Dawn Hemingway - Academia.edu (original) (raw)

Papers by Dawn Hemingway

Annals of Epidemiology, Sep 1, 2004

ABSTRACT Purpose The association between injurious falls requiring a visit to the emergency depar... more ABSTRACT Purpose The association between injurious falls requiring a visit to the emergency department and various classes of medications was examined in a case–control study of community living persons aged 66 years and older. It was hypothesized that medication use was related to injurious falls while controlling for comorbidity. Methods Administrative databases from a Canadian province provided the information used. Data were collected for all community-dwelling seniors aged 66 and older (n = 282,519) in the study year. Two series of analyses on medication use within 30 days of the fall were conducted using logistic regression; the first controlling for age, sex, socioeconomic status, and rural residence, and the second controlling for comorbid diagnoses as well. Results During the study year there were 9152 falls reported by 8534 individuals to provincial hospital emergency departments giving a crude fall rate of 32.4 per 1000 population per year (95% CI = 32.3, 32.5). The initial analysis identified 10 medication classes that were associated with an increased risk of an injurious fall, while controlling for age, sex, socioeconomic status, and rural residence. With further analysis controlling for the additional effects of comorbid disease, narcotic pain killers (odds ratio OR = 2.06, 95% confidence interval CI = 1.93, 2.17), anti-Parkinson agents (OR = 1.55, 95% CI = 1.26, 1.91), antidepressants (OR = 1.33, 95% CI = 1.23, 1.43), anticonvulsants (OR = 1.20, 95% CI = 1.07, 1.36), anticoagulants (OR = 1.20, 95% CI = 1.09, 1.33), electrolytic or water balance agents (OR = 1.19, 95% CI = 1.13, 1.26), antipsychotics (OR = 1.16, 95% CI = 1.01, 1.38), corticosteroids (OR = 1.13, 95% CI = 1.04, 1.22), and thyroid agents (OR = 1.07, 95% CI = 1.01, 1.15) remained as significant independent predictors of sustaining an injurious fall. Conclusion These results are based on a Canadian population-based study with a large community sample. The study found that taking certain medications were independent predictors of sustaining an injurious fall in the elderly population in addition to the risk associated with their medical conditions.

UNSTRUCTURED The number of people in society living with Dementia is growing. In Canada, most peo... more UNSTRUCTURED The number of people in society living with Dementia is growing. In Canada, most people who live with dementia live at home, often in a neighbourhood setting. Neighbourhood environments can be source of independence, social engagement, and well-being, but can also contain barriers that limit physical activity, social engagement, and well-being. A dementia-friendly neighbourhood includes assets that support persons living with dementia and their caregivers in multiple life domains, including those that support walking within the neighbourhood environment. The study design follow’s Arksey and O’Malley’s scoping review framework and PRISMA-P guidelines. A search of peer-reviewed studies in six electronic databases will be conducted to identify the use of GIS analysis to measure the walkshed of persons living with dementia in a community setting. Data will be extracted, analyzed and represented according to three domains, including study details, walkshed analysis methods, ...

Journal of Rehabilitation and Assistive Technologies Engineering

Introduction: Technology is an integral part of healthcare. With the rapid development of technol... more Introduction: Technology is an integral part of healthcare. With the rapid development of technological innovations that inform and support nurses, it is important to assess how these technologies may affect their workload particularly in rural contexts, where the workforce and supports may be limited. Methods: This literature review guided by Arksey and O’Malley’s scoping review framework describes the breadth of technologies which impact on nurses’ workload. Five databases (PubMed, CINAHL, PsycInfo, Web of Science, Business Source Complete) were searched. Thirty-five articles met the inclusion criteria. A data matrix was used to organize the findings. Findings: The technology interventions described in the articles covered diverse topics including: Cognitive care technologies; Healthcare providers’ technologies; Communication technologies; E-learning technologies; and Assistive technologies and were categorized as: Digital Information Solutions; Digital Education; Mobile Applicati...

International Journal of Qualitative Methods

Neighbourhoods are known to help maintain functional abilities and enable out-of-home activities ... more Neighbourhoods are known to help maintain functional abilities and enable out-of-home activities and social participation for people living with dementia. Dementia friendly and inclusive communities (DFC) frameworks recognize the importance of developing supportive and empowering environments for people living with dementia and their families. Beyond the core objective of raising awareness and eliminating stigma associated with dementia, most DFC frameworks also focus on improving accessibility and navigability in the neighbourhood environment. Limited research on this topic points to the importance of evidence-based design of the neighbourhood built environment to promote mobility and wayfinding, legibility, familiarity, and safety for people living with dementia. Increased relevance of DFCs for policy and practice calls for expanding this body of knowledge. The proposed study, titled “Dementia-inclusive Spaces for Community Access, Participation, and Engagement (DemSCAPE),” focuse...

Innovation in Aging

Aging in place has long been a policy objective in Canadian healthcare, with accompanying concern... more Aging in place has long been a policy objective in Canadian healthcare, with accompanying concerns about older adults in rural and remote regions, and growing interest in small urban areas as distinct from large urban ones. As one of the six health authorities in British Columbia (BC), Interior Health (IH) developed and implemented an innovative healthcare delivery model to support aging in place for older adults, while addressing system issues of cost containment and resource allocation. By transferring funds from acute care to primary care, IH created Seniors Health and Wellness Centres (SHWCs) in two small urban areas (Kelowna and Kamloops) and a third one with two rural sites (Salmon Arm and Revelstoke). Our multi-case study aimed to compare how the SHWCs are meeting their objectives, and addressing the priorities of rural and small urban older adults and their social determinants of health (SDoH). We used mixed methods of data collection and analysis, including key informant in...

Critical Inquiries for Social Justice in Mental Health

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Social Indicators Research, 2007

Social Indicators Research, 2003

The primary purpose of this study was tocompare the quality of life, health, and socialsupport of... more The primary purpose of this study was tocompare the quality of life, health, and socialsupport of caregivers and non-caregivers age 65or older. A secondary purpose was to examineage identity in these two groups. This samplewas taken from a large quality of life surveyof 875 individuals age 55 or older living incommunities in northern British Columbia,Canada (Michalos et al.,2001). We restricted

Administration & Society, 2012

This article applies and builds upon the network leadership models introduced by Provan and Kenis... more This article applies and builds upon the network leadership models introduced by Provan and Kenis to the case of the British Columbia Network for Aging Research (BCNAR). We specify a particular type of shared leadership model and term this a Targeted Shared Leadership (TSL) model based on the governance structure of BCNAR. Key features include six coleaders who are selected on the basis of representation of five major universities (typically in its gerontology center) situated in the five provincial health authorities in British Columbia. Several network characteristics are introduced and then applied to BCNAR to assess effectiveness of the leadership structure. Innovations in research grant capacity support, communication, mentorship and training of new gerontologists, and knowledge translation are used to specify the effectiveness of the leadership structural dynamics of BCNAR. Potential applications of this shared leadership model for other networks are discussed.

Journal of Comparative Social Work, 2012

This study examines and evaluates the effects of one-time funding on capacity building of health ... more This study examines and evaluates the effects of one-time funding on capacity building of health and social welfare organizations in a remote and northern section of British Columbia Canada. The Province of British Columbia awarded a two million dollar grant (Canadian) to the University of Northern British Columbia (UNBC). Organizations applied for funds through a competitive process that was managed by the School of Social Work at UNBC. Twenty-five different community organizations and agencies received funding for a period of eighteen months. The organizations and agencies delivered a range of services and activities located in remote First Nations communities as well as the natural resource-based single industry towns of northern BC.

This community-based study, incorporating both qualitative and quantitative methods, examines the... more This community-based study, incorporating both qualitative and quantitative methods, examines the views of citizens across northern British Columbia, Canada who faced a potential shift from a centralized child welfare governance model, to one that was promoted as a more community-sensitive, regional approach to governance. The study utilizes a community survey, focus groups and key informant interviews to solicit the views of residents regarding their awareness of and inclusion in the change process as well as their thoughts about how to create genuine community-based governance. Results indicate that most participants had limited knowledge of the government-initiated consultation process and even less involvement in it. Participants point out government failure to value local knowledge, experience and capacity and an unwillingness to provide communities with the opportunity to craft and implement their own vision for healthy children and families. Features of genuine community gove...

utilise les TIC (techniques infomzatiques de communica-tion) pour joindre les femmes duns les com... more utilise les TIC (techniques infomzatiques de communica-tion) pour joindre les femmes duns les comrnunautks rururales du nord de h Colombie- Britannique autour desproblkmes qui les concernent. Cepuissant outilde communication est en voie de tranrfomzer h vie desfemmes rurales du Nord. Northern British Columbia (BC) is avast geographic area covering almost 600,000 square kilometres, with a popu-lation density ofless than one person per square kilometre. Less than 50 per cent of the 300,000 people residing in northern BC live in communities with a population of more than 10,000 people with the remaining living in communities of less than 5,000 people (Province of British Columbia). Given its geography, demographic features, and lack of proximity to the lower mainland, receiving appropriate health and social services in north-

Canadian Woman Studies, 2005

Northern British Columbia (BC) is avast geographic area covering almost 600,000 square kilometres... more Northern British Columbia (BC) is avast geographic area covering almost 600,000 square kilometres, with a population density ofless than one person per square kilometre. Less than 50 per cent of the 300,000 people residing in northern BC live in communities with a population of more than 10,000 people with the remaining living in communities of less than 5,000 people (Province of British Columbia). Given its geography, demographic features, and lack of proximity to the lower mainland, receiving appropriate health and social services in northern BC can be a challenge. Regardless of geographical location, women already face a disproportionately negative impact from poverty, violence, and economic inequality (Lippman, 1998; Lock, 1998). For northern women, this challenging situation is further complicated by geographic, social, and cultural isolation; lack of access to basic needs, appropriate housing and employment; uncertain resource-based economies; and lack of appropriate health an...

The author has granted a nonexclusive licence allowing the National Li'brary of Canada to reprodu... more The author has granted a nonexclusive licence allowing the National Li'brary of Canada to reproduce, loan, distribute or sell copies of this thesis in microform, paper or electronic formats. The author retains ownership of the copyright in this thesis. Neither the thesis nor substantial extracts h m it may be printed or otheMlise reproduced without the author's pamission. L'auteur a accord6 une licence w n exclusive pennettant i la Biblioth@ue nationale du Canada de repr0Ctpk.e' p r h , distribuer ou vendre des copies de cette th&se sous la f m e de microfiche/film, de reproduction sur papia ou sur format electronique. L'autew conserve la propri6te du h i t d'auteur qui prot&ge cette thbse. Ni la th6se ni des extraits substantiels de celle-ci ne doivent &re imprim& ou autrement reproduits sans son ABSTRACT The purpose of this study is to examine the usefulness of the Geriatric Learning and Memory Battery (G-LAMB) for assessing leaming and memory performance in persons with Alzheimer's Disease (AD). Individuals with AD often perform so poorly on standard memory tests that assessing learning and memory strengths and weaknesses or tracking changes over time is, at best, difficult. The G-LAMB is a recently developed test composed of a Paragraph and a simple Figure and was designed specifically to help assess and monitor verbal and visuospatial leaming and memory performance in people already diagnosed with cognlive deficits. One group for whom this test may have particular utility are people with AD who experience both verbal and visuospatial leaming and memory changes and who can live for extended periods of time post-diagnosis. Alongside efforts to identify an etiology and cure for AD, there is an emerging emphasis on quality of life issues for both those living with AD and their caregivers. In this context, the ability to assess deficits, prescribe treatment and then monitor changes becomes critical. In the current study, the G-LAMB verbal (Paragraph) and visuospatial (Figure) subtests were administered to individuals with mild and moderate stages of AD. Findings suggest that the G-LAMB is a useful tool for assessing leaming and memory performance in those with AD. First, the scores of individuals with Mild AD are high enough to allow one to monitor changes in learning and memory, at least into the moderate stages of the disease. Second, it is possible to differentiate the performance levels of those with Mild and Moderate AD, particularly on the Paragraph subtest.

Historically, individuals with cognitive problems such as Alzheimer' s disease (AD), and other fo... more Historically, individuals with cognitive problems such as Alzheimer' s disease (AD), and other forms of dementia, have had little say in determining the course of their own lives. Assumptions have been made by professional caregivers, family, friends, and government agencies (such as those responsible for social and health services), that people with AD, even in the early stages, are incapable of enunciating their own concerns and speaking on their own behalf But times are changing and a growing number of people with dementia are developing organizational forums that will allow their voices to be heard. This project examines the development process of one such forum-support and self-help groups. The project is set within an emancipatory framework and is undertaken in the hopes that it will contribute to the empowerment and self-determination of persons with AD. The development process of a new support and self-advocacy group for people with early stage AD, established in Prince George in September 1999, is examined utilizing a case study format. A review of the literature relating to the formation of support and self-help groups for persons with cognitive problems both in Canada and internationally is presented, along with a case description of the formative months of the Prince George group (for which the author is a co-facilitator). A critical, retrospective case analysis of the group ' s development process is undertaken. Major themes, including new ageism, empowerment, group theory, practice challenges and policy issues, are identified and examined. A comparative analysis of the Prince George group and other early stage support groups (as presented in the literature review) suggests that early stage supports groups can play a positive role in facilitating the empowerment of persons with Alzheimer' s disease and related dementias. lll

Dementia (London, England), Jan 15, 2014

This longitudinal, exploratory study was designed to better understand the lived experience of sp... more This longitudinal, exploratory study was designed to better understand the lived experience of spousal caregivers age 60 and older providing care to partners with Alzheimer's disease and related dementias resident in a care facility. Twenty eight spousal caregivers were interviewed up to three times over a period of 2 years, and long-term care facility staff from four locations across British Columbia (BC), Canada participated in four focus groups. Thematic analysis of interview and focus group transcripts revealed a central, unifying theme 'together but apart'. The results identify key targets for policy makers and service providers to support positive health and well-being outcomes for spousal caregivers providing care to their partners diagnosed with Alzheimer's disease and related dementia and living in care facilities.