The Perspective of Younger People with Dementia

Abstract

This paper describes a longitudinally based discharge planning and treatment model. The model proposes to develop linkages between inpatient and community mental health providers during the early stages of hospitalization. The goal is to put the client's need first to ensure a smooth transition from the structure of the inpatient ward to the community, while maintaining continuity of care and reducing potential re-admissions to the hospital. The barriers that prevent such an adoption and implementation of such a system are discussed. Both clinical and policy issues are examined. Part 1 focuses on the background of case management and discharge planning and provides a critique of case management models (Belcher &; DeForge, 2005). Part 2 presents and describes the components of the longitudinally based discharge planning and treatment model (LDPTM) (DeForge &; Belcher, 2005).     

Disabling Spaces and Spatial Strategies: Feminist Approaches to the Home Environment of Family Caregivers of People with Dementia

ABSTRACT

The home environment becomes very important for family caregivers of people with dementia as a place of safety, retreat and care provision. Using a gender-based perspective, the authors analyzed thirteen interviews with family caregivers to understand how they perceived their home space. The data was analyzed thematically with the help of adjacency diagrams. Our analysis identified three main themes: compact layout, spatial flexibility, and the wider neighborhood. Given the gendered nature of caring, the findings are discussed drawing on the work of feminist architects regarding the home environment. The authors argue that feminist architectural approaches can usefully inform spatial strategies regarding dementia, ageing friendly housing, accessible living and the wellbeing of the caregiver. Different bodies and users’ needs should be at the epicenter of design, as opposed to conventional design and the current practices by developers, which may create a series of disabling spaces.     

The Impact of the Physical Home Environment for Family Carers of People with Dementia: A Qualitative Study

Background: The majority of people with dementia are cared for by their families at home. This study aimed to elicit family carers' perceptions on home environmental aspects and strategies with the view to identify barriers and facilitators when caring for a person with dementia at home.

Design and methods: Thirteen co-resident family carers were engaged in semi-structured in-depth walking interviews. Interviews were recorded, transcribed and analysed using thematic analysis.

Results: Home environments can pose a number of challenges and opportunities. Aspects of the architectural and interior environment (e.g. size, condition, layout and accessibility, familiarity) are perceived as important (Theme 1) as well as a plethora of environmental strategies that encourage independence and comfort at home (Theme 2). Carers' scepticism, timing, costs, property characteristics and mistrust to services are some barriers to implementing environmental strategies (Theme 3).

Conclusions: Carers improvised solutions via trial and error and need further education on strategies to create an enabling and comfortable home environment.     

A Qualitative Study on Home Modification of Rural Caregivers for People with Dementia

Opinions about the responsibility for procuring sheltered housing in Norway have been studied among people 50 and older. Until recently, Norway offered standard public provision, where the state has been the central provider and organizer of care for the elderly. The results indicate great support for public responsibility for providing sheltered housing for the frail elderly, which is only marginally affected by background characteristics. However, older people's attitudes as to whether they would choose private housing provision are affected by income, age, and knowledge of the market, and many are uncertain. Women and low-income groups are overrepresented among those who are uncertain.     

Language Reversion among People with Dementia from Culturally and Linguistically Diverse Backgrounds: The Family Experience

Abstract

Culturally and linguistically diverse (CALD) older people with dementia, along with their families, face many unique challenges and have unique needs. One such challenge is language reversion, an issue that has received little research attention. This paper presents the findings of an exploratory study of the experiences of family members of people with language reversion emanating from dementia. Using a qualitative, phenomenological approach, in-depth interviews were conducted with seven participants. The study found that the presence of language reversion created additional challenges for family members of someone with dementia, particularly if the family member did not share the person's first language. Community-based aged care services have the potential to offer valuable support, but barriers of negative past experiences, lack of communication, stigma, cultural understanding, and locality need to be overcome. While further research is recommended, these findings have implications for both policy and social work practice in community-based aged care with CALD populations.     

Let People Be People: Everyday Substance Use in a Public Work Site

This article complicates the prevailing portrait of substance use as being incompatible with work. Drawing on in-depth ethnographic data of one informal economic zone collected over a four-year period between January 2010 and January 2014, I expose the daily interactions through which substance use becomes compatible with work and the mechanisms by which drug and alcohol use become embedded in the local ecology of a public work site. To capture the ways in which people link their substance use to their experience of work, I utilize three concepts—taking a break, maintaining a cycle, and tipping the balance—each of which is suggestive of different patterned relationships between substance use and work in public. Data indicate that people link their substance use to their work in different ways and with different consequences and that each of these patterned relationships becomes an interrelated part of a single social system. These findings add necessary nuance and complexity to substance use literature, which is more frequently focused on abject abuse and disorder, and provide a more complete understanding of the ways in which substance use practices become linked to urban economies. Furthermore, they illuminate how participation in informal economic activity can play a variety of roles in the lives of people engaged in substance use practices.     

Dementia and Dementia Care: The Contributions of a Psychosocial Perspective

The social sciences have and continue to play a unique role in the study of dementia and dementia care. For central to the social sciences, particularly the discipline of sociology is a history of critical inquiry that challenges long held societal assumptions, a concern for issues of social justice, social exclusion and the treatment of marginalized populations. All significant areas to consider when caring for a person with dementia. This chapter will trace the development of the study of dementia and dementia care starting with its biomedical roots, examine the contributions of the social sciences in furthering the conceptual development of the field, and suggest future areas where sociologists can play a critical role in the provision of quality dementia care.     

A Descriptive Study of Home Modifications for People with Dementia and Barriers to Implementation

This study describes home environmental features, safety issues, and health-related modifications in a community dwelling sample of 82 elderly people with dementia. Main barriers to the accessibility of the homes were steps, both inside and outside the house. The majority of the caregivers had made home modifications, which pertained mainly to physical limitations. Home modifications to support cognitive deficits were made to a lesser extent. The main barrier to the implementation of home modifications to accommodate the care recipient's memory loss was skepticism about their usefulness. Regarding the removal of physical barriers, financial constraints were most frequently mentioned.     

A Descriptive Study of Home Modifications for People with Dementia and Barriers to Implementation

This study describes home environmental features, safety issues, and health-related modifications in a community dwelling sample of 82 elderly people with dementia. Main barriers to the accessibility of the homes were steps both inside and outside the home. The majority of the caregivers had made home modifications that pertained mainly to physical limitations. Home modifications to support cognitive deficits were made to a lesser extent. The main barrier to the implementation of home modifications to accommodate the care recipient's memory loss was skepticism about their usefulness. Regarding the removal of physical barriers, financial constraints were most frequently mentioned.     

农村地区彝族青年婚姻困境破解的公共政策支持

当前,农村地区彝族青年的婚姻困境问题明显,形式变异的买卖婚在强大的社会心理支撑下普遍存在,婚姻困境中的性别差异明显,青年男女的婚姻自由受到限制,固守传统婚姻形式造成多种社会问题。破解农村地区彝族青年婚姻困境,需要给予公共政策支持的外力推动,形成解决这一问题的内生动力,并最终帮助彝族青年男女突破婚恋的物质和精神束缚,促进农村地区婚姻进步和经济社会发展。     

Peach Trees Grow in the Spaces Between People: Counselling Practices in the Territory of Violence

In this paper the authors reflect on how therapeutic practices wove a community of care and concern with a young man in South Africa who was at risk of anger ruling his life. A counselor and outsider witnesses participated in responding to the problems the young man and his family faced. The authors discuss the steps they took in the therapeutic journey and describe how their personal and professional lives were shaped by this collaboration. This work inspires and sustains their enthusiasm in seeking to understand how to best respond when positioned to counsel.     

The Transition from Public Residential Schools for Retarded People to Custodial Facilities: An Economic Explanation

Conventional histories of residential services for mentally retarded persons in the United States explain the development of custodial care as the result of the failure of early residential schools to achieve their educational goals. Review of the historical evidence indicates that the conventional explanation is inadequate. An alternative explanation is suggested based on an economic model of the structure of the residential services industry. The economic model explains the decline of education and transition to low-quality custodial care in terms of economic incentives. Particularly important is the role of the mental retardation profession as monopolists of expertise regarding mentally retarded people and in rationing residential services to parents of retarded people. It is argued that the profession used its expertise monopoly to generate demand for residential services by portraying retarded persons first as in need of protection and later as a 'menace' to society.     

The Development of a Multi-dimensional Gambling Accessibility Scale

The aim of the current study was to develop a scale of gambling accessibility that would have theoretical significance to exposure theory and also serve to highlight the accessibility risk factors for problem gambling. Scale items were generated from the Productivity Commission’s (Australia’s Gambling Industries: Report No. 10. AusInfo, Canberra, 1999) recommendations and tested on a group with high exposure to the gambling environment. In total, 533 gaming venue employees (aged 18–70 years; 67% women) completed a questionnaire that included six 13-item scales measuring accessibility across a range of gambling forms (gaming machines, keno, casino table games, lotteries, horse and dog racing, sports betting). Also included in the questionnaire was the Problem Gambling Severity Index (PGSI) along with measures of gambling frequency and expenditure. Principal components analysis indicated that a common three factor structure existed across all forms of gambling and these were labelled social accessibility, physical accessibility and cognitive accessibility. However, convergent validity was not demonstrated with inconsistent correlations between each subscale and measures of gambling behaviour. These results are discussed in light of exposure theory and the further development of a multi-dimensional measure of gambling accessibility.     

Personal Trouble or Public Issue? Towards a Model of Policy for People with Physical and Mental Disabilities

For many years, community solutions have been the favoured response to physical and mental disability, but theoretical frameworks to guide these policies have not developed alongside the rhetoric. This paper attempts to fill the gap with one possible sociological model. We begin by distinguishing the dominant individualistic or 'personal trouble' perspective from the more controversial social or 'public issue' approach which, whether it takes an interpretative or a structural form, acknowledges the role of society in causing disabilities and shaping economic and social strategies. A model of policy is then drawn up for each viewpoint, bearing in mind the implications for public expenditure, state intervention, family and community support, and service organisation. Finally, it is argued that since help in the individualistic mould cannot cope with disability, an alternative response is required, which tackles economic, social and political institutions or structures while at the same time recognising the resistance to change in an industrial society.     

The Government Communication Decision Wheel: Toward a Public Relations Model for the Public Sector

We argue that the existing public relations and communication models do not adequately account for the unique environmental characteristics of the public sector. By reviewing the public sector environment literature, we identify 8 attributes that affect government public relations: politics, focus on serving the public, legal constraints, extreme media and public scrutiny, lack of managerial support for public relations practitioners, poor public perception of government communication, lagging professional development, and federalism. We then review 5 existing public relations models, arguing that none of these models fully incorporates the unique environmental characteristics of the public sector. We conclude by proposing a new model: the government communication decision wheel.     

Organising Services for People with Mental Handicap: The Californian Experience

The organisation of services for California's mentally handicapped population is outlined and critically examined. Its distinctive features are noted: a concern for rights, rather than needs; an underlying free market philosophy; an explicit attempt to combine public and private enterprise; and an elaborate system of checks and balances designed to restrain the welfare bureaucracies and ensure that they remain responsive to the changing nature of individual need. It is argued that, despite certain limitations, the Californian system does seriously address three problems that bedevil all attempts to develop a satisfactory system of care for people with mental handicaps: the inherent powerlessness of the client group; the diversity and fragmentation of services; and bureaucratic inertia.     

People with disability and new disaster communications: access and the social media mash-up

This article explores how a lack of access to increasingly complex and overlapping digital communications platforms in times of disaster for people with disabilities has the potential to make already life-threatening situations considerably more dangerous. As we are increasingly coming to rely on a social media mash-up of digital platforms to assist in communications during disaster situations, the issue of accessibility for people with disabilities is as dire as if it was high ground during a tsunami or transport during a typhoon. The contemporary social media environment is characterised by a complex and overlapping network of complementary platforms, populated by user-generated content, where people communicate and exchange ideas. In this environment, YouTube videos are posted to Facebook and embedded in blogs, and Twitter is used to link to these other sites and is itself embedded in other platforms. These networks are increasingly supplementing and supplanting more traditional communication platforms, such as the television and radio, particularly in times of disaster. The concern of this paper is that the elements from which this mash-up of communications channels is made are not always accessible to people with disabilities. This evolving network of social media-based communication exposes the limits of existing Internet-based universal design.     

我国无障碍立法与构想

无障碍已成为国际公认的一项重要权利,而且与其他基本权利的实现密切相关.本文在厘清无障碍概念及发展的基础上,阐述我国无障碍立法的必要性和可行性,从依法治国的基本方略角度探讨无障碍立法在完善法治体系中的重要意义.无障碍立法对于引领全体社会成员正确理解和维护无障碍环境,对于我国残疾人事业和人权事业的发展都具有重要的推动作用.在无障碍立法中,应当参考域外无障碍法例,比较不同的立法模式,建立以权利为本位,以物质无障碍、信息无障碍、社区服务无障碍为主干,强化无障碍环境的监督和管理,完善法律责任,加大违法成本,从而建立和完善具有中国社会主义特色的无障碍法律制度.