Friendship and dementia

Friendship and dementia: Hints and tips on supporting friends with dementia | via Alzheimer Scotland

For people living with dementia, maintaining meaningful friendships can be a difficult task. A dementia diagnosis can turn someone’s world upside down and it’s at this time that friendship is valued the most, not only to offer comfort and support but to help to maintain an essence of normality.

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In a 2017 poll  of more than 500 participants,  Alzheimer Scotland’s  ‘Friendship and Dementia’ survey highlighted some disheartening statistics:

  • Two out of three people living with dementia have lost friendships following their diagnosis.
  • 60% of people living with dementia felt reluctant to attend social situations after their diagnosis.
  • 91% of participants felt that there was not enough public knowledge of dementia and what it’s like to live with the illness.

These findings show that more must be done to improve public understanding of attitudes towards dementia, so we are able to help friendships adapt following a diagnosis and throughout the illness. Alzheimer Scotland’s Friendship and Dementia leaflet provides hints and tips on how to provide emotional and practical support to people with dementia, at all stages of the illness. The leaflet provides tips such as:

  • Find out more about dementia and how it’s likely to affect their everyday life. This will help you to support your friend and make you more prepared for changes in the months and years ahead
  • Accept the person your friend is now; try not to draw comparisons with how they were before developing dementia
  • Make sure to talk directly to your friend, especially in social situations.

Full article at Alzheimer Scotland

Click here to access the ‘Friendship and Dementia leaflet’.

 

Interventions to reduce social isolation and loneliness among older people

Loneliness and social isolation are major problems for older adults. Interventions and activities aimed at reducing social isolation and loneliness are widely advocated as a solution to this growing problem.

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The aim of this study was to conduct an integrative review to identify the range and scope of interventions that target social isolation and loneliness among older people, to gain insight into why interventions are successful and to determine the effectiveness of those interventions.

Six electronic databases were searched from 2003 until January 2016 for literature relating to interventions with a primary or secondary outcome of reducing or preventing social isolation and/or loneliness among older people.

The review identified 38 studies. A range of interventions were described which relied on differing mechanisms for reducing social isolation and loneliness. The majority of interventions reported some success in reducing social isolation and loneliness, but the quality of evidence was generally weak.

Factors which were associated with the most effective interventions included adaptability, a community development approach, and productive engagement.

A wide range of interventions have been developed to tackle social isolation and loneliness among older people. However, the quality of the evidence base is weak and further research is required to provide more robust data on the effectiveness of interventions. Furthermore, there is an urgent need to further develop theoretical understandings of how successful interventions mediate social isolation and loneliness.

Gardiner, C.  Geldenhuys, G.  Gott, M | Interventions to reduce social isolation and loneliness among older people: an integrative review | Health and Social Care in the Community | Volume26, Issue2 | March 2018 | pages 147-157

Psychosocial interventions for people with dementia

New research finds good evidence to suggest that multi-component exercise with sufficient intensity improves global physical and cognitive functions and activities of daily living skills for people with dementia | Aging & Mental Health

Objectives: Over the last 10 years there has been a multitude of studies of psychosocial interventions for people with dementia. However, clinical services face a dilemma about which intervention should be introduced into clinical practice because of the inconsistency in some of the findings between different studies and the differences in the study qualities and trustworthiness of evidence. There was a need to provide a comprehensive summary of the best evidence to illustrate what works.

Methods: A review of the systematic reviews of psychosocial interventions in dementia published between January 2010 and February 2016 was conducted.

Results: Twenty-two reviews (8 physical, 7 cognitive, 1 physical/cognitive and 6 other psychosocial interventions) with a total of 197 unique studies met the inclusion criteria. Both medium to longer-term multi-component exercise of moderate to high intensity, and, group cognitive stimulation consistently show benefits. There is not sufficient evidence to determine whether psychological or social interventions might improve either mood or behaviour due to the heterogeneity of the studies and interventions included in the reviews.

Conclusion: There is good evidence that multi-component exercise with sufficient intensity improves global physical and cognitive functions and activities of daily living skills. There is also good evidence that group-based cognitive stimulation improves cognitive functions, social interaction and quality of life. This synthesis also highlights the potential importance of group activities to improve social integration for people with dementia. Future research should investigate longer-term specific outcomes, consider the severity and types of dementia, and investigate mechanisms of change.

Full reference: McDermott, O et al. | Psychosocial interventions for people with dementia: a synthesis of systematic reviews |Aging & Mental Health | Published online 17 Jan 2018

View the full article here

 

Marriage may lower the risk of developing dementia

Marriage may help stave off dementia, study finds | Journal of Neurology Neurosurgery & Psychiatry

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Researchers combining the results of 15 studies including data on more than 800,000 participants have found  that lifelong singletons and widowers appear to have a heightened risk of developing dementia.

Analysis of the data showed that lifelong singletons were 42% more likely to develop dementia than those who were married, and widowers were 20% more likely to develop the condition. Part of this risk might be explained by poorer physical health among lifelong single people, suggest the researchers.  Marriage may help both partners to have healthier lifestyles, including exercising more, eating a healthy diet, and smoking and drinking less, all of which have been associated with lower risk of dementia. Couples may also have more opportunities for social engagement than single people – a factor that has been linked to better health and lower dementia risk, the researchers suggest.

Full reference: Sommerlad A, et al. | Marriage and risk of dementia: systematic review and meta-analysis of observational studies |  Journal of Neurology Neurosurgery & Psychiatry | published online 28 November 2017

How people with dementia and carers understand and react to social functioning changes

This study aims to analyse people with dementia and their family carers’ attribution of social changes in dementia and the consequences of these attributions | BMJ Open

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Image source: Mauri – Flickr // CC BY 2.0

Design: Qualitative study, using a semi-structured interview guide. Individual interviews continued to theoretical saturation. Two researchers independently analysed interview transcripts.

Results: We interviewed nine people with dementia and nine carers, encompassing a range of age, ethnicity and educational backgrounds. Both groups reported that the person with dementia had changed socially. People with dementia tended to give one or two explanations for social change, but carers usually suggested several. People with dementia were often socially embarrassed or less interested in going out, and they or their relatives’ physical illness or fear of falls led to reduced social activity. Carers often attributed not going out to a choice or premorbid personality. Carers found that their relative needed more support to go out than they could give and carers needed time to themselves because of carer stress or other problems from which they shielded the person with dementia. Additionally, there was decreased opportunity to socialise, as people were bereaved of friends and family. Participants acknowledged the direct impact of dementia symptoms on their ability to socially engage but sometimes decided to give up socialising when they knew they had dementia. There were negative consequences from social changes being attributed to factors such as choice, rather than dementia.

Conclusion: Clinicians should ask about social changes in people with dementia. Explaining that these may be due to dementia and considering strategies to overcome them may be beneficial.

Full reference: Singleton, D. et al (2017) How people with dementia and carers understand and react to social functioning changes in mild dementia: a UK-based qualitative study. BMJ Open. 7:e016740

Age-appropriate services for people diagnosed with young onset dementia

Andrea Mayrhofer et al. Age-appropriate services for people diagnosed with young onset dementia (YOD): a systematic review. Aging & Mental Health Published Online: 16 Jun 2017 

Background: Literature agrees that post-diagnostic services for people living with young onset dementia (YOD) need to be age-appropriate, but there is insufficient evidence of ‘what works’ to inform service design and delivery.

Objective: To provide an evidence base of age-appropriate services and to review the perceived effectiveness of current interventions.

Methods: We undertook a systematic review including all types of research relating to interventions for YOD. We searched PubMed, CINHAL Plus, SCOPUS, EBSCO Host EJS, Social Care Online and Google Scholar, hand-searched journals and carried out lateral searches (July–October 2016). Included papers were synthesised qualitatively. Primary studies were critically appraised.

Results: Twenty articles (peer-reviewed [n = 10], descriptive accounts [n = 10]) discussing 195 participants (persons diagnosed with YOD [n = 94], caregivers [n = 91] and other [n = 10]) were identified for inclusion. Services enabled people with YOD to remain living at home for longer. However, service continuity was compromised by short-term project-based commissioning and ad-hoc service delivery.

Conclusion: The evidence on the experience of living with YOD is not matched by research and the innovation needed to mitigate the impact of YOD. The inclusion of people with YOD and their caregivers in service design is critical when planning support in order to delay institutional care

Full document available here

Positive and Negative Experiences of Social Support and Risk of Dementia in Later Life

Khondoker, M. et al. (2017). Positive and negative experiences of social support and risk of dementia in later life: an investigation using the English Longitudinal Study of Ageing. Journal of Alzheimer’s Disease. 2017; 58(1):99-108.

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Background: Having a network of close relationships may reduce the risk of developing dementia. However, social exchange theory suggests that social interaction entails both rewards and costs. The effects of quality of close social relationships in later life on the risk of developing dementia are not well understood.

Objective: To investigate the effects of positive and negative experiences of social support within key relationships (spouse or partner, children, other immediate family, and friends) on the risk of developing dementia in later life.

Conclusion: Positive social support from children is associated with reduced risk of developing dementia whereas experiences of negative social support from children and other immediate family increase the risk. Further research is needed to better understand the causal mechanisms that drive these associations.

Read the full article here

Technology-based tools and services for people with dementia and carers

Klara Lorenz et al. Technology-based tools and services for people with dementia and carers: Mapping technology onto the dementia care pathway. Published in Dementia, February 2017

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This paper provides an overview of the role of technology in dementia care, treatment and support by mapping existing technologies – by function, target user and disease progression.

Technologies identified are classified into seven functions: memory support, treatment, safety and security, training, care delivery, social interaction and other. Different groups of potential users are distinguished: people with mild cognitive impairment and early stages of dementia, people with moderate to severe dementia and unpaid carers and health- and social care professionals. We also identified the care settings, in which the technologies are used (or for which the technologies are developed): at home in the community and in institutional care settings.

The evidence has been drawn from a rapid review of the literature, expert interviews and web and social media searches. The largest number of technologies identified aim to enhance the safety and security of people with dementia living in the community. These devices are often passive monitors, such as smoke detectors. Other safety interventions, such as panic buttons, require active intervention.

The second largest number of interventions aims to enhance people’s memory and includes global positioning systems devices and voice prompts. These technologies mostly target people in the early stages of dementia. A third group focusing on treatment and care delivery emerged from the literature. These interventions focus on technology-aided reminiscence or therapeutic aspects of care for people with dementia and their carers.

While the review found a range of technologies available for people with dementia and carers there is very little evidence of widespread practical application. Instead, it appears that stakeholders frequently rely on everyday technologies re-purposed to meet their needs.

Social health in dementia

Social health in dementia. Towards a positive dementia discourse | Marjolein de Vugt and Rose-Marie Dröes  | Aging & Mental Health  Vol. 21 , Iss. 1,2017

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Abstract:

A shift in focus from symptoms and disability towards the capacity and potential of the person with dementia is urgently needed to create a more balanced view of dementia and a more dementia-friendly society, which enables people and their families to adapt to the changes dementia brings in their lives.

The new concept of social health suggested by Huber and colleagues seems helpful to make such a shift. In this dedicated special issue, a consensus-based operationalization of the concept of social health in dementia is proposed and several aspects of social health and related dementia care are addressed within the framework of European collaborative projects of the INTERDEM network.

Exploring the health and well-being benefits of singing for people with dementia and their carers

Osman, S.E. et al. (2016) Dementia. 15(6) pp. 1326-1339

microphone-1674903_960_720Dementia has detrimental effects on cognitive, psychological and behavioural functioning, as well as significant impact on those who provide care. There is a need to find suitable psychosocial interventions to help manage the condition, enhance well-being, and to provide support for caregivers. This study explored the impact of Singing for the Brain™, an intervention based on group singing activities developed by The Alzheimer’s Society for people with dementia and their carers. This qualitative study used semi-structured interviews with people with dementia and their carers. Ten interviews involving 20 participants were analysed thematically. Social inclusiveness and improvements in relationships, memory and mood were found to be especially important to participants. As well as enjoying the sessions, participants found that attending Singing for the Brain™ helped in accepting and coping with dementia.

Read the article here