TY - JOUR
T1 - An Interpretive Phenomenological Analysis (IPA) of coercion towards community dwelling older adults with dementia: Findings from MYsore studies of Natal effects on Ageing and Health (MYNAH)
AU - Danivas, V
AU - Bharmal, M
AU - Keenan, Paul
AU - Jones, Steven
AU - Karat, S
AU - Kalyanaraman, K
AU - Prince, M
AU - Fall, C
AU - Krishna, M
PY - 2016/9/26
Y1 - 2016/9/26
N2 - Abstract
Purpose Limited availability of specialist services places a
considerable burden on caregivers of Persons with
Dementia (PwD) in Low- and Middle-Income Countries
(LMICs). There are limited qualitative data on coercive
behavior towards PwD in an LMIC setting.
Aim The aim of this study was to find relevant themes of
the lived experience of relatives as caregivers for PwD in
view of their use of coercive measures in community setting
in South India.
Method Primary caregivers (n = 13) of PwDs from the
Mysore study of Natal effects on Ageing and Health
(MYNAH) in South India were interviewed to explore the
nature and impact of coercion towards community
dwelling older adults with dementia. The narrative data
were coded using an Interpretative Phenomenological
Analysis (IPA) approach for thematic analysis and theory
formation.
Results Caregivers reported feeling physical and emotional
burn-out, a lack of respite care, an absence of
shared caregiving arrangements, limited knowledge of
dementia, and a complete lack of community support
services. They reported restrictions on their lives through
not being able take employment, a poor social life,
reduced income and job opportunities, and restricted
movement that impacted on their physical and emotional
well-being. Inappropriate use of sedatives, seclusion and
environmental restraint, and restricted dietary intake,
access to finances and participation in social events, was
commonly reported methods of coercion used by caregivers
towards PwD. Reasons given by caregivers for
employing these coercive measures included safeguarding
of the PwD and for the management of behavioral problems
and physical health.
Conclusion There is an urgent need for training health and
social care professionals to better understand the use of
coercive measures and their impact on persons with
dementia in India. It is feasible to conduct qualitative
research using IPA in South India.
AB - Abstract
Purpose Limited availability of specialist services places a
considerable burden on caregivers of Persons with
Dementia (PwD) in Low- and Middle-Income Countries
(LMICs). There are limited qualitative data on coercive
behavior towards PwD in an LMIC setting.
Aim The aim of this study was to find relevant themes of
the lived experience of relatives as caregivers for PwD in
view of their use of coercive measures in community setting
in South India.
Method Primary caregivers (n = 13) of PwDs from the
Mysore study of Natal effects on Ageing and Health
(MYNAH) in South India were interviewed to explore the
nature and impact of coercion towards community
dwelling older adults with dementia. The narrative data
were coded using an Interpretative Phenomenological
Analysis (IPA) approach for thematic analysis and theory
formation.
Results Caregivers reported feeling physical and emotional
burn-out, a lack of respite care, an absence of
shared caregiving arrangements, limited knowledge of
dementia, and a complete lack of community support
services. They reported restrictions on their lives through
not being able take employment, a poor social life,
reduced income and job opportunities, and restricted
movement that impacted on their physical and emotional
well-being. Inappropriate use of sedatives, seclusion and
environmental restraint, and restricted dietary intake,
access to finances and participation in social events, was
commonly reported methods of coercion used by caregivers
towards PwD. Reasons given by caregivers for
employing these coercive measures included safeguarding
of the PwD and for the management of behavioral problems
and physical health.
Conclusion There is an urgent need for training health and
social care professionals to better understand the use of
coercive measures and their impact on persons with
dementia in India. It is feasible to conduct qualitative
research using IPA in South India.
U2 - 10.1007/s00127-016-1286-4
DO - 10.1007/s00127-016-1286-4
M3 - Article (journal)
SN - 0933-7954
SP - 1
EP - 6
JO - Social Psychiatry and Psychiatric Epidemiology
JF - Social Psychiatry and Psychiatric Epidemiology
ER -