• Health Care Aides' Conversations with Families About End-Of-Life and Dementia

      Meisenburg, Natalie; Applied Health Sciences Program
      Background: Research has demonstrated that health professionals have a difficult time talking with family members of people with dementia about end-of-life and avoid these conversations. A palliative approach is appropriate for dementia and effective communication between healthcare providers and relatives is imperative in this approach. Research Question: How do health care aides (HCAs) in long-term care (LTC) homes experience discussions about death and dying with relatives of residents who have dementia? The aim of this descriptive qualitative study was to explore the experiences of health care aides’ (HCAs) and understand the conversations they have with family members when a resident in long-term care has dementia and is nearing end-of-life. Methods: This study was a descriptive qualitative study, with thematic analysis of interviews of 14 HCAs from 6 LTC homes in Ontario, Canada. Findings: There were four themes. Findings include conversations occur in-person and families initiate conversations. Conversations can be difficult and emotional and relationships with residents, families, fellow HCAs, and nurses, influence the conversations. Conversations occur in the context of written and unwritten rules and can make conversations difficult. Discussion: Conversations between HCAs and families occur, and HCAs respond to relatives’ questions. It is important to support HCAs and provide them with a clear understanding of responding to relatives’ questions.
    • Music Lessons: Exploring the Role and Meaning of Music Among Community-Dwelling Older Adults with Dementia

      Elliott, Melanie; Applied Health Sciences Program
      An aging population and increasing rates of dementia point to the need for alternative strategies to allow individuals to age in place. The purpose of this multiple case study is to explore, from an insider’s perspective, the role and meaning of music in the lives of individuals with dementia who are aging in place. The following three questions guide this exploration: What does music mean to someone with dementia and if/how has this changed, over time? How does music influence the health and wellbeing of individuals with dementia? How is music integrated into the day-to-day lives of individuals with dementia aging in place? Critical qualitative research was conducted through semi-structured interviews, observations, and videos. All three participants were in the early stages of dementia, living in the community (not in an institution), residing in Ontario, using music in their lives in a routine capacity, and not enrolled in music therapy. The partners of each of the participants were also included in the data collection process. The qualitative data was analyzed following a 10-step process that integrated the textual, auditory, and visual data. Analysis revealed that music plays a beneficial, yet complicated, role in these individuals’ lives. Analysis highlighted ‘connection’ as the central theme of the study with the various ‘connectors’ - self, partner, music and the study itself - as subthemes. Connection to self is discussed through present moment awareness, accessing memories, and self-expression. Connection to partner is explained in light of self-connection and spending time together. The connection to music acknowledges the self and partner as well as the need to keep things “ordinary”. Lastly, connection to the research is a methodological finding that speaks to the transformative nature of qualitative research. Findings from each sub-theme are described using examples from the data and discussed in relation to the literature. This study provides insight into the growing body of interdisciplinary literature dedicated to dementia, music, aging in place, and contemplative practices, as well as makes suggestions for future areas of research.