A review of barriers and enablers to diagnosis and management of persons with dementia in primary care.

Background: With the rise in the prevalence of dementia disorders and the growing critical impact of dementia on health-care resources, the provision of dementia care has increasingly come under scrutiny, with primary care physicians (PCP) being at the centre of such attention.

Purpose: To critically examine barriers and enablers to timely diagnosis and optimal management of community living persons with dementia (PWD) in primary care.

Methods: An interpretive scoping review was used to synthesize and analyze an extensive body of heterogeneous Western literature published over the past decade.

Perceptions of family and staff on the role of the environment in long-term care homes for people with dementia.

Background: Disruptive behaviors are frequent and often the first predictor of institutionalization. The goal of this multi-center study was to explore the perceptions of family and staff members on the potential contribution of environmental factors that influence disruptive behaviors and quality of life of residents with dementia living in long-term care homes.

Methods: Data were collected using 15 nominal focus groups with 45 family and 59 staff members from eight care units.

Meanings, functions, and experiences of living at home for individuals with dementia at the critical point of relocation.

The sociophysical home environment is an integral component of everyday coping, self-identity, and well-being for individuals with dementia; however, residential discontinuity is a common experience for many of these individuals. This article examined the meanings, functions, and experiences associated with living at home for individuals with dementia at the critical point of relocation to a residential care facility. Qualitative research methods were used to analyze in-depth interviews with 16 individuals with dementia at their homes within 2 months prior to relocation.

Symbolic meaning of relocation to a residential care facility for persons with dementia.

Objectives: This study explored the perspectives of persons with dementia (PWD) on the meanings and experiences associated with relocation to a residential care facility (RCF).

Methods: A qualitative design was employed, which involved in-depth interviews with 16 PWD at their homes within two months prior to relocation. The work of Strauss and Corbin guided the analysis process.

Emotional impact of dementia diagnosis: exploring persons with dementia and caregivers' perspectives.

This paper examined the emotional impact of diagnosis disclosure on recently diagnosed people with dementia. Thirty patient/caregiver dyads attending a Geriatric Day Hospital Program in Ottawa, Canada participated in this qualitative exploratory study. Data sources included: (a) audio-tapes of diagnosis disclosure meeting, (b) in-depth interviews with patients and caregivers within one week of disclosure, and (c) focus group interviews with caregivers within one month.

Dementia diagnosis disclosure: a study of patient and caregiver perspectives.

This paper reports the findings of a descriptive, exploratory, qualitative study of patient and caregiver perspectives of the disclosure of a dementia diagnosis. Data were collected at 3 points in time: (1) the disclosure meeting, (2) patient and caregiver interviews, and (3) focus group interviews. Thirty patient-caregiver dyads participated in the disclosure meetings at the Geriatric Day Hospital at the Ottawa Hospital, Ottawa, Canada.

Effectiveness of outpatient geriatric assessment programs: exploring caregiver needs, goals, and outcomes.

In this study, the authors examined the goals and outcomes of 141 caregivers of older adults with cognitive impairment who attended a comprehensive geriatric assessment program (CGA). The vast majority of caregivers expressed at least one assessment goal, suggesting that the concept was relevant to them. Most caregiver goals focused on patient needs, with only 10% expressing goals specifically related to their own coping needs.

Development and evaluation of an instrument to measure seniors' attitudes toward the use of bathroom grab bars.

Bath grab bars can minimize the effects of many age-related deficits that may contribute to bath-related falls. Despite their potential value, bathroom safety devices remain largely underutilized by many community-living older adults and knowledge concerning attitudinal factors that influence the use of grab bars is sparse. This void of knowledge is due, at least in part, to the lack of instruments to measure the psychosocial constructs influencing bathroom safety device use.

Older adults in the emergency department: a systematic review of patterns of use, adverse outcomes, and effectiveness of interventions.

Study Objective: We sought to synthesize the literature on patterns of use of emergency services among older adults, risk factors associated with adverse health outcomes, and effectiveness of intervention strategies targeting this population.

Methods: Relevant articles were identified by means of an English-language search of MEDLINE, HealthSTAR, CINAHL, Current Contents, and Cochrane Library databases from January 1985 to January 2001. This search was supplemented with literature from reference sections of the retrieved publications.