Nursing staff needs in providing palliative care for people with dementia at home or in long-term care facilities: A scoping review

Nursing Staff Needs in Providing Palliative Care for Persons With Dementia at Home or in Nursing Homes: A Survey

“…Certain behaviors may be due to underlying pain (Malara et al, ; Pieper et al, ), and communication difficulties leave staff unsure about interpreting individual care needs (Midtbust, Alnes, Gjengedal, & Lykkeslet, ; Monroe, Parish, & Mion, ). The finding that nursing staff want to devote personal attention and make a connection with the individual further supports previous statements about the importance of a person‐centered approach in dementia care (Kitwood & Bredin, ) and in palliative care for persons with dementia (Bolt, van der Steen, Schols, Zwakhalen, Pieters, & Meijers, ; van der Steen et al, ). However, as in this study, nursing staff previously expressed concerns on how to achieve this with increasing work demands, scarce resources, and a lack of time (Midtbust, Alnes, Gjengedal, & Lykkeslet, ; Smythe et al, ).…”

“…The findings suggest that increasing feelings of competence among nursing staff may require interventions that focus on dealing with challenging behaviors and pain in particular. Difficulties in dealing with behaviors likely relate to difficulties in communication, and both require familiarity with the individual (Bolt, van der Steen, Schols, Zwakhalen, Pieters, & Meijers, 2019). Certain behaviors may be due to underlying pain (Malara et al, 2016;Pieper et al, 2013), and communication difficulties leave staff unsure about interpreting individual care needs (Midtbust, Alnes, Gjengedal, & Lykkeslet, 2018a;Monroe, Parish, & Mion, 2015).…”

“…Thereby, they are conveniently positioned to discuss care wishes, to identify burdensome symptoms, and to increase quality of life (van der Steen et al, ). However, nursing staff may not feel competent to provide adequate palliative care for persons with dementia; they report difficulties in recognizing and addressing physical, psychosocial, and spiritual care needs, dealing with challenging behaviors, and communicating with persons with dementia (Bolt, van der Steen, Schols, Zwakhalen, Pieters, & Meijers, ).…”

Practical nursing recommendations for palliative care for people with dementia living in long-term care facilities during the COVID-19 pandemic: A rapid scoping review

“…For instance, people with dementia are more likely to have unmet needs, to receive poor treatment of pain and other symptoms, to face inappropriate aggressive medical treatments and to be transferred to acute care at the end of life ( Birch and Draper, 2008 ). Professional caregivers such as nurses and physicians report difficulties in palliative dementia care related to lacking or fragmented palliative care services, pain management, psychosocial needs and challenging behaviours, and end-of-life communication and (shared) decision-making ( Bolt et al, 2019 , Davies et al, 2014 , Ryan et al, 2012 ).…”

Dementia care research: The key role of nurses and nursing

“…As emphasised by Kristiana Ludlow and Jeffrey Braithwaite in their editorial accompanying this issue, underlying these experiences is a nursing workforce that may be ill-prepared and inadequately resourced to deal with people living with dementia (Ludlow and Braithwaite, 2019). This is in addition to a lack of integration of services and a health system largely configured to address the needs of patients who present with a single, curable medical issue (Bolt et al, 2019, Handley et al, 2019). Transformation of health and social care delivery, drawing on innovations in systems design, service models and technology, and effective engagement with wider social networks, is urgently needed to create a care system that is sustainable and that meets the needs and expectations of the service users and their families, especially of people living with the most complex needs associated with ageing and dementia.…”