Wellbeing in Dementia

Elizabeth Milwain, Hazel May, Tessa Perrin

Description

The authors, specialists in the UK, draw on developmental theory to propose a model of practice specifically for dementia care. The number of people who suffer from dementia is increasing and in consequence the problems it presents are affecting a growing number of therapists and carers. Many of these problems are peculiar to dementia and the models of care used with other client groups have proved inadequate when dealing with the provision of quality of care to people who have dementia. This revised edition contains a new opening chapter which brings our understanding of dementia up-to-date. The book looks at the relationship between occupation, wellbeing and dementia and examines the critical role of the carer in developing therapeutic interventions.

• Proposes a realistic model of practice for dementia care which centres on the unique occupational potential of the person with dementia.
• Offers positive strategies to improve wellbeing.
• Current information on assessment tools.
• Written by therapists with extensive experience in working with this client group.

Sujets

• Occupational Therapy
• Allied Health Services
• Medical
• Médecine

Informations

• Publié par: Churchill Livingstone
• Date de parution: 27 juin 2008
• Nombre de lectures: 0
• EAN13: 9780702037030
• Langue: English

Extrait

Table of Contents

Cover image
Copyright
Foreword
Preface to 2nd edition
Chapter 1. Understanding dementia
Chapter 2. Occupational therapy revisited
Chapter 3. The altered world of dementia
Chapter 4. The significance of the carer
Chapter 5. The playful practitioner
Chapter 6. Principles of good practice in dementia care
Chapter 7. Non-verbal communication
Chapter 8. A model for dementia care
Chapter 9. Assessing capacity for doing and promoting engagement
Chapter 10. The dementia therapist
Index
Copyright
Second edition 2008
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the Publishers. Permissions may be sought directly from Elsevier's Health Sciences Rights Department, 1600 John F. Kennedy Boulevard, Suite 1800, Philadelphia, PA 19103-2899, USA: phone: [phone]; fax: [phone]; or, e-mail: healthpermissions@ elsevier.com . You may also complete your request on-line via the Elsevier homepage ( http://www.elsevier.com ), by selecting ‘Support and contact’ and then ‘Copyright and Permission’.
ISBN: 978 0 443 10399 5
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library.
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress.
Notice

Neither the Publisher nor the Authors assume any responsibility for any loss or injury and/or damage to persons or property arising out of or related to any use of the material contained in this book. It is the responsibility of the treating practitioner, relying on independent expertise and knowledge of the patient, to determine the best treatment and method of application for the patient.
The Publisher
Commissioning Editor: Rita Demetriou-Swanwick
Development Editor: Catherine Jackson
Project Manager: Kerrie-Anne Jarvis
Design Direction: George Ajayi
Illustrations Manager: Merlyn Harvey
Illustrator: Graeme Chambers
Printed in China
Foreword
Dawn Brooker, PhD, CPsychol, (clin) AFBPsS

Professor of Dementia Care Practice and Research, University of Bradford, Bradford Dementia Group

Wellbeing in Dementia
This is an important book. It was important when it came out in its first edition and its central message is still as fresh in this second edition. It is written by three women who in their own quiet way have played an enormous part in the way we conceptualise modern dementia care.
In these pages you will find a wealth of ways to challenge outdated assumptions about dementia and a therapeutic approach to promote wellbeing. Therapeutic nihilism towards dementia has no place here. The work is scholarly and provides a theoretical and conceptual underpinning for why wellbeing in dementia is promoted as a key outcome. From a practice point of view it is grounded in many case studies that those working directly with people with dementia will instantly recognise.
The additional material in this edition helps to clarify our understanding of the personal experience of dementia. People with dementia often suffer most when their behaviour and responses to their situation are misunderstood and misattributed. This book provides a number of interlinking models and frameworks to assist understanding.
Although this book has particular relevance for occupational therapists, there is so much within its pages that will appeal to a much wider audience. Commissioners of services, managers, educators, trainers as well as professionally qualified practitioners from all disciplines will find much here that will help them support the work of those delivering direct care. It is a practical book, written with great humanity that has the ability to change hearts and minds.
This book frees its readers to be creative and playful in the way in which we think about occupation and well-being. These chapters should be compulsory reading for all those involved in the organisation of activities for people with dementia. The chapters on the significance of the carer and non-verbal communication should be compulsory reading for all those involved in care and support. As part of the working group for the English National Dementia Strategy I have been involved in many discussions about the core competencies for those who work directly with people with dementia. The final chapter in this book on the role of the dementia therapist sets out these competencies beautifully.
When the first edition of this book appeared I believe it was way ahead of its time. I welcome this new edition as being of its time. It will be read by those thirsty for ways of working with people with dementia to help them live their lives despite of a diagnostic label that many people still see as signifying the end of a life worth living. This book is about life. Grab it with both hands.
Preface to 2nd edition
It is now some seven years since the first edition of this book went on the bookshelves. As we came to prepare the manuscript for the second edition we were reminded of our closing words to the original, in which we hoped that in ten years time advances in the fields of dementia care and occupational therapy would have made the book redundant. There have, of course, been considerable advances in both fields generally during that time, but none which we feel renders this book redundant, and so we decided to proceed.
Canvassing opinion from our colleagues on the need for this text to remain in print, one colleague who is very active in education and research made a helpful comment. She said that when guiding students and others towards essential reading in the occupation and dementia field, there was a range of texts she would recommend. But for those wanting a sound theoretical underpinning to the field, she would always highlight Wellbeing in Dementia . This has been a helpful insight which confirms our own feelings about the book. It was always intended to be a contribution to theory, a frame of reference which would serve to guide practice. It is pleasing that some still perceive it in this way. Over the years we have had a fair bit of feedback; none of it has been negative and nobody has challenged our propositions. We had expected some disagreement and had in some measure looked forward to some healthy debate, but it hasn't come our way. So maybe we need to assume that the greater number of our readers is in accord with our ideas. This too has encouraged us to feel that the book should remain available.
The essence of the book remains the same, but there are two key changes. Chapters 1 and 9 have been overhauled and updated. Thinking on the nature of dementia itself moves on apace and we were aware that we needed an abler brain to bring us up to speed. We are delighted therefore to welcome Dr Elizabeth Anderson's contribution in Chapter 1 . This has given us a succinct, up-to-date statement on dementia which addresses with clarity the neurological/psychological debate. Chapter 9 , reflecting the developments in assessment practice which have taken place over the intervening years, has also been revised. From her extensive experience in research and practice development, Hazel May has reviewed the assessment tools now available and has offered a model for assessment which reflects current thinking on the measurement of wellbeing and engagement in dementia care.
And so we edge towards an ever greater clarity and excellence in our dealings with the procedures and practices of dementia care. We have worked in the dementia care field now for well over 20 years, and have to say that it has been a great privilege to be a part of the wave of seminal development which has been gathering momentum over that time. Since the first edition was published, both Hazel and Tessa have been overtaken by a personal experience of dementia in the context of our respective families – altogether different of course, from dealing with dementia as a professional. It has been an experience which has taken us both to the edge, but a salutary experience nevertheless. We have both found ourselves grateful for the knowledge, the experience and the contacts we have acquired over our years in dementia care. This has made the undertaking of the carer role a little easier, but even with this as a foundation we have found that the experience has stretched us almost to our limits, and we have wondered what on earth it must be like for those coming to the experience without the ‘preparation’ that we have had. This further challenges our continued commitment to this field of work, to support, educate and provide for those living with dementia who have not had the privilege of the insights we have gained. The need remains urgent, the task remains vast: we commend our new edition to the continued endeavour.
Tessa Perrin
Hazel May
Elizabeth Anderson
2008
Chapter 1. Understanding dementia

CHAPTER CONTENTS

Introduction 1

What is dementia? 2

Living with primary dementia 6

The nature of the neurological impairment 8

Memory 19

Conclusion 23

INTRODUCTION
The question ‘What is dementia?’ is easy to ask and hard to answer. It may be easier to begin with what dementia is not. One thing that dementia is not, and has never been defined to be, is a disease. Rather, dementia has always been defined to be a syndrome of intellectual decline. ‘Syndrome’ sounds daunting but all it means is ‘a col