Supervision of supervisors : on developing supervision as pedagogy and support in post-graduate education

Abstract not available

Caring for a Person With Dementia on the Margins of Long-Term Care: A Perspective on Burden From 8 European Countries

© 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine Objectives To explore associations between carer burden and characteristics of (1) the informal carer, (2) the person with dementia, and (3) the care support network in 8 European countries. Design Cross-sectional study. Setting People with dementia judged at risk of admission to long-term care (LTC) facilities in 8 European countries (Estonia, Finland, France, Germany, Netherlands, Spain, Sweden, United Kingdom). Participants A total of 1223 people with dementia supported by community services at home or receiving day care or respite care and their informal carers. Measurements Variables regarding the informal carer included familial relationship and living situation. Variables relating to the person with dementia included cognitive functioning (S-MMSE), neuropsychiatric symptoms (NPI-Q), depressive symptoms (Cornell depression scale), comorbidity (Charlson Comorbidity Index), and physical functioning (Katz Activity of Daily Living [ADL] Index). The care support network was measured using hours of caregiving (ADLs, instrumental ADLs [IADLs], supervision), additional informal care support, and service receipt (home care, day care). Experience of carer burden was recorded using the Zarit Burden Interview. Logistic regression analysis was used to determine factors associated with high carer burden. Results Carer burden was highest in Estonia (mean 39.7/88) and lowest in the Netherlands (mean 26.5/88). High burden was significantly associated with characteristics of the informal carer (family relationship, specifically wives or daughters), of the person with dementia (physical dependency in ADLs; neuropsychiatric symptoms, in particular nighttime behaviors and irritability), the care support network (hours of caregiving supervision; receipt of other informal care support) and country of residence. Conclusion A range of factors are associated with burden in informal carers of people with dementia judged to be on the margins of LTC. Support for informal carers needs to take account of gender differences. The dual challenges of distressed behaviors and difficulties in ADLs by the person with dementia may be addressed by specific nonpharmacological interventions focusing on both elements. The potential protective effect of additional informal support to carers highlights the importance of peer support or better targeted home support services. The implementation of appropriate and tailored interventions to reduce burden by supporting informal carers may enable people with dementia to remain at home for longer

Supervision of supervisors - on developing supervision as pedagogy and support in Post-graduate education

Supervising Supervisors and Ph.D. Candidates - on the development of supervision as a form of instruction and a pedagogic instrument in postgraduate educatio

Identity and Relationships: On Understanding Social Work with Older People Suffering from Dementia

Many countries in the Western world are facing great challenges posed by an ageing population. Since cognitive impairments and the prevalence of dementia increases with age, we can expect an increasing number of older people in need of care. However, severe problems with such care are already reported by researchers as well as in the mass media. The aim of this paper is to discuss how the identity confusion among older people suffering from dementia might influence relationships and the staff's behaviour, and in that sense, be part of the care problems reported. Three studies carried out between 1993 and 2003 are introduced aimed at illustrating the severe care problems identified. The interaction between the residents and the staff is focused on and discussed from a psychodynamic viewpoint. Data show that the caregivers also become confused and express a need of affirmation comparable with that of the older people suffering from dementia. That is, even the caregivers' behaviour seems to be influenced by an identity-preserving ambition similar to the one of the dementia sufferers, and this might explain some of the problems in this form of care