Laird Elizabeth A, McGurk Phyllis, Reid Bernie, Ryan Assumpta
School of Nursing, Ulster University, Londonderry, Northern Ireland.
Primary Care and Older Persons Team, Western Health and Social Care Trust, Londonderry, Northern Ireland.
Int J Older People Nurs. 2017 Dec;12(4). doi: 10.1111/opn.12157. Epub 2017 Jun 29.
This study explored the experiences and perspectives of community psychiatric nurses, day centre managers and social workers about supporting clients living with and without dementia attending a generic day care service. The purpose of the study was to elucidate approaches that enable clients living with dementia to access and derive benefit from the service.
In the light of international ageing demographics and strategy towards social inclusion, it is anticipated that demand for generic day care services for clients living with and without dementia will increase.
A descriptive qualitative design utilised three focus groups for data collection. Community psychiatric nurses (n = 4), day centre mangers (n = 4) and social workers (n = 12) participated in the study. Data analysis informed a narrative description of the approaches that support adults living with dementia in day care.
An exhaustive description is encapsulated in five key themes. These are "easing the transition to day care," "proactively managing supervision and complexity of need," "sustaining the person and family carer," making the best of what we have" and "encountering a need for change," The data conveyed a sensitivity to the life story and needs of clients with dementia. Whilst the data revealed deficits in the physical environment of the centres, there were indications of the generation of a positive social environment.
A generic day care service that provides an integrated blend of care and treatment and social and recreational support to older adults, irrespective of whether they have or have not dementia, is realistic and manageable. The routine of day centre attendance may have value in sustaining clients with dementia and family care-giving relationships.
Approaches to support the attendance of clients with dementia at day care include home visits, life story work, proactive supervision and careful planning of social groupings and recreational activities.
本研究探讨了社区精神科护士、日间护理中心经理和社会工作者在支持患有和未患有痴呆症的客户参加一般日间护理服务方面的经验和观点。该研究的目的是阐明使患有痴呆症的客户能够使用该服务并从中受益的方法。
鉴于国际人口老龄化趋势以及社会包容战略，预计对患有和未患有痴呆症的客户的一般日间护理服务需求将会增加。
采用描述性定性设计，通过三个焦点小组收集数据。社区精神科护士（4名）、日间护理中心经理（4名）和社会工作者（12名）参与了该研究。数据分析为支持痴呆症患者在日间护理中的方法提供了叙事性描述。
详尽的描述包含在五个关键主题中。这些主题是“缓解向日间护理的过渡”“积极管理监督和复杂需求”“维持个人和家庭照顾者”“充分利用现有资源”以及“遇到变革需求”。数据传达了对痴呆症患者生活经历和需求的敏感性。虽然数据显示中心的物理环境存在不足，但有迹象表明产生了积极的社会环境。
为老年人提供护理与治疗以及社会和娱乐支持相结合的一般日间护理服务，无论他们是否患有痴呆症，都是切实可行且易于管理的。日间护理中心的日常活动对于维持痴呆症患者及其家庭照顾关系可能具有价值。
支持痴呆症患者参加日间护理的方法包括家访、生活经历工作、积极监督以及精心规划社交分组和娱乐活动。
