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P2‐487: DEVELOPING A DUAL PHARMACY‐HEALTH PSYCHOLOGY INTERVENTION TO SUPPORT THE NON‐PHARMACOLOGICAL MANAGEMENT OF BEHAVIORS THAT CHALLENGE IN PEOPLE LIVING WITH DEMENTIA IN CARE HOMES
Author(s) -
Shaw Rachel,
Maidment Ian D.
Publication year - 2019
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2019.06.2894
Subject(s) - intervention (counseling) , nursing , dementia , psychological intervention , context (archaeology) , medicine , motivational interviewing , health care , population , psychology , disease , environmental health , paleontology , pathology , economic growth , economics , biology
wandering. Methods: Semi-structured individual phone interviews containing 12 questions were conducted with family and formal caregivers, persons with mild dementia, health practitioners, police, social workers, industry and staff from community organizations that work with people affected by dementia. The purpose of the interviews was to determine what factors influenced strategy adoption of wander-management strategies and to identify differences between stakeholders. A secondary study involving family and formal caregivers identified antecedent behaviours indicative of critical wandering. Participants were requested to record daily observations of these behaviours among the persons with dementia within their care for 4 weeks. Responses from these interviews and observations were used to develop a guideline for strategy adoption of wander-management strategies. Face validity of the guideline was then assessed through 11 focus groups across stakeholders. Results: A total of 41 participants participated in the development of the guideline, and 34 participants assessed its face validity. Responses from the interviews produced 4 contextual factors that influence the successful adoption of wander-management strategies: (1) Risk associated with wandering; (2) Culture; (3) Geography; (4) Stigma. Perceived risk was conveyed as the most influential factor of strategy adoption across all stakeholder groups. Common antecedent behaviours of critical wandering events ranged from packing of belongings, preparing to go outside, and door lingering or tampering within continuing care facilities. The relationships of these 4 factors and antecedent behaviours were incorporated in the guideline. Conclusions: This is the first study to describe and validate factors that influence strategy adoption for dementiarelated wandering. The guideline of strategies will be made available for use by caregivers, health and community service providers to identify strategies to mitigate the risks associated with critical wandering.