Table of contents
The topic explored in this literature review will be focused on the services available for Dementia sufferers and whether more can be done. The Alzheimer’s Society defines Dementia as “A set of symptoms that may include memory loss and difficulties with thinking, problem-solving or language”. (Alzheimer’s Society) Currently, there are many social services available for people suffering with Dementia such as home carers, day centres and ‘meals on wheels’. The National Health Service (NHS) also provides services such as physiotherapy and optometry services (NHS) This literature review will critically assess what can be improved upon in terms of the quality of dementia care including alternative approaches.
Discussion of Journal Articles
The first Journal Article is a collaboration between four universities. The article written by Evans and Bray offers a professional perspective on the care of people suffering from Dementia and Sight loss. They conducted a research project focused on the experiences of people suffering from dementia who use the basic services and obstacles to high quality care being accessed. (Evans and Bray, 2016) This article is useful as it not only highlights the problems in Dementia Care in the UK but it also includes feedback from Dementia care on what could be improved on in the services provided.
The second article written by Kate Gridley discusses the hardships faced by the carers of people with dementia and what more could be to done to improve the quality of care for Dementia sufferers. Gridley discusses ‘Admiral Nursing’ the UK’s only specialist dementia service focused on supporting the carers of people suffering with dementia. The aim of admiral nursing being for nurses to be able to work together to provide more efficient care. A study was conducted using Admiral Nursing as an example which highlighted how important it was for nurses to feel supported in order for them to provide the best level of care possible. This article is relevant to the topic discussed in this literature review as Gridley clearly highlights why Dementia care in the UK is not as effective as it should be and provides a clear concise alternative approach to Dementia care. (Gridley, 2018)
The third journal article written by Reeves et al outlines the importance of allowing Dementia Sufferers to plan their end of life care with the aim of empowering people with dementia to express their wishes regarding end of life care before their mental capacity is lost. Reeves et al expressed that although Dementia is one of the largest contributing factors towards deaths in the UK it is still not seen as a terminal illness. (Reeves et al, 2019) This article is relevant as it outlines how the quality of life for dementia sufferers could be improved by allowing them to make their own decisions for their end of life care whilst they still have the mental capacity to by allowing them to avoid certain procedures and/or medications being administered to them towards the end of their lives if they wish.
The fourth article written by Smith et al focuses on the support given to people with young onset dementia and their families. It explores a project trialled where care workers were sent on a training course educating them on the variety of aspects when providing dementia care. Findings expressed that care workers who took part said the course increased their confidence thus allowing them to provide a better quality of care. (Smith et al, 2017). This journal article is relevant to this literature review as it provides an alternative approach to dementia care in the UK which has proven effective.
This final article written by Alden et al discusses how the staff and volunteers employed in dementia care can improve services by influencing the types of services offered through their attitudes and beliefs. The article also presents the findings of a research project where support and resources were offered to Age UK partners up and down England in order to enable them to improve their services for Dementia sufferers. (Alden et al, 2019). This journal article is relevant because it provides a different alternative approach to Dementia care in the UK by providing resources and support to an established company like Age UK.
Generally there is a clear mutual agreement between all five journal articles researched that the current state of Dementia care in the UK is inadequate. All the articles present alternative approaches to Dementia care in the UK which are proven effective. Findings from the research conducted by Evans and Bray, 2016 in the first article presented substantial feedback, carers of people who took part in the study reported that they felt they did not have enough support available especially when providing support in the difficult time when a diagnosis is given. (Evans and Bray, 2016). The second article written by Gridley, 2018 also supported this by saying that carers for people with Dementia placed significant value on the feeling of being supported and that having support from a specialist in the field of Dementia allowed them to provide care to the best of their ability even if they were facing difficulties. (Gridley, 2018)
This theory is also touched upon in the fourth article written by Smith et al where they propose introducing a training course for the care givers involved in Dementia care. A project was conducted in Surrey and London where 24 care givers involved in Dementia care were subject to a training course. As a result of this, the care givers responded positively to the training course, saying they had increased confidence and were more understanding to the needs and experiences of Dementia sufferers. Overall the findings of the studies were promising and significantly improved knowledge for the care workers which promoted a more positive working experience overall. (Smith et al, 2017) All three of these articles show a clear trend that care givers involved in Dementia care do not feel they have the correct support. This may contribute to the reason why many agree that Dementia care in the UK is inadequate. All three articles clearly show that when care givers are given the support they require, the overall care given is improved thus improving quality of care for Dementia patients.
The third journal article written by Reeves et al provides an important perspective on the effectiveness of allowing Dementia sufferers to organise their own end of life care procedures whilst they still have the mental capacity to. The research conducted showed that because Dementia is still not widely recognised as a terminal illness, there are no procedures put in place for Dementia sufferers to advance plan their end of life care, and as a result of this Dementia sufferers residing in care homes will often visit hospitals more often than they should in the last stages of their lives. Denying Dementia sufferers the opportunity to plan their own palliative care robs them of a ‘good death’ and the chance to live out the rest of their lives stress free. (Reeves et al, 2019) The fifth article written by Alden et al offers an alternative view on how Dementia care should be handled. A project was conducted where Age UK were looking to improve how their organisation handled Dementia care in the UK. Once the project began it became apparent that employees from Age UK had different views on what services were best to offer Dementia sufferers. The aim of the project was to re-educate care-givers on any misconceptions they had about Dementia care and to observe whether this led to a change in the quality of services provided. The researchers found that for some of the employees it only took a short session to reshape their misconceptions around Dementia.
Unlike the other articles, this article presented a project aimed at a large organisation like Age UK hoping to improve their services. This further proves the point that Dementia care in the UK is inadequate as Age UK is among the most established organisations in the UK and all it took was interviews with some staff members to get rid of their misconceptions and negative stereotypes associated with Dementia allowing them to promote a better quality of care offered overall.
Critical Appraisal - (Critical Appraisal Tool by Isobel Flint)
(Evans and Bray, 2016) – This study, written in 2016 added a vast amount of new evidence to the area of interest as it provided an in depth knowledge of exactly why Dementia care in the UK is inadequate, with participants in the study providing substantial feedback. The study recruited professionals in the north of England, the Midlands and the south of England. Initially the researchers aimed to recruit 90 professionals however this proved unachievable, 30 professionals instead were recruited and those took part provided a good overview of the main professions involved in Dementia care such as social workers, housing scheme managers and rehabilitation officers. Some of the participants also revealed they had personal experiences with Dementia which allowed them to offer perspectives from both personal and professional perspectives. Although the study was not performed in accordance to the original protocol the smaller sample size wasn’t found to impact the results of the study.
(Gridley, 2018) - This journal article, written in 2018 is a report of the qualitative findings from another study on the support for carers of people with Dementia. This article is relevant to the area of interest as it offers a perspective as to why Dementia care in the UK is poor and how it could be improved. This particular study did not address any potential sources of bias. The researchers recruited 35 care givers involved in dementia care but does not state how they were recruited. This could be due to the fact that this journal article is merely a short report of the qualitative findings.
(Reeves et al, 2019) – This article is a fully referenced, peer reviewed literature review written very recently in 2019. The topic is relevant to the area of interest as it provides an alternative view to how dementia care should be handled. It adds new and unexplored perspectives to the evidence gathered thus far in this literature review.
(Smith et al, 2017) – This article, written in 2017 is a fully referenced, peer reviewed research article on an evaluation of a training course for carers of people with Dementia. The study adds new knowledge to this literature review as it highlights the positive impact a training course for carers could have on the quality of life for Dementia sufferers. This methodology addressed important potential sources of bias by having an external researcher be responsible for all the data collection, this avoids any bias within the research team. The study also provides a clear statement of what the research team expected the study to show.
(Alden et al, 2019) – This article was written in 2019. It is written on a project conducted with Age UK trying to improve the services they offered. The study is relevant to this literature review as it provides a successfully trialled alternative approach to Dementia care with proven results directly from participants themselves. The study recruited employees working at Age UK. However this study did not address any potential forms of bias which could have potentially arisen in this particular project as some Age UK employees may have been convinced the organisation’s current care model was working effectively, which could then in turn bias the results.
In conclusion, it’s clear to see that all the journal articles researched provide a mutual agreement that Dementia care in the UK is inadequate, with even large companies like Age UK admitting alternative approaches to dementia care helped them improve the quality of their services. It is the responsibility of the government to accept the state of Dementia care in the UK could be improved massively by ensuring that carers are listened to and have support available from professionals in the field of Dementia. It is also important that the needs of Dementia patients are taken into account in order for them to have their own say regarding their end of life care so they can have a ‘good death’ and avoid unnecessary discomfort during the last stages of life.
It is now up to the professionals responsible for the five journal articles mentioned in this literature review to take their research to the next step by using larger sample sizes and taking the steps to integrate these alternative approaches to Dementia care into the basic services in the UK. Training programs for carers advising them how best to deal with Dementia patients should be branched out and offered across the UK in order to promote a better quality of care overall.
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