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Title: Caring for elderly people with dementia in Hong Kong : towards a holistic approach
Other Titles: Xianggang an lao yuan she shi zhi zhang zhe : quan ren zhao gu mo shi
香港安老院舍失智長者 : 全人照顧模式
Authors: Mok, Wai Kit Linda (莫惠潔)
Department: Department of Applied Social Studies
Degree: Master of Philosophy
Issue Date: 2009
Publisher: City University of Hong Kong
Subjects: Older people -- Institutional care -- China -- Hong Kong.
Senile dementia -- Patients -- Care -- China -- Hong Kong.
Notes: CityU Call Number: HV1484.C65 H6694 2009
xiii, 299 leaves : ill. (some col.) 30 cm.
Thesis (M.Phil.)--City University of Hong Kong, 2009.
Includes bibliographical references (leaves 192-201)
Type: thesis
Abstract: This study was undertaken with the purpose of enhancing the quality of care for elderly people with dementia living in institutional settings in Hong Kong through advancing from medical and behavioural management models towards a Holistic Care Approach. The Holistic Care Approach in this study is based on three core dimensions of a Person, which are shown in behavioural, cognitive, and humanistic social interactions. Literature support for the framework of such a Holistic Approach is to be found in theories arising from Behavioural Psychology, Cognitive Behavioural Psychology, and Humanistic Social Psychology. The study proceeded in two stages. Results from a Stage I quantitative survey were incorporated into an experimental design for Stage II which explored whether changes take place in formal care staff members following Holistic Approach training. Stage I, the quantitative study, took place in 2007. A total of 639 formal care staff members who worked directly with older people with dementia in 27 government sub-vented and 36 private homes in Hong Kong completed self-administered questionnaires on their difficulties in handling disturbed behaviours and their perception of burnout Stage II was conducted in 2008. Data was collected in two Care and Attention Homes. Eight weeks of Holistic approach training was provided for an intervention group while no training was provided for a comparison group. There were several major findings from the study. A first finding was that the five most frequently reported "difficult to handle behaviours" exhibited by older people with dementia were: spitting; going missing; wandering; complaining about personal items being stolen; and complaining about personal items being lost. Secondly, analysis found that lack of organizational support was the key determinant of staff burnout but that provision of training courses and support for formal care staff strengthened their sense of personal accomplishment. Thirdly, findings showed that the Mace behavioural dimension, one of the training elements in the Holistic Training Model, was effective for handling disturbed behaviours. Fourthly, formal care staff who had undertaken Holistic Training experienced an increased sense of personal accomplishment. The overarching contribution of this study is to demonstrate that receiving Holistic Approach training strengthens caring practices, benefiting those with dementia, and increases the sense of personal accomplishment in care givers, thus benefiting formal care staff members in institutions. The study reflects a trend towards a Holistic style of caring known as “Caring by Doing and Knowing” which addressed three core dimensions, behavioural, cognitive and social humanistic aspects of “Persons” with dementia.
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