Awareness, knowledge and attitudes

Much has been done in recent years across Ireland to improve awareness and knowledge of dementia among the general public and professionals working in the field of dementia care. In this section you will find papers that report on general levels of knowledge, awareness and attitudes but also papers on the perspectives of different groups on specific aspects of dementia and papers on the type of knowledge and information that people are seeking.

Exploring nursing staff views of responsive behaviours of people with dementia in long‐stay facilities.

Clifford, C. and Doody, O.
Journal of psychiatric and mental health nursing
This qualitiative study explored nurses views on supporting people with dementia and responsive behaviours in long term care facilities. Participants were able to discuss general reasons for responsive behaviours but gave less consideration to potential physical reasons.
They were committed to a person centred approach but were frustrated by the lack of time and resources to enable such an approach, feeling unsupported by management. This was highlighted in evidence of a wide range of person centred interventions that are favoured over chemical or physical restraint, but difficult to implement in practice due to lack of resources or time. Dementia education and trainng were viewed favourabley but participants emphasised the need for this to be ongoing. They also recognised the potential impact of different care environments on both a person with dementia's behaviour and on the approach taken by staff. The authors argue for a multi disciplinary, collaborative approach to dementia training and for better support for staff working with people with dementia and responsive behaviours.

Public knowledge and understanding of dementia-evidence from a national survey in Ireland.

Glynn, R.W., Shelley, E. and Lawlor, B.A.
Age and Ageing
This paper reports the results of a national survey that assessed the level of knowledge among the Irish general public on the relationship between ageing and dementia and of risk and protective factors.
39% of participants were confident they could differentiate between the early signs of dementia and normal ageing. One in five believed that those under 65yrs don't get dementia and 23% beleived that only old people get dementia. When it came to understanding that dementia risk could be modified, less than half knew there were things they could do to modify their risk. Some socio demographic variables influenced responses here but even those with better knowledge had considerable gaps in their knowledge. Younger people were more likely to answer incorrectly and participants who knew or had known someone with dementia were more likely to answer correctly. The results indicate confusion and poor levels of knowledge and the authors suggest any awareness campaigns must address a range of knowledge deficits.

A systematic review of the public’s knowledge and understanding of Alzheimer’s disease and dementia.

Cahill, S., Pierce, M., Werner, P., Darley, A. and Bobersky, A.
Alzheimer Disease & Associated Disorders
In this review Cahill et al. (2015) evaluated existing literature on the general publics’ knowledge of dementia. Forty studies from 15 countries, including Northern Ireland met the inclusion criteria.
Most of the studies (90%) took a quantitative approach and the authors highlight the need for more qualitative research. Almost half of the studies indicated poor levels of knowledge about dementia with the most common misconception being that dementia is a normal part of ageing. A further misconception was that individuals have no control over whether or not they develop dementia. The authors point out the difficulty in drawing conclusions from the data because of the wide range of approaches across the studies, conceptually and in areas such as sampling, inclusion and exclusion criteria. However they do conclude there is a need for more research in lower and middle income countries where most people with dementia live.

Nursing home manager's knowledge, attitudes and beliefs about advance care planning for people with dementia in long‐term care settings: a cross‐sectional survey.

Beck, E.R., McIlfatrick, S., Hasson, F. and Leavey, G
Journal of Clinical Nursing
Beck et al. (2017) report on the results of a survey examining nursing home managers’ knowledge, attitudes and beliefs about advance care planning (ACP) within their homes for people with dementia. Analysis of the results is informed by the theory of planned behaviour.
The authors found a lack of knowledge about ACP and dementia that affects any move to implement ACP within the nursing home. Managers expressed concerns about both the willingness and the capacity of people with dementia to participate in ACP. Participants were reluctant to use ACP terminology preferring to set any discussion in the context of palliative or future care. Overall there was evidence of a lack of leadership and ownership of ACP from participating nursing home managers. The authors conclude that managers need supported with resources to improve knowledge of both dementia and ACP.

Exploring dementia management attitudes in primary care: a key informant survey to primary care physicians in 25 European countries

Petrazzuoli, F., Vinker, S., Koskela, T.H., Frese, T., Buono, N., Soler, J.K., Ahrensberg, J., Asenova, R., Boreu, Q.F., Peker, G.C. and Collins, C.
International Psychogeriatrics
Petrazzuoli at al. (2017) report the findings from a key informant survey of primary care physicians (PCPs)in 25 European countries, including Ireland.
Most physicians were found to willing and actively involved in both dementia investigation and assessment but time constraints were a major barrier. When it came to the management of dementia and particularly drug prescription, there was considerable variability between countries with Ireland being one of only five countries where primary care physicians have the right to start treatment with memantine and cholinesterase inhibitors. The authors also found variation in dementia management within countries. They conclude that attitudes to dementia work up are affected by the official rules of the country and that where PCPs are not entitled to prescribe dementia drugs, they are more likely to refer patients to secondary specialist care.

Dementia knowledge and attitudes of the general public in Northern Ireland: an analysis of national survey data

International Psychogeriatrics, 24(10)

Mc Parland et al. (2012) explored the knowledge and attitudes of the general public to dementia.

 They found that while there is a reasonable level of knowledge about dementia, the general public hold overwhelmingly negative attitudes towards dementia and that stereotypical, stigmatising views of people with dementia dominate understandings.

Community pharmacists and people with dementia: a cross-sectional survey exploring experiences, attitudes, and knowledge of pain and its management

International Journal of Geriatric Psychiatry, 28(10)

Barry et al. (2013) examine the knowledge and experience of community pharmacists in managing pain in people with dementia.

 They found that community pharmacists had a positive person-centred attitude towards people with dementia, a good knowledge of the use of anti-psychotic medications but were uncertain about the difficulties people in the later stages of dementia may have with swallowing and were unsure about pain assessment and management.

An exploration of nursing home managers' knowledge of and attitudes towards the management of pain in residents with dementia

International Journal of Geriatric Psychiatry, 27(12)

Barry et al. (2012) explore the levels of knowledge and attitudes of nursing home managers towards the management of pain in residents with dementia.

While most respondents evidenced a good knowledge of pain experience in residents with dementia, there was little indication that recognised pain assessment or management tools are used, and surprisingly few respondents had received recent training on pain management. The authors identify the need for further research to identify the factors affecting the prescribing of analgesics for people with dementia in care settings.