ISSUES IN DEMENTIA 1
Dementia is a major problem affecting older individuals, and mostinstitutions have customized the supportive measures to provideappropriate therapies to the older individuals. Researchers haveconducted studies on various areas in dementia to make the servicesaccessible and developed in the most impactive ways. This paperpresents two independent studies, one qualitative and the otherquantitative. The studies were conducted in the different populationthey cover two distinct topics. This review will be significantbecause the programs developed for dementia need t be patientcentered and the two articles lay insight on the effectiveness ofpatient-centered practices in different institutions.
The articles reviewed are The Challenges of Achieving Person-CenteredCare in Acute Hospitals: A Qualitative Study of People with Dementiaand their Families authored by Clissett et al. in 2013 andGenderDifferences in Dementia Spousal Caregiving authored by Poysti et al.in 2012. Clissett et al. article was a quantitative study thatsought to identify the drawbacks experienced by health care providersin providing services to people with dementia. The article’sbackground shows that the person-centered care is an ideal approachfor proving health services to people with dementia. However, as theresearchers point out, there have been challenges to implementing theperson-centered services in acute care settings. The internationalpolicy that guides service delivery for individuals with dementiashould base its principle on the person-centered care. Theinterventions should incline to the concept of sustaining thepatients’ personhood. The study is significant in offering insightinto the efficiency of the current practices about personal care forpersons with dementia. It also provides a suggestion forintensifying person-centered services in acute hospitals. It alsolays insight on the philosophy that guides the person-centered carethat can transform the services in acute hospital settings. Thearticle followed a qualitative method whereby patients were recruitedfrom two major hospitals aged 70 years and over and having beendiagnosed with mental illnesses. A total of 34 participants took partin the in-depth qualitative study. Out of these 15 were females, 18were widowed, and eight were married. One of them had never beenmarried while two were divorced.
Poysti et al. authored the second article dubbed. The quantitativeresearch sought to exhibit the differences in gendered care indementia patients. The authors tried to understand the difference inmale and females taking care of the dementia patients. The article’sbackground shows that the proportion of male caregivers is on theincrease with an increased need for patients to receive care inhomes. The trend of caregiving is shifting from the traditionalapproach whereby women shouldered the highest burden of caring forindividuals with dementia. Men have also taken the challenge at thefamily level, and they take care of their partners who get diagnosedwith the disease. The study is significant in providing knowledge onthe gender disparities in continuous caregiving by providing thecharacteristics of the burden that males and females face. The studyfollowed a quantitative method whereby 335 dyads o wife-husbandmarried couples were recruited for the study. In the dyads, one o fthe partners was suffering from dementia while the other was thecaregiver. The observation took one year with a future follow-up oftwo years.
The findings in the article authored by Clissett et al. shows thathealth care professionals promoted feelings of attachment andinclusion. However, there was little evidence that the health careprofessionals supported a meaningful sense of dignity, occupation andcomfort. The study also found out that attachment is likely todevelop between an individual and the patient when there aconsistency of the professionals in service delivery. Identity wasalso found out to develop when the health care providers used thepatient`s preferred name and address. The comfort that patients haveemanates from the physical environment in the health care and theattitude of the professionals. Clinicians who exhibited a feeling ofunderstanding made the patients and their caregivers comfortable.
In the article authored by Poysti et al., the findings indicated thatthe husbands with female caregivers had a slightly advanced age thanthe patients with male caregivers. The male caregivers exhibited asignificantly higher co-morbidity that the females. A comparisonbetween the burdens shouldered by the two groups of caregivers showedthat female caregivers had a greater responsibility that the malecaregivers. Also, the burden of caregiving appeared to reduce withtime mainly due to getting used and taking the caregiving as part oftheir work.
When discussing their findings, Clissett et al. provides thathealthcare professionals are responsible for the promotion of thefeelings of attachment and inclusion. The way they handle thepatients and their caregivers largely determines the comfort ofpatients and the caregivers. Also, healthcare professional in acutecare hospitals significantly influence a feeling of identity. Thepractices have to be patient centered if they are to promote thedesirable feelings in individuals.
Poysti et al. discusses that the male caregivers with a higher levelof co-morbidities took care of their wives with severe and advanceddementia did not undergo similar suffering compared to their femalecounterparts taking care of their husbands. Also, the male caringfor their wives seemed to be protective when taking care of theirwives with dementia.
The two articles have several differences in their methodology. Inthe first article authored by Clissett et al., the observation takesplace in a span of 72 hours followed by informal interviews with nocontrol group. The results are therefore high qualitative. Thearticle has a weakness for the limited time for observation whereby,some of the attributes could not come out openly. Conversely, Poystiet al. observed the participants for one year followed by a two-yearobservation. They also include a control group of 70 couples. Thearticle has strength in the long period of observation. The findingsare, therefore, reliable. The presence of a control group also makesthe variable distinct and, therefore, easy to measure. The authorsused Cornell depression scale to measure the burden of caregiverswhile Clissett used the Kitwood’s model of personhood to identifythe positive attributes that should be developed in a person-centeredcare.
The articles provide new knowledge gaps in dementia. First, it hasbeen discovered that women experience a higher burden that men whentaking care of dementia patients. Also, Poysti et al. found out thatthe difficulty that individuals experience when caring for dementiapatients eases with time as they gradually accept the situation. Theauthors propose the need for a future study to understand the causeof the differences in burden between male and female caregivers.Secondly, Clissett et al. provides new knowledge that individuals inacute health settings contribute substantially to the quality ofservices that are deemed as patient-centered. They are responsiblefor comfort, identity, attachment and occupation. Clissett et al.propose a future study of whether the individual patients have a rolein enhancing their sense of personhood.
In conclusion, the paper provides a qualitative and quantitativestudy of dementia. Although the two articles reflect different studyareas and concentrations, they revolve around the importance ofpatient-centered care. The article authored by Clissett et al. seekto identify the most useful qualities that promote patient-centeredcare in a clinical setting with emphasis on acute care facilities.Poysti et al. (2012) look at the care given at home by the caregiversby laying insight on the difference between female and malecaregivers.
The burden of dementia is on the increase. Both men and women areincreasingly finding themselves caring for their partners. Promotingpatient-centered approaches becomes a necessity f the quality of lifeof the patients is to be enhanced. The recommendations for the futureresearch in the two articles would contribute to better service andcare delivery both in health institutions and at home.
Clissett, P.,Porock, D., Harwood, R. H., & Gladman, J. R. (2013). Thechallenges of achieving person-centred care in acute hospitals: aqualitative study of people with dementia and their families.International journal of nursing studies, 50(11),1495-1503.
Pöysti, M. M.,Laakkonen, M. L., Strandberg, T., Savikko, N., Tilvis, R. S.,Eloniemi-Sulkava, U., & Pitkälä, K. H. (2012). Genderdifferences in dementia spousal caregiving. International Journalof Alzheimer’s Disease, 2012.