Developing an educational dvd on the use of hand massage in the care of people with dementia: An innovation.

Tuohy, D., Graham, M.M., Johnson, K., Tuohy, T. and Burke, K.pp.299-303.
Nurse education in practice
Tuohy et al. (2015) describe the process of developing an educational DVD on the use of hand massage in the care of people with dementia. The authors refer to evidence that hand massage can provide physiological benefits for people with dementia.
They describe the collaborative nature of the project which took 10 months to complete. The DVD provides an overview of hand massage and a demonstration. The authors argue that the DVD responds to new developments in learning and to the time pressures on professionals and carers, particularly in attending face to face training. Since its launch in 2012, hand massage has been introduced to residential settings for people with dementia and a number of workshops provided for health professionals and carers.

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.

Continuing to Care for People with Dementia: Irish Family Carers’ Experience of their Relatives Transition to a Nursing Home

Argyle, E., Downes, M, Tasker, J.
Alzheimer Society of Ireland

The majority of people with dementia live in their own homes and family carers provide the main bulk of care for them. However, a time often comes when a person with dementia has to move into a long-stay care setting.

But what are the experiences of family carers in ROI when a relative with dementia moves into a long-stay care setting? This is the primary focus of this research by Argyle, Downes and Tasker (2011). It found a range of factors accumulated and contributed to the decision to pursue long-stay care, with health professionals often being the one to initiate discussions around this.  Family carers experienced conflicting emotions, from relief through to more painful emotions of guilt, grief and loneliness, with varying intensities. How well they adjusted to their relatives’ admission to long-stay care was influenced by the perceived quality of the long-stay care setting, their familiarity with it and receipt of emotional and spiritual support. Following transition, the carers’ role was characterised by both continuity and change. The research indicated that all carers wanted to continue to participate in the long term care of their relative and reported that good lines of communication with staff, having information and education about dementia and dementia care and having ongoing emotional support were essential. 

The Development of End of Life Care Standards for People with End Stage Dementia (Undated)


This report documents a study comprising two phases; phase one completed a qualitative enquiry into how 16 older spouse caregivers had experienced their spouses’ end of life care in a long stay care environment in ROI and NI.

Phase two involved the development and dissemination of draft guidelines to assist Nursing Homes to develop policies and practices on end of life care for residents. The draft guidelines were then amended based on feedback from health professionals based in both jurisdictions. Most spousal caregivers participating in the study were satisfied with the level of care received by their spouse. The draft guidelines focused on five key areas: person-centred care; good personal care; staff training; a partnership approach with the nursing home fully integrated into local health care systems; a shared approach to care.

Opening Conversations: Developing a Model for the Alzheimer Society of Ireland of best practice palliative care interventions for people with dementia and their families

MacConville, U.
Alzheimer Society of Ireland

This was a small-scale qualitative research project based in ROI that aimed to develop a model of best-practice palliative care interventions for people with dementia, integrating palliative care interventions into Alzheimer Society of Ireland service planning.

 Two key areas are the focus of the model: the transition from Alzheimer Society of Ireland services to long term care and end of life care.  The report produced by the Alzheimer Society of Ireland makes fourteen recommendations addressing: raising awareness; removing barriers to a clear diagnosis; providing a continuity of care; active management of the transition of care; addressing end-of-life care needs; and supporting family members and carers.

My Life until the End: Dying Well with Dementia

Lane, M.
Alzheimer’s Society (UK)

This report by the Alzheimer’s Society (UK) describes the policy landscape in England, Wales and NI relating to end of life and palliative care for people with dementia (see Living Matters, Dying Matters in the policy section of this review), summarises existing evidence, including examples of go

od practice and provides new evidence in the form of interviews with carers and people living with dementia. Seven key areas relating to dementia and end of life are highlighted as problematic: lack of public awareness and discussion about death and dying; provision of dignified care for people with dementia at the end of life; difficulty with communication affecting a person’s ability to articulate basic needs such as pain, discomfort, hunger and thirst; implications of the uncertain nature of dementia progression for planning palliative care including withholding and withdrawing treatment; little regard for emotional or spiritual support; differences in the quality of experience related to place of death - hospital, home, care home or hospice. The report concludes that the current health and social care system does not meet the needs of people with dementia at the end of life and makes a series of recommendations linked to the seven key areas listed above.

Building Consensus for the Future: Report on the Feasibility Study on Palliative Care for People with Dementia

Alzheimer’s Society, Irish Hospice Foundation
Alzheimer Society of Ireland

This report documents a joint partnership project in ROI between the Irish Hospice Foundation and The Alzheimer Society of Ireland that aimed to build consensus on palliative dementia care.

The report is set in the context of international and national policy, reviews examples of best practice, societal and service challenges and incorporates the perspectives of family members and health care professionals. A series of recommendations are presented thematically: services; education and training; research; policy and advocacy.

Planning for the Future Project Initiating End of Life Discussion with People with Dementia, Final Report Phase 1 (Undated)

Hayden, C., Parke, M., Lynch, M., Kelly, S.
Irish Hospice Foundation, HSE

This report produced by the Irish Hospice Foundation and the HSE documents the results of a joint project based in ROI between a residential care facility for older people and a specialist palliative care in-patient unit that aimed to develop a framework to support staff to engage in end of life

care discussions with residents.  The project took an action research approach and includes a series of planned actions to address: staff difficulties in initiating discussion; confidence in engaging with residents on this topic and on dealing with difficult situations; recording information gathered;  recognising the dying phase; finding clarity between palliative care and end of life care; supporting families.  A post project evaluation was completed six months later and a series of future action plans is included.

Integrated Care Pathways for People with Dementia: Exploring the Potential for Ireland and the forthcoming National Dementia Strategy

Irving, K., McGarrigle, L.
Alzheimer Society of Ireland

In this expert policy paper by Irving and McGarrigle (2012) and a book chapter bearing the same title (Irving et al., 2013), Integrated Care Pathways (ICPs) are defined as instruments designed to map out the direction of clinical and administrative activities for all care professionals working wi

th people who have a specific disease such as dementia. They scope out what Integrated Care Pathways are and consider the practical application of Integrated Care Pathways. They summarise the evidence pointing to the benefits of Integrated Care Pathways and outline the challenges that need to be addressed if Integrated Care Pathways are to be successful. They compare and contrast two cases studies, one from England and one from the Scotland, before looking at the relevance of Integrated Care Pathways for ROI, following which they highlight key issues relating to the health care system and the role of case management that need to be addressed if Integrated Care Pathways are to be successfully introduced in ROI. Cahill (2013), writing about dementia and integrated care, argues that although integrated care services is widely promoted in public policy in ROI, the evidence suggests that integrated care for people with dementia is more of an aspiration than a reality. She identifies several changes that are needed in service provision for integrated care to become a reality for people with dementia.    

National Dementia Project: Dementia Education Needs Analysis Report

De Siún, A., Manning, M.
Health Service Executive

In order to address the knowledge deficits of care staff in ROI regarding dementia through a three-year National Dementia Education Programme funded by the HSE, a decision was taken to first ascertain what the knowledge deficits were through an educational needs analysis.

De Siún and Manning (2010) collected data from nurses and care attendants via postal questionnaires and focus groups. They found very low levels of dementia care training among both nurses and care attendants. Responses to the Approaches to Dementia Questionnaire, which aims to capture attitudes to people with dementia revealed that respondents scored quite well on the Person-centred dimension, which refers to the way in which people with dementia are responded to as unique individuals with the same value as any other person, but scored less well on the Hope dimension, which reflects a sense of optimism/pessimism towards the abilities and the future of people with dementia. The report concluded that there is a need for a core generic dementia education programme focusing on both personal attitudes and general care practices to be offered and one that could be provided on a modular basis to staff in all areas of work. 


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