Claire Choi A.P. Seminar: Lit Map Template (IWA) by Claire Choi

CLAIM 1: Those with dementia are in a vulnerable state, requiring quality care.

claire_choi — 2025-03-31 13:58:24 UTC

Context + Introduction + Focus (Problem/Issue Statement)

claire_choi — 2025-03-31 13:58:24 UTC

As long-term care homes become more common, problems continue to rise in the context of the quality of care and living. However, nursing homes and long-term care facilities are most accessible and convenient for most. (Fatima, 2025) As those with dementia are vulnerable and in need of quality care, they must be placed in environments where they are cared for with precision and quality. This is not the case for many. In a study conducted by Botngard, it was discovered that 76% of staff observed one or more cases of elder abuse in a nursing home. (Botngard, 2020)This goes on to show how many long-term care facilities are unfit for this group of vulnerable people. Elder abuse can be perpetrated in different ways, one being medication abuse. Poorly trained staff are giving their patients antipsychotic medication, which is very risky. It is said that medication should be a last resort. (Dobbs, 2021) According to Dobbs and Kelly, experts in psychology/dementia, there are healthier and more effective ways that could benefit those with dementia, such as reminiscence therapy, circadian alignment, and keeping familiar environments. (Kelley, 2018) (Woods, 2018). Those with dementia must be treated with quality care. In today's society, that is not the case.

CLAIM 2: Elder abuse is far too normalized and cause direct harm to those with dementia.

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CLAIM 3: Nursing homes can cause mental health and behavioral issues to those with dementia.

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“We Moved Her Too Soon”: Navigating Guilt Among Adult Child and Spousal Caregivers of Persons Living With Dementia Following a Move Into Residential Long-Term Care

claire_choi — 2025-03-31 13:58:24 UTC

Attributive Language: Research done by Statz et al. (Statz et al., 2022) researchers at the health division at the University of Minnesota found that many people felt guilty because these homes are very depressing, expensive, and heartbreaking, as the elders ask to be “taken home.” (Statz et al., 2022). The residents in these long-term care facilities are in unfamiliar and unhealthy environments. They need to be provided quality care instead of being put in care homes. Additional research shows that they are more susceptible to mental health problems and deepened guilt. (Statz et al.,2022). Being placed in environments where guilt and depression are common, it may be risky and harmful for those with dementia.

Family perspectives on and experiences with advance care planning in nursing homes: A thematic synthesis

claire_choi — 2025-03-31 13:58:24 UTC

Research done by Choi et al., researchers at the School of Nursing of the University of Hong Kong, claims that families must make some decisions for their loved ones with dementia. This is due to the cognitive decline of these residents. End-of-life decisions are made by nurses and family who determine their future. (Choi et al., 2024). If they are unable to make their own decisions, there is no doubt that they are in critical condition or in need of quality care.

Research Question

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How can retirement homes improve to create a more accommodating environment for dementia patients while addressing the current factors that contribute to an unhealthy living space for them?

Synthesis Post

claire_choi — 2025-03-31 13:58:24 UTC

Once a resident's cognitive abilities decline to a certain point, they are unable to make their own decisions. These individuals are in a very fragile state, requiring care and attention from not only caregivers but also from loved ones.

BIG TAKEAWAY

claire_choi — 2025-03-31 13:58:24 UTC

These sources explain why it's important for dementia residents to have specialized care that aims to help those with the many complications of dementia. Those with dementia are in conditions where it may be hard to get through everyday, requiring assistance and supervision.

Synthesis Post

claire_choi — 2025-03-31 13:58:24 UTC

Elder abuse in nursing homes is far too normalized. Due to the unclear protocols and rules, it continues to happen. Those with dementia are especially susceptible to this issue, as they are in need of special care.

Synthesis Post

claire_choi — 2025-03-31 13:58:24 UTC

Another aspect that causes the detriment of residents condition is the constant supply of antipsychotic drugs, leading to many mental health issues that are prevalent in nursing homes.

Synthesis Post

claire_choi — 2025-03-31 13:58:24 UTC

Most of the mental health and behavioral issues stem from poorly trained staff who are responsible for the dementia residents. This is preventable with clear staff protocol.

Although dementia residents are in need of quality care, they are often faced with abuse and insufficient care.

claire_choi — 2025-03-31 13:58:24 UTC

Not only does the environment arise potential abuse-risks, nursing homes can lead to the detriment of one's mental health.

claire_choi — 2025-03-31 13:58:24 UTC

Synthesis Post

claire_choi — 2025-03-31 13:58:24 UTC

Family plays a big role in the placement of elders in nursing homes and the end-of-life decisions that are relevant to the elders. It's important for family members to be informed and educated on not only the choices, but the environment that they are putting their loved one into.

CONCLUSION

claire_choi — 2025-03-31 13:58:24 UTC

The quality of living in nursing homes for those with dementia is not talked about enough. Many injustices occur behind the scenes, making them unfit for vulnerable groups such as those with dementia. It is important to address these issues, while providing sufficient care for our elders.

MAIN IDEA

claire_choi — 2025-03-31 13:58:24 UTC

While nursing homes are most feasible for families, there are better options that provide better care for those with dementia. Nursing homes are infamous for treating their residents poorly. There are also better strategies in improving mood and cognitive ability for those with dementia. These strategies are hardly used in nursing homes, causing residents to feel lonely, depressed, and anxious.

Nursing homes provide an unfit environment for those with dementia. Other care units and methods can provide for a healthier lifestyle.

claire_choi — 2025-03-31 13:58:24 UTC

CLAIM 4: There are healthier and more efficient ways to help those with dementia.

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Synthesis Post

claire_choi — 2025-03-31 13:58:24 UTC

The lack of protocols and rules leads to a potentially non-regulated supply of medication to the residents with dementia. Not only could this cause a reliance on drugs, but they are also harmful to the well-being of the fragile individuals.

Synthesis Post

claire_choi — 2025-03-31 13:58:24 UTC

Special care units provide quality care for their residents, unlike nursing homes. They provide therapy that aims to mitigate dementia-motivated behaviors. One example of that is reminiscence therapy that is specifically targetted for those with dementia.

Synthesis Post

claire_choi — 2025-03-31 13:58:24 UTC

There are many methods to increase mood and stability for those with dementia. With the combination of mental help and cognitive help, the risk of depression and other mental health issues diminishes, while the cognitive ability of those may increase.

Longitudinal Predictors of Time to Care Facility Placement in Patients With Dementia: A Joint Longitudinal and Survival Model Approach

claire_choi — 2025-03-31 13:58:24 UTC

Attributive Language: Hudaisia Fatima from the Department of Psychiatry at University of Texas Southwestern Medical Center claims that the likelihood of being in assisted care increases with older age, living alone, impairments, and neuropsychiatric symptoms. (Fatima, 2025) All of these symptoms are effects of dementia, making it more likely for them to need specialized dementia care. Impairments and neuropsychiatric symptoms are detrimental and difficult to get through without help. Those with these symptoms are in need of specialized care.

Living with dementia in a nursing home, as described by persons with dementia: a phenomenological hermeneutic study

claire_choi — 2025-03-31 13:58:24 UTC

According to Marit Mjorud, a researcher at the Norwegian National Advisory Unit, claims that although most residents have accepted the fact that they are in nursing homes, they have feelings of loss. This consisted of loss of familiar environments, routines, personal belongings, and more, which eventually led to a sense of emptiness. (Mjorud, 2017) The way that the nursing homes are set up leads to a loss of personalization and familiarity. Residents feel an increased sense of emptiness due to the lack of personal items, routines, and more. They are often reminded of the little that they have left from their past.

"They Want Docile"

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Attributive Language:

The Human Rights Watch, an organization that documents human rights violations, claims many nursing homes across the US routinely give antipsychotic drugs to residents with dementia to control common behaviors. (Human Rights Watch, 2018) This can lead to the abuse and reliance on drugs for those with dementia. Not only can this cause misuse, but too much of these drugs can cause cognitive, social, and emotional consequences after their use.

Elder abuse and neglect: an overlooked patient safety issue. A focus group study of nursing home leaders’ perceptions of elder abuse and neglect

claire_choi — 2025-03-31 13:58:24 UTC

Hanne Myhre et al., researchers at the Department of Public Health and Nursing at the Norwegian University of Science and Technology, claim Many care homes lack clear protocols for addressing and preventing abuse, leading to the commonality of the issue. (Myhre et al., 2020) The main issue is the unclear protocols that protect the elders. There is also a lack of disciplinary actions for those who perpetrate abuse against elders in nursing homes. Abuse keeps on happening in nursing homes, making it an unsafe environment for all, but especially those with dementia.

Elder abuse in Norwegian nursing homes: a cross-sectional exploratory study.

claire_choi — 2025-03-31 13:58:24 UTC

Attributive Language: Anja Botngard et al., researchers at the Norwegian University of Science and Technology, claim "Among the subtypes of abuse, the prevalence of staff-reported psychological abuse was 32.5%; neglect 12.0%; physical abuse 9.3%, and sexual abuse 0.7%, and these rates were even higher when reported by older resident themselves" (Botngard, 2020) Abuse comes in many different ways in these nursing homes. As the dementia residents are most vulnerable, they are most susceptible to abuse. Abuse is too normalized in these nursing homes.

BIG TAKEAWAY

claire_choi — 2025-03-31 13:58:24 UTC

There are many ways that elder abuse is perpetrated. Due to the unclear protocols, the commonality of abuse risks the well-being of elders in long-term care facilities.

BIG TAKEAWAY

claire_choi — 2025-03-31 13:58:24 UTC

Many factors can contribute to the detriment of one's mental health or behavior in the environment that nursing homes provide. They are often preventable with proper training.

A Critical Study on the Impact of Dementia on Older People Undergoing Treatment in Care Homes

claire_choi — 2025-03-31 13:58:24 UTC

Aggarwal et al., researchers at the Datta Meghe Institute of Medical Sciences, claim, “Loneliness is a significant problem for most dementia patients, and this may trigger anxiety and depression. Hence, it is critical to attend to the psychosocial needs of the patients to ensure they are emotionally more stable.” (Aggarwal, 2022) In long-term care facilities, the conditions lead to common loneliness. This causes mental health issues amongst those with dementia. The combination of mental health issues and dementia could be very harmful for those.

Dementia, nurse staffing, and health outcomes in nursing homes

claire_choi — 2025-03-31 13:58:24 UTC

Dana Mukamel, at the Department of Medicine at the University of California, Irvine, claim, nursing homes and antipsychotic drugs lead to behavioral issues, anxiety, and aggression. (Mukamel, 2024) The combination of drug abuse and being in the nursing home environment can lead to multiple issues, including mental health. These facilities are poorly trained, leading to many issues.

Making Memories: Why Time Matters

claire_choi — 2025-03-31 13:58:24 UTC

Paul Kelley, who is a memory neuroscientist at the Open University, claims that circadian alignment, which aligns the internal (bodily) schedule with the external time, increases cognitive ability, more specifically, the ability to retain memories. (Kelley, 2018) Most residents in nursing homes follow routine schedules that do not account for the circadian rhythm. By prioritizing one's internal schedule, cognitive behaviors may improve.

Reminiscence therapy for dementia

claire_choi — 2025-03-31 13:58:24 UTC

Bob Woods et al., who is a reseracher at Bangor University in the Dementia Services Development Centre Wales, claim that reminiscentce therapy, which is using past items, memories, and other reminders to develop a sense of the past for those who have trouble remembering, improves mood, social interaction, and well-being in individuals with dementia while also potentially increasing cognitive abilities. There are far better ways to address some difficult behaviors that come with dementia.

The Quality of Advanced Dementia Care in the Nursing Home: The Role of Special Care Units

claire_choi — 2025-03-31 13:58:24 UTC

Rebecca Orfaly Cadigan from the School of Medicine of Harvard claims that those with dementia were treated with more specialized care than those with dementia in standard nursing homes. (Cadigan, 2012) This is due to the specially trained staff who know how to deal with specific behaviors that dementia residents may experience, further showing that nursing homes do not provide enough specialized care for those with dementia.

BIG TAKEAWAY

claire_choi — 2025-03-31 13:58:24 UTC

There are many ways to improve and address the complicated factors that dementia brings. This consists of factors that may change the environment of a resident or address their mental health and cognitive ability.