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Australian Journal of Dementia Care
December 2016/January 2017 Vol 5 No 6
ANew Zealand study offers
insights about what people with
dementia seek from dementia-
friendly communities.
As Christchurch, New
Zealand, rebuilds following the
devastation of the 2010 and 2011
earthquakes, researchers
interviewed 26 people with
dementia to gain insight into
how Christchurch can be rebuilt
in a dementia-friendly way.
Participants lived either in their
own home or a residential care
facility.
Several common themes
emerged from the one-to-one
interviews. Participants talked
about the importance of being
engaged in community and
social life; accessible and
accommodating leisure
activities and transport;
respectful and responsive
businesses/services; and the
need for raising awareness of
dementia and building
understanding within the
community.
Participants expressed the
need for clear signage to enable
independent navigation around
the city and plenty of access to
outdoor spaces which
incorporate trees and plants.
Reliable public transport was
also a priority as most
participants were no longer
driving.
The researchers noted that
feelings of belonging,
connection and safety were
overarching issues that had
been affected by the separation
of communities due to
earthquake damage.
Interestingly however,
participants did not express a
need to prioritise restoration of
familiar landmarks.
In closing, the researchers
reiterate that Christchurch has
the opportunity to embrace
dementia- and disability-
friendly design rather than
recreating unnecessary barriers
to inclusion and independence.
Smith K, Gee S, Sharrock T,
Croucher M (2016) Developing a
dementia-friendly Christchurch:
perspectives of people with
dementia.
Australasian Journal on
Ageing
35(3) 188-192 .
Building a dementia-
friendly city
An e-Learning education intervention for aged
care staff was recently trialled in Queensland and
Northern NSW. It focused on sexuality, an often
low-priority training topic, but one that can have
very real effects on the well-being and quality of
life of people with dementia.
Forty-two participants including nursing
students, registered and enrolled nurses, personal
care workers and diversional therapists
volunteered for the trial. Participants were
surveyed about their knowledge and attitudes
towards sexual expression by older people in
residential care both before and after the
intervention.
The e-Learning resource included four learning
modules: 1) intimacy, sexuality and sexual
behaviour; 2) dementia and the expression of
sexuality; 3) ethical considerations, developing
policy and guidelines for sexuality and dementia
in care settings; and 4) developing dementia and
sexuality policy guidelines for care practice.
Surveys and intervention took approximately
one hour each to complete. Ahandful of
participants were then interviewed and asked to
verbalise their decision-making processes in
response to two fictitious scenarios involving a
resident with dementia and their involvement in
sexual activity. The interviews were recorded and
then analysed for common themes in participant
responses.
Results of the e-Learning intervention were
promising, with participants’ knowledge of, and
attitudes towards, sexuality in older people
significantly improving. Common themes
extracted from the interview responses were
‘being happy and well’, ‘conferring with family’,
and ‘workplace policy’.
Interviewed participants acknowledged that
people with dementia are able to consent to
involvement in intimate and/or sexual
relationships and that these relationships could
have positive effects on the person’s happiness
and well-being.
They also acknowledged that family members
may need support in accepting such relationships.
Participants also highlighted the need for
workplace policies to help guide them in
responding appropriately to the individual as
well as their family.
Overall, participants felt that the intervention
was beneficial and increased their understanding
of sexual expression in older people. However,
they wanted to be able to discuss the topics with
others, which the platform did not allow for.
The researchers suggest presenting the
intervention as a web-based seminar to enable
discussion. They also acknowledge that more
research is required to assess whether the
intervention resulted in changes in care delivery
and resident outcomes.
Jones C, Moyle W (2016) Sexuality and dementia: an e-
Learning resource to improve knowledge and attitudes of
aged-care staff. Educational Gerontology 42(8) 563-571.
Sexuality education intervention assessed
Agroup of researchers from
WesternAustralia and NSW has
developed a tool for assessing
the appropriateness of
medication for comorbid health
conditions in people with
dementia.
The ‘Medication
Appropriateness Tool for
Comorbid Health Conditions in
Dementia’ (MATCH-D) is
designed to provide specific
consensus-based advice on:
symptommanagement;
prescribing to reduce the risk of
future events; medications to
slow dementia progression;
psychoactive medications; the
experience of side-effects; and
indicators of the need for
medication reviews.
The researchers surveyed 55
clinical and research-based
experts with relevant
backgrounds including
pharmacists, doctors, nurse
practitioners, a patient advocate
and psychologist. Statements
included in the final tool were
refined over three rounds of
surveys.
Responses in round one were
analysed for common themes
and these formed the basis of
statements presented in
subsequent rounds. The
researchers developed the
MATCH-D criteria from 111
statements that participants
reached consensus on,
condensing them into 67
statements across eight
categories.
The researchers’ initial
intention was to create an
explicit list of medications that
are/are not appropriate.
However a strong message
received from the experts was
the importance of an
individualised, person-centred
approach to medication
management for people with
dementia.
Researchers noted the need
for medication management to
focus on treatment goals
important to the individual and
their families, as medication
decisions are frequently a trade-
off between potential risks,
benefits and side-effects.
They also noted the
importance of reviewing
medications for comorbid
conditions as dementia
progresses. Further research is
required to assess the clinical
usefulness of the MATCH-D
and to determine whether its
application leads to improved
health outcomes and quality of
life for people with dementia.
Page AT, Potter K, Clifford A,
McLachlan AJ, Etherton-Beer C
(2016) Medication appropriateness
tool for comorbid health conditions in
dementia: consensus
recommendations from a
multidisciplinary expert panel.
Internal
Medicine Journal
46(10) 1189-1197.
New medication management tool developed