University Assignment: Evaluating Dementia Care Research Studies

This report provides a detailed summary and critical analysis of two research articles focused on dementia care. The first article examines the views of people with dementia and family carers on end-of-life care, highlighting key areas important for care provision and the discrepancies between the perspectives of individuals and their families. The second article investigates the effects of a group music intervention using percussion instruments on anxiety and agitation in institutionalized older adults with dementia, revealing the positive impact of music in managing behavioral symptoms. The report explores the study designs, sampling issues, methods of data collection and analysis, and findings of each article. Furthermore, it includes a critical discussion of the research, addressing ethical and legal considerations, and offering recommendations for future nursing care practices, emphasizing the importance of non-pharmacological interventions and the need for comprehensive care approaches in both primary and specialized settings. The report concludes by emphasizing the importance of understanding and addressing the unique challenges and perspectives of individuals with dementia and their families to improve the quality of care and support.

Dementia Care

Table of Content.
INTRODUCTION...........................................................................................................................1
SUMMARY OF THE RESEARCH................................................................................................1
Aim and Approach.......................................................................................................................1
Study Design................................................................................................................................1
Sampling Issues...........................................................................................................................1
Methods of data collection and analysis......................................................................................1
Findings........................................................................................................................................1
Conclusion...................................................................................................................................1
Ethical and legal issues................................................................................................................1
CRITICAL DISCUSSION..............................................................................................................1
CONCLUSION................................................................................................................................1
REFERENCES................................................................................................................................2

INTRODUCTION
A rapid enhancing prevalence of the dementia is generally reported across nation, more
commonly among the developing countries of the Asia. The illness of dementia is generally a
syndrome of the cognitive deterioration, that can outcomes in the alterations within the
personality as well as can influence the daily living activities as well as its social functions as
well. In this, an agitated behaviours and anxiety are more commonly seen among the older
people having dementia and are specifically reported by the care professionals as a more difficult
care issue. It is generally an enhancing, a global challenge (Arvanitakis, Shah and Bennett,
2019). Dementia is generally a most essential well-being and care problems which the world
mainly faces as the population ages. Across nation, there is a new case of dementia within every
minute and by the year 2023 there will nearly about 90 million of the public will living with the
dementia condition as well. In this, there are approximately about 670,000 of the public within
England are living with dementia. The number will double in the coming 30 years. The
discussion will express that the prevalence of both an early onset as well as a late onset of the
dementia illness can enhances with the age of a person. The dementia care is generally essential
for the dementia patients as there is recently no cure is available for the patients suffering from
dementia and can rely on the care management mainly given by the care nurses in both the
clinical and homes-based care settings as well. In the research report, it will cover the discussion
about two research articles regarding the perceptions and prevalence of dementia among UK
people. In addition to this, there is a discussion about the ethical and legal issues which came
across while investigating the evidence-based research on dementia care among UK public.
Furthermore, there is also a discussion about the recommendations and implications for the
future nursing care practice to provide an effective care to the dementia patients.
SUMMARY OF THE RESEARCH
Aim and Approach
AIM: “To provide an effective care to patients suffering from dementia to live an independent
life.”
The chosen research articles in the study are both qualitative and quantitative. As they
both involve a randomised control trail among the participants to effectively evaluate the
outcomes or to determine the outcomes of group music intervention given to the public which
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had significantly a reduced anxiety scores than other people. In context with second article, it
will aim to compare the view points of the people having dementia as well as their family carers
of the people with dementia on the optimal end-of-life care.
Study Design
Article 1: It is known by the study of this article that the experimental group generally received
the music interventions by an active engagement within a group for about half an hour in the
mid-afternoon twice a week for six weeks in the activity room within the facility. In this, a half
an hour group music intervention can involve 10 min warm-up sessions of a static stretch of the
major muscle groups as well as breathing, a 20 min session of an active engagement of the
people generally using the percussion instruments directed by the study assistant within a group
setting as well as having a five-minute cool-down session of stretching with the soft music. In
this, a gathering of music as well as songs are quite familiar to the participants and was used with
the sessions of music as well. From all such engagements, all the members of the participants
were mainly assessed for their agitated behaviours by using a CMAI (Cohen-Mansfield Agitation
Inventory) as well as for the levels of anxiety using the RAID (Rating of Anxiety in the
Dementia) scale. In this, a CMAI with the good reliability and validity was mainly used to
specifically access the happening of an agitated behaviours among people having dementia.
Article 2: It is determined by the study that the death is not a taboo view point for the people
generally dying with the dementia, the participants who take part in the study generally did not
consider themselves to be an approaching the end of life as well. In this, the people having
dementia was recruited from the community as well as from the region of England instead from
the well-being care services. However, the views of the people suffering generally living in the
residential care or the people having dementia without the family members as well as the
regional variation was not effectively captured. As the outcomes of the randomised control trials
was not checked within the family dyads as well as its influence of the gender problems was not
properly illustrated. These such limitations can significantly influence over the broad of the
findings towards the more diverse public. It is identified by the study that it involves a call for
the higher involvement of the healthcare specialist palliative care services within the care of old
age people having non-malignant conditions. It can also include absence of clarity on how to
give such care for the old age group people.
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Sampling Issues
The inclusion criteria can involve: older people having dementia above age group of 65
age years, participation of people having dementia in sample activities, participated people
having psychological and behavioural symptoms, the study includes randomized control trail as
well. In context with second article, the randomised control trails were there. There were used a
music interventions to reduce the anxiety and depression. Target population is older age group
people.
Methods of data collection and analysis
From the point of view of first article, it is analysed that a randomised control trail was
done over a 60 people and the outcomes was received 30-min music interventions using a
percussion instrument with a known music within a group setting in the afternoon 2 times a week
for about six weeks. There was a scale which was used to assess the anxiety levels among the
dementia people and the Cohen-Mansfield Agitation inventory was specifically used to assess
the agitation at a baseline i.e., fourth and sixth weeks. From the second article, it is analysed that
in the article there was a qualitative approach was adopted to effectively explore the views of the
people having dementia as well as their family members about their end-of-life care. The
reporting of the research is generally consistent with the reliable guidance on the reporting
qualitative study. In addition to this, the people with prior stage of dementia were mainly enlistee
by through the local clinical research network as well as a national voluntary registry to
effectively participate by using a Q-sort methodology to efficiently seek their view points on the
specific components generally essential to the people with dementia in end-of-life care.
Findings
From the provided first article, it has been identified that the older adults can specifically
manifest the anxiety and agitated behaviours are more frequently managed by an antipsychotic
medication. Therefore, the given the concerns of a damaging side effects that are generally
caused by an antipsychotic medication, the use of non-pharmacological care interventions that
has become an essential in managing all the behavioural symptoms for the people having
dementia. In this, as a complementary and an alternative medicine has specifically enhanced a
popularity across nation in the current years, and it has been often used for the old age group
people having dementia as well as are suggested to have a positive influence in treating the
various types of dementia and its associated symptoms as well (Beaudart and et. al., 2019). From
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the second provided article, it has been identified that there are about 11 people having dementia
and about 25 family carers mainly participated within the study. The people with dementia and
the family carers were not the family dyads. In this, the findings can generally high spot the
specific seven aspects of core to the care service provision of the good care quality towards as
well as at the end of life. In addition to this, the preferences and views, these both can vary
among the people having dementia and their family members as well. Such that, both the people
and their family are stressed over the necessity of remaining in their preferred place of care and
ensuring the comfort as well as reducing the distress as well.
Conclusion
It has been concluded by the research articles that the end-of-life for the people having
dementia generally has been neglected at both a professional as well as a policy level. In this, the
research generally determines the possible key divergent perspectives of the people having
dementia as well as their family members. Additionally, the research can also high spot the
necessary discrepancies among the perspectives of people having dementia as well as their
family members. The practice and policy should, however, can reflect the varied perspectives of
various stakeholder groups. In this, the people having dementia were generally more confident as
the family members can coordinate as well as manage their care as needed, therefore, the
families can find this quite challenging within their care practice (Davis and et. al., 2015). As per
the other article, it has been concluded that the effective care methods for managing the anxiety
and an agitated behaviours of the old age group people having dementia are quite necessary,
mainly given the enhancing prevalence of the dementia as well as its linked anxiety and the
specific negative consequences of such behavioural issues among old age group people, as this
can effectively leads to an enhanced burden and a cost in care as well. However, the decrease
and prevention in the anxiety and agitated behavioural levels of older group people having
dementia is generally one of an essential goal of the healing care interventions while caring the
dementia people.
Ethical and legal issues
The article provided the information about the effectiveness of music interventions to
reduce the anxiety and depression among older age group people are specifically proved to be
ethically effective. As it is determined by the study that listening to the music can significantly
aid in calming the nervous system as well as reduces the levels of cortisol. These both can
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effectively decreases the stress levels among old age group people and can enhance the mental
health (Duke 2017).
CRITICAL DISCUSSION
The old age group people having dementia can receive care within the primary care
settings as well as can involve the challenging clinical as well as psychiatric problems. The
dementia associated symptoms are more frequently not identified by the primary well-being care
settings, they mainly suffer from various chronic clinical conditions, can receive multiple
psychotropic medications consisting an anticholinergics as well as can display the clinically
relevant psychological as well as behavioural symptoms. In this, enhancing the care for the
vulnerable older adults can demand the encouraging primary care settings with multiple
resources, consisting the care manager of dementia, access to as well as coordination with an
inter-disciplinary care team dementia specialists, and a feasible dementia screening and
diagnosis process. Understanding the primary care medical as a complex adaptive care settings
can improve the capacity of the healthcare worker to deliver a flexible supportive process by
simply using the care resources to adequately access as well as effectively manage the vulnerable
older adults with dementia (Kivipelto, Mangialasche and Ngandu, 2018). In addition to this,
having a complex adaptive care system can have the best probability of surviving the
unknowable future challenges which will face the primary well-being care settings. In addition to
this, there are the effective campaigns which were organized for the people with dementia across
community such as the people who are affected by the dementia as well as their carers must be
given higher opportunities to effectively participate within the clinical trails, they must involve
higher opportunities to be included within the design and research process as well, they must
have access towards the best effective evidence-based care treatment.
The possible ethical issues with the research consisting the older age group people with
dementia consist the respecting their capabilities in order to make effective decisions, can secure
the consent to effectively participate from a proxy decision makers such as the family members
without seeking direct agreement to effectively participate from the old age group people with
dementia. In this, the analysis can significantly revealed the three main ethical dilemmas when
the autonomy of the older adults with dementia can conflicted with the family members as well
as the healthcare professionals requirement to overcome the harm such as non-maleficence, the
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beneficence of the relatives as well as the healthcare workers and the autonomy of the family
members as well (Lacerenza and et. al., 2018).
CONCLUSION
From the above research, it is concluded that the music interventions as well as the end-
of-life care can play a significant role in providing care to older age group people with dementia.
In context with end-of-life, it can aim to encourage the old age group people within their last
living stage of a life-restricting the conditions to live and possible till they die. In this, a person-
centred care can effectively aid to ensure the old age group people with dementia can specifically
take part in the things which they enjoy. The patent-centred care can be an efficient pathway of
preventing as well as managing the psychological as well as behavioural symptoms of dementia.
While providing care to older adults with dementia, there were multiple issues associated such as
having loss of capability to speak or can hold the conversations, facing challenges while walking
and swallowing, facing difficulties to recognize the people as well as not capable to participate
in the daily living activities and many more. To overcome all these such issues, there were given
a patient-centred care approach to the older age group people so that they can effectively able to
manage their daily living activities as well as can help in recognising the people as well. In this,
most of the elderly people with dementia often refuses the care services that is being offered to
them in the care home settings, the ethical problems which can originate generally cover the
respect for dignity as well as autonomy, giving beneficence, and reassert the paternalism as well.
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REFERENCES
Books and Journals:
Arvanitakis, Z., Shah, R.C. and Bennett, D.A., 2019. Diagnosis and management of
dementia. Jama, 322(16), pp.1589-1599.
Beaudart, C., et. al., 2019. Assessment of muscle function and physical performance in daily
clinical practice. Calcified tissue international, 105(1), pp.1-14.
Davis, D.H., et. al., 2015. Montreal Cognitive Assessment for the diagnosis of Alzheimer’s
disease and other dementias. Cochrane Database of Systematic Reviews, (10).
Duke, L.H., 2017. The importance of social ties in mental health. Mental Health and Social
Inclusion.
Kivipelto, M., Mangialasche, F. and Ngandu, T., 2018. Lifestyle interventions to prevent
cognitive impairment, dementia and Alzheimer disease. Nature Reviews
Neurology, 14(11), pp.653-666.
Lacerenza, C.N., et. al., 2018. Team development interventions: Evidence-based approaches for
improving teamwork. American psychologist, 73(4), p.517.
McCabe, M., You, E. and Tatangelo, G., 2016. Hearing their voice: a systematic review of
dementia family caregivers’ needs. The Gerontologist, 56(5), pp.e70-e88.
Mehta, N., et. al., 2015. Evidence for effective interventions to reduce mental health-related
stigma and discrimination in the medium and long term: systematic review. The British
Journal of Psychiatry, 207(5), pp.377-384.
Mitchell, S.L., 2015. Advanced dementia. New England Journal of Medicine, 372(26), pp.2533-
2540.
Powell, K.E., et. al., 2018. The scientific foundation for the physical activity guidelines for
Americans. Journal of Physical Activity and Health, 16(1), pp.1-11.
Shaw, I., 2018. Evaluating in practice. Routledge.
Steinbrenner, J.R., et. al., 2020. Evidence-Based Practices for Children, Youth, and Young
Adults with Autism. FPG Child Development Institute.
Tricco, A.C., et. al., 2018. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and
explanation. Annals of internal medicine, 169(7), pp.467-473.
Tsoi, K.K., et. al., 2015. Cognitive tests to detect dementia: a systematic review and meta-
analysis. JAMA internal medicine, 175(9), pp.1450-1458.
Wittenberg, R., et. al., 2019. Projections of older people with dementia and costs of dementia
care in the United Kingdom, 2019–2040. London: London School of Economics.
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