British Psychological Society |June 2018 | New dementia briefing suggests that behaviour that challenges can be a result of unmet needs 21 June 2018
The British Psychological Society have recently published an evidence briefing which outlines the importance of having a psychological understanding of the complex causes of behaviour that challenges in dementia.
The key messages of the briefing, prepared by the Society’s Dementia Advisory Group, include:
- Behaviour that challenges can be a consequence of a person’s unmet needs
- Non-pharmacological approaches are the first-line treatments
- Service pathways for people living at home require different workforce skills and resources compared with those living in 24 hour care settingsThe evidence briefing can be read in full here
The government is asking organisations with expertise and experience in tackling loneliness to provide views on the strategy framework being developed. It is believed that factors contributing to loneliness include disability, ill health and caring responsibilities. The closing date for comments is 20 July 2018.
The Government’s Loneliness Strategy will be its first step in tackling the long-term challenge of loneliness. Loneliness is a complex issue that affects many different groups of people, and its evidence base is still developing. The current evidence base tends to measure loneliness in terms of frequency, and it shows that people who feel lonely most or all of the time are more likely to suffer ill health.
In addition, people who feel lonely more often can become more sensitive to perceived threats and withdraw further, creating a vicious cycle. As a result, the stratgey will look at approaches that reduce the risk, prevent loneliness or that intervene early, before loneliness becomes entrenched.
The Office for National Statistics (ONS) recently analysed how individual circumstances and characteristics contribute to the likelihood of experiencing loneliness, holding all else equal. The ONS found that the following were significant factors:
- age – younger people (16-24) were significantly more likely to report feeling lonely
- gender – women were more likely to report feeling lonely
- marital status – widowed people were more likely to report feeling lonely
- disability and ill-health (self-reported) – those reporting were more likely to feel lonely
- number of adults in the household – those living alone were more likely to report feeling lonely
- caring responsibilities – those caring were more likely to report feeling lonely
- neighbourhood connectedness – those who do not chat to neighbours more than to say hello, or do not feel as though they belong to or satisfied with their neighbourhood were more likely to report feeling lonely
- how often you meet up in person with family members or friends – those who met up once a month or less were more likely to feel lonely
Read more about the Government’s Loneliness Strategy
Therapeutic lies are frequently used communication strategies, often employed when the person with dementia does not share the same reality as the carer. Their use is complex and controversial, and a number of protocols have been produced to guide their usage (Mental Health Foundation, 2016).
The study examined clinicians’ perspective on using therapeutic lies in their daily practice and their roles in encouraging the proper use of such a communication strategy. Method: This project sampled the views of clinicians, mainly psychologists, before and after attending a workshop on communication in dementia care; they were asked whether psychologists should have a role in teaching others to lie more effectively.
Results: It was found that following a comprehensive discussion on the use of lies, the clinicians recognized they lied more than they had originally thought, and were also significantly more supportive of having a role in teaching others to lie effectively.
Conclusions: Clinicians, mainly psychologists, increased their support in the use of therapeutic lying. They considered others would benefit from the psychologists giving supervision in how to lie effectively.
Full reference: James, I., & Caiazza, R. | Therapeutic Lies in Dementia Care: Should Psychologists Teach Others to be Person-Centred Liars? | Behavioural and Cognitive Psychotherapy | Volume 46(4) | July 2018 | p454-462
The National Institute for Health and Care Excellence (NICE) have updated their guidance on the management and support of dementia. This is the first time the guideline has been updated in 10 years, and acts as a reference for best practice for all those working in the health and social care field, including GPs, and social workers.
A NICE spokesman said the key changes are the recommendations around training staff correctly and those to help carers to better support people living with dementia.
It also recommends providing people living with dementia with a single named health or social care professional who is responsible for coordinating their care.
The updated guidance also recommends that the initial assessment includes taking a history (including cognitive, behavioural and psychological symptoms, and the impact symptoms have on their daily life) from the person with suspected dementia, and if possible, from someone who knows the person well.
Full guideline: Dementia: assessment, management and support for people living with dementia and their carers (NG97)
See also: New NICE guidelines recommend telling people about dementia research opportunities
Healthcare professionals in GP surgeries and the community will soon give advice on dementia risk to patients as part of the NHS Health Check.
Adding the dementia element to the NHS Health Check programme will enable healthcare professionals to talk to their patients about how they can reduce their dementia risk, such as by maintaining their social life, keeping mentally and physically active and stopping smoking.
It is estimated that over 850,000 people are living with dementia in the UK with little public understanding of how it’s possible to reduce the risk. While much of the NHS Health Check focuses on reducing cardiovascular disease (CVD) risk, the advice for preventing CVD is much the same as for dementia: ‘what’s good for the heart is good for the brain’.
Full story at Public Health England
This guide is part of a series of guides looking at reasonable adjustments in a specific service area | Public Health England
It is intended to help staff in public health, health services and social care to ensure that their services are accessible to people with learning disabilities who may have, or be developing, dementia. The guide can also be of use to family and friends of people with learning disabilities.
Full guidance: Dementia and people with learning disabilities: making reasonable adjustments
People affected by dementia can make a unique and valuable contribution in every stage of research. Alzheimer’s Society has championed the active involvement of people affected by dementia in research for nearly two decades through it’s Research Network , helping to ensure it funds the highest quality, relevant research on dementia.
Alzheimer’s Society has pioneered the involvement of people affected by dementia in its research programme since 1999. During this time its Network of people with dementia, carers and former carers have been actively involved in all research funded by the Society and has developed over 100 individual research partnerships to ensure that the dementia research community across the UK has access to lived expertise of dementia in the design, delivery and dissemination of their research.
In 2017 Alzheimer’s Society undertook an evaluation of the impact of the Research Network by interviewing and surveying researchers and people affected by dementia about their involvement. The findings clearly establish that involving people affected by dementia has benefits across all types of research and across four themes:
- Impact on volunteers
- Impact on researchers
- Impact on research
- Impact on Alzheimer’s Society
A report has been published which includes a number of quotes from researchers across each of these four themes and a short video which describes impact.
Full report: ‘We can make our research meaningful’. The impact of the Alzheimer’s Society Research Network
Bringing dementia out: working with LGBT+ communities | Natasha Howard | Alzheimer’s Society
In this blog, Natasha Howard shares the latest developments from Alzheimer’s Society’s innovative LGBT+ and dementia project.
The approach of the project has been to work together with stakeholders and those affected by dementia to define the problems and find an effective solution. Learning from people who are directly affected, Alzheimer’s Society hopes to meet their needs and make a difference to people’s lives. The project follows the Innovation LIFE model – Learn, Investigate, Find and Experiment.
Full blog available at Alzheimer’s Society
Research has found that some of the genes affected by alcohol and inflammation are also implicated in processes that clear amyloid beta — the protein that forms globs of plaques in the brain and which contributes to neuronal damage and the cognitive impairment associated with Alzheimer’s disease | Journal of Neuroinflammation | story via ScienceDaily
Previous studies investigating the effects of alcohol consumption on Alzheimer’s disease have been controversial — some have indicated that alcohol has a protective effect, while others have pointed to a deleterious role for alcohol in the development of this neurocognitive disease. Recent research has suggested that alcohol consumption, and its impact on the immune system and inflammation in the brain, may be the vehicle through which alcohol might exert its influence on the development of Alzheimer’s disease, but no previous studies have directly evaluated which genes are affected by alcohol in cells in the brain involved in protecting against Alzheimer’s disease.
In this study, researchers conducted a cell-based study which suggests that alcohol may impede the clearance of amyloid beta in the brain. Their results are published in the Journal of Neuroinflammation.
Full reference: Kalinin, S. et al | Transcriptome analysis of alcohol-treated microglia reveals downregulation of beta amyloid phagocytosis | Journal of Neuroinflammation, 2018; 15 (1)