Nurturing attentiveness: a naturalistic observation study of personal care interactions between people with advanced dementia and their caregivers

Backhouse, Tamara ORCID: https://orcid.org/0000-0001-8194-4174, Jeon, Yun-Hee, Killett, Anne ORCID: https://orcid.org/0000-0003-4080-8365, Green, Jessica, Khondoker, Mizanur ORCID: https://orcid.org/0000-0002-1801-1635 and Mioshi, Eneida (2024) Nurturing attentiveness: a naturalistic observation study of personal care interactions between people with advanced dementia and their caregivers. The Gerontologist. ISSN 0016-9013

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Abstract

Background and objectives: Personal care interactions can provide vital opportunities for caregivers to engage with a person living with advanced dementia. However, interactions may also be a contentious experience, what makes this so is not fully understood. We aimed to examine features of personal care interactions between caregivers and people with advanced dementia to understand how care may be improved. Research design and methods: This was a naturalistic observation study using one-off video-recorded observations of personal care interactions between fourteen people with advanced dementia and twelve caregivers (n=7 care-home staff, n=5 family carers) in the UK (total observation time 03:01:52). Observations were analysed with observational video coding to determine the frequency of actions of people with dementia and qualitative content analysis for in-depth examination. Results: Refusals of care were present in 32% of video sections. Active engagement of people with dementia was observed in 66% of sections. Rare contentious interactional components were characterised by the person with dementia appearing to show uneasiness and caregivers being flustered and uncertain. However, caregivers typically emanated a nurturing attentiveness, were attuned to the person and skilled in seamlessly supporting them through care activities. Discussion and implications: Findings draw on real-world empirical evidence to reinvigorate the notion of person-centredness in dementia care. The findings provide much needed insight into practical ways to improve care interactions for people with advanced dementia and enhance their personhood. Appropriate training/guidance for caregivers could support positive personal care experiences for both the person with dementia and caregiver.

Item Type:	Article
Additional Information:	Data Availability: Raw data cannot be shared due to ethical restrictions, however anonymised transcripts are available on reasonable request from the corresponding author. Funding information: This work was supported by a fellowship award from The Alzheimer’s Society, UK (Grant Number: 372: AS-JF-17-002). Author TB received support from the NIHR Applied Research Collaboration ARC [East of England] and Alzheimer’s Society funded through a Post-Doctoral Fellowships. EM, and AK are supported by the National Institute for Health and Care Research Applied Research Collaboration East of England (NIHR ARC EoE). The views expressed are those of the authors and not necessarily those of the funders, Alzheimer’s Society, National Institute for Health and Care Research, NHS, or the University of East Anglia.
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Health Sciences Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Dementia & Complexity in Later Life Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Centres > Population Health Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging
Depositing User:	LivePure Connector
Date Deposited:	06 Dec 2023 02:20
Last Modified:	04 Mar 2024 18:23
URI:	https://ueaeprints.uea.ac.uk/id/eprint/93875
DOI:	10.1093/geront/gnae004

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