Exploring nursing staff views of responsive behaviours of people with dementia in long‐stay facilities

Abstract

Introduction Caring for people with dementia and responsive behaviours can challenge nurses, and little is known of their experiences. Aims To explore nurses' views of supporting people with dementia and responsive behaviours in long-stay facilities. Methods A qualitative descriptive study utilizing in-depth audio-recorded interviews of nine nurses, recruited from private and public care facilities. Qualitative content analyses conducted involving iterative comparisons of transcripts, summaries and memos, where coding, key quotes and tables were developed to determine themes. Results Four themes emerged: recognizing and understanding responsive behaviour, resources and interventions to support people with dementia and responsive behaviour, the impact of education on nursing practice and the care environment. Discussion Availability of staff, adequate time and financial restraints hinder nurses' ability to provide care. Access to ongoing education and being able to provide one-to-one care was valued as dementia-specific education changed nursing practice. Implications for practice Place of care was seen as dependent on the type of responsive behaviour in question, the duration of the behaviour and the impact of the behaviour on the person, other residents and staff. Dementia education needs to be accessible to all staff, and a collaborative approach is necessary in order to develop management guidelines and support strategies.

Nurses’ decision‐making related to administering as needed psychotropic medication to persons with dementia: an empty systematic review

“…These concerning findings from literature in other contexts, combined with the absence of literature related to nurses’ administration of PRNs to hospitalized people with dementia, support the need for further research into the processes used by nurses to make PRN psychotropic medication administration decisions in hospitalized persons with dementia. Nurses identify challenges associated with caring for people with dementia in acute care (Borbasi et al, 2006; Clifford & Doody, 2018; Eriksson & Saveman, 2002; Moyle et al, 2010), that could lead them to using PRN psychotropic medications with this population. However, unless we study nurses’ decision‐making related to PRN psychotropic medications, and the prevalence of psychotropic medication prescribing and use in acute care, we cannot fully understand, or effectively address the situation.…”

“…It is well understood that older people in acute care are at risk for functional decline (Zisberg et al, 2011). Nurses in acute care have consistently identified environment, staffing, insufficient knowledge and time as constraints to providing optimal care to persons with dementia (Borbasi et al, 2006; Clifford & Doody, 2018; Eriksson & Saveman, 2002; Moyle et al, 2010). Scholars have suggested that nurses are using PRN medications to promote what they perceive to be ‘safety’ in acute care (Dahlke et al, 2019).…”

The Impact of Using Measurements of Electrodermal Activity in the Assessment of Problematic Behaviour in Dementia

“…The assistant nurses in this study perceived EDA measurements to be an important objective tool that strengthened their otherwise subjective assessments and observations and enhanced continuity, which, in turn, contributed to a more comprehensive understanding of the individual's needs. Clifford and Doody [ 2 ] stress nursing staff's opportunities to spend time with individuals with dementia as an important factor that affects their ability to support those with problematic behaviours. Understanding an individual's needs is a continuous process that develops over time and facilitates more holistic decisions regarding care interventions and support based on a deeper understanding of the individual.…”

“…The ability to adequately assess and monitor problematic behaviours is essential in determining when interventions are needed. However, this is challenging due to factors such as nursing staff's educational level [ 2 ], the fluctuating nature of the behaviours [ 3 ], and the time available to perform systematic observations.…”

The experience of hospital staff in applying the Gentle Persuasive Approaches to dementia care

“…As the world's older population continues to grow at an unprecedented rate, older people are becoming a major group of hospital service users (Health and Social Care Information Centre, ). Evidence suggests that, while in the hospital, older people with dementia experience distress and exhibit behavioural symptoms, mainly because their needs are not understood or met (Champion, ; Clifford & Doody, ; Jurgens, Clissett, Gladman, & Harwood, ). Dewing and Dijk () argued that one of the significant barriers to good dementia care is a lack of clarity about how to apply person‐centred care in hospital settings.…”