Psychological support for people with dementia: A preliminary study

Aim/Purpose

Evidence suggests nonpharmacological therapies could improve quality of life in people with Alzheimer's disease (Olazaran et al., 2010). This study aimed to explore attitudes to, and acceptability of, psychological support for people with mild dementia, from their perspective.

Design/Methodology

Semi‐structured interviews were conducted with five people identified from secondary care services. Questions concerned the experience of being diagnosed, experience of support services and their opinion of alternative support options. Interviews were audio‐recorded, transcribed and analysed using thematic analysis.

Results/Findings

Three main themes were identified: loss, coping mechanisms and support. Loss of physical abilities was associated with loss of identity and place in the community. Coping mechanisms included asserting control, and growth and development, including engaging in new activities or using humour. Individual needs and preferences were key to effective support. Social aspects of support and opportunities to talk about their feelings were valued by participants. Counselling, mindfulness and group‐based activities, including walking and gardening, were viewed positively. Support from admiral nurses or specialist nurses tended to be viewed in terms of physical health needs, and most needed in later stages of dementia.

Research Limitations

Limitations include the small sample size, potential inaccuracies acknowledged by participants regarding recollections of events and researcher bias in hoping that psychological support would be well received.

Conclusions/Implications

Talking therapies and psychosocial interventions are acceptable sources of support. Person‐centred support which considers personal preferences and abilities can support people to live well with dementia.     

损失规避源于得失程数多于获得？——损失规避的得失程数变化视角的再检验

刘欢、梁竹苑 和 李纾（2009a）在证明损失规避的得失程数变化视角时所取的损益值取值范围、对安于现状偏差影响的控制以及所选取的得两程失一程和得三程失两程的决策对象这四个方面存在的缺陷。本研究通过弥补上述缺陷并设计无关变量得到更严格控制的得三程失两程的决策情景,对得失程数变化视角重新进行了检验。结果发现,寿命“得一程失一程”的属性并未导致损失规避消失;在广泛的损益值范围内以自由为对象的决策同样表现为损失规避;将自由感知为生而拥有和后天获得的人数大致相当;因而得失程数变化视角需作出重要修正,同时前景理论与情绪预测误差理论亦不可完全预测损失规避出现的条件。     

得失程数的变化: 损失规避现象的新视点

损失规避是预期理论的核心部分之一, 指等量的损失和获得产生的心理效用并不相同, 前者大于后者。大量研究从生理、认知、情感等角度探讨损失规避的内在机制和规律, 以期认识、预测并控制损失规避导致的偏差。本研究假设损失规避与获得或损失的“程数”(route)有关, 以往研究发现了损失规避现象, 是由于其采用的“双程损失-单程获得”典型情境中, 损失程数多于获得程数。为检验该假设, 本研究设计了不同于传统范式的“获得和损失程数相等”的镜像情境、“单程损失－双程获得”及“三程获得”三种不同的得失情境。研究结果支持本假设: 当损失的程数等于或少于获得的程数时, 损失规避现象消失; 获得或损失的程数越多, 个体对其的心理感受强度趋于越高。建议未来研究进一步检验心理感受强度在程数和损失规避行为之间的中介作用。     

The interplay of stress and attachment in individuals weathering loss of employment

This study addressed two questions concerning the interplay between adult romantic attachment and exposure to stressful circumstances: do stressful events predict fluctuation in romantic attachment during a period of unemployment, and does attachment measured at one point predict later changes in stressors? Stressors and attachment were measured over a six month period following involuntary job loss for a sample of 426 adults. Autoregressive models found evidence for both the stress-effects and stress-generation hypotheses, with more stressors associated with prospective decreases in attachment, and lower attachment associated with prospective increases in stressors. These findings support a more dynamic formulation of the interplay between attachment and exposure to stressors over the months following job loss.     

Conceiving existence: on Hume’s argument against the distinctness of the idea of existence

There are two questions concerning Hume’s doctrine of existence which have not yet found any persuasive answer: (a) What is his argument in favour of the thesis that there is no distinct idea of existence? (b) What are the semantic and metaphysical consequences of this thesis within his philosophical framework? This paper mainly aims to answer question (a). In order to do that, I will first explain why some reconstructions suggested by interpreters such as Cummins and Bricke are problematic. One of them relies on exegetically dubious presumptions; the other departs too much from Hume’s text. Then, I will offer my own reconstruction that makes maximal use of some principles which are very familiar to Hume’s readers, including the principle stating the similarity between perceptions and their images. After that, I will discuss a potential objection to my reconstruction and make a brief remark on question (b), arguing that, as opposed to numerous interpreters’ concerns, Hume’s thesis that there is no distinct idea of existence does not by itself prevent him from being able to conceive negative existential propositions.     

Caffeine reduces the impact of drowsiness on driving errors

AimThe study examined the moderating effect of repeat-dose, chewing gum-administered caffeine on the well-established relationship between drowsiness and driving performance, under the conditions of accumulating sleep loss.Method50-h sleep deprivation protocol with a double-blind, placebo-controlled design. Eleven volunteers (6 male), aged 18–28 years were screened for pre-existing medical conditions (including sleep disturbances), tobacco and recreational drug use, recent time-zone travel and shift-work. They were randomly allocated to placebo or caffeine group and administered 4 oral doses of either caffeinated gum pellets (200 mg/dose) or non-caffeinated placebo gum every two hours (01:00, 03:00, 05:00, 07:00) on the first and second nights of the protocol. Participants were constantly monitored and remained awake for 50 h, while performing 15 identical, evenly-spaced 40-min monotonous driving tasks in a medium-fidelity moving-base driving simulator. Their drowsiness was monitored with a spectacle frame-mounted infra-red sensor registering ocular parameters and converting them into a Johns Drowsiness Scale (JDS) score every 60 s. Lane keeping and speed variability measures were used to assess driving performance.ResultsDriving performance declined and drowsiness increased from the first simulated drive to the last. When driving performance was examined in one-minute epochs synchronised with JDS scores, both lateral lane positioning and speed variability were found to be associated with drowsiness. The strength of this association was significantly weaker in the caffeine group, compared to placebo. Placebo group replicated the linear relationship between drowsiness and driving errors across the full range of JDS scores. This pattern was significantly weaker under the caffeine condition, and was even reversed at the upper range of JDS, with higher JDS scores not resulting in further degradation of driving performance. This dissociation between drowsiness and driving errors persisted across the 24-h cycle under the caffeine condition, despite caffeine being administered only during early morning hours.ConclusionStrategically timed, repeat 200 mg doses of caffeine administered via chewing gum can mitigate fatigue-induced impairments in driving performance by not only reducing drowsiness but also by significantly weakening its impact on driving errors. This dual effect of sustained drowsiness reduction and the dissociation between drowsiness levels and driving errors seems worth further investigation as it might offer an effective emergency countermeasure against driver drowsiness and its subsequent conversion into potentially fatal driving errors.     

Congruent auditory display and confusion in sound localization: Case of elderly drivers

Elderly people may suffer from age-related hearing loss. They often report difficulties to perceive and localize sound sources in noisy environment. How this can be a driving safety issue? This study investigates the effect of hearing impairment, on the driver behavior to localize external sound sources such as emergency vehicles sirens. Subjective tests show that localization confusion appears to be a common problem. Thus, we focus on how to assist the driver, taking into consideration the age-related hearing impairment, to better localize emergency vehicle siren. The hypothesis was based on the stimulus-response compatibility using an effective congruent auditory display, for attentional guidance toward the direction of arrival (DOA) of the external alarm. The proposed approach aims to reduce front-back confusion and enhance the sound localization accuracy of the driver, which is very important for elderly driver, subject to older age cognitive decline. A localization test was performed in lab and in vivo on a test track, where a group of drivers was asked to identify the DOA of an emergency vehicle siren, with and without a dedicated embedded system set up to assist them on sound localization task.     

A continuing sense of self in the lived experience of dementia

ABSTRACT

Diagnosis with dementia often leads to an overwhelming fear of loss of self, which is assumed in the social discourse about the condition. After my own diagnosis with dementia in 1995, I reflected on this fear from a Christian theological perspective and was nonetheless able to discover a sense of hope. Highlighting what remains in dementia, as seen through the lens of the lived experience, provides a counter-story to the views of outside observers, which have dominated the literature to date. Although people with dementia experience a change in their cognitive sense of self, there are still important aspects of self that remain, which are: a sense of being an embodied self, in relationships with others and with God, and being able to find meaning in the present moment. By demonstrating that people living with dementia have a continuing sense of self, the aim is to prompt improved pastoral care and ministry.     

Discovery and Revitalization of “Feeling of Hometown” from a Disaster Site Inhabitant's Continuous Engagement in Reconstruction Work: Ethnographic Interviews with a Radiation Decontamination Worker Over 5 Years Following the Fukushima Nuclear Power Plant Accident1

After hometown loss due to the Fukushima Nuclear Power Plant accident, many radiation decontamination workers started to engage in the reconstruction of their hometown. However, little is known regarding the meaning of experience of engaging in such work. We describe the process of such experience through a series of ethnographic interviews over 5 years with a radiation decontamination worker. The process was classified into the following three periods: “recovery of lost land by inhabitants' own hands,” “goal loss and semiotic trap in pursuit of recovery,” and “revitalization of feeling of hometown.” Consequently, the informant overcame the contradiction theorized as a “semiotic trap” that radiation decontamination for physical recovery would make his return to home impossible, and updated his narrative to the revitalization of “feeling of hometown” through continuous engagement in the work by creating a sense for transplacement, in which the individual focuses on the psychological aspects of his/her hometown instead of the physical aspects. Psychological reconstruction for disaster victims requires the discovery and revitalization of feeling of hometown rather than the completion of physical reconstruction.     

Cultural Dimensions of Early Pregnancy Loss: Spiritual and Religious Issues

Nearly one in five clinically confirmed pregnancies ends in a loss before 20 weeks (Bardos et al., 2015). Despite the prevalence of miscarriage, many women and partners experience a lack of acknowledgment and support while also encountering complicated concerns related to the intersection of perinatal loss, culture, religious and spiritual issues, medical treatment, their reproductive stories, and grief (Randolph et al., 2015). Counselors working with these clients must address complex cultural considerations. As such, we review key cultural and religious/spiritual issues related to early pregnancy loss and offer recommendations for practice based on the current literature in the context of the Association for Spiritual, Ethical, and Religious Values in Counseling (2009) counseling competencies.