Nursing homes

Annotated Bibliography

Kimberly Phillips

Colorado Technical University

Abstract

Nursing home or home care are the options loved ones of dementia suffers are faced with. For Comment by user: sufferers

some, nursing homes are not an option because of fear. Many dementias suffer are cared for in his or her place of residence. This paper is going to examine some pros and cons of caring for loved ones who has dementia at home. It is also going to review ways that home-dwelling dementia patients caregivers can receive the support he or she may need to provide good quality care to their loved ones. Comment by user: Keep in mind, you are in a Doctorate of Management Program and your paper has to be related to Management. You must start thinking about how you are going to manage something.

Keywords: Elderly, geriatric, home care, dementia

Running head: ANNOTATED BIBLIOGRAPHY 1

ANNOTATED BIBLIOGRAPHY 2

Annotated Bibliography or Replace with Your Title

This is review of the papers I am going to use to help me focus on my topic. I am interested in keeping elderly people who suffers from dementia in his or her own place of residence than being admitted into a nursing home. Comment by user: This annotated bibliography is a review of sources being used to support my topic of interest. Comment by user: With your dissertation, you aren’t trying to solve anything.

Annotation # 1

Bantry White, E., & Montgomery, P. (2015). Dementia, walking outdoors and getting lost:

incidence, risk factors and consequences from dementia-related police missing-person

reports. Aging & Mental Health, 19(3), 224-230. doi:10.1080/13607863.2014.924091

Author’s Abstract

“Objectives: To estimate incidence, identify consequences and potential risk factors for harm in people with dementia who got lost in one UK policing region. Methods: In a retrospective observational study, data were extracted from missing-person records over a four-year period in one UK policing region (population of 2.1 million). Results: Two hundred and eighty-one incidents of getting lost were identified. Incidence of getting lost was estimated at 0.5% of the regional dementia population. Fifty-nine percent of reports came from domestic settings, 29% from care homes/hospitals, and 12% on excursions from home. Five percent (n= 15) sustained significant harm, including two deaths. Average age was 78 years (SD 8.3). Harm was associated with older age (mean difference 6.16 years, CI 1.86 to 10.46,p= 0.005,t= 2.82), length of time missing (Mdn time 2.48 hours; IQR 0.97 to 9.45,p= 0.02), and season (9% winter, 2% summer,p= 0.006). The length of time missing increased with delays in reporting to police (r= 0.15,p= 0.018), getting lost at night (Mdn time 1.70 hours, IQR 0.52–3.32,p= 0.028), driving themselves (Mdn time 2.45 hours, IQR 0.42–2.00,p= 0.001), and using public transport (Mdn 1.78 hours, IQR 1.07–3.92,p= 0.001). Conclusion: Incidence in this study suggests getting lost is a low-frequency event for people with dementia but for a small minority, the risks are considerable. Exploratory analyses suggest individual and environmental factors increase the risk of harm. Suitable methods need to be developed to replicate these findings in larger prospective samples. A focus on the predictors of harm may aid development of assessment protocols to ensure intervention is proportionate.”

Reviewer’s Abstract

This article reviewed incidence reports of missing elderly with dementia. The incidents reports studied were reported from home care providers and nursing homes. They give the time the individuals were last seen and the time the report was time. The reports even told the weather, rather the individuals were last seen walking or on public transportation. According to the report, majority of the missing reports came from community-dwelling individuals. Relevance = 3

Strengths

This article’s review of missing elderly rebuts my argument, which is to keep elderly who suffer from dementia in their homes. However, it shows the age in which these incidents occur, and it gives an age to which these types of incidents are likely to occur. I can use this in my paper to inform the reader that at this age the individual will need 24-hour care. It also states where there is a need for more research for better accuracy. Comment by user: You will not be solving anything in your dissertation

Weaknesses

The report was taken from incidents in the UK. There are ethical issues to consider. For instance, the culture of the people involved in the incidents. How many were Afro-American, Caucasian, Indian, Hispanic, and so forth. Each group has their own way of caring for their elders. Demographics are another weakness. The United States is different from the UK. The weather for each season here is different from that of the UK. It also did not mention the care giver. It did not the care provider’s or the person making the report age. Comment by user: Not sure why this is considered a weakness. Comment by user: How does the weather relate? Comment by user: Not clear

Annotation # 2

Dawson, A., Bowes, A., Kelly, F., Velzke, K., & Ward, R. (2015). Evidence of what works to

support and sustain care at home for people with dementia: a literature review with a

systematic approach. BMC Geriatrics, 15(1), 59. doi:10.1186/s12877-015-0053-9

Author’s Abstract

“Background This paper synthesises research evidence about the effectiveness of

services intended to support and sustain people with dementia to live at home,

including supporting carers. The review was commissioned to support an inspection

regime and identifies the current state of scientific knowledge regarding

appropriate and effective services in relation to a set of key outcomes derived from

Scottish policy, inspection practice and standards. However, emphases on care at

home and reduction in the use of institutional long-term care are common to many

international policy contexts and welfare regimes. Methods Systematic searches of

relevant electronic bibliographic databases crossing medical, psychological and

social scientific literatures (CINAHL, IngentaConnect, Medline, ProQuest, PsychINFO

and Web of Science) in November 2012 were followed by structured review and

full-text evaluation processes, the latter using methodology-appropriate quality

assessment criteria drawing on established protocols. Results Of 131 publications

evaluated, 56 were assessed to be of ‘high’ quality, 62 of ‘medium’ quality and 13 of

‘low’ quality. Evaluations identified weaknesses in many published accounts of

research, including lack of methodological detail and failure to evidence conclusions.

Thematic analysis revealed multiple gaps in the evidence base, including in relation

to take-up and use of self-directed support by people with dementia, use of rapid

response teams and other multidisciplinary approaches, use of technology to

support community-dwelling people with dementia, and support for people without

access to unpaid or informal support. Conclusions In many areas, policy and

practice developments are proceeding on a limited evidence base. Key issues

affecting substantial numbers of existing studies include: poorly designed and

overly narrowly focused studies; variability and uncertainty in outcome

measurement; lack of focus on the perspectives of people with dementia and

supporters; and failure to understanding the complexities of living with dementia,

and of the kinds of multifactorial interventions needed to provide holistic and

effective support. Weaknesses in the evidence base present challenges both to

practitioners looking for guidance on how best to design and deliver evidence-based

services to support people living with dementia in the community and their carers

and to those charged with the inspection of services.”

Reviewer’s Abstract Comment by user: The Reviewers Abstract, strengths and weaknesses must be a paragraph each and they must be critically analyzed. THIS NOTE IS FOR YOUR ENTIRE PAPER!!

This is a literature review of what works to help keep people with dementia in his or

her home. It also discusses support for the family who is providing the care at home.

Strengths

This fact that this is literature review speaks for itself. This article is a study of past literature

pertaining to what works when it comes to providing home care for people with dementia. It also

is a study of what kind of support his or her family carer will need. This article makes my

research on the topic easier. Relevance = 4.5

Weaknesses

The article did not make any suggestions for further research.

Annotation # 3

de Oliveira, D. C. (2015). Ageing and quality of life in family carers of people with dementia

being cared for at home: a literature review. Quality In Primary Care, 23(1), 18-30.

Author’s Abstract

“Background: Despite the increasing older population providing care for family members with

dementia at home, there is no consensus in the literature in terms of how caring impacts on their

quality of life (QoL) and the association of the family carer’s age with QoL outcomes. Aims: To

explore the available literature investigating the QoL of older family carers (family carers aged >

60) and the association of family carers’ age and QoL outcomes in a dementia context. Methods:

A review of the literature to December 2013 was onducted using Embase-O VID, CINAL,

Medline-OVID, Psyc INFO-OVID, Grey literature and the references of the included studies.

Cross-sectional or prospective longitudinal studies published in English were eligible. The

selection and appraisal processes were performed by two reviewers independently and the

methodological quality was assessed by STROBE statement. Results: From the 12 selected

studies, 4 were carried out with older family carers’ samples and 8 associated the variable ‘age’

with QoL outcomes. Eight different instruments were used to assess family carers’ QoL, however

none were designed specifically for older people or older family carers. The mean age of the

carers’ samples ranged from 55.2 to 76.0 years old. Older family carers showed low levels of

QoL and were often below the age-matched standard population. Carers’ age was negatively

correlated with QoL outcomes in most of the studies. Conclusion: Older people are increasingly

involved with dementia care and family carer’s advanced age was shown to be associated with

low levels of QoL. Future research should investigate the QoL of older family carers separately

and use QoL instruments containing older family carers’ specific needs and perspectives of QoL.

In planning care and support, primary health care practitioners should consider family carer’s age

group and their specific needs.”

Reviewer’s Abstract Comment by user: See previous notes

This is a literature view pertaining to the quality of life of those providing home care for their

loved ones with dementia. It involves home care providers who are of age themselves. Relevance

= 5

Strengths

This fact that this is literature review speaks for itself. This article is a study of past literature

pertaining to individuals who take care of a loved one at home who suffers from dementia. This

article makes me research on the topic easier. Relevance = 4.5

Weaknesses

The article did not make any suggestions for further research.

Annotation # 4

Fleming, J., Calloway, R., Perrels, A., Farquhar, M., Barclay, S., & Brayne, C. (2017). Dying

comfortably in very old age with or without dementia in different care settings – a

representative “older old” population study. BMC Geriatrics, 171-17.

doi:10.1186/s12877-017-0605-2

Author’s Abstract

“Background: Comfort is frequently ranked important for a good death. Although rising

numbers of people are dying in very old age, many with dementia, little is known about symptom

control for “older old” people or whether care in different settings enables them to die

comfortably. This study aims to examine, in a population-representative sample, associations

between factors potentially related to reported comfort during very old people’s final illness:

physical and cognitive disability, place of care and transitions in their final illness, and place of

death. Methods: Retrospective analyses linked three data sources for n = 180 deceased study

participants (68% women) aged 79-107 in a representative population-based UK study, the

Cambridge City over-75s Cohort (CC75C): i) prospective in-vivo dementia diagnoses and

cognitive assessments, ii) certified place of death records, iii) data from interviews with

relatives/close carers including symptoms and “How comfortable was he/she in his/her final

illness?” Results: In the last year of life 83% were disabled in basic activities, 37% had

moderate/severe dementia and 45% minimal/mild dementia or cognitive impairment. Regardless

of dementia/cognitive status, three-quarters died following a final illness lasting a week or

longer. 37%, 44%, 13% and 7% of the deceased were described as having been “very

comfortable”, “comfortable”, “fairly comfortable” or “uncomfortable” respectively during their

final illness, but reported symptoms were common: distress, pain, depression and delirium or

confusion each affected 40-50%. For only 10% were no symptoms reported. There were ≥4-fold

increased odds of dying comfortably associated with being in a care home during the final

illness, dying in a care home, and with staying in place (dying at what death certificates record as

“usual address”), whether home or care home, compared with hospital, but no significant

association with disability or dementia/cognitive status, regardless of adjustment. Conclusions:

These findings are consistent with reports that care homes can provide care akin to hospice for

the very old and support an approach of supporting residents to stay in their care home or own

home if possible. Findings on reported high prevalence of multiple symptoms can inform policy

and training to improve older old people’s end-of-life care in all settings.”

Reviewer’s Abstract

This article addresses the comfort level of people with dementia in his or her last stage of life; from very comfortable to uncomfortable. It addresses living at home or in a nursing home. It is a deceased study of women ages 79-107 residing in the UK. It gives the percentage level of mobility and the level of the individuals’ dementia; low, moderate, or severe. The study was conducted using dementia diagnosis, death records, and information used from interviews of family and close care providers. Relevance = 3

Strengths Comment by user: See previous notesStrengths and weaknesses must be indented

It analyzes the comfort level of elderly women diagnosed with dementia during his or her last stage of life. It used death certificates and interviews of the individuals’ care givers. It is a study of those living at home and in a nursing home. It also talks about some of the care providers being of age themselves.

Weaknesses

The study was based on women that resided in the UK. It does not equally study men. The culture and ethnic of the group is not disclosed.

Annotation # 5

Goeman, D., Renehan, E., & Koch, S. (2016). What is the effectiveness of the support worker

role for people with dementia and their carers? A systematic review. BMC Health

Services Research, 16 doi:http://dx.doi.org/10.1186/s12913-016-1531-2

Author’s Abstract

“Background: Dementia is progressive in nature and the associated functional decline inevitably leads to increasing dependence on others in areas of daily living. Models of support have been developed and implemented to assist with adjusting to living with memory loss and functional decline; to navigate the health and aged care system; and to access services. We undertook a systematic review of international literature on key worker type support roles to identify essential components and ascertain how the role can be best utilised to assist community-dwelling people with dementia and their carers. This review of support roles is the first to our knowledge to include both quantitative and qualitative studies and all models of support. Method: A systematic review of studies written in English and published between January 2003 and December 2014. Data sources were Medline, PsychInfo and CINAHL, internet, expert consultation and reference lists of included studies. After screening articles to ensure that they reported on a key worker type support role, involved carers and or people with dementia living at home and removing duplicates, eligible papers were appraised and evaluated. Results: Thirty-six studies were eligible for inclusion in the review. Eligible studies were divided into type of support roles and study type. The heterogeneity of included studies and high risk of bias made a meta-analysis inappropriate and it was therefore difficult to draw overall conclusions. However, essential components shared across support worker models that demonstrated a positive impact on carer burden and improved quality of life included: long term intervention, face to face contact, individualised education and support based on needs, multi-disciplinary teams, collaborative input, health/clinical background of support workers, ongoing follow up and inter professional and inter-sectoral collaborations. There was a lack of studies assessing cost-effectiveness. Conclusions: Studies that include a highquality evaluation of holistic, tailored models of support that identify which components of support produce the most valuable outcomes to assist people with dementia and their carers and families to continue to live meaningful lives are needed. There is also a need for a cost effectiveness evaluation of support worker roles.

Reviewer’s Abstract

The progressiveness of dementia enables individuals who suffers from it to carryout daily activities of life. This cause he or she to lose their dependence. The person that most of them depends on are elderly themselves. This study addresses the needs for support for both the patient and the person who cares for he or she at home. This study was conducted using information taken from scholarly databases – papers dated between January 2003 and December 2014, a reference list of included studies, the internet, and expert consultation. Thirty-six studies made the cut. However, a meta-analysis was not possible due to heterogeneity and high bias risk making it difficult to make overall conclusions. Nonetheless, there were some evidence of positive impact on things such as the providers’ burden and life quality improvements in face-to-face contact, support and individualized education on a needed basis, long-term intervention and more. Relevance = 3 Comment by user: What are you referring to? Comment by user: Stay away from jargons and reword Comment by user: was

Strengths Comment by user: see previous notes. The strengths and weaknesses must be indented

It talks about the support the care givers and the patient need to maintain a quality life at home. It uses peer-reviewed studies and interviews with the patient and the caregiver. It shows that with the right support system, the patient and the care provider quality of life enhanced. It also gave suggestion to the next researcher to examine.

Weaknesses

It is inconclusive and at risk for being highly bias.

Annotation # 6

Hansen, A., Hauge, S., & Bergland, Å. (2017). Meeting psychosocial needs for persons with

dementia in home care services – a qualitative study of different perceptions and practices

among health care providers. BMC Geriatrics, 171-10. doi:10.1186/s12877-017-0612-3

Author’s Abstract

“Background: Many persons with dementia are home-dwelling. To enable these persons to stay

in their own homes if possible, a holistic, individual and flexible care is recommended. Despite a

requirement for meeting psychological, social and physical needs, home care services seem to

focus on patients’ physical needs. Accordingly, the aim of this study was to explore how the

psychosocial needs of home-dwelling, older persons with dementia were perceived, emphasized

and met by home care services. Methods: A descriptive, qualitative approach was used. Data

were collected through semi-structured focus group interviews with 24 health care providers in

home care services from four municipalities. Data were analysed using systematic text

condensation. Results: This study showed major differences in how health care providers

perceived the psychosocial needs of older home-dwelling persons with dementia and how they

perceived their responsibilities for meeting those psychosocial needs. The differences in the

health care providers’ perceptions seemed to significantly influence the provided care. Three co-

existing logics of care were identified: the physical need-oriented logic, the renouncement logic

and the integrated logic. Conclusions: The differences in how health care providers perceived the

psychosocial needs of persons with dementia and their responsibilities for meeting those needs,

influenced how the psychosocial needs were met. These differences indicates a need for a

clarification of how psychosocial needs should be conceptualized and who should be responsible

for meeting these needs. Further, increased competence and increased consciousness of

psychosocial needs and how those needs can be met, are essential for delivering high-quality

holistic care that enables persons with dementia to live in their own home for as long as

possible.”

Reviewer’s Abstract

With most of elderly with dementia living at home, it is important for home care health providers

to take into consideration their physical, social, and psychological needs. This is a qualitative

study of how these needs can be met. Data was collected via interviews with home care health

providers of different municipalities and analyzed utilizing a systematic text. The results showed

that there a big difference in how the home care providers seen their patients’ psychological

needs and how they viewed their responsibilities for meeting those needs. This study also

identified some co-existing logics. This study concluded that each home care provider perceived

the needs of their patients different and that increased consciousness and competence of

psychological needs were enhanced. Relevance = 4.5

Strengths Comment by user: see previous notes

This study is very strong pertaining to my topic. It is focused on keeping dementia patients in his

or home and it looks at how to greatly achieve it.

Weaknesses

This study was conducted in the UK. The culture, demographics, and politics are different from

the US.

Annotation # 7

Lislerud Smebye, K., Kirkevold, M., Engedal, K., & Smebye, K. L. (2016). Ethical dilemmas

concerning autonomy when persons with dementia wish to live at home: a qualitative,

hermeneutic study. BMC Health Services Research, 161-12. doi:10.1186/s12913-015-

1217-1

Author’ Abstract

“Background:Caring for people with dementia living in their own homes is a challenging care

issue that raises ethical dilemmas of how to balance autonomy with their safety and well-being.

The theoretical framework for this study consisted of the concepts of autonomy, beneficence,

non-maleficence, paternalism and from the ethics of care. The aim of this study was to explore

ethical dilemmas concerning autonomy that were identified when persons with dementia wished

to live at home. Methods:This Norwegian study had a qualitative, hermeneutic design and was

based on nine cases. Each case consisted of of a triad: the person with dementia, the family carer

and the professional caregiver. Inclusion criteria for the persons with dementia were: (1) 67 years

or older (2) diagnosed with dementia (3) Clinical Dementia Rating score 2 i.e. dementia of

moderate degree (4) able to communicate verbally and (5) expressed a wish to live at home. The

family carers and professional caregivers registered in the patients’ records were included in the

study. An interview guide was used in interviews with family carers and professional caregivers.

Field notes were written after participant observation of interactions between persons with

dementia and professional caregivers during morning care or activities at a day care centre. By

means of deductive analysis, autonomy-related ethical dilemmas were identified. The final

interpretation was based on perspectives from the theoretical framework. Results:The analysis

revealed three main ethical dilemmas: When the autonomy of the person with dementia

conflicted with (1) the family carer’s and professional caregiver’s need to prevent harm (non-

maleficence) (2) the beneficence of family carers and professional caregivers (3) the autonomy

of the family carer. Conclusions:In order to remain living in their own homes, people with

dementia accepted their dependence on others in order to uphold their actual autonomy and live

in accordance with their identified values. Paternalism could be justified in light of beneficence

and non-maleficence and within an ethics of care.”

Reviewer’s Abstract

This is article is about the autonomy of home-dwelling elderly with dementia. It is a qualitative

study conducted via interviews. The elderly with dementia, the professional care provider, and

the family carer were interviewed. The study concluded that the elderly with dementia were ok Comment by user: in your responses, any thoughts on using the word caregiver instead of carer? Comment by user: okay

with the fact that he or she need help in for them to remain at home. Relevance = 4.5

Strengths Comment by user: see previous notes

This article is very strong in dealing with my topic. It talks about maintaining people with

dementia dignity and safety as professional and family care providers. It also concludes that it is

possible for people with dementia to remain in his or her home.

Weaknesses

This study was conducted in the UK. The culture, demographics, and politics are different from

the US.

Annotation # 8

Mansfield, E., Boyes, A. W., Bryant, J., & Sanson-Fisher, R. (2017). Quantifying the unmet

needs of caregivers of people with dementia: A critical review of the quality of measures.

International Journal of Geriatric Psychiatry, 32(3), 274-287.

doi:http://dx.doi.org.proxy.cecybrary.com/10.1002/gps.4642

Author’s Abstract

“Objective The array of demanding tasks carried out by caregivers of people with

dementia have significant negative impacts on their physical, mental and social well‐

being. Needs assessment allows individuals to indicate the extent to which their needs

across different areas have or have not been met, allowing for estimations of the

prevalence of needs and the extent to which help is required. This approach is

extremely valuable in a clinical context, as it enables identification of the areas with

which caregivers report a particular desire for help and allows targeting of support and

resources to those who identify high levels of unmet needs. This systematic review aimed to

critically examine the psychometric properties of measures that assess unmet needs of caregivers

of people with dementia. Methods Medline, Embase, PsycINFO and Cochrane electronic

databases were searched between January 1990 and August 2015 for English‐language

publications describing the development or validation of measures assessing the unmet needs of

adult caregivers of people with dementia. The psychometric properties of included measures

were assessed against standard criteria for psychometric quality. Results Four measures met the

inclusion criteria. Only half of the indices of psychometric quality were tested across measures.

Three measures had adequate internal consistency reliability, of which one also showed adequate

test–retest reliability. Two measures reported adequate construct validity, while criterion validity

was not assessed for any measure. Conclusions There is a clear need to develop a

psychometrically rigorous instrument to identify the unmet needs of caregivers of people with

dementia.”

Reviewer’s Abstract Comment by user: see previous notes

This article is about the unmet needs of those who live with and provide care for people with

dementia. It talks about providing support and resources for these individuals. Relevance = 4.5

Strengths

This is a strong article dealing with my topic. It gives a take on the home care providers. Comment by user: what does this mean?

It talks about providing support and resources for them. It includes them in my study.

Weaknesses

It does not state rather or not the home care providers are elderly themselves.

Annotation # 9

Miranda-Castillo, C., Woods, B., & Orrell, M. (2013). The needs of people with dementia living

at home from user, caregiver and professional perspectives: A cross-sectional survey.

BMC Health Services Research, 13, 43.

doi:http://dx.doi.org.proxy.cecybrary.com/10.1186/1472-6963-13-43

Author’s Abstract

“Background: Few reports have been published about differences in perspectives on

perceived needs among community-residing people with dementia, their family

caregivers, and professionals. The aim of this study was to compare these

perspectives. Method: During 2006 and 2007, one-hundred and fifty two interviews of

people with dementia and their caregivers about the needs of the person with dementia

were performed by four professionals using The Camberwell Assessment of Need for

the Elderly (CANE). Professionals’ views on met and unmet needs of people with

dementia were obtained for the total sample, family caregivers’ perspectives were

gained for 125 people with dementia, and people with dementia’s views on their own

needs were obtained for 125 persons with dementia. Results: People with dementia

reported fewer needs compared with the reports of their caregivers and the

professionals. The most frequent unmet needs reported by people with dementia,

caregivers and professionals were in the areas of daytime activities, company, and

psychological distress; however, people with dementia rated psychological distress as

the commonest unmet need. Conclusions: Since the priorities of people with dementia

can be different from those of caregivers and professionals, it is important to consider all

perspectives when making care plans. Thus, compliance with treatment of people with

dementia and also their quality of life could be potentially improved by a more

collaborative partnership with them.”

Reviewer’s Abstract Comment by user: you gave the same response as above, which is unacceptable

This is an article about the needs, unmet needs, and support for people with dementia, their family care provider, and his or her professional health care provider. Relevance = 4.5

Strengths

It discusses the needs, unmet needs, and support for those who live at home with dementia, his or her family care giver, and their professional health care provider.

Weaknesses

It does not state rather or not the home care providers are elderly themselves.

Annotation # 10

Nadine, J. P., Scherer, M., & Eisele, M. (2017). (In-)formal caregivers and general practitioners

views on hospitalizations of people with dementia – an exploratory qualitative interview

study. BMC Health Services Research, 17

doi:http://dx.doi.org.proxy.cecybrary.com/10.1186/s12913-017-2484-9

Author’s Abstract

“Dementia is an irreversible chronic disease with wide-ranging effects on patients’, caregivers’

and families’ lives. Hospitalizations are significant events for people with dementia. They tend to

have poorer outcomes compared to those without dementia. Most of the previous studies focused

on diagnoses leading to hospitalizations using claims data. Further factors (e.g. context factors)

for hospitalizations are not reproduced in this data. Therefore, we investigated the factors leading

to hospitalization with an explorative, qualitative study design. Methods We interviewed

informal caregivers (N = 12), general practitioners (GPs, N = 12) and formal caregivers (N = 5)

of 12 persons with dementia using a semi-structured interview guideline. The persons with

dementia were sampled using criteria regarding their living situation (home care vs. nursing

home care) and gender. The transcripts were analyzed using the method of structuring content

analysis. Results Almost none of the hospitalizations, discussed with the (in-)formal caregivers

and GPs, seemed to have been preventable or seemed unjustifiable from the interviewees’ points

of view. We identified several dementia-specific factors promoting hospitalizations (e.g. the

neglect of constricted mobility, the declining ability to communicate about symptoms/accidents

and the shift of responsibility from person with dementia to informal or formal caregivers) and

context-specific factors promoting hospitalizations (e.g. qualification of nursing home personal,

the non-availability of the GP and hospitalizations for examinations/treatments also available in

ambulatory settings). Hospitalizations were always the result of the interrelation of two factors:

illnesses/accidents and context factors. The impact of both seems to be stronger in presence of

dementia. Conclusions Points for action in terms of reducing hospitalization rates were: better

qualified nurses, a 24-h-GP-emergency service and better compensation for ambulatory

monitoring/treatments and house calls. Many hospitalizations of people with dementia cannot be

prevented. Therefore, hospital staffs need to be better prepared to handle patients with dementia

in order to reduce the negative effects of hospitalizations.”

Reviewer’s Abstract Comment by user: see previous notes

This article is about the hospitalization of people with dementia and the effect it has on them. It

talks about reasons why people with dementia are hospitalized. Relevance = 5

Strengths

This article is strong for my research. It gives a review of why people with dementia are

hospitalized and it discusses the effect that it has on them.

Conclusion

Dementia is an irreversible condition that many elders suffer from. Majority of them expresses desires to want to maintain in his or her home. Many of their family carers are of age themselves. I want to look at ways to keep them in their homes and provide support for his or her caregiver. Thus far, research has shown that the not only does the person with dementia needs support, so does his or her home care and professional health care providers need support. Comment by user: Need to indent Comment by user: not sure what this statement means Comment by user: it sounds as if you are trying to solve something. Solving a matter is not a part of your dissertation.

Running head: ANNOTATED BIBLIOGRAPHY

1

Annotated Bibliography

Kimberly Phillips

Colorado Technical University

Running head: ANNOTATED BIBLIOGRAPHY 1

Annotated Bibliography

Kimberly Phillips

Colorado Technical University

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"