Challenges for professional care of advanced dementia

Qualitative methodology based on action research identified challenges when caring for persons with advanced dementia, as perceived by key professional providers. Data collection was via five focus groups (total n = 24) and 20 follow‐up individual interviews. Participants included palliative care, a...

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Bibliographic Details
Published in:International journal of nursing practice 2009-02, Vol.15 (1), p.41-47
Main Authors: Chang, Esther, Daly, John, Johnson, Amanda, Harrison, Kathleen, Easterbrook, Sally, Bidewell, John, Stewart, Heather, Noel, Michael, Hancock, Karen
Format: Article
Language:English
Subjects:
Action research
Advance Care Planning
Aged
Assessment
Attitude of Health Personnel
Clinical Competence
Communication Barriers
Dementia
Dementia - complications
Dementia - prevention & control
Dementia - psychology
Family - psychology
Family Practice - organization & administration
Focus Groups
Geriatric Nursing - organization & administration
Health professionals
Humans
Medical personnel
Needs Assessment - organization & administration
New South Wales
Nursing
Nursing Assessment
nursing home
Nursing homes
Nursing Homes - organization & administration
Nursing Methodology Research
Palliative care
Palliative Care - organization & administration
Patient Care Team - organization & administration
Qualitative Research
Severity of Illness Index
Specialists
Surveys and Questionnaires
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Summary:Qualitative methodology based on action research identified challenges when caring for persons with advanced dementia, as perceived by key professional providers. Data collection was via five focus groups (total n = 24) and 20 follow‐up individual interviews. Participants included palliative care, aged care and dementia specialist nurses, medical specialists from an area health service, residential aged care staff and general medical practitioners. Responses emphasized the need for improved knowledge and skills, and clearer policy. Concerns included accurate assessment, especially of pain, owing to the inability of people with advanced dementia to communicate their symptoms. Assessment, managing physical and behavioural symptoms, and communicating with family presented as further challenges. Conclusions are that the need for a palliative approach to care in advanced dementia should be recognized. Aged care staff can deliver palliative care to people with advanced dementia only if the staff receive relevant education and training beyond their generalist competencies.
ISSN:1322-7114
1440-172X
DOI:10.1111/j.1440-172X.2008.01723.x