The care of older people with dementia in acute hospitals

Cowdell, Fiona

doi:10.1111/j.1748-3743.2010.00208.x

Cited by 80 publications

(161 citation statements)

References 48 publications

Supporting

Mentioning

158

Contrasting

Order By: Relevance

“…The papers were published across a 12 year period, between 2002 and 2014. Studies selected for inclusion originated mainly from the UK (Atkin, Holmes, & Martin, 2005;Baille, Cox, & Merritt, 2012a ;Baille, Merritt, & Cox, 2012b ;Charter & Hughes, 2012;Cowdell, 2010;Fessey, 2007;Smythe et al, 2014), but also from Ireland (Nolan, 2006;Nolan, 2007), Sweden (Eriksson & Saveman, 2002;Nilsson, Rasmussen, & Edvardsson, 2013) and Australia (Borbasi, Jones, Lockwood, & Emden, 2006;Moyle, Borbasi, Wallis, Olorenshaw, & Gracia, 2010). Most data were gathered using focus groups or semi-structured 8 interviews.…”

Section: Characteristics Of Selected Studiesmentioning

confidence: 99%

“…When patients were admitted with a known diagnosis, many staff felt uncertain about how to manage what were considered more challenging behaviours Cowdell, 2010;Eriksson & Saveman, 2002;Smythe et al, 2014), such as communication difficulties, aggression and disorientation: Sometimes I think, there's a confused patient, do I re-orientate them? Do I explain they're in hospital?…”

Section: Overcoming Uncertainty In Carementioning

confidence: 99%

“…Consequently, patients with dementia could often be perceived negatively (Baille et al, 2012a;Cowdell, 2010;Eriksson & Saveman, 2002;Smythe et al, 2014) and assigned powerful and pervasive labels such as "difficult" (Cowdell, 2010, p. 87).…”

Section: Overcoming Uncertainty In Carementioning

confidence: 99%

See 2 more Smart Citations

The experience of caring for patients with dementia within a general hospital setting: a meta-synthesis of the qualitative literature

Turner

Eccles

Elvish

et al. 2015

Aging & Mental Health

View full text Add to dashboard Cite

Objectives: The optimal care of people with dementia in general hospitals has become a policy and practice imperative over recent years. However, despite this emphasis, the everyday experiences of staff caring for this patient group is poorly understood. This review aimed to synthesise the findings from recent qualitative studies in this topic published prior to January 2014 to develop knowledge and provide a framework to help inform future training needs.Method: A systematic search of the literature was conducted across five academic databases and inclusion/exclusion criteria applied to the retrieved papers. A meta-ethnographic approach was utilised to synthesise the resulting 14 qualitative papers.Results: Five key themes were constructed from the findings: overcoming uncertainty in care; constraints of the environmental and wider organisational context; inequality of care; recognising the benefits of person-centred care; and identifying the need for training. These themes explore the opportunities and challenges associated with caring for this group of patients, as well as suggestions to improve staff experiences and patient care. Conclusion:The synthesis highlighted a lack of knowledge and understanding of dementia within general hospital staff, particularly with regard to communication with patients and managing behaviours that are considered challenging. This limited understanding, coupled with organisational constraints on a busy hospital ward, contributed to low staff confidence, negative attitudes towards patients with dementia and an inability to provide person-centred care. The benefits of dementia training for both ward staff and hospital management and peer discussion/support for ward staff are discussed.

show abstract

Section: Characteristics Of Selected Studiesmentioning

confidence: 99%

Section: Overcoming Uncertainty In Carementioning

confidence: 99%

See 1 more Smart Citation

The experience of caring for patients with dementia within a general hospital setting: a meta-synthesis of the qualitative literature

Turner

Eccles

Elvish

et al. 2015

Aging & Mental Health

View full text Add to dashboard Cite

show abstract

“…For example, a national audit of dementia care in general hospitals in England (Royal College of Psychiatrists, 2011) found that care was largely task focussed and delivered in an impersonal manner. This can lead to additional and unnecessary distress for a person with dementia (Cowdell, 2009) and longer hospital stays.…”

Section: Introductionmentioning

confidence: 99%

“…Studies highlight four main reasons for poor reported outcomes for people with dementia being cared for in acute hospitals: 1) an unsupportive physical environment including issues with safety, orientation, way finding and availability of space to walk around (Heath et al, 2010, Nolan, 2007, Royal College of Psychiatrists, 2011 2) a negative organisational and ward culture, including inflexible, strict routines, weak clinical leadership (National Audit Office, 2010, Webster, 2011 and a culture of care that labels people with dementia as 'difficult' (Cowdell, 2009); 3) stigma and negative staff attitudes towards people with dementia, including seeing them as demanding too much nursing time, being disruptive to ward routines and threatening to other patients (Eriksson andSaveman, 2002, Moyle et al, 2010); 4) poor staff skills and knowledge (Eriksson andSaveman, 2002, Thompson and including failure to meet basic dignity and care needs (Care Quality Commission, 2011).…”

Section: Introductionmentioning

confidence: 99%

Impact of a person-centred dementia care training programme on hospital staff attitudes, role efficacy and perceptions of caring for people with dementia: A repeated measures study

Surr¹,

Smith

Crossland³

et al. 2016

International Journal of Nursing Studies

126

185

View full text Add to dashboard Cite

Background: People with dementia occupy up to one quarter of acute hospital beds. However, the quality of care delivered to this patient group is of national concern. Staff working in acute hospitals report lack of knowledge, skills and confidence in caring for people with dementia. There is limited evidence about the most effective approaches to supporting acute hospital staff to deliver more person-centred care.Objectives: This study aimed to evaluate the efficacy of a specialist training programme for acute hospital staff regarding improving attitudes, satisfaction and feelings of caring efficacy, in provision of care to people with dementia.Design: A repeated measures design, with measures completed immediately prior to commencing training (T1), after completion of Foundation level training (T2: 4-6 weeks post-baseline), and following Intermediate level training (T3: 3-4 months postbaseline). Setting: One NHS Trust in the North of England, UK.Participants: 40 acute hospital staff working in clinical roles, the majority of whom (90%) were nurses.Methods: All participants received the 3.5 day Person-centred Care Training for Acute Hospitals (PCTAH) programme, comprised of two levels, Foundation (1/2 day) and Intermediate (3 days), delivered over a 3-4 month period. Staff demographics and previous exposure to dementia training was collected via a questionnaire. Staff attitudes were measured using the Approaches to Dementia Questionnaire (ADQ), satisfaction in caring for people with dementia was captured using the Staff Experiences of Working with Demented Residents questionnaire (SEWDR) and perceived caring efficacy was measured using the Caring Efficacy Scale (CES). Results:The training programme was effective in producing a significant positive change on all three outcome measures following intermediate training compared to baseline. A significant positive effect was found on the ADS between baseline and after completion of Foundation level training, but not for either of the other measures. Conclusions:Training acute hospital staff in Intermediate level person-centred dementia care is effective in producing significant improvements in attitudes towards and satisfaction in caring for people with dementia and feelings of caring efficacy. Foundation level training is effective in changing attitudes but does not seem to be sufficient to bring about change in satisfaction or caring efficacy.2 Keywords: acute hospitals; dementia; education; general hospitals; person-centred care; staff training. Contribution of the paper:What is already known about this topic? Care for people with dementia is has often been found to be of poor quality in acute general hospitals and deficiencies in staff knowledge, skills and confidence to deliver dementia care is a contributory factor.  Person-centred dementia care can improve quality of life for people with dementia in specialist settings but there remains limited knowledge and understanding about its application in acute hospitals.  There is limited research about the...

show abstract

Service utilisation and family support of people with dementia: a cohort study in England

Gage

Cheynel

Williams

et al. 2014

Int J Geriatr Psychiatry

View full text Add to dashboard Cite

show abstract

The care of older people with dementia in acute hospitals

Abstract: It is imperative that innovative methods of developing practice are implemented and evaluated. Education alone will not lead to sustained changes in practice. Further research into this subject needs to be undertaken.

Cited by 80 publications

References 48 publications

The experience of caring for patients with dementia within a general hospital setting: a meta-synthesis of the qualitative literature

The experience of caring for patients with dementia within a general hospital setting: a meta-synthesis of the qualitative literature

Impact of a person-centred dementia care training programme on hospital staff attitudes, role efficacy and perceptions of caring for people with dementia: A repeated measures study

Service utilisation and family support of people with dementia: a cohort study in England

Contact Info

Product

Resources

About