2 research outputs found
An Interpretive Phenomenological Analysis (IPA) of coercion towards community dwelling older adults with dementia: Findings from MYsore studies of Natal effects on Ageing and Health (MYNAH)
The final publication is available at Springer via http://dx.doi.org/10.1007/s00127-016-1286-4Purpose Limited availability of specialist services places a
considerable burden on caregivers of Persons with
Dementia (PwD) in Low- and Middle-Income Countries
(LMICs). There are limited qualitative data on coercive
behavior towards PwD in an LMIC setting.
Aim The aim of this study was to find relevant themes of
the lived experience of relatives as caregivers for PwD in
view of their use of coercive measures in community setting
in South India.
Method Primary caregivers (n = 13) of PwDs from the
Mysore study of Natal effects on Ageing and Health
(MYNAH) in South India were interviewed to explore the
nature and impact of coercion towards community
dwelling older adults with dementia. The narrative data
were coded using an Interpretative Phenomenological
Analysis (IPA) approach for thematic analysis and theory
formation.
Results Caregivers reported feeling physical and emotional
burn-out, a lack of respite care, an absence of
shared caregiving arrangements, limited knowledge of
dementia, and a complete lack of community support
services. They reported restrictions on their lives through
not being able take employment, a poor social life,
reduced income and job opportunities, and restricted
movement that impacted on their physical and emotional
well-being. Inappropriate use of sedatives, seclusion and
environmental restraint, and restricted dietary intake,
access to finances and participation in social events, was
commonly reported methods of coercion used by caregivers
towards PwD. Reasons given by caregivers for
employing these coercive measures included safeguarding
of the PwD and for the management of behavioral problems
and physical health.
Conclusion There is an urgent need for training health and
social care professionals to better understand the use of
coercive measures and their impact on persons with
dementia in India. It is feasible to conduct qualitative
research using IPA in South India
Birth size, risk factors across life and cognition in late life:protocol of prospective longitudinal follow-up of the MYNAH (MYsore studies of Natal effects on Ageing and Health) cohort
INTRODUCTION: For late-life neurocognitive disorders, as for other late-life chronic diseases, much recent interest has focused on the possible relevance of Developmental Origins of Health and Disease (DOHaD). Programming by undernutrition in utero, followed by overnutrition in adult life may lead to an increased risk, possibly mediated through cardiovascular and metabolic pathways. This study will specifically examine, if lower birth weight is associated with poorer cognitive functioning in late life in a south Indian population. METHODS AND ANALYSIS: From 1934 onwards, the birth weight, length and head circumference of all babies born in the CSI Holdsworth Memorial Hospital, Mysore, India, were recorded in obstetric notes. Approximately 800 men and women from the Mysore Birth Records Cohort aged above 55 years, and a reliable informant for each, will be asked to participate in a single cross-sectional baseline assessment for cognitive function, mental health and cardiometabolic disorders. Participants will be assessed for hypertension, type-2 diabetes and coronary heart disease, nutritional status, health behaviours and lifestyles, family living arrangements, economic status, social support and social networks. Additional investigations include blood tests (for diabetes, insulin resistance, dyslipidaemia, anaemia, vitamin B(12) and folate deficiency, hyperhomocysteinemia, renal impairment, thyroid disease and Apolipoprotein E genotype), anthropometry, ECG, blood pressure, spirometry and body composition (bioimpedance). We will develop an analysis plan, first using traditional univariate and multivariable analytical paradigms with independent, dependent and mediating/confounding/interacting variables to test the main hypotheses. ETHICS AND DISSEMINATION: This study has been approved by the research ethics committee of CSI Holdsworth Memorial Hospital. The findings will be disseminated locally and at international meetings, and will be published in open access peer reviewed journals