Dementia (London, England)
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Dementia accounts for one in three deaths among people aged 65 and over, but end-of-life care for people with dementia is often sub-optimal. Palliative care for people with dementia poses particular challenges to those providing services, and current policy initiatives recommend education and training in palliative care for those working with patients with dementia. However, there are few evaluations of the effectiveness of dementia education and training. ⋯ A total of eight papers were identified that described and evaluated such palliative care education; none reported benefits for people with dementia. There is a clear need to develop and evaluate educational interventions designed to improve palliative and end-of-life care for people with dementia. Some suggestions for educationally sound approaches are discussed.
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The aim of this study was to test the effectiveness of writing poetry on psychological functioning in people with early stage dementia. ⋯ Creative activities such as writing poetry hold promise for enhancing the quality of life of people with dementia.
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This article considers the work of a number of contemporary British poets who have attempted to articulate some of the experiences that dementia entails. The unique potential of poetry as a means of portraying the dislocations and reinventions of self that dementia involves has been mostly overlooked. The insights offered by critical gerontology are central to this article. ⋯ The challenges posed by poets such as Vuyelwa Carlin, Valerie Laws and Jo Shapcott in particular, are examined. The complex poetic representations offered by these poets acknowledge the pathological declines of dementia and simultaneously celebrate the individuality and life of their subjects. Considering dementia with reference to the work of contemporary poets and critical gerontology is one way in which we can deepen our understanding of what this illness involves and humanise those who suffer from it.
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Research is limited on end-of-life treatment decisions made by African American family caregivers. In a pilot study, we examined the feasibility of implementing an advance care treatment plan (ACT-Plan), a group-based education intervention, with African American dementia caregivers. Theoretically based, the ACT-Plan included strategies to enhance knowledge, self-efficacy, and behavioral skills to make end-of-life treatment plans in advance. ⋯ Self-efficacy and knowledge about dementia, cardiopulmonary resuscitation, mechanical ventilation, and tube feeding increased for ACT-Plan participants but not for the attention-control. More ACT-Plan than attention-control participants developed advance care plans for demented relatives. Findings warrant a randomized efficacy trial.
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The experience of being a carer of a person with dementia at the end of life is expressed in these 12 accounts. This is a synthesis of the concerns and challenges for carers at the end of life. ⋯ What emerges from this review is a range of perspectives that provide contrasting views of the heterogeneity of carers and professionals. This may be helpful for professionals and policy makers to consider when planning end-of-life care strategies for people with dementia and insights drawn from hearing directly from carers may be powerful learning tools.