Adolescents’ experiences and perceptions of dementia

Objectives: There is a lack of understanding about how adolescents perceive dementia, and what their dementia related experiences are. Without such information, it is hard to make a case for the need to raise awareness of dementia in adolescents, and the best strategies to achieve this. Methods: In a cohort of 901 adolescents (aged 13-18) from the South East of England, we explored what the experiences and perceptions of dementia were using a series of questionnaires. Descriptive data of individual items were reported, comparing differences between genders. Results: The adolescents within this study tended to have positive or neutral attitudes towards dementia, though there was evidence that a proportion of adolescents had misconceptions or held negative attitudes (e.g. 28.5% of adolescents disagreed with the statement “In general, I have positive attitudes about people with dementia”). We also identified that the adolescents had a range of experiences of dementia including providing some form of care for someone with dementia (23.2%), though most had indirect contact with dementia through TV and movies (77.3%), or adverts (80.2%). Females nearly always had better attitudes towards dementia and had significantly more contact with dementia. Conclusions: Considering that adolescents are already forming negative attitudes and misconceptions of dementia, it is important that we raise awareness about dementia in this age group

Perceptions and attitudes towards dementia among university students in Malaysia.

BACKGROUND: One of the major challenges worldwide is the stigma associated with dementia. There is limited dementia awareness within Malaysian communities, including levels of confusion regarding the differences between dementia and the usual ageing progress, which can lead to delays in support seeking. The need for additional training and education for healthcare professionals has been highlighted. The present study aimed to evaluate the benefits of a one-hour dementia education session (Dementia Detectives workshop) for pharmacy and medicine undergraduate students at a Malaysian university. METHODS: Participants attended the workshop and completed pre- (Time 1) and post-workshop (Time 2) questionnaires consisting of validated measures exploring attitudes towards dementia and older people more broadly. RESULTS: A total of 97 students were recruited. Attitudes towards people with dementia showed significant positive changes between Time 1 and Time 2, whereas no differences were found for attitudes towards older people. CONCLUSIONS: As medical and pharmacy students develop theoretical knowledge, practical skills and professional attitudes during their undergraduate studies, it is important for students to also learn about the humanistic side of diseases and conditions through workshops such as the one presented here. Further research should now be conducted to consider how Dementia Detectives can be delivered to non-healthcare students and what the barriers and facilitators to wider delivery are

Effectiveness of counselling and psychotherapeutic interventions for people with dementia and their families: a systematic review

As there is currently no cure for dementia, providing psycho-social support is imperative. Counselling and psychotherapeutic interventions offer a way to provide individualised support for people with dementia and their families. However, to date, there has not been a systematic review examining the research evidence for these interventions. This review aimed to examine the following research questions: (1) Are counselling/psychotherapeutic interventions effective for people with dementia?, (2) Are counselling/psychotherapeutic interventions effective for care-givers of people with dementia? and (3) Which modes of delivery are most effective for people with dementia and care-givers of people with dementia? A systematic literature search was conducted in MEDLINE (via PubMed), PsycINFO and CINAHL in March 2019. Keyword searches were employed with the terms ‘dement*’, ‘counsel*’, ‘psychotherapy’, ‘therap*’, ‘care’ and ‘outcome’, for the years 2000–2019. Thirty-one papers were included in the review, from seven countries. Twenty studies were randomised controlled trials (RCTs) or adopted a quasi-experimental design. The remaining studies were qualitative or single-group repeated-measures design. The review identified variation in the counselling/psychotherapeutic approaches and mode of delivery. Most interventions adopted either a problem-solving or cognitive behavioural therapy approach. Mixed effectiveness was found on various outcomes. The importance of customised modifications for people with dementia was highlighted consistently. Understanding the dyadic relationships between people with dementia and their care-givers is essential to offering effective interventions and guidance for practitioners is needed. Information about the cognitive impairment experienced by participants with dementia was poorly reported and is essential in the development of this research area. Future studies should consider the impact of cognitive impairment in developing guidance for counselling/psychotherapeutic intervention delivery for people with dementia

Implementing Dementia Care Mapping as a practice development tool in dementia care services: A systematic review

Dementia Care Mapping (DCM) is an observational tool set within a practice development process. Following training in the method, DCM is implemented via a cyclic process of briefing staff, conducting mapping observations, data analysis and report preparation, feedback to staff and action planning. Recent controlled studies of DCM’s efficacy have found heterogeneous results and variability in DCM implementation has been indicated as a potential contributing factor. This review aimed to examine the primary research evidence on the processes, barriers and facilitators to implementing DCM as a practice development method within formal dementia care settings. PUBMED, PsycINFO, CINAHL, The Cochrane Library-Cochrane reviews, HMIC (Ovid), Web of Science and Social Care Online were searched using the term “Dementia Care Mapping”. Inclusion criteria was primary research studies, in any formal dementia care settings where DCM was used as a practice development tool and which included discussion/critique of implementation processes. Assessment of study quality was conducted using the Mixed Methods Appraisal Tool (MMAT). Twelve papers were included in the review, representing nine research studies. The papers included discussion of various components of the DCM process including mapper selection and preparation; mapping observations; data analysis, report writing and feedback; and action planning. However, robust evidence on requirements for successful implementation of these components was limited. Barriers and facilitators to mapping were also discussed. The review found some consensus that DCM is more likely to be successfully implemented if the right people are selected to be trained as mappers, with appropriate mapper preparation and ongoing support, with effective leadership for DCM within the implementing organisation/unit and in organizations that already have a person-centred culture or ethos. Future development of the DCM tool should consider ways to save on time taken to conduct DCM cycles. More research to understand the ingredients for effective DCM implementation is needed

The prospective role of defeat and entrapment in caregiver burden and depression amongst formal caregivers

The mental and physical demands of working in a care home are known to lead to elevated risk for staff of work and stress related illnesses such as depression. However, little is known about how these develop. Recent developments in defeat and entrapment research have demonstrated that they are best conceptualised as a single factor. Our aim was to establish whether combined defeat and entrapment influences the development of depression and caregiver burden amongst health care staff. Formal care staff (N= 195) were recruited from a care organisation and completed self-report measures of caregiver burden, depression, defeat and entrapment at two time points approximately 12 months apart. Regression analyses demonstrated that changes in caregiver burden and depression between Time 1 and Time 2 were predicted from baseline levels of combined defeat and entrapment. This research provided the first evidence of a link between defeat, entrapment and caregiver burden and depression in care staff. There are implications for improving education and training within care organisations about caregiver burden to help identify individuals at risk of developing illnesses

Development of the Adolescent Attitudes towards Dementia Scale (A-ADS).

Objective: There has been an increasing interest in establishing dementia friendly communities leading to the development and delivery of various dementia awareness initiatives. These initiatives have generally been aimed at adults, however to sustain dementia friendly communities, the involvement of young people is imperative. Very few dementia awareness initiatives exist for young people and none have been independently evaluated to establish their impact. This research aimed to design and develop a scale to measure adolescents’ attitudes towards dementia to allow such initiatives to be evaluated. Methods: The Adolescent Attitudes toward Dementia Scale (A-ADS) was developed in two stages. Firstly, cognitive interviews were conducted with 15 young people and secondly, a new scale (based on items from two existing scales) was piloted with 262 young people, recruited through schools. Results: A scale consisting of 23 items was developed. Exploratory factor analysis demonstrated that this captured three factors; perceptions of dementia, personal sacrifice and empathy with people living with dementia. The three sub-scales showed adequate internal consistency (>.60), correlated with the original scales (r = .79-.91, p <.001) and correlated with an existing measure of attitudes towards older people at a similar level to the original scales (r = .47, p < .001). Discussion: The scale will allow the evaluation of educational initiatives for young people and provide a validated and standardised measure to establish adolescents’ attitudes towards dementia

Pro re nata prescribing and administration for neuropsychiatric symptoms and pain in long-term care residents with dementia and memory problems: a cross-sectional study

Background: Prescribing, dispensing and administering pro re nata (PRN; as needed or necessary, as determined by an individual) medicines to people with intermittent or short-term conditions is a potential area for medication errors and inappropriate prescribing and administration. In people with dementia, regular PRN medicines use can demonstrate good practice when appropriate or poor in situations where their use is not recommended. However, the frequency of PRN prescription and administration within long-term care settings (care homes) for people with dementia is largely unknown. A limited number of studies worldwide suggest variation between countries. Objective: To describe the prescription and administration rates of PRN medicines for people with dementia in UK care homes. Setting: Fifty UK care homes. Method: Medication details were collected from review of residents’ medicines records within the care home for the previous month. Main outcome measure: Prescription and administration of PRN medicines for the treatment of behaviours associated with neuropsychiatric symptoms and pain. Results: The most commonly prescribed PRN medicines were analgesics (35.3%), although lower levels of PRN prescription were observed compared to recent studies. The percentage of residents receiving PRN administrations varied, with 20% for antipsychotics, 50% for benzodiazepines, 59% for analgesics, and 85.7% for nonbenzodiazepine hypnotics being administered. Conclusion: Further research is needed to understand the decision making in PRN prescription and administration within long-term care. The prescribing of potentially inappropriate medicines remains a problem in long-term care settings and pharmacists have a key role in reducing inappropriate polypharmacy by undertaking medication reviews that consider both regular and PRN medicines

The Road to Quantum Computational Supremacy

We present an idiosyncratic view of the race for quantum computational supremacy. Google's approach and IBM challenge are examined. An unexpected side-effect of the race is the significant progress in designing fast classical algorithms. Quantum supremacy, if achieved, won't make classical computing obsolete.Comment: 15 pages, 1 figur