Richard Cheston

Verified

Richard verified their affiliation via an institutional email.

Learn more

Verified

Richard verified their affiliation via an institutional email.

Learn more

• Psychology
• Professor at University of the West of England, Bristol

The Living Well with Dementia (LivDem) group intervention aims to support people to adjust following a diagnosis of dementia and is delivered across the UK and abroad. However, LivDem was designed for older people with dementia and may not address the needs of younger adults. This study aimed to identify the perspectives of LivDem facilitators on a...

Background: This scoping review investigates the effectiveness of mindfulness meditation in alleviating sleep disturbances among individuals with mild cognitive impairment (MCI) and Alzheimer’s disease (AD). With the rising prevalence of dementia and its profound impact on cognitive function and quality of life, this review aims to synthesize exist...

Background Emerging literature shows that nostalgia induced by autobiographical reflection and music confers psychological benefits to people living with dementia. Objective Our objective was to test the potential benefits of nostalgic landmarks for people living with Alzheimer's disease. Methods We displayed the landmarks as wall-mounted picture...

Introduction: Despite the psychological challenges that dementia creates, comparatively little attention has been paid to how individuals or families can be helped to adjust to dementia. One of the few interventions to do this is the Living well with Dementia (LivDem) post-diagnostic course. LivDem focuses on supporting individuals to talk more ope...

Background: People from South Asian communities are under-represented at all levels of dementia services. Consequently, there is pressure for the statutory sector to deliver services in partnership with Voluntary, Community, Faith and Social Enterprises (VCFSEs). This study set out to explore the constraints to effective partnership working which p...

Introduction The Living Well with Dementia (LivDem) intervention is an eight-week, group based post-diagnostic course for people living with dementia that aims to facilitate adjustment to the diagnosis. We set out to establish the views of course facilitators in two areas: first, the benefits of LivDem for participants, their families and for facil...

Objectives To investigate staff experiences of, and approaches to behaviour that challenges displayed by patients with dementia in the emergency department (ED). Behaviour that challenges is defined as ‘actions that detract from the well-being of individuals due to the physical or psychological distress they cause within the settings they are perfo...

There is little opportunity for people living with dementia to talk about their experiences and about what is happening to them. This often makes it harder for them to adjust to, and to accept, the diagnosis. Dementia and Psychotherapy Reconsidered introduces a new and distinctive way of thinking about dementia. Each of the four sections is augmen...

This study set out to investigate whether there were disparities in service provision for people from Black, Asian and Minority Ethnic (BAME) communities compared to White British (WB) communities within a primary care led dementia service in the UK. Data were extracted from 30 cases from three BAME (African-Caribbean, South Asian and Chinese) comm...

Objectives: Nostalgic memories are more social than other forms of autobiographical recall, often refer to atypical events, express more positive affect and reflect life as meaningful. Recalling a nostalgic (compared to ordinary) memory increases self-esteem, self-growth, meaning in life and social connectedness for people living with dementia. We...

Although dementia may affect the reliability of autobiographical memories, the psychological properties of nostalgic memories may be preserved. We compared the content of nostalgic (n = 36) and ordinary (n = 31) narratives of 67 participants living with dementia. Narratives were rated according to their self-oriented, social, and existential proper...

Background People in the later stages of dementia often express their needs and distress through their behaviour in ways that challenge care staff to respond appropriately. Technological solutions may help staff to recognise this distress at an early stage and take preventative action. The aim of this project is to develop and test the feasibility...

As the risk of dementia increases with age, the condition represents a more immediate threat for older than for younger adults. Consequently, the strategies that younger and older people use to defend the self against the threat of dementia may vary, with the latter more likely to recruit psychological defence mechanisms such as mnemic neglect (in...

Dementia represents a substantial threat to the self. However, to date, there is no reliable way to measure how threatened people feel by dementia. This article reports on two online studies. In Study 1, 248 participants rated statements about dementia according to their threat to well-being. In Study 2, 99 participants (all undergraduate students...

Objectives: Technology-based prompting has the potential to support people with dementia to complete multistep tasks in the home. However, these devices can be complex to use. This paper reports a feasibility trial of a personalised touchscreen digital prompter designed for home use. Methodology: A tablet-based prompter suitable for people living...

Objectives: People who are living with dementia typically experience difficulties in completing multi-step, everyday tasks. However, digital technology such as touchscreen tablets provide a means of delivering concise personalised prompts that combine audio, text and pictures. This study was one component of a broader, mixed methods study that test...

Background: Paramedics are increasingly required to make complex decisions as to whether they should convey a patient to hospital or manage their condition at the scene. Dementia can be a significant barrier to the assessment process. However, to our knowledge no research has specifically examined the process of decision-making by paramedics in re...

Psychotherapy is a well-established, efficacious, and fully accepted treatment for mental disorders and psychological problems. Psychotherapy is an interpersonal practice engaging patient values, interests, and personal meanings at every step. Thereby, psychotherapy abounds with moral issues. In psychotherapy ethics, numerous moral issues converge,...

Introduction Mental health problems are highly prevalent throughout the world; however, all too frequently individuals do not receive treatment. Psychological therapy is a potentially successful intervention, but barriers to access are likely to vary across countries and cultures and could be better understood. This paper aimed to identify perceive...

Human beings have a unique facility: we know we are mortal, and yet, for the most part, we lead our lives without becoming overwhelmed by this knowledge. This capacity to know but also not know about the inevitability of our deaths does not just protect us against the knowledge of its certainty, it also helps us to defend against other existential...

People who are living with dementia often describe their worlds as characterized by loss and isolation. Understandably, then, dementia research has emphasized the importance of the quality of social relationships for good dementia care. In the UK, Tom Kitwood described how a malignant social psychological world impacted on the personhood of the per...

People living with dementia continually face reminders of their illness, be it subtle, insidious failures in carrying out everyday tasks, being asked to complete a cognitive assessment that explicitly tests their deterioration, or hearing a news report on the radio about exciting new drug discoveries for dementia. In this book, we have argued that...

A diagnosis of dementia threatens not only many of the core aspects of what it is to be human, but leads, through a progressive deterioration, to death. Dementia thus represents an existential threat that creates profound emotional and psychological challenges for those who are directly affected by the illness. In this chapter, we argue that the ps...

In this chapter, we examine how people who are living with dementia balance the need to preserve their identity and self-esteem against a requirement to understand their dementia. Adjusting to dementia involves both cognitive and affective processes. It is something that is done with both the heart and the mind. In creating meaning from their demen...

This chapter sets out the results from a research programme that has explored the benefits of nostalgia for people who are affected by dementia. First, we replicated the finding from social psychology that nostalgic reminiscence increases levels of self-esteem, social connectedness, and meaning in life for people living with dementia. We then found...

One of the ways that dementia has an impact on a person is by compromising their ability to perform even relatively basic activities such as remembering names or managing a sequence of tasks. Some people cope with the embarrassment that might otherwise result from having these failings exposed by withdrawing from social activities such as going sho...

This chapter continues our exploration of dementia as an existential threat by focusing on one way by which we protect ourselves from distress when we encounter reminders of dementia in our everyday lives. The specific coping mechanism we will discuss is known as mnemic neglect. This is a self-protective memory bias that shields us from being consc...

The term “dementia” refers to a group of symptoms that are caused by different neurodegenerative diseases, the most common of which are Alzheimer’s disease and vascular dementia. The disease process is progressive, gradually affecting almost all areas of brain functioning. Although treatments exist for dementia, the condition is not curable. With t...

Background/Aims/Objectives The purpose of this study is to explore the relationship between the discrete facets of personality and dispositional, or trait-like, mindfulness. Methodology/Methods The study employed a factoral quantitative design and 229 participants completed two online measures, the Five Factor Mindfulness Questionnaire (FFMQ) and...

Explores dementia as an existential threat Proposes new ways of supporting people facing dementia Highlights the different ways people attempt to regulate emotional distress in the face of dementia This book explores how dementia acts as an existential threat, both to people diagnosed with the condition, and to their carers. The authors highlight h...

Objective Thought suppression may not work effectively when people have a cognitive impairment. This study tests whether participants with dementia showed lessened or enhanced recall and recognition of dementia‐related words compared to a control population. Methods Fifty participants living with dementia with mild levels of cognitive impairment a...

An estimated 25,000 people of Black, Asian and other Minority Ethnic (BAME) origins live with dementia in UK - a number which is expected to increase sevenfold by 2051. People from many BAME communities experience dementia in a markedly different way to their white British counterparts. For instance diagnosis is more likely to occur at an advanced...

Background Studies with non-clinical populations show that nostalgia increases psychological resources, such as self-esteem and social connectedness. Objectives Our objectives were to find out if the benefits of nostalgia in non-clinical populations generalize to people with dementia and if nostalgia facilitates recall of dementia-related informat...

Objectives An increasing number of older people are calling ambulances and presenting to accident and emergency departments. The presence of comorbidities and dementia can make managing these patients more challenging and hospital admission more likely, resulting in poorer outcomes for patients. However, we do not know how many of these patients ar...

Rationale: If nostalgia is to be used as a clinical intervention to boost well-being in dementia by reducing threat, then it is important to assess its therapeutic potential. Results Searches carried out in July 2014 and updated in February 2018 identified 47 eligible experimental studies comparing nostalgic reminiscence and non-nostalgic reminisc...

Objective We tested whether people with dementia manifest selective forgetting for self‐threatening information, the mnemic neglect effect (MNE). This selective forgetting is observed among healthy adults in the recall, but not the recognition, of self‐threatening feedback. Methods Sixty‐four statements about dementia were rated for their level of...

Objectives To evaluate the association between the quality of relationship between a person with dementia and their family carer and outcomes for the person with dementia. Design Systematic review. Eligibility criteria Cohort studies of people with clinically diagnosed dementia and their main carers. Exposures of interest were any elements of rel...

Dear Sir or Madam: To date, surveys of attitudes towards dementia have largely been conducted using unvalidated materials or have focussed on health-care professionals supporting people affected by dementia. Research commissioned by the Bristol Dementia Health Integration Team in 2012 aimed to carry out a survey using a modified, online version of...

Background It is unclear how attitudes towards people with dementia are formed and whether, for instance, increased contact with people with dementia, either through work or personal experience alters attitudes. This study used a validated questionnaire (the Approaches to Dementia Questionnaire) to examine whether having experience of dementia (eit...

During protected engagement time (PET), ward routines are adjusted so that staff can spend time together with patients without interruption. The aim of PET is to increase staff and patient interaction on wards, and ultimately patient well-being. Although PET has been implemented on inpatient wards within the UK, including older adult wards, there i...

Report funded by Bristol City Council looking at the dementia experiences of people from three BME communities in Bristol

Introduction Older people with multimorbidities frequently access 999 ambulance services. When multimorbidities include dementia, the risk of ambulance use, accident and emergency (A&E) attendance and hospital admission are all increased, even when a condition is treatable in the community. People with dementia tend to do poorly in the acute hospit...

This technology evaluation study assessed a personalised digital prompter designed for people with dementia, by trialling its use in the home by people with dementia and their carers. Technology based prompting may be used to support people with dementia to complete multi-step tasks in the home, provided that suitable tasks can be chosen and that a...

This technology evaluation study assessed a personalised digital prompter designed for people with dementia, by trialling its use in the home by people with dementia and their carers.

Objectives: This paper reports two related analyses of verbal material from seven Living Well with Dementia groups: the first examines changes in the verbal behaviours of participants across the course of the sessions in all seven groups; while the second contrasts therapist behaviour in two groups. Methods: In the first analysis, recordings of...

Older people with multiple health problems often call a 999 ambulance. Where one of these health problems is dementia, the risk of ambulance use, A&E attendance and hospital admission are all increased. It is important to try and reduce this, as patients with dementia tend to have poor outcomes when they are taken to A&E or admitted to hospital unn...

Objectives: Psychotherapy provides a means of helping participants to resolve emotional threats and play an active role in their lives. Consequently, psychotherapy is increasingly used within dementia care. This paper reviews the existing evidence base for individual and group psychotherapy with people affected by dementia. Design: The protocol...

UK government policy makes it clear that people who are affected by dementia should not only receive a timely, ideally early diagnosis but that they should also be provided with support to help them to adapt to the illness. In part, this is based around a belief that early diagnosis and support will facilitate people who receive a diagnosis being a...

Introduction Serious adverse outcomes for people with dementia include institutionalisation, hospitalisation, death, development of behavioural and psychiatric symptoms, and reduced quality of life. The quality of the relationship between the person with dementia and their informal/family carer is thought to affect the risk of these outcomes. Howev...

Protected engagement time (PET) is a concept of managing staff time on mental health inpatient wards with the aim of increasing staff and patient interaction. Despite apparent widespread use of PET, there remains a dearth of evidence as to how it is implemented and whether it carries benefits for staff or patients. This protocol describes a study w...

Dementia is an umbrella term for a large number of illnesses, all of which involve neurodegenerative changes in the brain. The most common forms of dementia are Alzheimer’s disease and vascular dementia, but there are over 100 other, rarer conditions. All of these different illnesses involve a progressive decline of cognitive functions in which sym...

One way research can explore the psychological and social factors underlying the awareness of people affected by dementia about their illness is by intensive examination of the process of psychological change as it occurs both within psychotherapy and in ordinary life. The assimilation model describes a series of stages through which clients' probl...

This study aimed to determine whether the Markers of Assimilation of Problematic Experiences in Dementia scale (MAPED) can be used to identify whether the way in which participants talk about dementia changed during the group. All eight sessions of a LivDem group, which were attended by participants were recorded and transcribed. An initial analysi...

This paper describes the use of the "Living Well with Dementia" or LivDem model of group support for people affected by dementia within a Primary Care setting. Five people affected by dementia and their carers joined a 10-week group, although one man withdrew before the start due to illness. Joint sessions were held on the first and the final meeti...

Simulated presence therapy is a technique which utilises a familiar recorded voice to calm and reassure people with dementia who are agitated or anxious. Although simulated presence therapy has shown potential benefits in small-scale studies, practical limitations in making and playing the recordings have restricted its use. An alternative method o...

This qualitative study aimed to see whether the Markers of Assimilation of Problematic Experiences in Dementia (MAPED) scale could be applied to couples. It aimed to explore the interactions between couples and how this affected the levels of assimilation. Semi-structured interviews were conducted with four heterosexual couples. The results suggest...

Primary care-led dementia services are an increasingly common form of service delivery; however, little is known about how these services are understood by their main stakeholders: the patients, family members and health care professionals. A primary care-led dementia service was piloted in the South Gloucestershire area during 2012, in which gener...

Background Typically people who go to see their GP with a memory problem will be initially assessed and those patients who seem to be at risk will be referred onto a memory clinic. The demographic forces mean that memory services will need to expand to meet demand. An alternative may be to expand the role of primary care in dementia diagnosis and c...

Guidance around post-diagnostic support for people living with dementia

Objectives: The aim of this paper is to report a pilot study in which participants who had recently received a diagnosis of dementia were randomised to either a 10-week group intervention or a waiting-list control. Method: Memory clinic staff with limited previous experience of group therapy were trained to lead a 10-week group therapy intervent...

Dementia has been recognised as a significant health and social threat which is increasingly affecting individuals, families and societies. Recent conceptualizations of dementia argue that it represents an existential threat that is more than a series of technical challenges to the skill of carers. In this regard, dementia increases dependency, thr...

This qualitative study used semi-structured interviews to explore how six people talked about their difficulties before and after a dementia diagnosis. Participants' accounts of their memory problems were analysed in terms of the verbal Markers of Assimilation of Problematic Voices Scale. This analysis indicated that after diagnosis some participan...

In recent years there has been increasing interest in how different aspects of object relations theory might apply to dementia. While attachment theory in dementia has been well studied, there have been no systematic investigations of the way in which transitional objects are used by people with dementia. This study explores the relationship people...

This paper presents an outline of how the assimilation of problematic voices model (APV) can be used as a framework to understand changes in awareness of people with dementia. APV is a dialogical model of change developed within psy-chotherapy process research. Within this framework, the concept of dementia can be understood as being psychologicall...

Past research suggests that dementia care staff are vulnerable to the development of burnout, which has implications for staff well-being and hence the quality of care for people with dementia. Studying personal vulnerability factors in burnout is important as it can guide staff training and support. Attachment theory suggests that adult attachment...

This paper presents material from 30 hours of observations within a nursing home in the south-west of England. The residents’ use of objects is evaluated in terms of a framework developed from Winnicott’s description of transitional objects. The papers concludes that there is evidence that a number of residents were using objects in ways that met W...

This paper sets out an argument for understanding the subjective experience of people with dementia in terms of Terror Management Theory (TMT). This theory is a broad and detailed account derived from experimental psychological research of the way in which material that represents an existential threat to psychological equanimity triggers a range o...