Discussions about the importance of the built environment for healthcare delivery extend at least as far back as Hippocrates 1 (400 BC). The iconic Florence Nightingale (1859) also strongly believed in the influence the indoor environment has on the progress of disease and recovery. Today, the role of the built environment in the healing process is of growing interest to healthcare providers, environmental psychologists, consultants, and architects. Although there is a mounting evidence 1 linking healthcare environments to health outcomes, because of the varying quality of that evidence, there has also been a lack of clarity around what can and cannot be achieved through design. Given the ageing of society and the ever increasing numbers of persons with dementia in the Western World, the need for detailed knowledge about aged care environments has also become increasingly important. The mental and physical health state of these persons is extremely fragile and their needs demand careful consideration. Although environmental interventions constitute only a fraction of what is needed for people with dementia to remain as independent as possible, there is now sufficient evidence (2, 3) to argue they can be used as a first-line treatment, rather than beginning with farmalogical interventions.
Artikel van Judith Huis in het Veld, docent onderzoeker van de Hogeschool Inholland verschenen in Research in Gerontological Nursing ABSTRACT The current article discusses how and by whom family caregivers want to be supported in selfmanagement when managing changes in behavior and mood of relatives with dementia and whether family caregivers consider eHealth a useful tool for self-management support. Four asynchronous online focus groups were held with 32 family caregivers of individuals with dementia. Transcripts of the online focus groups were analyzed using qualitative thematic analysis. Family caregivers need support from professionals or peers in the form of (a) information about dementia and its symptoms, (b) tips and advice on managing changes in behavior and mood, (c) opportunities to discuss experiences and feelings, and (d) appreciation and acknowledgement of caregiving. The opinions of family caregivers about self-management support through eHealth were also reported. Findings suggest a personal approach is essential to self-management support for family caregivers managing changes in behavior and mood of relatives with dementia. In addition, self-management support can be provided to some extent through eHealth, but this medium cannot replace personal contacts entirely.
IntroductionObservable dementia symptoms are hardly studied in people with severe/profound intellectual (and multiple) disabilities (SPI(M)D). Insight in symptomatology is needed for timely signaling/diagnosis. This study aimed to identify practice-based observations of dementia symptoms in this population.MethodsCare professionals and family members were invited to complete a survey about symptoms. Quantitatively analyzed survey data were further deepened through semi-structured interviews with care professionals having vast experience in signaling/diagnosing dementia in this population. Symptoms were categorized using a symptom matrix.ResultsSurvey respondents and interviewees frequently observed a decline in activities of daily living (ADL) functioning and behavioral and psychological changes, like increased irritability, anxiety, apathy and decreased eating/drinking behavior. Cognitive symptoms were particularly recognized in persons with verbal communication and/or walking skills. To lesser extent motor changes and medical comorbidities were reported.ConclusionIncreased insight in dementia symptoms contributes to developing a dedicated screening instrument for dementia in people with SPI(M)D.
