A comparison of the characteristics of elderly people with dementia and the needs of their caregivers in community and institutional settings

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A comparison of the characteristics of elderly people with dementia and the needs of their caregivers in community and institutional settings

 

Author: Tse, Lai-kwan Donna
Title: A comparison of the characteristics of elderly people with dementia and the needs of their caregivers in community and institutional settings
Degree: M.Sc.
Year: 2002
Subject: Hong Kong Polytechnic University -- Dissertations
Senile dementia -- Patients -- Care
Caregivers -- Psychology
Department: School of Nursing
Pages: x, 140 leaves ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1641634
URI: http://theses.lib.polyu.edu.hk/handle/200/1542
Abstract: This study aimed to compare the cognitive, functional and behavioral attributes of elderly with dementia, and the caring difficulties and needs of their caregivers in both conununity and institutional settings. The convenient samples included elderly and caregivers from the community, Care and Attention Homes (C&A home) and private nursing homes (PNH). One hundred and three elderly and 141 caregivers were recruited. The elderly were assessed by the Cantonese version of Mini Mental Status Examination (CMMSE), the Chinese version of Dementia Rating Scale (CDS) and the Chinese version of Rating Scale of Rating Scale the elderly for Aggressive Behavior in Elderly (CRAGE). The caregivers completed a validated questionnaire with regard to the information on their caring difficulties and caring needs. The results found that there were statistical significances in age, CMMSE and CDS scores in elderly in the community group than elderly in the C&A and PNH groups. The elderly in the community was significantly younger, had better cognitive status and less physical impaired than both the C&A and PNH groups. Although the cognitive status and age of the C&A and PNH groups was not statistical significant, the elderly in C&A group was more functional impaired than PNH group. There was no statistical significance in the CRAGE scores among these groups. When individual item of CRAGE was analyzed, the problems of shouting, swearing, injury to other and overall aggressiveness were statistically different among groups. The elderly in the PNH group had more behavioral problems than elderly in both the C&A and community groups. The caregivers of community group expressed great difficulties in managing cognitive, functional and behavioral problems of elderly, including problems in related to poor memory, bathing, feeding, incontinence, uncooperative and resistive to help. This group may need a variety of support that can help them manage the cognitive, functional and behavioral problems of their relatives. The caregivers of both C&A and PNH groups expressed difficulties in managing behavioral problems, but not cognitive or functional problems. The caregivers expressed that unstable mood, uncooperative and resistive to help were the most difficult problems for them. In addition, it was found that the caregivers of PNH groups would use physical restraints more often. The staff of both C&A and PNH groups need training on managing the behavioral problems and proper use of physical restraint in elderly with dementia. This is especially true in the PNH group which showed a higher frequency to use physical restraints on elderly with dementia. In order to improve the quality of care, the government should review the manpower ratio of institutional settings. The staff ratio should base on the proportion of elderly with dementia, but not only base proportion of residents.

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