Occupational therapists' experiences of working with people with dementia: a qualitative study.

BACKGROUND: Dementia is an age-related disease associated with complex health and care needs. Due to demographical shifts, the number of older people with dementia is forecasted to increase. Occupational therapists encounter people with dementia in their daily work, yet little is known about their experience of working with people with dementia. AIM/OBJECTIVES: To explore occupational therapist's experiences of working with people with dementia. MATERIAL AND METHODS: Ten occupational therapists were interviewed using semi-structured interviews. Data were analysed using reflexive thematic analysis. RESULTS: The results are presented in five different themes: Working with persons who do not recognise decline in their abilities; Saving-face of the person in assessment situations; Facilitating continued engagement in everyday activities; Utilising information provided by care staff; Balancing different preferences on how to proceed. CONCLUSION: Occupational therapists perceive a need in their work to employ various face-saving strategies and facilitate engagement in everyday activities. The results are exploratory and additionally research is needed to understand the therapists' experiences of working with persons with dementia. SIGNIFICANCE: Everyday activities should be tailored to the person's abilities, with an emphasis on facilitating the person in carrying them out rather than the social environment taking them over.

A dyadic exploration of support in everyday life of persons with RA and their significant others.

BACKGROUND: Support from significant others is important for participation in everyday life for persons with rheumatoid arthritis (RA). Meanwhile, significant others also experience limitations. AIMS: To explore how support is expressed by persons with RA and significant others, and how support relates to participation in everyday life of persons with RA. MATERIAL AND METHODS: Sixteen persons with RA and their significant others participated in individual semi-structured interviews. The material was analyzed using dyadic analysis. RESULTS: Persons with RA and significant others reported that RA and support had become natural parts of everyday life, especially emotional support. The reciprocal dynamics of support were also expressed as imperative. Also, support from people outside of the dyads and well-functioning communication facilitated everyday life. CONCLUSIONS: Significant others and the support they give are prominent factors and facilitators in everyday life of persons with RA. Concurrently, the support persons with RA provide is important, along with support from outside of the dyads. SIGNIFICANCE: The results indicate that the interaction between persons with RA and the social environment is central to gain insight into how support should be provided for optimal participation in everyday life. Significant others can preferably be more involved in the rehabilitation process.

Older people's experiences of visiting social day centres: The importance of doing and being for health and well-being.

BACKGROUND: Social day centres can support active and healthy ageing amongst older people. However, little is known regarding the importance of social day centres. AIMS/OBJECTIVES: The aim of this study was to explore how older people visiting social day centres perceive the day centres' social influence on their health and well-being. MATERIAL AND METHODS: Twenty older persons attending social day centres on a regular basis were interviewed regarding activities at the day centre and their importance for active and healthy ageing. The data were analysed using qualitative content analysis. RESULTS: The social day centres were described as arenas to provide a structure (and something to do) in the visitor's everyday life. By attending a day centre, the participants created a social context with other visitors. Staff acted as facilitators for visitors, helping them to interact with other visitors and to experience the feeling of being needed by others. CONCLUSIONS: The findings suggest that social day centres are important arenas for creating a sense of context and belongingness amongst older people. SIGNIFICANCE: This study provides knowledge on how doing and being contribute to healthy and active ageing.

Collaboration and coordination of health and care services for older people with dementia by multidisciplinary health and care providers: a scoping review protocol.

INTRODUCTION: Collaboration and coordination of health and care services are key to catering for the diverse needs of a growing population of older people with dementia. When multidisciplinary health and care providers work together, they have the possibility to use resources in a fair, accurate and effective way and thereby do the right thing, at the right time, for the right individual. The aim of this scoping review is to map how different care-providing agencies collaborate and coordinate health and care services for older people with dementia. METHODS AND ANALYSIS: A scoping review will be carried out following the proposed methodology by Joanna Briggs Institute and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review Extension guidelines. Systematic searches will be carried out in scientific databases. Studies published within the last 10 years will be included based on certain eligibility criteria. All included studies will be critically appraised using the Research Pyramid. Data from included studies will be charted and subjected to content analysis. ETHICS AND DISSEMINATION: Ethics approval is not required for scoping reviews. The dissemination of findings will be conducted through conference presentations and publication in international scientific journals.

Characteristics of research with older people (over 65 years) in occupational therapy journals, 2013-2017.

Background: A growing population of older people will require different types of occupational therapy services in the future. For occupational therapists to provide effective services and to optimize care, their practice must rely on high-quality evidence. Research is one important pillar of evidence-based practice. Therefore, it is important to examine the research published in occupational therapy journals, which guides practitioners in their work with clients.Aim: The overall aim of this study was to review research characteristics in articles with older persons as participants, aged over 65 years, with or without illness, diseases or disabilities, reported in occupational therapy journals during the period 2013-2017.Materials and methods: Data was collected from peer-reviewed occupational therapy journals and categorized in relation to research characteristics using descriptive statistics.Results: The findings show that most articles presented basic research, using quantitative design where the sources of data were instruments.Conclusion: The findings suggest that both qualitative and quantitative articles use appropriate sample sizes. However, descriptions of the studied populations are frequently unclear, which may affect the transferability and generalization of the results.Significance: In order to support practice, efforts are needed to develop research aims and questions that develop knowledge to embrace more than just basic research.

Significant others' influence on participation in everyday life - the perspectives of persons with early diagnosed rheumatoid arthritis.

Purpose: To describe the meaning of significant others in relation to participation in everyday life of persons with early diagnosed rheumatoid arthritis (RA).Materials and methods: Fifty-nine persons participated in this interview study. Inclusion criteria were three years' experience of diagnosis and being of working age. Semi-structured interviews were conducted using critical incident technique (CIT), and the material was analysed using content analysis.Results: Four categories were revealed: (1) My early RA causes activity adaptations for us all, referring to the person and significant others modifying activities. (2) Making the significant others balance between shortfalls and participation, where the participants distinguished between needing help and feeling involved in activities. (3) Physical interactions with significant others, referring to both the problematic and manageable impact RA could have on body contact. (4) Emotions in relation to activities with others, where participants described feelings of failing others, and anxiety about future activities.Conclusions: For persons with early diagnosed RA, significant others can be both hindering and facilitating for participation in everyday life. As a clinical implication, it is valuable to identify how significant others can be involved in the rehabilitation process, to enhance participation in everyday life early in the disease process.Implications for rehabilitationSignificant others of persons with rheumatoid arthritis can facilitate as well as hinder participation in everyday life, even early in the disease process.It is important to include the significant others in the rehabilitation process of persons with early diagnosed rheumatoid arthritis.It is of great importance to identify when and how significant others can be facilitators of participation in everyday life for persons with early rheumatoid arthritis.To make it easier for significant others to facilitate participation, there is a need for the healthcare system to explore ways to support significant others with easily accessible information about early rheumatoid arthritis.

Satisfaction with assistive technology device in relation to the service delivery process-A systematic review.

The service delivery process (SDP) of assistive technology devices (ATDs) is attracting interest, as the provision of ATDs is critical for the independence and participation in society of individuals with disabilities. The purpose of the current study was to investigate what impact the SDP has on satisfaction with ATDs in individuals with disabilities in relation to everyday activities. A systematic literature review was conducted, which resulted in 53 articles included. The results showed that there are factors in almost all the different steps of the SDP that affect the satisfaction with of the devices, which can lead to underutilization and abandonment of ATDs. Only a few studies have been conducted with a design robust enough to generalize the results; therefore, more research is needed. Therefore, the conclusion is the SDP as a whole contributes to the satisfaction with and usability of ATDs in individuals with disability in relation to achieving the desired goals of participation in everyday activities, for the articles included must be deemed as moderate. A client-centred approach in the process is advocated, and was found to be an important factor for an effective SDP and satisfied users.

Assessing occupational performance in special housing in Sweden.

BACKGROUND: Assessing occupational performance is commonly done by occupational therapists [OTs] working in special housing in municipal elder care. Assessments should be relevant and evidence-based. Even so, we know little about how assessment of occupational performance is conducted in special housing. AIM: The aim of this study was to identify OTs' use and perceptions of different methods to assess occupational performance for elderly clients living in special housing. METHOD: An email questionnaire was sent to OTs working in special housing in Sweden. Data was analyzed using descriptive and parametric statistics. RESULTS: The findings, based on data from 660 respondents, showed that OTs regularly assessed occupational performance but did not use standardized assessment instruments or structured methods to any great extent. In general, OTs reported that they were not pleased with their ability to assess their clients; however, OTs with higher education and with responsibility for fewer clients were more pleased with their assessments and stated that they had more knowledge about assessment methods. CONCLUSIONS: To support OTs in using structured assessments of occupational performance in everyday practice, organization as well as structures in the work environment and educational development need to be taken into consideration.

Elderly people's perceptions of using Wii sports bowling - A qualitative study.

The Nintendo Wii is a gaming console with motion-sensitive controls that is making inroads into health care and rehabilitation. However, there is still limited knowledge on how elderly people perceive the use of such a product. The aim of this study was to examine how the use of the Wii Sports Bowling in an activity group was perceived by elderly people. The data consisted of observations and interviews with participants who used Wii Sports Bowling and was analysed with content analysis. The findings are described in three themes; 'The use of the Wii Sports game', 'Engagement in the game' and 'Social interaction around the activity'. Wii Sports Bowling was described as easier to play compared to real-life bowling and was enjoyable and a social activity. The opportunity to meet the group each week was important for the participants. Playing the game resulted in signs of immersion and a flow-like state. The Wii was perceived to be easy to use, to provide a way to socialize with peers and to give opportunities to participate in activities in a new way. More studies regarding elderly people's experiences and apprehensions regarding new technology such as gaming consoles and virtual reality are needed.

Everyday doings in a nursing home - described by residents and staff.

OBJECTIVE: For many groups of elderly people it is important to be active, which can be hindered by disabilities that come with age. Research has progressed in this area but mostly concerns the elderly living at home. The aim of this study was to examine how residents and staff at a nursing home described the residents' everyday doings. METHODS: A nursing home was selected in which 15 of the residents and six of the staff were interviewed about the residents' activities during an ordinary day and week. RESULTS: The material was analysed using qualitative content analysis in which two categories emerged: shared doings and individual doings. The shared doings were important for supporting the residents in their social and physical activities, but participation in these was often hampered by reduced functions. The individual doings, where the residents' own interests can be promoted, were also hampered by their disabilities. Being able to be active and having something to do were emphasized, either continuing with previous activities or participating in shared activities at the nursing home. CONCLUSIONS: Receiving care and being forced to adjust to the context at the nursing home had a significant impact on the residents' daily doings. Most of the residents needed help to be able to continue performing their activities or to find new ones. The social environment consisting of other residents and staff also influenced the residents' activities.

All the things I have - handling one's material room in old age.

The article explores how old people who live in their ordinary home, reason and act regarding their 'material room' (technical objects, such as household appliances, communication tools and things, such as furniture, personal belongings, gadgets, books, paintings, and memorabilia). The interest is in how they, as a consequence of their aging, look at acquiring new objects and phasing out older objects from the home. This is a broader approach than in most other studies of how old people relate to materiality in which attention is mostly paid either to adjustments to the physical environment or to the importance of personal possessions. In the latter cases, the focus is on downsizing processes (e.g. household disbandment or casser maison) in connection with a move to smaller accommodation or to a nursing home. The article is based on a study in which thirteen older people (median age 87), living in a Swedish town of medium size were interviewed (2012) for a third time. The questions concerned the need and desire for new objects, replacement of broken objects, sorting out the home or elsewhere, most cherished possessions, and the role of family members such as children and grandchildren. The results reveal the complexity of how one handles the material room. Most evident is the participants' reluctance to acquire new objects or even to replace broken things. Nearly all of them had considered, but few had started, a process of sorting out objects. These standpoints in combination resulted in a relatively intact material room, which was motivated by an ambition to simplify daily life or to facilitate the approaching dissolution of the home. Some objects of special value and other cherished objects materialized the connections between generations within a family. Some participants wanted to spare their children the burden of having to decide on what to do with their possessions. Others (mostly men), on the contrary, relied on their children to do the sorting out after they had died.