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  • 1.
    Marmstål Hammar, Lena
    et al.
    Mälardalens högskola.
    Swall, Anna
    Sophiahemmet Högskola.
    Summer Meranius, Martina
    Ethical aspects of caregivers' experience with persons with dementia at mealtimes2016In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 23, no 6, 624-635 p.Article in journal (Refereed)
    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.

  • 2.
    Marmstål Hammar, Lena
    et al.
    Mälardalens högskola.
    Williamn, Christine
    Florida Atlantic University.
    Swall, Anna
    Sophiahemmet Högskola.
    Engström, Gabriella
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Humming as a mean of communicating during meal time situations: A Single Case study involving a women with severe dementia and her caregiver2012In: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 2, no 3, 93-102 p.Article in journal (Refereed)
    Abstract [en]

    Objective:

    ‘Music Therapeutic Caregiving’, when caregivers sing for or together with persons with dementia during morning care situations, has been shown to increase verbal and nonverbal communication between persons with dementia and their caregivers, as well as enhance positive and decrease negative emotions in persons with dementia. No studies about singing during mealtimes have been conducted, and this pilot project was designed to elucidate this. However, since previous studies have shown that there is a risk that persons with dementia will start to sing along with the caregiver, the caregiver in this study hummed such that the person with dementia did not sing instead of eat. The aim of this pilot project was threefold: to describe expressed emotions in a woman with severe dementia, and describe communication between her and her caregivers without and with the caregiver humming. The aim was also to measure food and liquid intake without and with humming.

    Method: The study was constructed as a Single Case ABA design in which the ordinary mealtime constituted a baseline which comprised a woman with severe dementia being fed by her caregivers in the usual way. The intervention included the same woman being fed by the same caregiver who hummed while feeding her. Data comprised video observations that were collected once per week over 5 consecutive weeks. The Verbal and Nonverbal Interaction Scale and Observed Emotion Rating Scale were used to analyze the recorded interactions.

    Results:

    A slightly positive influence of communication was shown for the woman with dementia, as well as for the caregiver. Further, the women with dementia showed a slight increase in expressions of positive emotions, and she ate more during the intervention.

    Conclusion:

    Based on this pilot study no general conclusions can be drawn. It can be concluded, however, that humming while feeding persons with dementia might slightly enhance communication, and positive expressed emotions in persons with dementia. To confirm this, more studies on group levels are needed. Because previous studies have found that caregiver singing during caring situations influences persons with dementia positively it might be desirable to test the same during mealtime.

  • 3. Park, Juyoung
    et al.
    Newman, David
    Engström, Gabriella
    Marmstål Hammar, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Swall, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    The moderating and covarying effects of social support and pain intensity on depressive symptomology among racially and ethnically diverse older adults2017In: Pain Management, ISSN 1758-1869, Vol. 7, no 1, 19-32 p.Article in journal (Refereed)
    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.

  • 4.
    Swall, Anna
    Sophiahemmet Högskola.
    "Being in the present": the meaning of the interaction between older persons with Alzheimer's disease and a therapy dog2015Doctoral 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

  • 5.
    Swall, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Sophiahemmet Högskola.
    Ebbeskog, Britt
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Fagerberg, Ingegerd
    'Bringing respite in the burden of illness' - dog handlers experience of visiting older persons with dementia together with a therapy dog2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 15-16, 2223-2231 p.Article in journal (Refereed)
    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.

  • 6.
    Swall, Anna
    et al.
    Sophiahemmet Högskola.
    Ebbeskog, Britt
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Fagerberg, Ingegerd
    Can therapy dogs evoke awareness of one's past and present life in persons with Alzheimer's disease?2015In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 10, no 2, 84-93 p.Article in journal (Refereed)
    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.

  • 7.
    Swall, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ebbeskog, Britt
    Lundh Hagelin, Carina
    Fagerberg, Ingegerd
    Stepping out of the shadows of Alzheimer's disease: a phenomenological hermeneutic study of older persons with Alzheimer's disease caring for a therapy dog2017In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no 1, 1347013Article in journal (Refereed)
    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.

  • 8.
    Swall, Anna
    et al.
    Sophiahemmet Högskola.
    Fagerberg, Ingegerd
    Ebbeskog, Britt
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    A therapy dog's impact on daytime activity and night-time sleep for older persons with Alzheimer's disease: a case study2014In: Clinical Nursing Studies, ISSN 2324-7940, E-ISSN 2324-7959, Vol. 2, no 4, 80-93 p.Article in journal (Refereed)
    Abstract [en]

    Background: Animal-Assisted Therapy using dogs have been described as having a calming effect, decrease sundowning and blood-pressure in persons with Alzheimer’s disease. The aim was to investigate how continuous and scheduled visits by a prescribed therapy dog affected daytime and night-time sleep for persons with Alzheimer’s disease.

    Methods: In this case study, registration of activity and sleep curves was conducted from five persons with moderate to severe Alzheimer’s disease living at a nursing home, over a period of 16 weeks using an Actiwatch. Data was analysed with descriptive statistics.

    Result: The study shows no clear pattern of effect on individual persons daytime activity and sleep when encounter with a therapy dog, but instead points to a great variety of possible different effects that brings an increased activity at different time points, for example during night-time sleep.

    Conclusions: Effects from the use of a Animal-Assisted Therapy with a dog in the care of persons with Alzheimer’s disease needs to be further investigated and analysed from a personcentred view including both daytime and nightime activities.

1 - 8 of 8
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