Jenkins Emerald, Szanton Sarah, Hornstein Erika, Reiff Jenni Seale, Seau Quinn, Huynh Grace, Gray Ja'Lynn, Wright Rhonda Smith, Li Qiwei, Cotter Valerie, Curriero Samantha, Taylor Janiece
School of Nursing, Johns Hopkins University, USA.
Bloomberg School of Public Health, Johns Hopkins University, USA.
Dementia (London). 2025 Jan;24(1):40-70. doi: 10.1177/14713012241272754. Epub 2024 Aug 12.
Although co-occurring cognitive impairment and physical disability in older adults is common, there is little understanding of how this group perceives their ability to do their daily activities. This study used photovoice to explore how older adults with MCI/early dementia and physical disability without and with care partners (dyads) perceive challenges with their daily activities. Photovoice is a visual research methodology to capture participants' insight on aspects of their daily lives. No known studies have taken this approach to explore the experiences of older adults with MCI/early dementia and co-occurring physical disability. We used a cross-sectional, exploratory research design to understand participants' ( = 12) experiences in their home environment. Photos and participant thoughts on the photos were categorized based on the Blackfoot Breath of Life Theory and the Hierarchy Model of Needs in Dementia, an adaptation of Maslow's Model. Notable findings included: awareness of physical/cognitive difficulties by older adults, solutions for ADL difficulty in persons with MCI/early dementia, care partners' difficulty recognizing pain without the presence of severe emotional or physical responses, reducing mood severity, and self-esteem needs met with structured, memory-issue adapted, meaningful activities. Older adults with co-occurring physical disability and MCI/early dementia identified both physiological and psychological needs despite challenges impacting their cognition. Photovoice evoked daily situations of these individuals and revealed the importance of developing individualized intervention elements for older adults with dementia and physical disability.
尽管认知障碍和身体残疾在老年人中同时出现很常见，但对于这一群体如何看待自己进行日常活动的能力却知之甚少。本研究采用摄影声音法来探究患有轻度认知障碍/早期痴呆症且伴有或不伴有照护伙伴（二人组）的身体残疾老年人如何看待其日常活动中的挑战。摄影声音法是一种视觉研究方法，用于捕捉参与者对其日常生活各方面的见解。尚无已知研究采用这种方法来探究患有轻度认知障碍/早期痴呆症且伴有身体残疾的老年人的经历。我们采用横断面探索性研究设计，以了解参与者（ = 12）在其家庭环境中的经历。根据黑脚印第安人生命呼吸理论和痴呆症需求层次模型（对马斯洛模型的改编）对照片及参与者对照片的想法进行分类。显著发现包括：老年人对身体/认知困难的认识、患有轻度认知障碍/早期痴呆症者日常生活活动困难的解决方法、照护伙伴在没有严重情绪或身体反应时难以识别疼痛、减轻情绪严重程度以及通过结构化的、适应记忆问题的有意义活动满足自尊需求。患有身体残疾和轻度认知障碍/早期痴呆症的老年人尽管面临影响其认知的挑战，但仍确定了生理和心理需求。摄影声音法唤起了这些个体的日常情境，并揭示了为患有痴呆症和身体残疾的老年人制定个性化干预要素的重要性。
