Dementia and Dementia Care: The Contributions of a Psychosocial Perspective

The social sciences have and continue to play a unique role in the study of dementia and dementia care. For central to the social sciences, particularly the discipline of sociology is a history of critical inquiry that challenges long held societal assumptions, a concern for issues of social justice, social exclusion and the treatment of marginalized populations. All significant areas to consider when caring for a person with dementia. This chapter will trace the development of the study of dementia and dementia care starting with its biomedical roots, examine the contributions of the social sciences in furthering the conceptual development of the field, and suggest future areas where sociologists can play a critical role in the provision of quality dementia care

Patterns of absolute, differential and structural continuity in perceptions of nurturance in mother-daughter, mother-son, father-daughter and father-son dyads

Parents\u27 and their adolescent children\u27s perceptions have found to have both similar and different perceptions of their parent-adolescent relationship (Carlson, Cooper, & Spradling, 1991; Comstock, 1994) with changes in perceptions of nurturing and/or warmth becoming more apparent during the adolescent transitional phase and as a function of parent - adolescent gender differences (Clark-Lempers, Lempers, & Ho, 1991);Three waves of data were collected from Iowa parents with adolescent children in the sixth (11-to 13-years) or eighth grade (12-to 14-years) at the first wave of measurement responded at each wave of measurement to 21 parenting questionnaire items taken from Roberts, Block and Block (1984) Child Rearing Practicing Report, and from Schaefer\u27s (1965) Child\u27s Report of Parental Behavior Inventory;Differential, absolute and structural continuity was assessed in parents\u27 and their adolescent children\u27s perceptions of parental nurturance. Differential continuity was investigated by correlating for mothers, fathers and the adolescent children their respective nurturance scores at wave 1, wave 2 and wave 3. Absolute continuity was assessed with 2 (gender of child or parent) by 2 (grade) by 3 (time) repeated measures ANOVAs to determine significant difference in mean scores between the 3 times of measurement. Structural continuity was investigated by running confirmatory factor analyses;No evidence for differential continuity was found among mothers, fathers, nor the adolescent children in their respective perceptions of parental nurturance correlate across the 3 measurements. There was significant but low correlations between mothers\u27 perceptions of maternal nurturance, fathers\u27 perceptions of paternal nurturance and adolescent\u27s perceptions of parental nurturance at the 3 waves of measurement;Absolute continuity for mothers and fathers were significant, with small decreases in their respective level of parental nurturance over time. The adolescent children perceived a significant but small increase for both mothers and fathers in their respective level of nurturance across time;No evidence was found for structural continuity across the 3 different respondents at each point in time nor for structural continuity across the 3 waves of measurement. Therefore, the assumption that the same underlying uni-dimensional construct is measured across time or across respondents is not justified

Selfhood in younger onset dementia: Transitions and testimonies.

Younger people with dementia and their carers are an overlooked population for research, policy and practice attention. In this study, data were collected from both the United States and the UK in order to explore the meaning and construction of selfhood and identity. The US data collection included in-depth interviews with 23 people diagnosed with younger-onset dementia, while the UK data collection comprised 15 face-to-face interviews with younger carers of younger people with dementia; all carers were/had been caring for a younger person with dementia diagnosed through the DSM-IV-R criteria. A grounded theory analysis of the data resulted in the emergence of five themes to explain the interview data, these were: (1) identity as a worker; (2) identity of abandoned individual; (3) sexual identity; (4) family identity; and (5) identity as an individual engaged in living. Additional research is necessary to further develop the attributes and application of these identity profiles

Making a university community more dementia friendly through participation in an intergenerational choir.

A dementia friendly community is one that is informed about dementia, respectful and inclusive of people with dementia and their families, provides support, promotes empowerment, and fosters quality of life. This study presents data from four cohorts of undergraduate college students and people with dementia and their family members, using an intergenerational choir as the process through which to begin to create a dementia friendly community. This was accomplished by breaking down the stereotypes and misunderstandings that young adults have about people with dementia, thus allowing their commonalities and the strengths of the people living with dementia to become more visible. Data were gathered for each cohort of students through semi-structured open-ended questions on attitudes about dementia and experiences in the choir, collected at three points over 10 weeks of rehearsals. Data about their experiences in the choir were collected from each cohort of people with dementia and their family members through a focus group. Results across all four cohorts showed in the students: changed attitudes, increased understanding about dementia and the lived experience, reduced dementia stigma, and the development of meaningful social connections. People with dementia and their family members expressed feelings of being part of a community

Making a university community more dementia friendly through participation in an intergenerational choir

A dementia friendly community is one that is informed about dementia, respectful and inclusive of people with dementia and their families, provides support, promotes empowerment, and fosters quality of life. This study presents data from four cohorts of undergraduate college students and people with dementia and their family members, using an intergenerational choir as the process through which to begin to create a dementia friendly community. This was accomplished by breaking down the stereotypes and misunderstandings that young adults have about people with dementia, thus allowing their commonalities and the strengths of the people living with dementia to become more visible. Data were gathered for each cohort of students through semi-structured open-ended questions on attitudes about dementia and experiences in the choir, collected at three points over 10 weeks of rehearsals. Data about their experiences in the choir were collected from each cohort of people with dementia and their family members through a focus group. Results across all four cohorts showed in the students: changed attitudes, increased understanding about dementia and the lived experience, reduced dementia stigma, and the development of meaningful social connections. People with dementia and their family members expressed feelings of being part of a community

Heart Rate Variability Measured Early in Patients with Evolving Acute Coronary Syndrome and 1-year Outcomes of Rehospitalization and Mortality

Objective: This study sought to examine the prognostic value of heart rate variability (HRV) measurement initiated immediately after emergency department presentation for patients with acute coronary syndrome (ACS). Background: Altered HRV has been associated with adverse outcomes in heart disease, but the value of HRV measured during the earliest phases of ACS related to risk of 1-year rehospitalization and death has not been established. Methods: Twenty-four-hour Holter recordings of 279 patients with ACS were initiated within 45 minutes of emergency department arrival; recordings with �18 hours of sinus rhythm were selected for HRV analysis (number [N] �193). Time domain, frequency domain, and nonlinear HRV were examined. Survival analysis was performed. Results: During the 1-year follow-up, 94 patients were event-free, 82 were readmitted, and 17 died. HRV was altered in relation to outcomes. Predictors of rehospitalization included increased normalized high frequency power, decreased normalized low frequency power, and decreased low/high frequency ratio. Normalized high frequency �42 ms2 predicted rehospitalization while controlling for clinical variables (hazard ratio [HR] �2.3; 95% confidence interval [CI] �1.4–3.8, P�0.001). Variables significantly associated with death included natural logs of total power and ultra low frequency power. A model with ultra low frequency power �8 ms2 ( HR �3.8; 95% CI �1.5–10.1; P�0.007) and troponin �0.3 ng/mL (HR �4.0; 95% CI �1.3–12.1; P�0.016) revealed that each contributed independently in predicting mortality. Nonlinear HRV variables were significant predictors of both outcomes. Conclusion: HRV measured close to the ACS onset may assist in risk stratification. HRV cut-points may provide additional, incremental prognostic information to established assessment guidelines, and may be worthy of additional study