A study on the help-seeking experience of Chinese older adults with early dementia in Hong Kong

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A study on the help-seeking experience of Chinese older adults with early dementia in Hong Kong

 

Author: Chan, Chui King Liliane
Title: A study on the help-seeking experience of Chinese older adults with early dementia in Hong Kong
Degree: D.H.Sc.
Year: 2012
Subject: Help-seeking behavior -- China -- Hong Kong
Dementia -- Patients -- China -- Hong Kong
Older people -- China -- Hong Kong
Dementia -- Patients -- Services for -- China -- Hong Kong
Hong Kong Polytechnic University -- Dissertations
Department: Faculty of Health and Social Sciences
Pages: x, 251, 17 leaves, 20 pages : illustrations ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2760488
URI: http://theses.lib.polyu.edu.hk/handle/200/7623
Abstract: Aim: The study aims to uncover and examine the experiences of older adults with early-stage dementia and the process by which they seek help. Method: By using grounded theory constructivist approach, intensive interviews were conducted with 26 participants who met the following criteria: (1) aged 65 or above; (2) had been diagnosed with early-stage dementia (Morris, 1993) by visiting psychiatrists of an early screening service; (3) not in the acute stage of their psychiatric illness (e.g., acute depression); (4) not in the acute stage of their chronic diseases; and (5) able to understand and speak Cantonese or Putonghua. Findings: Orchestrating the process to achieve self reliance was the core category governing the help-seeking process by which older adults with early cognitive impairment handle their daily living activities with both formal and informal support and services. The process of seeking help was comprised of three distinct phases: making sense, accommodating, and engaging. The phase of making sense was a period of noticing, appraising, comparing, and negotiating. In the phase of accommodating, the elderly employed self-management strategies to live with their declining memory. In the final phase of engaging, they assumed an active role in delineating their criteria for help and forming help networks. Contacts were established with formal services, although the time span in the help-seeking process differed for each individual. In the transition state of signalling impairment, the triggers for help-seeking were identified. They were: (l) increasing occurrence of forgetfulness; (2) recent worsening of the condition; and (3) personal safety at stake. Older adults preferred to signal their need for help through social communication, calling for sensitivity from formal and informal care providers. Older adults were concerned about the negative image of dementia and the burden of caring for a person with dementia, and were reluctant to approach a doctor to receive a diagnosis. The older adults were proactive in adopting self-managing and self-enhancing strategies to maintain normalcy in their life and to strengthen their cognitive functions. They realized the importance of having a support network, and were able to delineate their help network to maintain their regular pattern of daily life and for times of emergency.
Conclusion: Public education to raise awareness of the warning signs of cognitive decline as well as of the services available for those with cognitive decline is recommended. The study revealed that a non-medical setting is ideal for early detection and intervention and educational activities for the community-dwelling older adults with early cognitive impairment. Insights on both the positive and negative influences of informal and formal care providers in the help-seeking process were noted. Mindful communication was suggested as an approach to facilitate the seeking of help. Research on the views and experience of the family caregivers in seeking help can deepen our understanding of the conditions that hinder and facilitate the seeking of help - information that will be useful in designing appropriate support services. Studies should be conducted to understand the perceptions and knowledge that medical professionals have of dementia, in order to facilitate early detection and intervention. Evidence-based research should be conducted to help design appropriate cognitive-enhancing interventions for older adults with early-stage dementia.

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