The impacts of family involvement on general hospital care experiences for people living with dementia: An ethnographic study

Abstract

This is a repository copy of The impacts of family involvement on general hospital care experiences for people living with dementia: An ethnographic study.

What are the needs of people with dementia in acute hospital settings, and what interventions are made to meet these needs? A systematic integrative review of the literature

“…has distinguishable features and a view of the outdoors, and 2) staff's experience of the physical environment as a barrier for patient safety. Experiences and needs of patients with dementia related to the physical environment in acute hospital wards were described from the perspective of staff [25,29,[33][34][35][36] persons with dementia [28,34,46], family carers [34] and by observations [31,35]. The studies demonstrate the importance of an environment that enables independence for people with cognitive impairment by making it easier to navigate the surroundings.…”

The experiences of hospital staff who provide care for people living with dementia: A systematic review and synthesis of qualitative studies

“…Plwd (Berg et al, 1998;Bryon et al, 2010;Dowding et al, 2016;Nilsson et al, 2016). Some talked about the importance of involving family carers, either by providing information or tips that helped staff understand certain behaviours (Kelley et al, 2019;Lichtner et al, 2016), or by their presence alongside the Plwd and their ability to physically help when staff time was limited (Kelley et al, 2019;Porock et al, 2015).…”

“…However, despite often recognising that carer involvement could help inform good care, it was rare for there to be a clear strategy or ward policies for involving them (Moyle et al, 2011), and staff could differ in their approach to carer involvement within wards and across wards (Kelley et al, 2019). In a study about the use of deception to manage the emotions of Plwd, noted a lack of policy to guide staff on this difficult issue.…”

“…The busy environment, the noise and the rapid pace were perceived by many to be less than ideal in relation to what these patients needed (Berg et al, 1998;Nilsson et al, 2016;Porock et al, 2015;Teodorczuk et al, 2015). Staff participants also described the unsuitability of wards for fostering good care for Plwd because of design that prevented interaction with others, for example because Plwd were alone in a room, sat alone or were kept in bed (Clissett et al, 2014;Kelley et al, 2019;Nilsson et al, 2013) [Researcher field notes, p1824] (Clissett et al, 2014) The physical structure of wards communicated their purpose and focus: resources (e.g. provision of social space), equipment and furnishings were often there to promote physical care with little provision for systems to support the sharing of knowledge about personal information of Plwd, or facilitate communication and interactions between staff, carers and Plwd (Clissett et al, 2014;Kelley et al, 2019;Moyle et al, 2011;Teodorczuk et al, 2015).…”

“…Staff participants also described the unsuitability of wards for fostering good care for Plwd because of design that prevented interaction with others, for example because Plwd were alone in a room, sat alone or were kept in bed (Clissett et al, 2014;Kelley et al, 2019;Nilsson et al, 2013) [Researcher field notes, p1824] (Clissett et al, 2014) The physical structure of wards communicated their purpose and focus: resources (e.g. provision of social space), equipment and furnishings were often there to promote physical care with little provision for systems to support the sharing of knowledge about personal information of Plwd, or facilitate communication and interactions between staff, carers and Plwd (Clissett et al, 2014;Kelley et al, 2019;Moyle et al, 2011;Teodorczuk et al, 2015). One study offered a slightly different emphasis by finding that a 'home-like' environment alone was inadequate to create the experience of being at home, but rather, such an experience required personal interaction that created feelings of safety, connection and welcome (Edvardsson et al, 2012).…”