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here - Able - Annette Johannesen

here - Able - Annette Johannesen

Assignment on Evidence

Assignment on Evidence Based Practice in OT - December 2000 Staff attitudes, social interaction and people with dementia in residential settings Abstract In the last decade there has been an increasing recognition of the role of familiar, active environments in increasing well being and reducing disruptive behaviour in dementia. All over the world, “small group living” replaces nursing homes in dementia. In the review, it is questioned, whether the ideas of the modern dementia environments are practised with success. Have the staffs’ attitude changed and do the residents experience more social interactions and well being compared to their former life in big institutions. Out of the review, three key results were identified: Understimulation and occupational deprivation is still present in the daily life of residents with dementia Staff - resident interaction is largely restricted to physical care with minimal social interaction Physical environment solely is not a guarantee for well-being and social interaction The review provides arguments for, but no evidence of the need for occupational therapists in residential settings for persons with dementia. The author calls for methodological strong trials which will demonstrate, that a policy is required to secure provision of occupation, stimulation with activity and time for prolonged communication as a basic part of the daily programme in residential settings for residents with dementia. 2

Assignment on Evidence Based Practice in OT - December 2000 Staff attitudes, social interaction and people with dementia in residential settings Introduction and background to review Since the beginning of 1990 the overall concept when designing environments for frail elderly and elderly with dementia is that of small group living (Annerstedt 1995, Jensen 1997). Modern institutions are typically constructed for groups of 6-8 persons living together in a building with private flats and with common facilities (Hansen & Bennedsen 1996). The idea is to create an environment as non-institutionalised as possible and as close as possible to a normal family living. Daily tasks, such as cleaning, cooking and shopping are used as part of the treatment, and the personnel are expected to support residents to participate as much as possible in these activities. However Morgan & Stewart (1997), have expressed the view that residents with dementia risks being deprived from stimulation and interaction as an adverse effect of living in the small group environment. When expressing and discussing this concern, staff commonly state that their particular residents are too badly impaired to take part in activities or they assert that low level of social interaction in the units are due to lack of staff-resources (Armstrong et al 1994). Another argument could be that staff are not skilled sufficiently or lack qualified supervision and advice, to meet the special needs of residents with dementia living in a small group environment (Annerstedt 1995; Heap 1990; Perrin & May 2000; Roscrow 1996). 3

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