PhD Study : Family dynamics and advance care planning in dementia: promoting mental well-being and effective decision-making in those affected by dementia

Summary

In addition to the essential criteria noted below, the Degree (or equivalent) qualification must be in Psychology or a closely related discipline. We will accept applications from candidates who are about to hold

* a minimum of and Upper Second Class Honours (2:1) Degree in Psychology or closely related discipline (or overseas award deemed equivalent via UK NARIC) .

* An additional Desirable criteria that may be applied is holding, being about to hold a Master's level qualification in Psychology or a closely related discipline.

*You must provide official, final results of qualifications used to meet the academic requirements before the start of the studentship

The Alzheimer’s society (2014) reported that there were 835,000 people living with dementia in the UK. At present, informal care provided by family members is an integral feature of dementia care yet annual treatment costs are in excess of £26 billion (1). People with dementia can lose capacity to make healthcare decisions leaving family carers responsible for decision making and advocating their end-of-life (EoL) wishes (2). Family carers report that while the experience can be positive it can lead to feelings of depression, anxiety, and isolation (2-3). Moreover, within a larger family circle, proxy decision-making can be difficult; leading to poor or difficult communication with services and impacting the overall quality of caregiving (4-5).

The relationship between family dynamics including; general family functioning, family discordance, and family relationships which may affect EoL decision making, is complex and poorly understood in dementia care (5-8). There is potential for exploring this issue through Advance Care Planning (ACP) where family dynamics may have considerable impact (9). ACP is a process of discussing and recording a person’s future healthcare and EoL wishes with those involved in their care and appointment of a surrogate (usually a family member) who will speak for them, should they become incapacitated (9). ACP is recommended as good practice for palliative patients – suggested benefits include improving their current quality-of-life and ensuring that their EoL care concurs with their preferences (10-11).

For family members, stress is significantly reduced as the burden of EoL decision-making is reduced which impacts positively on the grieving process (9-10).

This project will address the following questions:

i) How do family dynamics affect decision-making processes within families living with dementia;

ii) How might family dynamics influence care outcomes (e.g. ACP, medical decision making, physical and mental well-being) for people living with dementia and their carers;

iii) What type of family intervention might assist in decision-making and ACP for people living with dementia?

This PhD will address these questions using 4 main methods: i) A high quality, pre-registered systematic review of the literature to investigate family dynamics on dementia outcomes and its impact on EoL decision-making; ii) A Delphi study to seek expert views and evidence regarding family decision-making and the ACP process. Thus will approach key academics, health and social care professionals, people with dementia and family members, to gain consensus on how to best assist the ACP process; iii) Qualitative interviews with family groups (currently or previously involved with informal care) to explore prioritised aspects of the Delphi study; iv) Longitudinal (mixed methods) study to examine the relationship between family dynamics and EoL decision-making for people with dementia.

This project enhances existing strengths at Ulster combining researchers from the Institute for Mental Health Sciences and a collaborative, interdisciplinary partnership with the Northern Health and Social Care Trust, NI to expedite a co-supervised interdisciplinary PhD programme with impact embedded from the outset. The project will have an advisory board comprised of key stakeholders, including patient representatives ensuring that the research is relevant, impactful, and patient-centred.

Essential criteria

Applicants should hold, or expect to obtain, a First or Upper Second Class Honours Degree in a subject relevant to the proposed area of study.

We may also consider applications from those who hold equivalent qualifications, for example, a Lower Second Class Honours Degree plus a Master’s Degree with Distinction.

In exceptional circumstances, the University may consider a portfolio of evidence from applicants who have appropriate professional experience which is equivalent to the learning outcomes of an Honours degree in lieu of academic qualifications.

• Experience using research methods or other approaches relevant to the subject domain
• Sound understanding of subject area as evidenced by a comprehensive research proposal
• A comprehensive and articulate personal statement

Funding and eligibility

The University offers the following levels of support:

Vice Chancellors Research Studentship (VCRS)

The following scholarship options are available to applicants worldwide:

• Full Award: (full-time tuition fees + £19,000 (tbc))
• Part Award: (full-time tuition fees + £9,500)
• Fees Only Award: (full-time tuition fees)

These scholarships will cover full-time PhD tuition fees for three years (subject to satisfactory academic performance) and will provide a £900 per annum research training support grant (RTSG) to help support the PhD researcher.

Applicants who already hold a doctoral degree or who have been registered on a programme of research leading to the award of a doctoral degree on a full-time basis for more than one year (or part-time equivalent) are NOT eligible to apply for an award.

Please note: you will automatically be entered into the competition for the Full Award, unless you state otherwise in your application.

Department for the Economy (DFE)

The scholarship will cover tuition fees at the Home rate and a maintenance allowance of £19,000 (tbc) per annum for three years (subject to satisfactory academic performance).

This scholarship also comes with £900 per annum for three years as a research training support grant (RTSG) allocation to help support the PhD researcher.

• Candidates with pre-settled or settled status under the EU Settlement Scheme, who also satisfy a three year residency requirement in the UK prior to the start of the course for which a Studentship is held MAY receive a Studentship covering fees and maintenance.
• Republic of Ireland (ROI) nationals who satisfy three years’ residency in the UK prior to the start of the course MAY receive a Studentship covering fees and maintenance (ROI nationals don’t need to have pre-settled or settled status under the EU Settlement Scheme to qualify).
• Other non-ROI EU applicants are ‘International’ are not eligible for this source of funding.
• Applicants who already hold a doctoral degree or who have been registered on a programme of research leading to the award of a doctoral degree on a full-time basis for more than one year (or part-time equivalent) are NOT eligible to apply for an award.

Due consideration should be given to financing your studies. Further information on cost of living