The Volunteer Dementia and Delirium Care (VDDC)^© program: An exploration of perceived barriers and enablers to implementation in an acute and subacute metropolitan hospital

Abstract

People with dementia are high users of acute hospital services. Between 20% and 25% of inpatients aged 70 years and older and 47% of inpatients aged 90 years and older have a diagnosis of dementia. 1 In 2009-2010, dementia accounted for 83 226 hospitalisations in Australia (1 in every 100) and was the principal diagnosis for 12 286 patients (1 in every 1000). 2 For hospitalisations in which dementia was the primary diagnosis, delirium was also present for 17% of diagnoses. 2 For an individual with dementia, hospitalisation is associated with adverse events, including falls, malnutrition, dehydration, skin injury, increased length of hospital stay and delirium. 2 The prevalence of delirium in older hospitalised patients ranges from 14% to 56%. 3 However, the risk of delirium is increased for those with dementia or pre-existing cognitive impairment, ranging from 22% to 89%. Delirium is characterised by an acute decline in cognition, attention and level of consciousness. 3 Delirium can trigger negative events including functional decline, caregiver burden, increased morbidity and mortality, and increased health-care costs. 3 Although delirium is a common, burdensome condition, it may be preventable amongst older hospitalised patients. 4

Psychosocial volunteer support for older adults with cognitive impairment: development of MyCare Ageing using a codesign approach via action research

“…20 The VDDC programme was developed in rural hospitals in NSW, Australia. In 2017, preimplementation studies conducted by Ayton and colleagues (2019) 21 22 explored the acceptability and barriers and enablers of implementing the VDDC programme into a large metropolitan hospital in Melbourne. Nurses, geriatricians, volunteers, hospital key stakeholders and patient and carers participated.…”

Care home practitioners’ perceptions of the barriers and facilitators for using off-the-shelf gaming technology with people with dementia

“…To achieve this secondary aim, this study drew upon a combination of the Capability, Opportunity, Motivation and Behaviour model and the Theoretical Domains Framework. Combining these theoretical models has been advocated and undertaken within dementia care ( Ayton et al, 2020 ) and dementia education ( Surr et al, 2020 ) interventions as they enable a detailed exploration of implementation barriers at an individual and organisational level; something that the current research seeks to address. The Capability, Opportunity, Motivation and Behaviour model is widely used to contextualise individual-level change and the underlying determinants to achieve organisational change ( Michie, van Stralen and West, 2011 ).…”

Barriers and facilitators to the use of personal information documents in health and social care settings for people living with dementia: A thematic synthesis and mapping to the COM‐B framework

“…HCPs were perceived as disinterested by carers 37 ; yet, HCPs reported feeling satisfied at being able to provide good care through using the PID 34 . Concordant with single‐component intervention findings, the predominant theme was that of value of the PID with the potential to improve personalized care 33–35,37 ; support the PLWD's unique identity 34,37 ; and reduce or prevent responsive behaviours 37 …”