Modifications in the life space of people with dementia
Date Issued
2009
Date
2009
Author(s)
Hung, Chia-Jui
Abstract
The number of people afflicted with dementia in Taiwan was estimated to be about 140,000, among which the majority receive informal care given by family members. In order to create a better living environment for people with dementia and their caregiving family, it is essential to understand the changes in their life space, including both physical environments and social interpersonal networks. he major research method employed is semi-structured interviews with members in 18 families caring for relatives with mild to severe dementia. In these families 5 people with dementia participated in the study with non-structured interview. Cognitive mapping, physical enivorment assessment, and participatory observation were also used as multi-research methods. The life space frameworks proposed by Rowles(1978) and Tsai(2001) were modified to analyse the life space modification experiences of people with dementia and of their caregiving family members. The aspects of their life space consist of home, double surveillance zone, living neighborhood, social neighborhood, and fantasy. t is found that the life space of most people with dementia undergoes notable changes, and family caregivers play a key role in this dynamic change process. Family caregivers would accommodate their home to the safety and convenience of the person afflicted. They might also attempt to create a living environment—by spatial modification and activity arrangement–that can provide moderate stimuli for the elderly. Besides, the relationship and interaction pattern between the person with dementia and the caregiving family member also need some adjustment. As to life space beyond home, family caregivers would usually attempt to modify the outdoor activity patterns of people with dementia. To those elderly who are not allowed to go out by themselves or those whose mobility is limited, double surveillance zone may serve as a significant channel to get connected with the outside world. As the person with dementia stays at (or near) home to get in touch with the outdoor environment, family caregiviers can also make sure of their safety and well-being.reat heterogeneity exists in these families’ experiences of dementia home care and life space modification. A major changing tendency of their life space can be observed, however. As dementia progresses, the life space of the people afflicted concentrates more and more upon home environment. Activities inside or beyond their living neighborhood would most likely decrease. The occurrence of some events usually prompts family caregivers to modify the life space of people with dementia. Once the persons with dementia get loss or their physical strength and mobility declines to certain degree, or as they begin to show serious time and space disorientation, their life space might face further compression. variety of factors influence the dynamic changing process in which family caregivers try to shape a suitable caregiving life space for people with dementia. On the one hand, family caregivers need to respond to the elderlys’ changing conditions whether from their ageing or from their cognitive and noncognitive symptoms. On the other hand, family caregivers try hard to find balance among internal factors such as caregiving values, family conditions, family relationships, and resources, as well as external and structural factors such as social welfare accessability and living area environment. he life space of family caregivers turns out to be in covariation with that of people with dementia. In order to take control of caregiving and living requirements, most family caregiviers would modify the life space of the elderly carereceiver. In this modification process the caregiver’s own life space also undergoes changes to different extents. Some family caregivers, on the contrary, find it hard to alter the life space of the people with dementia due to the dyad’s relationship. They resort to changing their own life space or help from social networks so as to react to constantly-changing caregiving requirements.
Subjects
people with dementia
life space
family caregiver
home modification
double surveillance zone
living neighborhood
social neighborhood
Type
thesis
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