Aging & mental health
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Aging & mental health · Mar 2006
The relation of entrapment, shame and guilt to depression, in carers of people with dementia.
There is increasing research exploring depression in carers of people with dementia. This study explored the relation of entrapment, shame and guilt to depression in a group of 70 carers of those with dementia. As in other studies the experience of entrapment in the role was highly related to depression. ⋯ Guilt however, as focused on the fears of harming others, letting others down and sense of responsibility, was not associated with depression or entrapment. Depression in carers may relate in part to feeling trapped in a role but also being vulnerable to criticism and feelings of inadequacy in that role. In this study, degree of behavioural disturbance/dependence was not found to be significantly associated with any of the research variables.
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Aging & mental health · Mar 2006
Comparative StudyStandards of care in home care services: a comparison of generic and specialist services for older people with dementia.
Current policy in England emphasises both the importance of caring for highly dependent older people for as long as possible in their own homes, and the development of specialist care services for people with dementia. However, the differences between specialist and generic home care services for people with dementia are poorly understood. This cross-sectional postal survey describes the standards of home care services for people with dementia in the North West of England, and investigates the differences in quality standards between specialist and generic home care services. ⋯ Few differences were found between the two service types, although generic services appeared to offer a greater degree of flexibility than specialist services. These results help to inform the understanding of home care service mix and provision, and the uptake of national minimum standards. They provide key material for shaping the future provision of home care for older people with dementia.
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Several researchers have examined how acculturation shapes the self-esteem of adolescents, but few studies have looked at the influence of acculturation for older Mexican Americans. The aim of this study was to examine how language acculturation shaped the self-esteem of older Mexican Americans. The data come from the baseline wave (N=3050) of the ongoing Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE), a multistage area probability sample conducted in 1993 and 1994. ⋯ However, depressive symptoms mediate and moderate the association of acculturation on self-esteem. Language acculturation among older Mexican Americans is positively associated with self-esteem, even when individuals experience depressive symptoms. Findings suggest that acculturation influences multiple dimensions of mental health.
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Aging & mental health · Sep 2005
ReviewAwareness in dementia: ethical and legal issues in relation to people with dementia.
Our improved understanding of the experience of people with dementia provides a new impetus to address legal and ethical issues. This paper explores emerging issues in relation to awareness in dementia and its impact on legal and ethical matters. ⋯ The tensions that exist between the imperatives of doing no harm and of maintaining autonomy in addressing legal and ethical issues are highlighted, and attention drawn to the manner in which the attribution of unawareness is used to justify withholding autonomy. The review emphasizes the importance of considering competency and awareness as being multi-faceted, to be understood in the context of social interaction.
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Aging & mental health · May 2004
Comparative StudyEffect of Meeting Centres Support Program on feelings of competence of family carers and delay of institutionalization of people with dementia.
The study tested the hypotheses that integrated support, in which patients and carers are both supported by one professional staff member, will be more effective in reducing the feelings of (over)burden of carers and in positively influencing some potential determinants of experienced burden than non-integrated support, such as psychogeriatric day-care. A quasi-experimental pre-test/post-test control group design was applied with matched groups and measurements at baseline and after seven months. Fifty-five of the eighty dyads (31% dropped out) of persons with mild-to-moderate dementia and their carers who presented for four community meeting centres and three day-care centres in nursing homes over an 18 month period, were included in the study. ⋯ However, as compared to the control group in regular day-care, the persons with dementia in the MCS Program participated for a longer period of time before they were placed in a nursing home. The MCS Program proved more effective than psychogeriatric day-care in influencing the feeling of competence of the carers, and seems to lead to an increased delay of nursing home placement of the person with dementia, as compared to regular day-care. Because of the small sample and limited power of the study, and the possible influence of the selection of carers on the study outcome, further research into the value of meeting centres for carers of people with dementia is recommended.