Bradford Dementia Group Good Practice Guides There are always difficult day to day decisions to be faced when caring for a person with dementia - from knowing how to deal with wandering to end of life decisions. Many of these decisions are underpinned by value judgments about right and wrong and reflect a particular view of dementia. This book considers these ethical decisions in the context of relationships, treatment, safety and quality of life, offering practical guidance and advice. It draws on the experiences of family carers as well as on existing research and emphasizes the importance of empathy and the need to acknowledge different perspectives in order to reach the best decision for the person with dementia. In particular the authors discuss the way that decision makers are themselves changed by the decisions they make, and the impact of this on the decision-making process. This book should be read by all those who work caring for people with dementia.
This book is invaluable to nurses and all health and social care practitioners working with people living with dementia in a variety of contexts. It presents a series of true-to-life case studies tackling the ethical and practical dilemmas of dementia care and how to use theoretical approaches to come to potential solutions. The reader is encouraged to explore evidence-based approaches to practice, based on the professional reasoning and experience of the practitioner and the emotional psychological and practical needs of the person living with dementia. Key themes running through case studies include: effective communication, person-centred practice, social citizenship, strengths-based approaches and relationship-focused support, as well as organisational culture. Each case study provides readers with opportunities to experience and discuss clinical dilemmas in a safe space with an annotated thinking-aloud framework that allows them to unpack the elements of each situation so as to develop a range of solution-focused perspectives in order to overcome barriers and deliver best practice.
As the largest generation in U.S. history - the population born in the two decades immediately following World War II - enters the age of risk for cognitive impairment, growing numbers of people will experience dementia (including Alzheimer's disease and related dementias). By one estimate, nearly 14 million people in the United States will be living with dementia by 2060. Like other hardships, the experience of living with dementia can bring unexpected moments of intimacy, growth, and compassion, but these diseases also affect people's capacity to work and carry out other activities and alter their relationships with loved ones, friends, and coworkers. Those who live with and care for individuals experiencing these diseases face challenges that include physical and emotional stress, difficult changes and losses in their relationships with life partners, loss of income, and interrupted connections to other activities and friends. From a societal perspective, these diseases place substantial demands on communities and on the institutions and government entities that support people living with dementia and their families, including the health care system, the providers of direct care, and others. Nevertheless, research in the social and behavioral sciences points to possibilities for preventing or slowing the development of dementia and for substantially reducing its social and economic impacts. At the request of the National Institute on Aging of the U.S. Department of Health and Human Services, Reducing the Impact of Dementia in America assesses the contributions of research in the social and behavioral sciences and identifies a research agenda for the coming decade. This report offers a blueprint for the next decade of behavioral and social science research to reduce the negative impact of dementia for America's diverse population. Reducing the Impact of Dementia in America calls for research that addresses the causes and solutions for disparities in both developing dementia and receiving adequate treatment and support. It calls for research that sets goals meaningful not just for scientists but for people living with dementia and those who support them as well. By 2030, an estimated 8.5 million Americans will have Alzheimer's disease and many more will have other forms of dementia. Through identifying priorities social and behavioral science research and recommending ways in which they can be pursued in a coordinated fashion, Reducing the Impact of Dementia in America will help produce research that improves the lives of all those affected by dementia.
Risk is central to professional practice, assessment and decision-making in dementia care. Yet theories of risk are often complex and difficult to translate into everyday practice. This book outlines some of the key issues in risk perception, assessment and management in dementia care in a way that is both practical and accessible to a wide range of practitioners. It develops an approach to risk that promotes choice for people with dementia whilst also acknowledging the complex challenges care providers face. The authors provide an overview of the legislative framework currently in place, and of the ethical dilemmas which may emerge in practice. Frameworks for informed and balanced decision-making are offered, and the importance of including the person with dementia, their family, and care providers in decision-making is emphasised. Throughout the book, case studies are used to illustrate effective negotiation and practical solutions to risk dilemmas in practice. This book highlights principles of good practice for managing risk in dementia care, and presents a rounded approach that will help practitioners negotiate some of the complex issues this entails.
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Care and support affects a large number of people: eight out of 10 people aged 65 will need some care and support in their later years; some people have impairments from birth or develop them during their working life; some 5 million people care for a friend or relative, some for more than 50 hours a week. The current system does not offer enough support until a crisis point is reached, the quality of care is variable and inconsistent, and the growing and ageing population is only going to increase the pressure. Consequently, two core principles lie at the heart of this White Paper. The first is that individuals, communities and Government should do everything possible to prevent, postpone and minimise people's need for formal care and support. The system should be built around the promotion of people's independence and well-being. The second principle is that people should be in control of their own care and support, with personal budgets and direct payments, backed by clear, comparable information and advice that will allow individuals and their carers to make the choices that are right for them. This paper sets out the principles and approach, with sections covering: strengthening support within communities; housing; better information and advice; assessment, eligibility and portability for people who use care services; carers' support; defining high-quality care; improving quality; keeping people safe; a better local care market; workforce; personalised care and support; integration and joined-up care.
The increasingly widespread implementation and use of intelligent assistive technologies (IATs) is reshaping dementia care. This volume provides an up-to-date overview of the current state of IATs for dementia care. The new essays collected here examine what IATs will mean for clinical practice and the ethical and regulatory challenges they will pose.
Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.
