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Craftman, Å., Swall, A., Båkman, K., Grundberg, Å. & Hagelin, C. L. (2019). Caring for older people with dementia reliving past trauma. Nursing Ethics
Open this publication in new window or tab >>Caring for older people with dementia reliving past trauma
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2019 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989Article in journal (Refereed) Epub ahead of print
National Category
Nursing
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30698 (URN)10.1177/0969733019864152 (DOI)000484196300001 ()2-s2.0-85071636070 (Scopus ID)
Available from: 2019-09-17 Created: 2019-09-17 Last updated: 2019-09-20Bibliographically approved
Swall, A., Craftman, Å., Grundberg, Å., Wiklund, E., Väliaho, N. & Hagelin, C. L. (2019). Dog handlers' experiences of therapy dogs' impact on life near death for persons with dementia. International Journal of Palliative Nursing, 25(2), 65-71
Open this publication in new window or tab >>Dog handlers' experiences of therapy dogs' impact on life near death for persons with dementia
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2019 (English)In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 25, no 2, p. 65-71Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:: Persons with dementia may have severe physical and psychological symptoms at the end of life. A therapy dog used in their care can provide comfort and relieve their anxiety. The dog handler guides the dog during the interaction with the patient.

AIM:: To describe the impact of therapy dogs on people with dementia in the final stages of life from the perspective of the dog handler.

METHODS:: Interviews were conducted and analysed using qualitative content analysis.

FINDINGS:: The dog provides comfort and relief through its presence and by responding to the physical and emotional expressions of the dying person.

CONCLUSIONS:: Interactions with dogs were found to have a positive impact on persons with dementia and eased the symptoms associated with end of life according to the dog handlers.

Keywords
Animal-assisted therapy, Dementia, Palliative care, Therapy dog
National Category
Nursing
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29575 (URN)10.12968/ijpn.2019.25.2.65 (DOI)000458858200003 ()30785819 (PubMedID)2-s2.0-85061972493 (Scopus ID)
Note

Open Access APC beslut 2/2019

Available from: 2019-02-26 Created: 2019-02-26 Last updated: 2019-06-27Bibliographically approved
Swall, A., Williams, C. & Marmstål Hammar, L. (2019). The value of “us”: Expressions of togetherness in couples where one spouse has dementia. International Journal of Older People Nursing, Article ID e12299.
Open this publication in new window or tab >>The value of “us”: Expressions of togetherness in couples where one spouse has dementia
2019 (English)In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, article id e12299Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background Living with dementia involves both illness and health, and self-care and care from others. As most persons with dementia live in their own homes, dementia affects not only the person with the disease, but also family, commonly the partner. Research shows that spousal carers feel as though they are losing their partners since they can no longer share thoughts, feelings and experiences as a couple. Aim The aim of the study was to describe the sense of togetherness of the spouses when one spouse has dementia. Method The sample consists of 18 recorded conversations between 15 persons with dementia and their spouses. The filmed conversations were transcribed verbatim and then analysed using qualitative content analysis. Findings One overarching theme arose: Dementia preserved and challenged the value of ?us.? It can be challenging for a couple in which one partner has dementia to preserve a sense of togetherness and to have the relationship they wish for. Conclusion Based on our results, we suggest that practitioners should help couples to strengthen their bond as a couple so as to maintain a sense of well-being. Future studies should examine couplehood under differing conditions, such as long- versus short-term relationships. Prior relationship quality may also be a factor that influences the sense of couplehood following a serious health challenge, such as dementia. Implication for practice When spouses were able to live together, their relationship was enriched at many levels. Their love for each other strengthened them as a unit ? as an ?us? ? where togetherness seemed to be strong. Future studies need to examine whether the sense of couplehood varies depending on the length of the relationship (i.e., a relationship of many years or a relatively new relationship).

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
caring, communication, couples, dementia, nursing
National Category
Nursing
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-31590 (URN)10.1111/opn.12299 (DOI)000504766300001 ()31886633 (PubMedID)2-s2.0-85077853315 (Scopus ID)
Available from: 2020-01-03 Created: 2020-01-03 Last updated: 2020-02-03
Craftman Gransjöm, Å., Swall, A. & Marmstål Hammar, L. (2018). Outcomes of education in using music and caregivers singing as a tool to person centered care when working with persons with dementia. In: : . Paper presented at American Geriatrics Society 2018 Annual General Meeting, Orlando, 3-5 May 2018.
Open this publication in new window or tab >>Outcomes of education in using music and caregivers singing as a tool to person centered care when working with persons with dementia
2018 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-27529 (URN)
Conference
American Geriatrics Society 2018 Annual General Meeting, Orlando, 3-5 May 2018
Available from: 2018-04-25 Created: 2018-04-25 Last updated: 2018-04-25Bibliographically approved
Swall, A., Ebbeskog, B., Lundh Hagelin, C. & Fagerberg, I. (2017). Stepping out of the shadows of Alzheimer's disease: a phenomenological hermeneutic study of older persons with Alzheimer's disease caring for a therapy dog. International Journal of Qualitative Studies on Health and Well-being, 12(1), Article ID 1347013.
Open this publication in new window or tab >>Stepping out of the shadows of Alzheimer's disease: a phenomenological hermeneutic study of older persons with Alzheimer's disease caring for a therapy dog
2017 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no 1, article id 1347013Article in journal (Refereed) Published
Abstract [en]

Purpose: Living with Alzheimer’s disease (AD) can involve a person being unable to recall and convey information in daily life. There are several ways to provide person-centred care to older people with AD, e.g. by empowering them in a situation. The use of animal-assisted therapy (AAT) with a therapy dog in the care of people with dementia is increasing, with the presence of a therapy dog being described as improving, among other things, the well-being and socialization of the person. The aim of this study was to illuminate meanings of care for people with AD in their encounters with a therapy dog.

Method: The study used video-recorded observations of the person with AD and the dog. Data were transcribed and analysed using a phenomenological hermeneutic method.

Results: The main theme was “Using one’s own resources and abilities as a human being”, which meant being the person one can be and distancing oneself from the symptoms of AD during the time with the dog.

Conclusions: The feelings evoked in the people with AD included empathy and altruism, which allowed for a sense of joy and tenderness, which may induce a sense of self-worth, of being needed, and of being meaningful.

Keywords
Alzheimer’s disease, caring, animal-assisted therapy, person-centredness, phenomenological hermeneutics, life world
National Category
Nursing
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-21594 (URN)0.1080/17482631.2017.1347013 (DOI)000406176900001 ()28699394 (PubMedID)
Note

Open Access APC beslut 21/2017

Available from: 2015-04-01 Created: 2016-06-02 Last updated: 2020-02-18Bibliographically approved
Park, J., Newman, D., Engström, G., Marmstål Hammar, L. & Swall, A. (2017). The moderating and covarying effects of social support and pain intensity on depressive symptomology among racially and ethnically diverse older adults. Pain Management, 7(1), 19-32
Open this publication in new window or tab >>The moderating and covarying effects of social support and pain intensity on depressive symptomology among racially and ethnically diverse older adults
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2017 (English)In: Pain Management, ISSN 1758-1869, Vol. 7, no 1, p. 19-32Article in journal (Refereed) Published
Abstract [en]

AIM: To examine the interplay of social support, pain intensity and ethnicity as moderators and covariates of relationship on depressive symptomatology.

METHODS: Racially and ethnically diverse elders responded to measures of depressive symptomatology and social support.

RESULTS: Hispanics reported significantly higher prevalence of moderate pain intensity and depressive symptomology, and lower prevalence of high social support compared with other ethnic groups. Although social support showed reduced depressive symptomatology among those with high pain intensity, it did not play a significant role in decreasing depressive symptomatology among those with low/moderate pain intensity.

CONCLUSION: Social support in decreasing depressive symptomatology is more effective in older adults with high pain intensity than those with moderate or low levels of pain intensity.

Keywords
chronic pain; depressive symptomatology; ethnicity; older adults; social support
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-23313 (URN)10.2217/pmt-2016-0027 (DOI)000398173600005 ()27794630 (PubMedID)
Available from: 2016-11-01 Created: 2016-11-01 Last updated: 2020-02-24Bibliographically approved
Swall, A., Ebbeskog, B., Lundh Hagelin, C. & Fagerberg, I. (2016). 'Bringing respite in the burden of illness' - dog handlers experience of visiting older persons with dementia together with a therapy dog. Journal of Clinical Nursing, 25(15-16), 2223-2231
Open this publication in new window or tab >>'Bringing respite in the burden of illness' - dog handlers experience of visiting older persons with dementia together with a therapy dog
2016 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 15-16, p. 2223-2231Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES:

To illuminate meanings of the lived experiences of dog handlers' when visiting older persons with dementia with their therapy dog.

BACKGROUND:

Studies indicate that care of persons with dementia should focus on a person-centred approach with the person's interests in the centre. Animal-assisted therapy using a therapy dog in the care of persons with dementia has been shown to increase well-being and decrease problematic behaviours associated with the illness.

DESIGN:

A qualitative lifeworld approach was adopted for this study.

METHODS:

Data were collected from open-ended interviews with nine dog handlers, and the analysis conducted using the phenomenological hermeneutical method.

RESULTS:

The structural analysis resulted in one theme, 'Respite from the burden of illness for persons with dementia'.

CONCLUSIONS:

Visiting a person with dementia can be seen as an act of caring, providing temporary respite from their illness, and creating a special relationship between handler and patient. A therapy dog visit can represent a moment of communion between the handler and the person with dementia.

IMPLICATION FOR CLINICAL PRACTICE:

Dog handlers use their skills and knowledge to promote a situation that reduces symptoms of illness and encourages healthier behaviour. The results of this study may be of interest to researchers, clinical practitioners, caregivers and dog handlers who care for persons with dementia using therapy dog teams on prescription as an alternative method to minimise behavioural and psychological symptoms of dementia.

Keywords
caring; dementia; dog handlers; person-centredness; phenomenological hermeneutics; therapy dog; well-being
National Category
Nursing
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-21591 (URN)10.1111/jocn.13261 (DOI)000385024500016 ()27277921 (PubMedID)
Available from: 2015-04-01 Created: 2016-06-02 Last updated: 2017-09-11Bibliographically approved
Marmstål Hammar, L., Swall, A. & Summer Meranius, M. (2016). Ethical aspects of caregivers' experience with persons with dementia at mealtimes. Nursing Ethics, 23(6), 624-635
Open this publication in new window or tab >>Ethical aspects of caregivers' experience with persons with dementia at mealtimes
2016 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 23, no 6, p. 624-635Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Persons with dementia are at risk of malnutrition and thus in need of assistance during mealtimes. Research suggest interventions for caregivers to learn how to facilitate mealtimes and eating, while other suggest a working environment enabling the encounter needed to provide high-quality care. However, the phenomenon of caring for this unique population needs to be elucidated from several perspectives before suggesting suitable implications that ensure their optimal health.

OBJECTIVES: To illustrate the meanings within caregivers' experiences of caring for persons with dementia during mealtime situations. We also measured weight and food intake among individuals with dementia to explain better the phenomenon of caring for them during mealtimes.

METHODS: Mixed method including focus group interviews with seven caregivers analyzed using phenomenological hermeneutics. In addition, for nine persons with dementia, weight and food intake were collected and descriptive statistics were calculated.

ETHICAL CONSIDERATIONS: Ethical review was obtained from an ethics committee, and all caregivers signed a consent form after being informed on the issue of research ethics. Relatives for persons with dementia were informed and signed the consent. In addition, throughout the study, the persons' expressions were observed aiming to respect their vulnerability, integrity, and dignity.

FINDINGS: One theme emerged from interviews (struggling between having the knowledge and not the opportunity), which was built upon three subthemes (being engaged and trying; feeling abandoned and insufficient; being concerned and feeling guilty). Seven of nine persons with dementia lost a minimum of 1.3 kg of weight and ate a maximum of 49.7% of the food served.

CONCLUSION: Caregivers struggle because they have knowledge about how to provide high-quality care but are unable to provide this care due to organizational structures. The weight loss and insufficient eating among the persons with dementia may support this conclusion. Sufficient time for adequate care should be provided.

Keywords
Caregivers, Dementia, Ethical aspects, Focus group interviews, Malnutrition, Mealtime, Mixed method, Phenomenological hermeneutics
National Category
Nursing
Identifiers
urn:nbn:se:du-21568 (URN)10.1177/0969733015580812 (DOI)25977521 (PubMedID)
Available from: 2015-06-01 Created: 2016-06-01 Last updated: 2017-11-30Bibliographically approved
Swall, A. (2015). "Being in the present": the meaning of the interaction between older persons with Alzheimer's disease and a therapy dog. (Doctoral dissertation). Stockholm: Karolinska Institutet
Open this publication in new window or tab >>"Being in the present": the meaning of the interaction between older persons with Alzheimer's disease and a therapy dog
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The number of persons with Alzheimer’s disease is increasing world-wide and the disease affects the persons, their families, the health care system and the economy within society worldwide. The symptoms and behaviours caused by Alzheimer’ disease may be difficult to manage for the person and their caregivers. Alternative methods are recommended before pharmacological treatment. The presence of a therapy dog has been described as beneficial, in for instance increasing well-being and alleviating symptoms and dementia behaviours. The overall aim of this thesis was to gain a deeper understanding of the influence of therapy dogs on persons with Alzheimer’s disease from the person’s and the dog handler’s perspectives. Further, adopting a longitudinal perspective, the study investigates the therapy dog’s influence on activity and sleep for persons with Alzheimer’s disease. Video observations of five persons with Alzheimer’s disease interacting with a therapy dog (I, II), as well as interviews with nine dog handlers (III) were gathered and transcribed. Data was analyzed using a phenomenological hermeneutical method (I, II, III). Registration of activity and sleep was conducted over a period of 16 weeks using an Actigraf that generated curves, and were then analysed using descriptive statistics (III). The time spent with the dog revealed memories and feelings resulting in existential thoughts of oneself and life, which then connected to the present situation (I). Distancing oneself from the symptoms of the disease when interacting with the dog showed a person functioning in the present with the dog, striving for the dog’s best and putting the dog before and above oneself (II). The therapy dog’s presence showed no pattern of effect on the patients’ daytime activity and sleep. The findings instead pointed to a great variety of possible different effects, bringing about increased activity at different time points, for example during night-time sleep (III), creating a respite from illness and contributing wordlessly to an existence but thoroughly directed by the dog handler, where the person was comfortable and took the initiative (IV). In conclusion, the therapy dog team’s presence with the person with Alzheimer’s disease induced meaning that allowed the person’s hidden qualities and abilities to develop and, when observed from a person-centred perspective, also brought out the individual in each person

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet, 2015. p. 69
Keywords
Animal-assisted therapy, Alzheimer's disease, Descriptive statistics, Lifeworld, Memories, Person-centred care, Phenomenological hermeneutics, Therapy dog
National Category
Nursing
Identifiers
urn:nbn:se:du-21590 (URN)978-91-7549-847-8 (ISBN)
Public defence
2015-04-17, H3 blå, Alfred Nobels Allé 23, Huddinge, 09:00
Opponent
Supervisors
Available from: 2015-04-08 Created: 2016-06-02 Last updated: 2016-06-02
Swall, A., Ebbeskog, B., Lundh Hagelin, C. & Fagerberg, I. (2015). Can therapy dogs evoke awareness of one's past and present life in persons with Alzheimer's disease?. International Journal of Older People Nursing, 10(2), 84-93
Open this publication in new window or tab >>Can therapy dogs evoke awareness of one's past and present life in persons with Alzheimer's disease?
2015 (English)In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 10, no 2, p. 84-93Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Persons with Alzheimer's disease (AD) sometimes express themselves through behaviours that are difficult to manage for themselves and their caregivers, and to minimise these symptoms alternative methods are recommended. For some time now, animals have been introduced in different ways into the environment of persons with dementia. Animal-Assisted Therapy (AAT) includes prescribed therapy dogs visiting the person with dementia for a specific purpose.

AIM: This study aims to illuminate the meaning of the lived experience of encounters with a therapy dog for persons with Alzheimer's disease.

METHOD: Video recorded sessions were conducted for each visit of the dog and its handler to a person with AD (10 times/person). The observations have a life-world approach and were transcribed and analysed using a phenomenological hermeneutical approach.

RESULTS: The result shows a main theme 'Being aware of one's past and present existence', meaning to connect with one's senses and memories and to reflect upon these with the dog. The time spent with the dog shows the person recounting memories and feelings, and enables an opportunity to reach the person on a cognitive level.

CONCLUSIONS: The present study may contribute to health care research and provide knowledge about the use of trained therapy dogs in the care of older persons with AD in a way that might increase quality of life and well-being in persons with dementia.

IMPLICATIONS FOR PRACTICE: The study might be useful for caregivers and dog handlers in the care of older persons with dementia.

Keywords
Alzheimer's disease, Caring, Existence, Memories, Phenomenological hermeneutics, Therapy dog
National Category
Nursing
Identifiers
urn:nbn:se:du-21592 (URN)10.1111/opn.12053 (DOI)24814254 (PubMedID)
Available from: 2016-06-02 Created: 2016-06-02 Last updated: 2017-11-30
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-0781-3771

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