Psycho-social Approaches

The body of work on the island of Ireland pertaining to psychosocial approaches is limited.  Five of the nine papers detailed here relate to a large cluster randomised trial: the DementiA education programme incorporating REmininscence for Staff (DARES), and as such are all related to reminiscence.  Two of the remaining articles are literature reviews.  The final two articles examine Life Story Work, a term Dempsey et al. (2014) considers a surrogate for reminiscence and the effects of cognitive stimulation therapy on cognition and QoL for people with dementia.  

Developing a structured education reminiscence-based programme for staff in long-stay care facilities in Ireland

COONEY, A., O'SHEA, E., CASEY, D., MURPHY, K., DEMPSEY, L., SMYTH, S., HUNTER, A., MURPHY, E., DEVANE, D., JORDAN, F.
Journal of Clinical Nursing
2013

Cooney et al. (2013) describe the development and piloting of a structured education reminiscence programme for staff in long stay care settings.

 The programme was structured around a four-phase model: problem definition, accumulation of building blocks for intervention design, intervention design and validation.  The authors acknowledge that taking such a comprehensive approach is time consuming and labour intensive but argue that the nature of the programme gave staff ownership and enabled them to effectively use reminiscence in daily practice, improving their knowledge and ability to meet the psychosocial needs of residents.

Efficacy of a cognitive stimulation therapy programme for people with dementia

COEN, R. F., FLYNN, B., RIGNEY, E., O'CONNOR, E., FITZGERALD, L., MURRAY, C., DUNLEAVY, C., MCDONALD, M., DELANEY, D., MERRIMAN, N., EDGEWORTH, J.
Irish Journal of Psychological Medicine
2011

This study by Coen et al. (2011) aimed to replicate previous research by Spector et al.

(2003) which found that Cognitive Stimulation Therapy (CST) produced improvements in cognition and quality of life for people with dementia that compared favourably with trials of cholinesterase inhibitors. While this study used a smaller sample and a control group engaged in routine activities, findings reflected those of Spector et al. that CST has beneficial effects for people with dementia, evidenced by improved MMSE AND QoL-AD scores that fell just short of statistical significance. The authors acknowledge the limitations of the small sample size and also that the changes in MMSE and QoL-AD were not reflected in the ADAScog. 

Life story work in practice: aiming for enduring change

GIBSON, F., CARSON, Y.
Journal of Dementia Care
2010

Gibson and Carson (2010) report on a Northern Ireland Trust Project to establish life story work for people with dementia in residential and day care settings.

 They document the initial enthusiasm that many creative projects are greeted with, only to fall in the face of obstacles such as a newer ‘fad’ promising better, cheaper results. They document the work to engage management and staff with a view to establishing a more durable project.  Staff reported positively on the programme but the single greatest obstacle was lack of time, as already reported in Cooney et al.’s study (2014). The authors suggest the project has highlighted the complexity of establishing enduring creative projects, even where they are regarded positively. 

The effects of music therapy for older people with dementia

WALL, M., DUFFY, A.
British Journal of Nursing
2010

Wall and Duffy (2010) review the literature on the effects of music therapy for older people with dementia.

 They found that music therapy had a positive impact on the behaviour of people with dementia but that there were methodological limitations in all thirteen studies reviewed.  Most of the studies were quantitative and the authors recommend larger sample sizes to allow for generalisation of results. They also suggest there is a need for more qualitative studies.

The participative arts for people living with a dementia: A critical review

ZEILIG, H., KILLICK, J., FOX, C.
International Journal of Ageing and Later Life
2014

Zeilig et al. (2014) completed a review of the literature to address the question: What is the value of arts and culture for people living with dementia? The authors acknowledge that this field is in its infancy and much of the research has methodological limitations.

 However, the literature suggests that participative arts can make a positive contribution to those affected by dementia. They conclude the evidence must be strengthened but that studies should take account of the wider context, should be theoretically informed, include the views of people with dementia and incorporate economic analysis.

The impact of reminiscence on the quality of life of residents with dementia in long-stay care

O'SHEA, E., DEVANE, D., COONEY, A., CASEY, D., JORDAN, F., HUNTER, A., MURPHY, E., NEWELL, J., CONNOLLY, S., MURPHY, K.
International journal of geriatric psychiatry
2014

In the context of increasing recognition of the potential value of reminiscence in maintaining or improving quality of life, O’Shea et al.

(2014) evaluated the effectiveness of a structured education-based reminiscence programme for people with dementia in long stay residential care settings in ROI. Effectiveness was measured in a two-group, single-blind clustered randomised trial, using self-rated quality of life as the primary outcome. The results on the effects of the intervention suggest that there was a positive but clinically non-significant improvement in the mean quality of life of the residents in the intervention group compared with the control group. However, the results of per-protocol analysis, which includes only units that followed protocol, indicates that there was a clinically and statistically significant effect of the intervention on quality of life of residents with those in the intervention groups experiencing a better improvement in quality of life compared to those in the control group.  

‘Seeing me through my memories': a grounded theory study on using reminiscence with people with dementia living in long-term care

COONEY, A., HUNTER, A., MURPHY, K., CASEY, D., DEVANE, D., SMYTH, S., DEMPSEY, L., MURPHY, E., JORDAN, F., O'SHEA, E.
Journal of Clinical Nursing
2014

Cooney et al. (2014) examined the perceptions of reminiscence and its impact among relatives, staff and people with dementia participating in the study.

Staff felt that reminiscence allowed them to “see and know” the person behind the dementia and felt that it also allowed the person with dementia to view them as individuals, while residents perceived staff to be more interested in them as individuals.  The authors suggest this ‘revealing’ is not necessarily a result of the reminiscence but rather due to the resulting interaction and the shared bond that is created.  Family members welcomed staff getting to know their relative as an individual and the study also found that positive effects impacted on the wider group of residents.  Lack of time was the most significant barrier.

Reminiscence in dementia: A concept analysis

DEMPSEY, L., MURPHY, K., COONEY, A., CASEY, D., O'SHEA, E., DEVANE, D., JORDAN, F., HUNTER, A.
Dementia
2014

Dempsey et al. (2014) analyse the concept of reminiscence in dementia.  They identify a range of definitions and the use of surrogate terms, and that reminiscence is a process that takes place in stages in the context of interaction with others.

 They conclude that reminiscence is an effective psychosocial intervention and that developing the concept further would benefit from an operational definition.

Effectiveness of a structured education reminiscence-based programme for staff on the quality of life of residents with dementia in long-stay units: a study protocol for a cluster randomised trial

O'SHEA, E., DEVANE, D., MURPHY, K., COONEY, A., CASEY, D., JORDAN, F., HUNTER, A., MURPHY, E.
Trials
2011

O’Shea et al. (2011) outline the study protocol for the trial referred to above. This study aimed to address the scarcity of trials on reminiscence as an intervention for people with dementia and the methodological issues associated with existing evidence.

 The protocol outlines a two-group, single blind cluster randomised trial conducted in long stay care settings.  The primary outcome is quality of life for residents, with secondary outcomes of agitation levels and depression in residents, and staff care burden.