Delivering dementia care differently-evaluating the differences and similarities between a specialist medical and mental health unit and standard acute care wards: A qualitative study of family carers' perceptions of quality of care

BMJ Open

Volumn 3, Issue 12, 2013, Pages

  Spencer, Karen ^a   Foster, Pippa ^a   Whittamore, Kathy H ^b   Goldberg, Sarah E ^a   Harwood, Rowan H ^a,b  

^a UNIVERSITY OF NOTTINGHAM   (United Kingdom)

^b QUEEN S MEDICAL CENTRE   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; BOREDOM; CAREGIVER; COGNITIVE DEFECT; DELIRIUM; DEMENTIA; ENVIRONMENT; FAMILY; HEALTH CARE QUALITY; HOSPITAL; HUMAN; HUMAN DIGNITY; INDEPENDENCE; INTERPERSONAL COMMUNICATION; KNOWLEDGE; LEISURE; MEDICAL SPECIALIST; MEDICAL STAFF; MENTAL HEALTH CENTER; NATIONAL HEALTH SERVICE; ORIENTATION; PATIENT CARE; PERCEPTION; QUALITATIVE RESEARCH; SEMI STRUCTURED INTERVIEW; SKILL; WARD;

EID: 84892576264     PISSN: None     EISSN: 20446055     Source Type: Journal    
DOI: 10.1136/bmjopen-2013-004198     Document Type: Article

References (41)

1. World Health Organization (WHO). Dementia: a public health priority. 2012. http://www.apps.who.int/iris/bitstream/10665/75263/1/ 9789241564458-eng. pdf
2. Goldberg SE, Whittamore K, Harwood RH, et al. The prevalence of mental health problems amongst older adults admitted as an emergency to a general hospital. Age Ageing 2012;41:80-6.
3. Royal College of Psychiatrists. Who cares wins: improving the outcomes for older people admitted to the general hospital: Guidelines for the development of Liaison Mental Health Services for older people. London, 2005. http://www.rcpsych.ac.uk/pdf/ whocareswins.pdf
4. Royal College of Psychiatrists. Report of the National Audit of Dementia Care in General Hospital. In: Young J, Hood C, Woolley R, Gandesha ASouza R. eds London: Healthcare Quality Improvement Partnership. 2011. http://www.rcpsych. ac.uk/pdf/NATIONAL% 20REPORT%20-%20Full%20Report%201201122.pdf
5. Department of Health. Living well with dementia: a national dementia strategy: a national dementia strategy. London: Department of Health, 2009. https://www.gov.uk/government/publications/ living-well-with-dementia-A- national-dementia-strategy
6. Department of Health. Quality outcomes for people with dementia: building on the work of the national dementia strategy. London: Department of Health, 2010. https://www.gov.uk/government/publications/ quality-outcomes-for-people- withdementia- building-on-The-work-of-The-national-dementia-strategy
7. Royal College of Nursing. Improving quality of care for people with dementia in general hospitals. London: Royal College of Nursing, 2010. http://nursingstandard.rcnpublishing.co.uk/shared/cms/file. asp?e=35&i= 172190
8. Alzheimer's Society. Counting the cost: caring for people with dementia in hospital ward. London: Alzheimer's Society, 2009. http:// www.alzheimers.org.uk/countingthecost
9. Jurgens F, Clissett P, Gladman JRF, et al. Why are family carers of people with dementia dissatisfied with general hospital care? A qualitative study. BMC Geriatr 2012;12:1-10.
10. Gladman J, Porock D, Griffiths A, et al. Care of older people with cognitive impairment in general hospitals. Final report NIHR Service Delivery and Organisation Programme. 2012. http://www.netscc.ac. uk/hsdr/projdetails.php? ref=08-1809-227
11. Harwood RH, Porock D, King N, et al. Development of a specialist medical and mental health unit for older people in an acute general hospital. Medical Crises in Older People discussion paper series, issue 5, University of Nottingham. 2010:1-46. http://nottingham.ac. uk/mcop/documents/papers/mcop- issn2044-4230-issue5.pdf
12. Kitwood T. Dementia reconsidered: the person comes first. Buckingham: Open University Press, 1997.
13. Brooker D. Person-centred dementia care. London &Philadelphia: Jessica Kingsley Publishers, 2007.
14. Pool J. The Pool Activity level (PAL) instrument for occupational profiling: a practical resource for people with cognitive impairments. 3rd edn. London: Jessica King Publishers, 2008.
15. Harwood RH, Goldberg SE, et al. Study protocol. 2011. Evaluation of a Medical and Mental Health Unit compared with standard care for older people whose emergency admission to an acute general hospital is complicated by concurrent 'confusion': a controlled clinical trial. Trials 2011;12:1-11. http://www.trialsjournal.com/content/12/1/ 123
16. Goldberg SE, Bradshaw LE, Kearney FC, et al. Care in a specialist Medical and Mental Health Unit compared with standard care for older people with cognitive impairment admitted to a general hospital: a randomised controlled trial (NIHR TEAM trial). BMJ 2013;347:f4132.
17. Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess RG, eds. Analyzing qualitative data. London: Routledge, 1994. 173-194.
18. Srivastava A, Thomson SB. Framework analysis: a qualitative methodology for applied policy research. J Adm Governance 2009;4:72-9. http://www.joaag.com/ uploads/06-Research-Note- Srivastava-and-Thomson-4-2-.pdf
19. Rozenblum R, Lisby M, Hockley PM, et al. Uncovering the blind spot of patient satisfaction: an international survey. BMJ Qual Saf 2011;20:959-65.
20. Brooker D. What is person-centred care in dementia? Rev Clin Gerontol 2003;13:215-22. http://journals.cambridge.org/action/ displayAbstract?fromPage= online&aid=230595
21. Edvardsson D, Winblad B, Sandman PO. Person-centred care of people with severe Alzheimer's disease: current status and ways forward. Lancet Neurol 2008;4:362-7. (Pubitemid 351380537)
22. Clissett P, Porock D, Harwood RH, et al. The challenges of achieving person-centred care in acute hospitals: a qualitative study of people with dementia and their families. Int J Nurs Stud 2013; (11):1495-503. http://dx.doi.org/10.1016/j.ijnurstu.2013.03.001
23. Clarke A, Hanson EJ, Ross H. Seeing the person behind the patient: enhancing the care of older people using a biographical approach. J Clin Nurs 2003;12:697-706. http://www.ncbi.nlm.nih.gov/pubmed/ 12919216 (Pubitemid 37260183)
24. Day K, Carreon D, Stump C. The therapeutic design of environments for people with dementia. Gerontologist 2000;40:397-416. http://www. ncbi.nlm.nih.gov/pubmed/10961029
25. Lawton MP. The physical environment of the person with Alzheimer's disease. Aging Ment Health 2001;5:56-64. http://www. ncbi.nlm.nih.gov/pubmed/ 11513499
26. Overshott R, Burns A. Non-pharmacological treatment of severe dementia: an overview. In: Burns A, Winblad B, eds. Server dementia. Chichester: John, Wiley &Sons Ltd, 2006:164-75.
27. Edvardsson D, Fetherstonhaugh D, Nay R. Promoting a continuation of self and normality: person-centred care as described by people with dementia, their family members and aged care staff. J Clin Nurs 2010;19:2611-18.
28. Whittamore KH, Goldberg SE, Gladman J, et al. The diagnosis, prevalence and outcome of delirium in a cohort of older people with mental health problems on general hospital wards. Int J Geriatr Psychiatry 2014;29:32-40
29. Borbasi S, Jones J, Lockwood C, et al. Health professionals' perspectives of providing care to people with dementia in the acute setting: toward better practice. Geriatr Nurs 2006;27:300-8. http:// www.ncbi.nlm.nih.gov/pubmed/ 17045129 (Pubitemid 44509756)
30. Adams T, Gardiner P. Communication and interaction within dementia care triads. Developing a theory for relationship person-centred care. Dementia 2005;4:185-205.
31. Nolan MR, Davies S, Brown J, et al. Beyond person-centered care: a new vision for gerontological nursing. J Clin Nurs 2004;13:45-53. http://www.ssiacymru.org.uk/resource/9-n-Beyond-Person- Centred-Care.pdf (Pubitemid 38453245)
32. Tolson D, Smith M, Knight P. An investigation of the components of best nursing practice in the care of acutely ill hospitalized older patients with coincidental dementia: a multi-method design. J Adv Nurs 1999;30:1127-36. http://onlinelibrary.wiley.com/doi/10.1046/j. 1365-2648.1999.01194.x/pdf
33. Bradshaw LE, Goldberg SE, Schneider JM, et al. Carers' for older people with co-morbid cognitive impairment in general hospital: characteristics and psychological well-being. Int J Geriatr Psychiatry 2013;28:681-90.
34. Li H, Powers BA, Melnyk BM, et al. Randomized controlled trial of CARE: an intervention to improve outcomes of hospitalized elders and family caregivers. Res Nurs Health 2012;35:533-49.
35. Waller S. Redesigning wards to support people with dementia in hospital. Nurs Older People. 2012;24:16-21. http://nursingolderpeople. rcnpublishing.co.uk/archive/article-redesigningwards- to-support-people-with- dementia-in-hospital
36. Nufer TW, Spichiger E. How family carers of people with dementia experienced their stay on an acute care facility and their own collaboration with professionals: a qualitative study. Pflege 2011;24:229-37.
37. Lindhardt T, Nyber P, Hallberg IR. Collaboration between relatives of elderly patients and nurses and it's relation to satisfaction with the hospital care trajectory. Scand J Caring Sci 2008;22:507-19.
38. Tadd W, Hillman A, Calnan S, et al. Dignity in practice: an exploration of the care of older adults in acute NHS Trusts. (A research summary). NIHR Service Delivery and Organisation Programme. 2011. http:// www.sdo.nihr.ac.uk/ projdetails.php?ref=08-1819-218
39. Care Quality Commission. Dignity and nutrition inspection programme: national overview. 2011. http://www.cqc.org.uk/sites/ default/files/media/ documents/20111007-dignity-and-nutrition- inspection-report-final-update.pdf
40. Royal College Nursing (RCN). Dementia: commitment to the care of people with dementia in hospital settings. London. 2013. http://www. rcn.org.uk/-data/assets/pdf-file/0011/480269/004235.pdf
41. Alzheimer's Society. Dementia 2012: a national challenge. London: Alzheimer's Society, 2012. http://www.alzheimers.org.uk/ dementia2012