Using RE-AIM to Evaluate Implementation of an Evidence-Based Program: A Case Example From Minnesota

The RE-AIM framework was used to evaluate the implementation experience of 14 organizations in Minnesota over 4 years as they adopted an evidence-based intervention for spousal caregivers. Purpose: To examine the implementation experience and describe sustainability issues. Methods: Mixed-methods using data from qualitative interviews, cost data, and caregiver experience data. Findings: Although the intervention was valued, most organizations were not able to continue providing the program. Conclusion: The results indicate a need for further translation or technical support to identify readiness and prepare the interventionist to offer the program, more robust recruitment methods, and additional funding strategies.     

Danger and Dementia: Caregiver Experiences and Shifting Social Roles During a Highly Active Hurricane Season

This study examined disaster preparedness and decision-making by caregivers of community-dwelling persons diagnosed with Alzheimer’s or a related dementia (ADRD). Interviews were conducted with 20 caregivers in South Florida. Twelve of these interviews include caregiving experiences during the highly active 2004–2005 hurricane seasons. Results indicate that persons in earlier stages of ADRD can, and often do, remain engaged in the disaster preparation and planning process. However, during the early stages, persons may also resist evacuation, even if the caregiver felt it was necessary. During later stages of the disease, caregivers reported less resistance to disaster-related decisions, however, with the tradeoff of less ability to assist with preparation.     

The circumstances surrounding the death of 105 elders as a result of resident-to-resident incidents in dementia in long-term care homes

Resident-to-resident incidents in dementia in long-term care homes resulting in deaths represent a growing concern among residents, family members, care providers, care advocacy organizations, and policy makers. Despite these concerns and experts’ predictions by which injurious and fatal incidents will increase in the coming years due to the projected growth in the number of people with dementia, no studies have been conducted in North America on these fatal incidents. This exploratory pilot study makes first steps towards bridging this major gap in research and practice. Using publicly available information (primarily newspaper articles and death review reports), practically useful patterns were identified pertaining to the circumstances surrounding the death of 105 elders as a result of these incidents. The findings could inform various efforts to prevent future deaths in similar circumstances, keep vulnerable and frail residents safe, and encourage researchers to examine risk and protective factors for these incidents.     

An evaluation study of a dementia screening program in taiwan: an application of the theory of planned behaviors

A challenge facing dementia service providers is how to detect dementia early to facilitate timely intervention. This article reports findings of an evaluation study of a dementia-screening program in Taiwan utilizing the Theory of Planned Behaviors. We present the Short Portable Mental Status Questionnaire (SPMSQ) program rationale and examine the effects of this important health and social service intervention. Follow-up telephone interviews were completed by 108 respondents. Findings indicate that the SPMSQ program was successful in identifying suspected dementia. Results also show that the dementia-screening program contributed to an increase in medical service utilization and in unpaid informal care.     

Aging and Elder Care in Japan: A Call for Empowerment-Oriented Community Development

This article provides a brief overview of the situation of the elderly and their caregivers in Japan, including demographic changes in Japan, development and changes in long-term care policy that have targeted the poorly integrated community care system, and other challenges that the elderly and family caregivers face. Policy direction designed to address these issues is increasingly targeting care by the community versus support care by society (which was initially the main strategy). The potential of empowerment-oriented community development intervention strategies to decrease the gap between available institutional and formal community-based services and the needs of the elderly and their families in their efforts to meet late life challenges is described. The need for an increased role of social workers in community development interventions is explored and strategies are suggested.     

Use of Space and Human Rights: Planning Dementia Friendly Settings

Environmental psychology has been a topic of great interest for many researchers in the field of aging and dementia. Thus, several orientations can be identified in the contemporary scientific literature concerning environmental design for people with dementia. In this article, we discuss recent research on environmental design models for people with dementia and propose an approach referring to the concept of use of space and human rights.We use a methodology based on observation of special care units to determine an environmental design framework that should be taken into account when designing residential facilities for people with dementia. Content analysis identified 6 primary dimensions and 13 secondary dimensions relevant to the rights of people with dementia. We then discuss the results according to the related literature in environmental psychology and gerontology in terms of well-being and quality of life.     

Statewide Implementation of “Reducing Disability in Alzheimer’s Disease”: Impact on Family Caregiver Outcomes

There have been few replications of efficacious evidence-based programs for dementia caregivers offered in community settings. This study highlights the replication of the evidence-based Reducing Disability in Alzheimer’s Disease program and explores the changes in outcomes for participating caregivers and whether those changes are related to level of program utilization. With data from 219 caregivers, regression results indicate that more exercise sessions are associated with a decrease in caregiver strain and more behavior management sessions are associated with a decrease in unmet needs after 3 months. Findings demonstrate how a multicomponent program can have positive benefits for family caregivers.     

Asian Pacific Islander Dementia Care Network: A Model of Care for Underserved Communities

This study presents the results of the work of the Asian Pacific Islander Dementia Care Network (APIDCN)—a collaborative model of care created to develop community capacity to deliver dementia capable services, build community awareness about Alzheimer’s disease and other dementias, and offer direct services to caregivers in the API community in Los Angeles. Through trainings, mentoring, and outreach campaigns, the APIDCN expanded the availability of culturally competent services in the API community. The knowledge that was embedded within partner organizations and in the community at large assures sustainability of the services after the project ended.     

Broadening the scope of ageing femininities on TV: the evolution of the older woman in two contemporary Catalan soap operas

The older woman has been an unacknowledged character in fiction up until recently, when it has become the focus of some studies in the interconnected fields of literary and cultural gerontology. Given their popularity, TV shows are especially powerful in the propagation of images of any form of identity; accordingly, they can be regarded as an interesting and highly effective artistic and socio cultural vehicle through which representations of old people and of old women in particular can be analysed and discussed. Despite the success of The Golden Girls in the 80s and the exponential ageing of the baby-boom generation, TV series have also continued to depict older female characters as either motherly figures, always looking after their families at any cost, or as devilish older women characterised by inappropriate sexualised appearance and sexual behaviour. In contrast to this predominant tendency, Six Feet Under (2001–2005) stands out as a significant exception. In this article, we argue that Six Feet Under is innovative in presenting the older woman through the central character of Ruth Fisher (Francis Connor) and through the interaction of Ruth Fisher with other women within her same generation which face ageing from different perspectives.     

Determinants of the Rigor of State Protection Policies for Persons With Dementia in Assisted Living

Continued growth in the number of individuals with dementia residing in assisted living (AL) facilities raises concerns about their safety and protection. However, unlike federally regulated nursing facilities, AL facilities are state-regulated and there is a high degree of variation among policies designed to protect persons with dementia. Despite the important role these protection policies have in shaping the quality of life of persons with dementia residing in AL facilities, little is known about their formation. In this research, we examined the adoption of AL protection policies pertaining to staffing, the physical environment, and the use of chemical restraints. For each protection policy type, we modeled policy rigor using an innovative point-in-time approach, incorporating variables associated with state contextual, institutional, political, and external factors. We found that the rate of state AL protection policy adoptions remained steady over the study period, with staffing policies becoming less rigorous over time. Variables reflecting institutional policy making, including legislative professionalism and bureaucratic oversight, were associated with the rigor of state AL dementia protection policies. As we continue to evaluate the mechanisms contributing to the rigor of AL protection policies, it seems that organized advocacy efforts might expand their role in educating state policy makers about the importance of protecting persons with dementia residing in AL facilities and moving to advance appropriate policies.