Cognitive Rehabilitation Strategies and Dementia: Benefitting the Professional Caregiver

Leander Mitchell (). Cognitive Rehabilitation Strategies and Dementia: Benefitting the Professional Caregiver Professional Doctorate, School of Psychology, The University of Queensland.

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Author Leander Mitchell
Thesis Title Cognitive Rehabilitation Strategies and Dementia: Benefitting the Professional Caregiver
School, Centre or Institute School of Psychology
Institution The University of Queensland
Thesis type Professional Doctorate
Supervisor Associate Professor Nancy Pachana
Total pages 177
Subjects 1702 Cognitive Sciences
Abstract/Summary Abstract Alzheimer's Australia (2008) reported that the dementia population of Australia at that time totalled some 227,300 people. At the same time, the Australian Bureau of Statistics (2008) listed Australia's over 65’s population at around 2.8 million. Within this context, approximately 8% of Australia's older adult population has been diagnosed with a dementia-related illness and, as a result, requires varying levels of care from either a loved one or a professional carer. On a global scale, the expectation is that the dementia population will double every 20 years (Ferri et al., 2005). In Australia, it is expected that the dementia population will quadruple between the years 2000 and 2050 (Access Economics, 2005). The same report further states that if accurate, this will mean that approximately 2.8% of Australia’s predicted population will have been diagnosed with a dementia-related illness by 2050. While Australia’s rate is slightly below that predicted at a global level, it nonetheless means that the ratio of carers-to-care receivers will dramatically change across time, placing a greater burden on society for adequate numbers of carers. Much research has been published measuring the impact of such responsibilities on the family carer in terms of the associated psychological and physiological burden. Conversely, a comparatively small amount of research has looked at utilising the intact functionality of the dementia patient and thereby maximising the potential to improve daily living. Even less prevalent again is research around the impact of the caring role on the professional carer. This, despite the fact that job satisfaction is low, turnover is high, and facilities often struggle to fill staff vacancies (Cheek et al., 2003). Ironically, a rehabilitative treatment framework that promotes the maintenance of functionality in people with dementia has the potential to reduce the psychological and physiological burden commonly associated with the role of a carer (Hawley & Cherry, 2008). Further, there can be a tendency within the aged care industry to assume a need for the provision of a high level of care for extended periods of time for people with dementia in long-term care facilities. Combined with a perceived lack of achievement (i.e., an inability to help the person with dementia get “better” – a philosophy consistent with the medical training model) this outlook has the potential to diminish self-efficacy and reduce the positive aspects that can be associated with the caring process. The following thesis looks specifically at deteriorating memory function within the dementia population. Research to date has provided support for a correlation between increased independence in activities of daily living for the person with dementia and decreased stress and strain on carers (Rosemond & Mercer, 2002). The RECAPS Program (Smith et al., 2010) was developed to provide professional carers with the tools to encourage independent functioning in patients diagnosed with dementia. As a result, it was hypothesised that the professional carers would experience an increase in self-efficacy and an increase in their perception of positive aspects of caring. A cluster randomised control trial design was chosen and included four clusters; three forming the training group (N = 26) and one forming the control group (N = 13). Baseline, immediately post-training (for the training group only), and three month follow-up data were collected for knowledge of memory strategies. Baseline and three month follow-up data were collected for the self-efficacy and positive aspects of caring measures for both groups. Results, while not promising with regards to improved self-efficacy and positive aspects of caring, demonstrated that professional carers do have a positive attitude towards training. The RECAPS Program (Smith et al., 2010) was well received, being described as both easy to understand and implement. The theoretical implications of the research are discussed, and the limitations of the current study, as well as potential future research directions, are explored.
Keyword dementia; carer burden; memory

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Created: Wed, 10 Nov 2010, 16:13:40 EST by Dr Leander Mitchell on behalf of Scholarly Publishing and Digitisation Service