showed coping humor to be significantly associated with social support, self-efficacy, depression, and anxiety. Forward stepwise regression analyses showed that coping humor and self-efficacy contributed to outcome variance in measures of mental health status. Contrary to expectation, neither social support nor spirituality contributed to the total outcome variance on any of the dependant measures. Conclusion - The importance of spirituality, self-efficacy and social support in determining the quality of life of older adults is well supported in the literature. Coping humor as a mechanism for managing the inevitable health stresses of aging has received less attention. This study shows that coping humor and self efficacy are important factors for explaining health status in older adults. Correlations among coping humor, self efficacy, and social support suggest that a sense of humor may play an important role in reinforcing self-efficacious approaches to the management of health issues.coping humor, aging, health status