Dementia Care (eBook)

Acknowledgements 5
Contents 6
About the Editor 8
1 Introduction Perspectives on Dementia Care—Issues and Responses 9
References 18
2 Suicide in Dementia 19
Phenomenology 19
Clinical Medicine and Suicide in Dementia 22
Biomarkers for Suicide in Dementia 26
Biomarkers for Suicide 26
Ethics and Policy 27
Conclusion 29
References 29
3 The Power of Music in the Lives of People Living with Dementia 33
The Power of Music 34
What is So Good About Music for People with Dementia? 35
Different Ways to Use Music 37
As Background or Individually Targeted Music to Alter Mood and Interaction by Stimulating or Calming 38
As a Reminiscence Tool Used as a Way to Trigger Memories 39
As a Stimulation to Encourage and Enable Dancing and Physical Activity 41
Songs to Dance to or Use Different Tempos with 43
As a Personal Playlist Individually Tailored to Each Person, Enhancing Their Sense of Self and Individual Choice 44
As a Way to Give People an Opportunity to Sing Alongside Others 46
Singing Groups 48
Important Aspects of a Singing Group for People with Dementia and Their Carers 51
Summary of the Different Formats and Their Benefits 53
Entertainment From Musicians 55
Conclusion 55
References 55
4 The McDonaldization of Long-Term Care 57
Introduction 57
Rationalization Processes: Bureaucratization and McDonaldization 59
Efficiency 60
Calculability 64
Predictability 65
Control 66
The Impacts of McDonaldization 67
Conclusion 70
References 72
5 Delivering Multidisciplinary and Cross-Cultural Education in Dementia Studies 78
Introduction 79
The Need for Dementia Education 80
A Case Study 81
Knowledge Exchange and Peer to Peer Learning 82
Cross-Cultural Learning 84
Inter-Disciplinary Learning 86
Cascading Learning Through Training and Evaluation 87
Discussion 89
References 90
6 Language Impairments in Dementia: From Word-Finding Difficulties to Everyday Conversation in a Dementia-Friendly Community 92
Introduction 93
Clinical and Neuropsychological Assessments of Language Impairments in Dementia: Biomedical Diagnostic Approaches 95
Variety of Language Impairments Across Clinical States of Dementia: Psycholinguistic Approaches 98
Socio-linguistic Approaches to Understand the Discourse, Language and Message of Dementia 103
Conclusions: Treatment Approaches to Restore Language Functions in Dementia 106
References 108
7 Psychosocial Rehabilitation of Persons with Dementia in Indian Context 116
The Importance of Making Early Diagnosis 118
Monitoring the General Health and Well-Being 118
Specific Interventions 119
Cognition-Oriented Approaches 119
Emotion-Oriented Approaches 120
Behaviour-Oriented Approaches 120
Stimulation-Oriented Approaches 120
Psychosocial Rehabilitation—An Indian Experience 121
Identification of dementia 122
Domiciliary Care 123
Home Care is Aimed to Provide Better Care in a Familiar Setting 123
Day Care 123
Memory Clinic 123
Support Groups 124
Help Line 124
References 125
8 Family Caregiving in Dementia in India: Challenges and Emerging Issues 127
Introduction 127
Family Caregiving in Dementia in the Indian Sociocultural Context 128
Emerging Issues and Challenges for Family Caregiving in India 130
Supporting Family Caregivers 133
Family Interventions and Support for Caregivers of People with Dementia 135
Conclusions 138
References 138
9 Local Strategies of Strengthening the Caregiving Potential of Families of People with Alzheimer’s Disease—Good Practices Introduced in Poland 143
Introduction 144
Epidemiological Risk of Alzheimer’s Disease in the Perspective of Population Ageing 144
Economic Aspects of Caring for People with Dementias 146
Care for People with Alzheimer’s Disease in Poland 147
Local Programme of Financial Support for Caregivers of People with Alzheimer’s Disease-Bon Alzheimer 75 (Care Voucher: Alzheimer 75) 150
Results of Research Conducted Among the Beneficiaries of Alzheimer 75 Voucher Programme 152
Conclusion 158
References 159
10 Supporting Home-Based Dementia Care 161
Introduction 162
Supporting Home-Based Care 163
Role of Specialist Care Providers 163
Role of Non-specialist Healthcare Providers 164
Other Models of Support 165
Technological Assistance for Home Base Care 167
Other Interventions for Support 169
Community-Based Services and Resources 169
Conclusions 170
References 171
11 Rehabilitation in Dementia Care 174
Introduction 174
References 198
12 Psychological Health of Dementia Caregivers: An Overview 203
Introduction 204
Methodology 208
Discussion 209
Effects of Dementia on Informal Caregivers 209
Caregivers’ Mental Health Condition 210
Behavioural and Psychological Symptoms of Dementia (BPSD) Care Recipients and Caregivers’ Mental Health 211
Effect of Socio-demographic and Socio-cultural Factors on Caregivers’ Health 212
Caregiving Related Factors and Caregivers’ Health 213
Conceptualisation of Dementia Among Caregivers 215
Caregiver’s Coping and Intervention Strategies 216
Conclusion 219
References 220
13 Dementia Care in Malta: Policy, Experiences and Narratives 231
Introduction 231
Dementia Policy in Malta 233
A Juggling Act! Experiences of Informal Carers of Persons with Dementia 238
Experiencing Dementia: A Case Study Narrative 241
Conclusion 245
References 247
14 Walking a Legal Tightrope: Assessing the Legal Capacity of Persons Experiencing Dementia to Make and Revoke Enduring Powers of Attorney in Australia 251
Introduction 251
The Nature of an Enduring Power of Attorney 253
The Incidence of People Experiencing Dementia in Australia 256
What is Legal Capacity? 257
The Obligations of Lawyers 263
Conclusions 264
Recommendations 265
Cases 268
References 269
15 Cognitive Impairment and Dementia: A Risk Factor for Elder Abuse and Neglect 272
What is Elder Abuse and Neglect? 273
Dementia 273
Dementia and Elder Abuse and Neglect 274
Barriers to Identifying Elder Abuse and Neglect 275
Theoretical Framework for Understanding the Occurrence of Elder Abuse 276
Responding to Elder Abuse and Neglect 278
Towards a Holistic Approach to Address Elder Abuse and Neglect 280
Conclusion 282
References 283
16 Ethical Issues in Dementia—Global Challenges 286
Introduction 286
Challenge 1: Ethical Issues Related to the Diagnosis of Dementia 287
Challenge 2: Ethical Issues Related to Driving and Patients with Dementia 288
Challenge 3: Ethical Issues Related to Testamentary Capacity in Patients with Dementia 289
Challenge 4: Ethical Issues in Dementia Clinical Trials and Informed Consent 289
Challenge 5: Ethical Issues in Old-Age Home Residents with Dementia 291
Challenge 6: Therapeutic Lying in Dementia 291
Challenge 7: Ethical Issues with Respect to Biomarkers in Dementia 292
Challenge 8: Ethical Issues with Regard to Genetic Testing in Dementia 293
Challenge 9: Surrogate Decision-Making for Patients with Dementia 293
Challenge 10: Ethical Aspects of Stopping Medication in Dementia 294
Challenge 11: End-of-Life Care and Related Decisions in Patients with Dementia 294
Challenge 12: Living Wills and Advance Directives in Patients with Dementia 295
Challenge 13: Ethical Aspects of Sexual Issues in Patients with Dementia 296
Challenge 14: Covert Medication, Restraint and Its Use in Patients with Dementia 296
Challenge 15: Electronic Tagging of Patients with Dementia 297
Challenge 16: Everyday Ethics in Nursing Homes and Dementia Day Care 298
Challenge 17: Ethics of Neuroimaging in Dementia 299
Conclusions 299
References 300
17 Technology and Dementia Care—Global Challenges 304
Introduction 304
Different Types of Technology in Dementia Care 305
Role of Technology in Dementia Care 307
Robotics and Dementia 308
Virtual Reality Technology in Dementia Care 309
Electronic Tagging in Dementia 309
Creating Dementia Friendly Technological Environments 310
Disadvantages of Technology for Dementia Care 310
Conclusions 311
References 311
18 Leap into the Unknown: Artistic Collaboration Across Diagnosis of Dementia 314
Introduction 315
Background 315
Research Methods and Use of Technology 316
Interdependence, Stigma and Shared Practice Across Diagnosis of Dementia 318
Meaning and Gerotranscendence 322
The Significance of the Hand 323
Colour as Connective Tissue 326
A New Landscape to Experience the Unknown 328
The Role of Risk 330
Conclusions and Implications 332
Appendix 1 335
Appendix 2 336
Appendix 3 337
Appendix 4 338
References 339
19 Opening the Window: Art Therapy and Nature as Mindfulness Practices with People Living with Dementia 343
Inequities in Dementia Care 344
Creative Arts in Dementia Care 345
Creativity: A Gift of Dementia 346
Resistance to Art Making 348
Nature and Health 353
Nature and Eldercare 354
Eco-Arts Therapy as Mindfulness Practices in Dementia Care 356
Gerontological Lens 360
Nature and Art as a Window 361
References 363
20 Leaving Life Too Early or Leaving the Decision Too Late in Alzheimer-Type Dementias: Choices and Preferences for Medical Assistance in Dying (MAID) 366
References 378
21 Dementia in Under 65s—An Overview 381
Introduction 382
Etiology of Early Onset Dementia 383
Risk Factors for Developing Dementia 384
Diagnosing of Early Onset Dementia—Approach to a Case 385
Challenging Behaviour in EOD-Behavioural and Psychological Symptoms of Dementia (BPSD) 387
Management of Early Onset Dementia and BPSDs 389
Differences Between Early Onset Dementia and Late Onset Dementia 391
References 393
22 Pharmacological Management of Dementia—An Overview 396
Introduction 396
Cholinesterase Inhibitors 397
Tacrine 397
Donepezil 397
Rivastigmine 398
Galantamine 398
Indications 399
Side Effects 399
NMDA Receptor Antagonists 399
Donepezil–Memantine Combination 400
Nootropics 400
Piracetam 401
Curcumin 401
Ginkgo Biloba 403
Huperzine A 403
Piribedil 404
Pyritinol 405
Targeting Amyloid as a Future Disease—Modifying Treatment of Alzheimer’s Disease 405
Secretase Modulators 405
Anti Tau Drugs 406
Conclusions 408
References 408