Table of Contents
Dementia is a condition associated with a declining mental ability. Severe cases are capable of interfering with the normal daily activities of an individual. Dementia is not specifically a disease but a general term used to describe a broad range of symptoms associated with declining thinking skills or memory to the extent of reducing the abilities of an individual to perform daily activities. The primary cause is damage to the brain cells that interfere with the capacity to communicate. Patient-centered care and assistive technologies help in managing this condition. However, many people argue that technology is taking over as the preferred method of monitoring the performance or recovery of patients either in hospitals or at home. Dementia constitutes 80% of all the neuropsychiatric symptoms in nursing homes for the elderly patients. Despite their commitment to care for the dementia patients, nursing homes lack efficient and cost-effective strategies. For this reason, Draskovic et al. (2012) conducted a study to determine the effectiveness of dementia care mapping in improving person-centered care in nursing homes. Therefore, my interest in studying this topic is to understand how nursing homes can adopt dementia –care mapping to offer the best services that can improve health outcomes in patients with dementia.
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Summary of Qualitative Research Critique
Assistive caring for dementia patients requires the use of assistive technologies as well as the person-centered care and dementia care mapping approaches. With this raises the question whether general practitioners and family have knowledge and experiences on accessing information and using assistive technologies in caring for dementia patients. For this reason, Newton et al. (2016) conducted a qualitative study aimed at exploring the views of GPs, people with dementia and their caregivers on assistive technology. Generally, in the global outlook, the cost of providing quality care to dementia patients is still on the rise. On the other hand, those caring for dementia patients and the patients themselves require reliable, up to date, and accurate information to use the assistive technologies appropriately. In England today, researchers on the views of general practitioners on the importance of telehealth show that general practitioners lack enthusiasm on the telehealth and its concerns on how it affects their workload. According to the author, this study aimed at exploring the views and experiences of general practitioners as well as family caregivers on their knowledge and use of assistive technologies in practice. In essence, assistive technologies offer numerous solutions to most of the problems dementia patients face. Telehealth or telecare includes simple devices/aids such as hearing aids or walking sticks specially designed for dementia patients. The following are the key research questions in this study.
- How does access to appropriate and reliable information on assistive technology impact on quality care?
- What are some of the roles and responsibilities of the current care systems?
- What are some of the gaps existing in current services and what does the future commissioning of assistive technologies entail?
These questions are mainly aimed at finding the application of assistive technologies to patient care. This means that the research study is aimed at finding out how implementation and knowledge about assistive technologies have helped in ensuring positive outcomes for dementia patients.
Method of Study
The thematic analysis and semi-structured interviews outlined as the qualitative methods of the study were much appropriate in answering the research question. The author identified a perspective that most caregivers and general practitioners lack access to information on assistive technologies. In this essence, photographs of the same were carried along to show to the study participants. In the study, the literature search was thorough, and the author significantly cited qualitative and quantitative studies relevant to the focus of the research. In essence, this shed more light on what is already known and thus gave the study a sense of direction. Most of the references used in the study were current falling within the five-year category but all other references more than five years were relevant to the study. The author did a Little literature review, but the referencing and citations indicate that some of the available studies do not outline an essential element of information access and knowledge on the part of dementia caregivers thus building on the logic of the study.
From the study, the author was able to conclude that four themes were evident. These are; awareness and experiences with the assistive technologies, access to information related to assistive technologies, some of the responsibilities and roles of caregivers on the current care system and the future application of assistive technologies services. The participants in the study have had experiences with assistive technologies in use. Most of the dementia patients and their families gained knowledge about the assistive technologies through personal experiences as opposed to health care professionals informing them. This means that the nursing practitioners are supposed to be held responsible for the much less awareness and limited information access o assistive technologies to the part of dementia patients and their caregivers. Therefore, to maximize and appreciate the use of assistive technologies in ensuring a quality life for the dementia patients; nurse practitioners should be involved in providing necessary information to relevant patients and caregivers (Phaal et al., 2013; Boots et al., 2014).
Participant privacy was considered carefully in the study, and authors obtained their informed consent. Newcastle University Ethics committee and the NHS East of England research ethics committee approved this research study with reference 00712/2013 and 11/EE/0505 respectively awarded by the institutions.
Assistive technologies are essential for dementia patients. The only problem existing therein is in the use and knowledge about the same. Most caregivers and dementia patients do not understand the basic principles in using the assistive technologies available at their disposal. This means that healthcare professionals should at least come in and help with awareness campaigns aimed at availing information about assistive technologies and how they can be of much help for dementia patients in terms of improving the quality of life and ensuring positive health outcomes.
Proposed Evidence-Based Practice Change
From the two research studies, it is evident that much has not been done in regard to improving quality care for dementia patients. In essence, person-centered care approaches and availing accurate and appropriate information about the use of assistive technologies to general practitioners and caregivers would work milestones in ensuring positive outcomes for dementia patients. Implementation of the results from the two studies will facilitate achievement of a person-centered care approach where assistive technologies are used sufficiently to promote quality care in the health services unlike the traditional monitoring of medication use and pain. Accordingly, assistive technologies and person-centered care approaches offer the best solution for improving health outcomes in dementia patients.
Summary of Quantitative Research Critique
Dementia as a condition has been a challenge to many especially the aging populations. Hence, it is vital to define critical care approaches to ensure that the dementia patients achieve quality and improved life. In a study, Draskovic et al. (2012) discover that most nursing homes do not provide useful and cost-effective strategies in caring for the dementia patients. In this accord, the focus of the study was to recognize the effectiveness of dementia care mapping improving the person-centered care in nursing homes. The primary purpose of this study was to assess some of the effects of care staff training on dementia care mapping and person-centered care on qualify of dementia patients’ lives residing in a nursing home. Some of the research questions from this study include the following:
- What are some of the effects of person-centered care dementia care mapping approaches have on the quality of life of a dementia patient?
- What impact do dementia care mapping and person-centered care strategies have in terms of increased efficiency and cost-effectiveness?
The research questions outline the main guiding principles and steps of the research study. In this context, it is possible to make conclusions from the manner in which the research study attempted to answer the research questions.
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Method of Study
The study involved the staff in the dementia care nursing home in Dutch. 40 staff members available for the study in the geriatric nursing home volunteered to participate in the study. The research was quantitative, the main variables were clusters subjected to dementia care mapping, and another group subjected to the usual care approaches. Keen consideration was made to ensure a control group to come up with satisfactory conclusions. Data collection methods included questionnaires aimed at analyzing job satisfaction, staff turnover rates, absenteeism due to work-related stressors and stress reactions among nursing staff members. Using this technique, the author outlined the rationale that staff members’ welfare is directly related to their output, which in essence affects the quality care provided to dementia patients. The ill-being and well-being values of dementia residents in the nursing home were measured three times at intervals of one month each and classified as baseline, pre-intervention, and post-intervention. There was no significant difference between the first and the second rounds before training the staff (p = 0.211). The well-being and ill-being values increased between the first and the second rounds compared to the third post- intervention round (p = 0.035 and p < 0.001 respectively). The effect of training the staff on the quality of life of the dementia residents was evaluated by measuring forty residents with dementia. This data was used in linear mixed effect models and cost-effectiveness analysis. The author outlines that rigor of the process was maintained by electronically registering the systems and during the analysis of the data, to ensure accuracy, both the paper trails and electronic systems were used to achieve the objectives and to minimize bias, the randomization was the only tool applied. This was accomplished by randomizing the clusters to avoid contamination and possibilities of information exchange.
Results of the Study
From the study findings, the researcher was able to establish that dementia care mapping is a novel idea in that it is vital in outlining person-centered strategies of care for dementia patients in nursing homes. The basic of caring for dementia patients is compassion, and dementia care mapping as per the study outlines the same. The limitations of the findings identified are that the generalizability and implementation of the same are questionable in the control and intervention of person-centered approaches in nursing homes is way above average. In nursing practice, the findings can be used in the management of psychological and behavioral symptoms associated with dementia. It can as well be used by policy makers to improve the quality of care, safety of patients and ensuring positive outcomes for the patients.
Privacy and participant protection is essential in any research study. In this study, informed consent of the participants was sought and the Arnhem-Nijmegen ethical committee waived approval of the research study registration number of the study was 2010/147.
With dementia patients, compassion forms the basis of care. In this view, dementia care mapping and person-centered strategies are the best for rolling out care in nursing homes. This provides a systematic adaptation in managing organization climate as well as providing psychological action plans tailored for individual residents and staff members. The effect is the achievement of efficiency, cost-effectiveness, and quality care in dementia care nursing homes. In essence, assistive technologies meant to boost the quality of care are integrated with nursing competencies in terms of manual monitoring of pain and medication use, which ultimately translate to improve patient-centered care, safety, and quality of health services.
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