Human capabilities in advanced dementia: Nussbaum's approach

Melander, Catharina; Sävenstedt, Stefan; Wälivaara, Britt-Marie; Olsson, Malin

doi:10.1111/opn.12178

Cited by 14 publications

(38 citation statements)

References 37 publications

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“…Understanding an individual's needs is a continuous process that develops over time and facilitates more holistic decisions regarding care interventions and support based on a deeper understanding of the individual. In addition, understanding the individual has been shown to improve patient participation in the decision-making process [ 31 ], which is an important part of a good and dignified life [ 34 ]. However, spending sufficient time with each individual can be challenging in the demanding and often busy context of nursing homes and dementia care units [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Using Measurements of Electrodermal Activity in the Assessment of Problematic Behaviour in Dementia

Melander

Kikhia

Olsson

et al. 2018

Dement Geriatr Cogn Disord Extra

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Background: A major and complex challenge when trying to support individuals with dementia is meeting the needs of those who experience changes in behaviour and mood. Aim: To explore how a sensor measuring electrodermal activity (EDA) impacts assistant nurses’ structured assessments of problematic behaviours amongst people with dementia and their choices of care interventions. Methods: Fourteen individuals with dementia wore a sensor that measured EDA. The information from the sensor was presented to assistant nurses during structured assessments of problematic behaviours. The evaluation process included scorings with the instrument NPI-NH (Neuropsychiatric Inventory-Nursing Home version), the care interventions suggested by assistant nurses to decrease problematic behaviours, and the assistant nurses’ experiences obtained by focus group interviews. Results: The information from the sensor measuring EDA was perceived to make behavioural patterns more visual and clear, which enhanced assistant nurses’ understanding of time-related patterns of behaviours. In turn, this enhancement facilitated timely care interventions to prevent the patterns and decrease the levels of problematic behaviour. Conclusion: With the addition of information from the sensor, nursing staff could target causes and triggers in a better way, making care interventions more specific and directed towards certain times throughout the day to prevent patterns of problematic behaviours.

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Section: Discussionmentioning

confidence: 99%

The Impact of Using Measurements of Electrodermal Activity in the Assessment of Problematic Behaviour in Dementia

Melander

Kikhia

Olsson

et al. 2018

Dement Geriatr Cogn Disord Extra

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“…Some studies suggest that people with dementia are vulnerable to undignifying care practices when their inability to clearly communicate leads to a lack of understanding of their suffering and wishes by the professional care providers (42)(43)(44)54). Unnecessary suffering in the end of life is linked to misunderstanding and the lack of acknowledging that someone with dementia is dying can lead to a confused approach to care (33,40,41,45,(51)(52)(53)55).…”

Section: Impending Estrangement and Misunderstandingmentioning

confidence: 99%

“…Multiple studies (N = 11) suggest that personalisation and individualisation are essential dignifying aspects of care (31,34,36,38,39,42,44,46,(50)(51)(52). Some studies refer to providing person-centred care (35,44,52), address the importance to continue the self and identity (36,43,56), or point to respect and acknowledging personhood (30,35,44,49).…”

Section: Dignifying Aspects Of Dementia Carementioning

confidence: 99%

“…Studies based on the lived experiences of people with dementia showed their wish of being met as an equal human being with equal human worth (35,42,(47)(48)(49). Dignifying care practices ensure that residents feel like an active participant and expert on their own life (34)(35)(36)42,46,48,49,58). Professionals can show respect for self-determination of residents with mild cognitive impairment by informing about individual preferences and involving them in the care process (51)(52)(53)57).…”

Section: Respect Attentiveness and Encouragementmentioning

confidence: 99%

“…Professionals can show respect for self-determination of residents with mild cognitive impairment by informing about individual preferences and involving them in the care process (51)(52)(53)57). Respect for personal boundaries, privacy and personal space preserves dignity of residents (33,42,43,51,52,57). Consequently, care professionals are in need of compromising skills in order to respect wishes and perform the duty of care (41,51).…”

Section: Respect Attentiveness and Encouragementmentioning

confidence: 99%

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Dignifying and undignifying aspects of care for people with dementia: a narrative review

Geugten

Goossensen

2019

Scandinavian Caring Sciences

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Background: The progressive disease trajectory makes people with dementia increasingly vulnerable and gradually more dependent on others which can lead to admission to a nursing home. Special interest in dignity in people with dementia has led to a growing body of knowledge towards promoting or hindering their dignity. Aim: The aim of this narrative review was to synthesise dignifying and undignifying aspects of formal and informal care for people with dementia within nursing homes. Method: The electronic databases CINAHL, SCOPUS, PSy-cInfo and PubMed were systematically searched with the terms 'dementia' and 'dignity', complemented with the use of snowballing and reference check. A total of 789 unique items were found. The search and selection process was structured by the PRISMA framework, and both authors formulated the criteria of eligibility. A methodological check was performed using the critical appraisal tool of Hawker. This process led to inclusion of 29 articles which were reviewed with the help of the guidelines for narrative synthesis by Popay et al. Findings: The emerged dignifying and undignifying aspects of formal and informal care are characterised by either a successful or unsuccessful process of adjustment towards changing abilities, preferences and care needs of people with dementia. Three themes appeared as undignifying aspects of care: 'Stigmatisation and objectivation', 'Scarcity and hastiness' and 'Impending estrangement and misunderstanding'. Four themes were identified as dignifying aspect of care: 'Personalisation', 'Respect, attentiveness and encouragement', 'Attention for physical care and bodily gestures', and 'Foster belonging'. Literature synthesis showed mostly relational aspects of care concerning dignity in people with dementia. Formal and informal caregivers are important in maintaining and promoting their dignity.

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Digital Resources Aiding Opportunities for Affiliation and Practical Reasoning Among People with Dementia: A Scoping Review

Melander

Olsson

Jayousi

et al. 2019

Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering

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Human capabilities in advanced dementia: Nussbaum's approach

Abstract: The normative structure of the capability approach described by Nussbaum can ensure that nursing staffs move beyond fulfilling patients' basic needs to consider other capabilities vital for a dignified life.

Cited by 14 publications

References 37 publications

The Impact of Using Measurements of Electrodermal Activity in the Assessment of Problematic Behaviour in Dementia

The Impact of Using Measurements of Electrodermal Activity in the Assessment of Problematic Behaviour in Dementia

Dignifying and undignifying aspects of care for people with dementia: a narrative review

Digital Resources Aiding Opportunities for Affiliation and Practical Reasoning Among People with Dementia: A Scoping Review

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