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  • 1. Marmstål Hammar, Lena
    et al.
    Swall, Anna
    Sophiahemmet University.
    Summer Meranius, Martina
    Ethical aspects of caregivers' experience with persons with dementia at mealtimes2016In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 23, no 6, p. 624-35Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Persons with dementia are at risk of malnutrition and thus in need of assistance during mealtimes. Research suggest interventions for caregivers to learn how to facilitate mealtimes and eating, while other suggest a working environment enabling the encounter needed to provide high-quality care. However, the phenomenon of caring for this unique population needs to be elucidated from several perspectives before suggesting suitable implications that ensure their optimal health.

    OBJECTIVES: To illustrate the meanings within caregivers' experiences of caring for persons with dementia during mealtime situations. We also measured weight and food intake among individuals with dementia to explain better the phenomenon of caring for them during mealtimes.

    METHODS: Mixed method including focus group interviews with seven caregivers analyzed using phenomenological hermeneutics. In addition, for nine persons with dementia, weight and food intake were collected and descriptive statistics were calculated.

    ETHICAL CONSIDERATIONS: Ethical review was obtained from an ethics committee, and all caregivers signed a consent form after being informed on the issue of research ethics. Relatives for persons with dementia were informed and signed the consent. In addition, throughout the study, the persons' expressions were observed aiming to respect their vulnerability, integrity, and dignity.

    FINDINGS: One theme emerged from interviews (struggling between having the knowledge and not the opportunity), which was built upon three subthemes (being engaged and trying; feeling abandoned and insufficient; being concerned and feeling guilty). Seven of nine persons with dementia lost a minimum of 1.3 kg of weight and ate a maximum of 49.7% of the food served.

    CONCLUSION: Caregivers struggle because they have knowledge about how to provide high-quality care but are unable to provide this care due to organizational structures. The weight loss and insufficient eating among the persons with dementia may support this conclusion. Sufficient time for adequate care should be provided.

  • 2.
    Swall, Anna
    Sophiahemmet University.
    "Being in the present": the meaning of the interaction between older persons with Alzheimer's disease and a therapy dog2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The number of persons with Alzheimer’s disease is increasing world-wide and the disease affects the persons, their families, the health care system and the economy within society worldwide. The symptoms and behaviours caused by Alzheimer’ disease may be difficult to manage for the person and their caregivers. Alternative methods are recommended before pharmacological treatment. The presence of a therapy dog has been described as beneficial, in for instance increasing well-being and alleviating symptoms and dementia behaviours. The overall aim of this thesis was to gain a deeper understanding of the influence of therapy dogs on persons with Alzheimer’s disease from the person’s and the dog handler’s perspectives. Further, adopting a longitudinal perspective, the study investigates the therapy dog’s influence on activity and sleep for persons with Alzheimer’s disease. Video observations of five persons with Alzheimer’s disease interacting with a therapy dog (I, II), as well as interviews with nine dog handlers (III) were gathered and transcribed. Data was analyzed using a phenomenological hermeneutical method (I, II, III). Registration of activity and sleep was conducted over a period of 16 weeks using an Actigraf that generated curves, and were then analysed using descriptive statistics (III). The time spent with the dog revealed memories and feelings resulting in existential thoughts of oneself and life, which then connected to the present situation (I). Distancing oneself from the symptoms of the disease when interacting with the dog showed a person functioning in the present with the dog, striving for the dog’s best and putting the dog before and above oneself (II). The therapy dog’s presence showed no pattern of effect on the patients’ daytime activity and sleep. The findings instead pointed to a great variety of possible different effects, bringing about increased activity at different time points, for example during night-time sleep (III), creating a respite from illness and contributing wordlessly to an existence but thoroughly directed by the dog handler, where the person was comfortable and took the initiative (IV). In conclusion, the therapy dog team’s presence with the person with Alzheimer’s disease induced meaning that allowed the person’s hidden qualities and abilities to develop and, when observed from a person-centred perspective, also brought out the individual in each person

  • 3.
    Swall, Anna
    et al.
    Sophiahemmet University.
    Ebbeskog, Britt
    Lundh Hagelin, Carina
    Sophiahemmet University.
    Fagerberg, Ingegerd
    'Bringing respite in the burden of illness': dog handlers experience of visiting older persons with dementia together with a therapy dog2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 15-16, p. 2223-31Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES:

    To illuminate meanings of the lived experiences of dog handlers' when visiting older persons with dementia with their therapy dog.

    BACKGROUND:

    Studies indicate that care of persons with dementia should focus on a person-centred approach with the person's interests in the centre. Animal-assisted therapy using a therapy dog in the care of persons with dementia has been shown to increase well-being and decrease problematic behaviours associated with the illness.

    DESIGN:

    A qualitative lifeworld approach was adopted for this study.

    METHODS:

    Data were collected from open-ended interviews with nine dog handlers, and the analysis conducted using the phenomenological hermeneutical method.

    RESULTS:

    The structural analysis resulted in one theme, 'Respite from the burden of illness for persons with dementia'.

    CONCLUSIONS:

    Visiting a person with dementia can be seen as an act of caring, providing temporary respite from their illness, and creating a special relationship between handler and patient. A therapy dog visit can represent a moment of communion between the handler and the person with dementia.

    IMPLICATION FOR CLINICAL PRACTICE:

    Dog handlers use their skills and knowledge to promote a situation that reduces symptoms of illness and encourages healthier behaviour. The results of this study may be of interest to researchers, clinical practitioners, caregivers and dog handlers who care for persons with dementia using therapy dog teams on prescription as an alternative method to minimise behavioural and psychological symptoms of dementia.

  • 4.
    Swall, Anna
    et al.
    Sophiahemmet University.
    Ebbeskog, Britt
    Lundh Hagelin, Carina
    Sophiahemmet University.
    Fagerberg, Ingegerd
    Can therapy dogs evoke awareness of one's past and present life in persons with Alzheimer's disease?2015In: International journal of older people nursing, ISSN 1748-3743, Vol. 10, no 2, p. 84-93Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Persons with Alzheimer's disease (AD) sometimes express themselves through behaviours that are difficult to manage for themselves and their caregivers, and to minimise these symptoms alternative methods are recommended. For some time now, animals have been introduced in different ways into the environment of persons with dementia. Animal-Assisted Therapy (AAT) includes prescribed therapy dogs visiting the person with dementia for a specific purpose.

    AIM: This study aims to illuminate the meaning of the lived experience of encounters with a therapy dog for persons with Alzheimer's disease.

    METHOD: Video recorded sessions were conducted for each visit of the dog and its handler to a person with AD (10 times/person). The observations have a life-world approach and were transcribed and analysed using a phenomenological hermeneutical approach.

    RESULTS: The result shows a main theme 'Being aware of one's past and present existence', meaning to connect with one's senses and memories and to reflect upon these with the dog. The time spent with the dog shows the person recounting memories and feelings, and enables an opportunity to reach the person on a cognitive level.

    CONCLUSIONS: The present study may contribute to health care research and provide knowledge about the use of trained therapy dogs in the care of older persons with AD in a way that might increase quality of life and well-being in persons with dementia.

    IMPLICATIONS FOR PRACTICE: The study might be useful for caregivers and dog handlers in the care of older persons with dementia.

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  • 5. Swall, Anna
    et al.
    Ebbeskog, Britt
    Lundh Hagelin, Carina
    Sophiahemmet University.
    Fagerberg, Ingegerd
    Stepping out of the shadows of Alzheimer's disease: a phenomenological hermeneutic study of older people with Alzheimer's disease caring for a therapy dog2017In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no 1, article id 1347013Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Living with Alzheimer's disease (AD) can involve a person being unable to recall and convey information in daily life. There are several ways to provide person-centred care to older people with AD, e.g. by empowering them in a situation. The use of animal-assisted therapy (AAT) with a therapy dog in the care of people with dementia is increasing, with the presence of a therapy dog being described as improving, among other things, the well-being and socialization of the person. The aim of this study was to illuminate meanings of care for people with AD in their encounters with a therapy dog.

    METHOD: The study used video-recorded observations of the person with AD and the dog. Data were transcribed and analysed using a phenomenological hermeneutic method.

    RESULTS: The main theme was "Using one's own resources and abilities as a human being", which meant being the person one can be and distancing oneself from the symptoms of AD during the time with the dog.

    CONCLUSIONS: The feelings evoked in the people with AD included empathy and altruism, which allowed for a sense of joy and tenderness, which may induce a sense of self-worth, of being needed, and of being meaningful.

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  • 6.
    Swall, Anna
    et al.
    Sophiahemmet University.
    Fagerberg, Ingegerd
    Ebbeskog, Britt
    Lundh Hagelin, Carina
    Sophiahemmet University.
    A therapy dog's impact on daytime activity and night-time sleep for older persons with Alzheimer's disease: a case study2014In: Clinical Nursing Studies, ISSN 2324-7940, E-ISSN 2324-7959, Vol. 2, no 4, p. 80-93Article in journal (Refereed)
    Abstract [en]

    Background: Animal-Assisted Therapy using dogs have been described as having a calming effect, decrease sundowning and blood-pressure in persons with Alzheimer’s disease. The aim was to investigate how continuous and scheduled visits by a prescribed therapy dog affected daytime and night-time sleep for persons with Alzheimer’s disease.

    Methods: In this case study, registration of activity and sleep curves was conducted from five persons with moderate to severe Alzheimer’s disease living at a nursing home, over a period of 16 weeks using an Actiwatch. Data was analysed with descriptive statistics.

    Result: The study shows no clear pattern of effect on individual persons daytime activity and sleep when encounter with a therapy dog, but instead points to a great variety of possible different effects that brings an increased activity at different time points, for example during night-time sleep.

    Conclusions: Effects from the use of a Animal-Assisted Therapy with a dog in the care of persons with Alzheimer’s disease needs to be further investigated and analysed from a personcentred view including both daytime and nightime activities.

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  • 7.
    Swall, Anna
    et al.
    Sophiahemmet University.
    Lundh Hagelin, Carina
    Sophiahemmet University.
    Fagerberg, Ingegerd
    'Stepping out of the shadows of Alzheimer's disease': a phenomenological hermeneutic study of older persons with Alzheimer's disease caring for a therapy dogArticle in journal (Refereed)
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