Empowering older people with early dementia and family caregivers: A participatory action research study
Section snippets
What is already known about the topic?
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Studies on interventions in very early dementia are scarce, and institutionalized elderly with advanced stages of dementia have been the major focus of dementia care research.
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Few interventions on dementia care have targeted both the elderly with dementia and their family caregivers.
What this paper adds
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Cognitive rehabilitation, by restoring lost procedural skills which demented persons used to like or to be good at, is an effective tool for regaining self-confidence in persons with early dementia.
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Giving positive feedback to demented persons who have lost their confidence is an important element for their empowerment.
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Education and counselling in the form of coaching are effective for family caregivers of dementia persons to cope with symptoms of dementia.
Design
We employed a participatory action research (PAR) approach to develop a group activity programme for community-dwelling elderly individuals with early dementia and education and counselling programmes for family caregivers. The model for PAR is a community intervention model employed in the field of community health nursing; this model is used by nurses to conduct community assessments, initiate community collaborations, involve the target population, and include reflection (Kelly, 2005). The
Assessment: issue identification
Seventeen family caregivers participated in the focus group interview. To summarize the conclusions of the interview (Nomura and Ohnakado, 2005), the elderly with early dementia were thought to be withdrawn or had a reduced motivation towards life. As the disease progressed, the time the demented elderly residents spent indoors increased. The caregivers did not consider this to be a serious situation, presuming it to be one of the symptoms of aging and only sought help from care providers after
Discussion
The uniqueness of our PAR was the application of cognitive rehabilitation theory to regain lost procedural skills to empower PsWD. Cooking played a major role in restoring confidence in PsWD. Cooking involves many interdisciplinary factors: safety, standing, balance, fine motor coordination, memory, visual skills, problem-solving, socialization and cooperation (Johnstone and Stonnington, 2001b). If menus are carefully chosen based on the cognitive function and potential of the PsWD, cooking
Conclusion
The PAR reported here using the cognitive rehabilitation theory was conducted to empower elderly PsWD with early dementia and their FCPs. The PAR helped these elderly PsWD to regain lost procedural skills and acquire confidence. The recognition of their skills by the group members and by their families appeared to be the most powerful component of empowerment. The education and counselling programmes for family caregivers promoted problem-focused coping skills and improved family relationships.
Acknowledgements
We would also like to extend our appreciation to all the participants, the officers of Iyo City and the stuff members of the programme. We would like to acknowledge Professor Yoshiko Nojima, former Shiga University of Medical Science for her valuable comments. This study was funded by the Ministry of Education, Culture, Sports, Science and Technology (No. 17592316).
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