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Sökning: WFRF:(Skovdahl Kirsti) > Fossum Bjöörn

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  • Tyrrell, Marie, et al. (författare)
  • Embarking on a memory assessment voices of older persons living with memory impairment
  • 2021
  • Ingår i: Dementia. - : Sage Publications. - 1471-3012 .- 1741-2684. ; 20:2, s. 717-733
  • Tidskriftsartikel (refereegranskat)abstract
    • AimTo describe older persons who had commenced a memory assessment, experiences of living with memory impairment and related symptoms.BackgroundPersons with subjective memory impairment are two times more likely to develop dementia over the years than their peers. Older persons seldom seek help from primary health care clinics solely for subjective memory impairment. Of those who seek help, it can take up to 35 months from the person experiencing initial symptoms to referral to a memory clinic. Further research is needed regarding how older persons live with memory impairment with related symptoms before they receive a memory diagnosis.MethodA qualitative study with 23 participants who had commenced a memory assessment in primary care. Semi-structured interviews were held. During the interviews, the Neuropsychiatric Inventory was completed and discussed with the participants. Interview data were analysed using Interpretive Description.ResultsThe results are presented under four themes: Conflicting views about the situation, Unveiling the presence of neuropsychiatric symptoms, Compensating with external and internal strategies to recall and Worrying about self and future. Persons with memory impairment were encouraged by family members or others to seek a memory assessment. Few persons were self-referred as memory impairment was often seen as a part of aging. Polarised viewpoints existed within the families regarding the impact of memory impairment on daily life. The presence of neuropsychiatric symptoms appeared unexplored in the participants seeking a memory assessment. In this study, the majority of participants experienced neuropsychiatric symptoms at the time of contact for a memory assessment.ConclusionsMemory problems experienced were often viewed by the person as being part of an aging process. The presence of neuropsychiatric symptoms was not acknowledged as being connected to memory impairment. Contextualising ‘memory impairment’ as a part of a ‘cognitive process’ may help the person in identifying the presence of neuropsychiatric symptoms.
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  • Tyrrell, Marie, et al. (författare)
  • Feeling valued versus abandoned : Voices of persons who have completed a cognitive assessment
  • 2021
  • Ingår i: International Journal of Older People Nursing. - : John Wiley & Sons. - 1748-3735 .- 1748-3743. ; 16:6
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To describe older persons' experiences of a cognitive assessment and possible neuropsychiatric symptoms [NPS] related to a neurocognitive diagnosis.BACKGROUND: A cognitive assessment in primary care is offered to persons with suspected dementia with subsequent referral to a specialist clinic if required. The assessment process, with the likelihood of receiving a dementia diagnosis, is surrounded by uncertainty with long waiting times. Although NPS are common among persons with cognitive impairment persons are not routinely asked about these symptoms during a cognitive assessment.METHOD: Interviews were held with 18 participants who had completed a cognitive assessment. The Neuropsychiatric Inventory [NPI] was incorporated into one of the interview questions enabling participants to self-report NPS, if present. Interview data were analysed using Interpretive Description.RESULTS: Two main themes were identified: a matter of trust and making sense of a cognitive diagnosis. Experiences of the assessment process ranged from feeling valued to abandoned with variations of trust in the process. A diagnosis of mild cognitive impairment was experienced as an abstract diagnosis devoid of follow-up support. A lack of preparedness for the assessment existed among participants. Some experienced the process as standardised. One half of participants self-reported the presence of one to four NPS, regardless of neurocognitive diagnosis. Irritability and depression were most common NPS identified.CONCLUSIONS: Experiences of a cognitive assessment varied from feeling valued by society to abandoned in the absence of follow-up support. The assessment was viewed as a standardised procedure failing to see the person behind the testing. Diagnosis disclosure conversations were experienced as diffuse with participants unprepared for a dementia diagnosis. The NPI enabled participants to identify and report the presence of NPS which otherwise could go undetected during the cognitive assessment, impacting on the person's well-being and daily life.
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  • Tyrrell, Marie, et al. (författare)
  • Living with a well-known stranger : Voices of family members to older persons with frontotemporal dementia
  • 2020
  • Ingår i: International Journal of Older People Nursing. - : Wiley. - 1748-3735 .- 1748-3743. ; 15:1
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To describe family members' experiences of living with persons with neuropsychiatric symptoms (NPS) related to frontotemporal dementia (FTD).BACKGROUND: The majority of persons with dementia during the disease trajectory develop NPS. Persons with FTD are likely to develop greater levels of NPS than persons with other types of dementias. Research-based knowledge regarding family members' experiences of living with persons with FTD and NPS is limited.METHODS: Nine family members of persons with FTD were interviewed. Interviews commenced with completion of the Neuropsychiatric Inventory (NPI). Upon completion of the NPI, questions were posed from an interview guide where study participants provided in-depth information about NPS identified. Interview data were analysed using qualitative content analysis.RESULTS: Interviewed family members highlighted that persons with FTD had developed between four and eight co-existing NPS. Irritability and disinhibition were the most common NPS, with variations in severity, frequency and distress. From the interview data, two themes emerged: Living with a well-known stranger and Coping and overstepping social norms.CONCLUSIONS: Living with a well-known stranger depicted a new co-existence with a loved one with changes in personality and behaviour, which were not inherent to the person or predictable any more. The presence of NPS can threaten the safety of the person with FTD and their family in real world and on social media. Support offered should focus on the person's physical and psychological needs, not on a diagnosis.IMPLICATIONS FOR PRACTICE: From a health care perspective it is important to see the person with FTD and their family as unique individuals with specific needs.
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  • Tyrrell, Marie, et al. (författare)
  • Voices Of Spouses Living With Partners With Behavioural And Psychological Symptoms Related To Dementia
  • 2016
  • Ingår i: Alzheimer's & Dementia. - : John Wiley & Sons. - 1552-5260 .- 1552-5279. ; 12:7, s. 1174-1175
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • BackgroundPersons with dementia, whdo reside in their own homes, are often cared for by family members or friends. The presence of a family career is said to have a protective effect, postponing admissions to residential care. The majority of persons with dementia develop behavioural and personality changes during the disease trajectory. The quality of life for both the person with behavioural and psychological symptoms and their careers are affected, increasing both suffering and risk for hospitalisation. Family careers to persons with dementia have identified behavioural changes as more distressing than cognitive impairment leading to increased burden of care and admissions to residential care. Knowledge gaps exist regarding how family careers living with persons with dementia experience behavioural and psychological symptoms in a community setting. AIM: To describe spouses’ experiences of living with partners who have behavioural and psychological symptoms related to dementia.MethodsSemi-structured interviews were carried out with 14 spouses of partners with dementia. The interviews included the completion of the NPI (Neuropsychiatric Inventory, Cummings, 1994). Interview data was analysed using content analysis.Results(Preliminary) Spouses identified that partners with dementia had on average five to eight co-existing NPI symptoms. Frequency, severity and distress varied. The behavioural and psychological symptoms highlighted were within three of four possible symptom domains; Behaviour, Psychosis and Mood. From the narrative data four main categories emerged; Support, Coping, Vulnerability and domestic violence AND Social isolation.ConclusionsA large proportion of persons with dementia reside in the community. Support offered to persons with dementia and their families should have a person-centered approach meeting individual needs. A greater awareness is required regarding welfare and safety of persons with dementia and their partners in a community setting.
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  • Tyrrell, Marie, et al. (författare)
  • Voices Of Spouses Living With Partners With Neuropsychiatric Symptoms Related To Dementia
  • 2016
  • Ingår i: Alzheimer's & Dementia. - : John Wiley & Sons. - 1552-5260 .- 1552-5279. ; 12:7, s. 979-980
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • BackgroundPersons with dementia, who reside in their own homes, are often cared for by family members or friends. The presence of a family career is said to have a protective effect, postponing admissions to residential care. The majority of persons with dementia develop behavioural and personality changes during the disease trajectory. The quality of life for both the person with behavioural and psychological symptoms and their careers are affected, increasing both suffering and risk for hospitalisation. Family careers to persons with dementia have identified behavioural changes as more distressing than cognitive impairment leading to increased burden of care and admissions to residential care. Knowledge gaps exist regarding how family careers living with persons with dementia experience behavioural and psychological symptoms in a community setting. Aim: To describe spouses’ experiences of living with partners who have neuropsychiatric symptoms related to dementia.MethodSemi-structured interviews were carried out with 14 spouses of partners with dementia. The interviews included the completion of the NPI (Neuropsychiatric Inventory, Cummings, 1994). Interview data was analysed using content analysis.ResultsThe neuropsychiatric symptoms identified were within three of four possible symptom categories; Behaviour, Psychosis and Mood. From the narrative data three main themes emerged; Coping, Domestic violence and vulnerability and Social isolation.ConclusionsA large proportion of persons with dementia reside in the community, a greater awareness, within the emergency response services about the welfare and safety of these persons and their families is required. Support offered to persons with dementia and their families should be more person-centered meeting their individual needs.
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  • Tyrrell, Marie, et al. (författare)
  • Voices of spouses living with partners with neuropsychiatric symptoms related to dementia
  • 2019
  • Ingår i: Dementia. - : SAGE Publications. - 1471-3012 .- 1741-2684. ; 18:3, s. 903-919
  • Tidskriftsartikel (refereegranskat)abstract
    • Persons with dementia, who reside in their own homes, are often cared for by family members. The presence of a family career is said to have a protective effect, postponing admissions to residential care. The majority of persons with dementia develop behavioural and personality changes during the disease trajectory also known as neuropsychiatric symptoms. Quality of life for both the person with neuropsychiatric symptoms and their careers are affected, increasing suffering and risk for hospitalisation and admission to long-term residential care. Family careers to persons with dementia have identified behavioural changes as more distressing than cognitive impairment leading to increased burden of care and admissions to residential care. Knowledge gaps exist regarding how family careers living with persons with dementia experience neuropsychiatric symptoms in a community setting. The aim was to describe spouses' experiences of living with partners who have developed neuropsychiatric symptoms related to dementia in a community setting. Semi-structured interviews were carried out with 14 spouses of partners with dementia. The interviews included completion of the neuropsychiatric inventory. Interview data were analysed using a content analysis approach. The results showed that spouses identified in the neuropsychiatric inventory that partners with dementia had on average five to eight co-existing symptoms. Frequency, severity and distress varied. From the narrative data, the theme living on the edge lacking support and time for self, emerged. The findings of this study suggest that support offered to persons with dementia and their spouses should have a person-centred approach meeting individual needs. Safety and welfare of persons with dementia and their spouses residing in their own homes may be jeopardised in the presence of neuropsychiatric symptoms. A greater awareness is required in the community regarding the well-being of these persons.
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  • Tyrrell, Marie, et al. (författare)
  • Voices Of Spouses To Partners With Neuropsychiatric Symptoms Related To Dementia
  • 2017
  • Ingår i: Abstract Book. ; , s. 568-568
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction: The presence of a family career is said to have a protective effect in dementia care, postponing admissions to residential care. The majority of persons with dementia develop behavioural and personality changes during the disease trajectory. These symptoms are called neuropsychiatric symptoms (NPS). Little is known regarding family members` experiences of living with persons with NPS related to dementia, in a community setting.Objectives: To describe spouses’ experiences of living with partners who have neuropsychiatric symptoms related to dementia.Results Methods: Semi-structured interviews with 14 spouses of partners with dementia. The interviews were based on the NPI (Neuropsychiatric Inventory,Cummings, et al. 1994). The interview data was analysed using content analysisTable:Results: Spouses identified that partners with dementia had on average five to eight co-existing NPS . Frequency, severity and distress varied. The neuropsychiatric symptoms highlighted were within three of four possible symptom domains; Behaviour, Psychosis and Mood. From the narrative data five main categories emerged; Support needs, Understanding the impact dementia has on their partner, Being prepared for sudden unpredictable events, Feeling vulnerable and facing domestic violence and Feelings of social isolation. The theme; Living on the edge lacking support and time for self, evolved.Conclusion: A large proportion of persons with dementia reside in their own homes in the community. Support offered to persons with dementia and their families should have a person-centered approach meeting individual needs. Safety and welfare of persons` with dementia and their partners residing in their own homes may be jeopardized in the presence of neuropsychiatric symptoms. A greater awareness is required in the community of the welfare and wellbeing of these persons.References: Cummings, J.L., Mega, M., Gray, K.,Rosenberg-Thompson, S., Carusi, D.A. & Gornbein, J. (1994) The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. See comment in PubMed Commons belowNeurology. Dec;44(12):2308-14Holtzer, R., Tang, M.X., Devanand, D. P., Albert, S. M., Wegesin, D.J., Marder, K., Bell, K., Albert, M., Brandt, J. & Stern, Y. (2003). Psychopathological features in Alzheimer´s disease: course and relationship with cognitive status. Journal American Geriatric Society. 51(7):953-60Fauth E, B, & Gibbons A. (2014). Which behavioral and psychological symptoms of dementia are the most problematic? Variability by prevalence, intensity, distress ratings, and associations with carer depressive symptoms. Int J Geriatr Psychiatry; 29: 263–71.Moore, K., Ozanne, E., Ames, D., & Dow, B., (2013). How do family carers respond to behavioural and psychological symptoms of dementia? International Psychogeriatrics.25:5 743-753.Disclosure of Interest: None Declared
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