Dementia‐friendly community indicators from the perspectives of people living with dementia and dementia‐family caregivers

[[abstract]]Aims To identify dementia‐friendly communities’ indicators and their current conditions in Taiwan from the perspectives of people with dementia and dementia‐family caregivers. Design This qualitative study explored the opinions and experiences of people with dementia and dementia‐family caregivers regarding dementia‐friendly communities. Methods Participants (16 people with dementia and 20 family caregivers) were recruited from neurological clinics, day care centres for people with dementia and support groups for family caregivers in the Taipei community from July ‐ October, 2016. Data were collected in face‐to‐face interviews, which were tape recorded and transcribed verbatim. Transcripts were analysed by Miles and Huberman's (1994) guidelines. Results Similar indicators for dementia‐friendly communities were identified in Taiwan as in other countries, including dementia‐friendly care services, dementia‐friendly hospitals, dementia‐friendly community environment, dementia‐friendly transportation, dementia‐friendly stores and shops, dementia friendly people, integrated dementia‐related information and community contribution‐ and ‐involvement opportunities for people with dementia. However, Taiwanese people with dementia and family caregivers described no emphasis on the potential of people with dementia to contribute to developing dementia‐friendly communities and more top‐down expectations for the government's role. Conclusion These indicators can be a guide for developing and evaluating dementia‐friendly communities in Taiwan. Differences between Taiwan and Western developed countries in indicators for dementia‐friendly communities can be further explored. Community nursing assessment, interventions, and evaluation based on these dementia‐friendly communities indicators can be further developed. Impact This study developed indicators for dementia‐friendly communities in an Asian country. These indicators can be used as a guide for developing and evaluating dementia‐friendly communities

Literature review: understanding nursing competence in dementia care

Aims and objectives. The aim of this study was to review dementia nursing competencies. The objectives were to explain the relevancy of dementia competencies across care settings and levels of practice. Background. Dementia is strongly associated with increasing age and as the world population ages there is an imperative to ensure the healthcare workforce is fully equipped to meet the needs of people with dementia and their carers. Design. A literature review study addressed the research aim and objectives. Method. Literature sources were (i) academic databases, (ii) the internet and (iii) snowballing. Search terms were \u27dementia\u27, \u27care standards\u27, \u27training and education\u27 and \u27competency\u27. Results. The sample consisted of 59 reviewed publications. A synthesis of the findings generated 10 dementia competencies: (i) Understanding Dementia; (ii) Recognising Dementia; (iii) Effective Communication; (iv) Assisting with Daily Living Activities; (v) Promoting a Positive Environment; (vi) Ethical and Person-Centred Care; (vii) Therapeutic Work (Interventions); (viii) Responding the needs of Family Carers; (ix) Preventative Work and Health Promotion and (x) Special Needs Groups. There were also five levels of practice: (i) Novice; (ii) Beginner; (iii) Competent; (iv) Proficient and (v) Expert and no care setting specific competencies were generated. Conclusion. Government initiatives demonstrate commitments to dementia, such as Australia\u27s adoption of dementia as a National Health Priority and the UK National Dementia Strategy. Registration boards for the nursing workforce in Japan and the UK included dementia competencies in generalist frameworks to emphasise the importance of dementia as a healthcare issue. This study demonstrated that there is no dementia competency framework relevant across care settings or levels of practice. Relevance to clinical practice. An empirical study will develop a multi-disciplinary dementia competency framework relevant across care settings and levels of practice to ensure the healthcare workforce can effectively deliver services to people with dementia and their carers

Global perspectives on children's unpaid caregiving in the family: research and policy on 'young carers' in the UK, Australia, the USA and Sub-Saharan Africa

This article provides the first cross-national review and synthesis of available statistical and research evidence from three developed countries, the UK, Australia and the USA, and from sub-Saharan Africa, on children who provide substantial, regular or significant unpaid care to other family members (‘young carers/caregivers’). It uses the issue of young carers as a window on the formulation and delivery of social policy in a global context. The article examines the extent of children’s informal caregiving in each country; how young carers differ from other children; and how children’s caring has been explained in research from both developed and developing countries. The article includes a review of the research, social policy and service developments for young carers in each country. National levels of awareness and policy response are characterized as ‘advanced’, ‘intermediate’, ‘preliminary’ or ‘emerging’. Explanations are provided for variations in national policy and practice drawing on themes from the globalization literature. Global opportunities and constraints to progress, particularly in Africa, are identified. The article suggests that children’s informal caring roles in both developed and developing nations can be located along a ‘caregiving continuum’ and that young carers, globally, have much in common irrespective of where they live or how developed are their national welfare systems. There is a need in all countries for young carers to be recognized, identified, analysed and supported as a distinct group of ‘vulnerable children’

Housing Choices and Care Home Design for People With Dementia

This article reviews the current state of housing for people with dementia by exploring housing choices available to this group, and identifying potential issues with design of care homes. Older people who wish to age in place are faced with the challenge of adapting their domestic environment to ensure independence, accessibility, and social connectivity. This is even more challenging for people with dementia who continue to live at home, given the risks of self-harm and getting lost. More imaginative and inclusive forms of collective housing are needed. For people with dementia, a move to a new environment is often a stressful experience that causes shock, withdrawal, and anger. Hence, more research is needed to develop more fitting long-term housing options for people with dementia. This article presents a brief review on housing choices and housing design for people with dementia. Interviews with managers of 22 care homes were conducted to explore housing choices and design issues. Results show that the main housing choices available to people with dementia offer different levels of care. The choice of care homes relates to the atmosphere of a home as some occupants favor a homely or relaxing environment and others prefer dynamic settings. A combination of appropriate level of care, a good atmosphere, and design quality within the care home are elements that lead to a more enabling environment. Design of a successful caring environment also requires appropriate care and a positive therapeutic and domestic-looking environment