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PO2. Care services

Detailed programme and abstracts

PO2.1. The needs of people living with dementia in acute hospital care

BLÁHOVÁ Hana1, BÁRTOVÁ Alžběta2, DOSTÁLOVÁ Vladimíra2, HOLMEROVÁ Iva2

1Charles University, Faculty of Humanities, Prague, Czech Republic, 2Additional Author, Prague, Czech Republic

Our population is rapidly aging and vulnerable older patients have increasing care needs. The needs of these patients in acute hospital care, especially those diagnosed with dementia, have not been sufficiently explored.

Objective: Our project n. 760219 (Met and unmet needs of vulnerable older patients receiving healthcare at home and in hospital) was accepted for funding by the Grant Agency of Charles University. It aims to provide a comprehensive overview of the needs of vulnerable older patients and patients with dementia. Initial deliverables of the project are scoping reviews of self-reported needs of 1) older people in home care; 2) older patients in hospital care; and 3) home dwelling people with dementia. The aim of this presentation is to explore the needs of people living with dementia in acute hospital care.

Methods: A scoping review of the articles published between 2009 and 2019 was carried out using the databases Scopus, Web of science, PsycInfo, ProQuest Central, CINAHL and PubMed to search for relevant articles according to PRISMA guidelines.

Results: The poster will present the results from the scoping review of the needs of people with dementia in acute hospital care. The context and comparison of the previous results of our project will be included.

PO2.2. Caring for people with dementia in perioperative environments: the experiences of healthcare professionals

DIAZ-GIL Alicia1, APPLETON Jane1, KOZLOWSKA Olga1, PENDLEBURY Sarah2

1Oxford Brookes University, Oxford, United Kingdom, 2Nuffield Department of Clinical Neurosciences, Oxford, United Kingdom

Background: The increasing prevalence of dementia has an impact on healthcare services, with higher numbers of people diagnosed with dementia undergoing surgical procedures. Perioperative care for patients with dementia represents a challenge for the person with dementia, their family members and healthcare professionals. Previous literature suggests that people with dementia experience higher risk of negative outcomes after a surgical procedure. Exploring the surgical trajectory and identifying the main issues and risks is necessary to start working on solutions.

Aim: To identify the major issues and challenges that healthcare professionals working in perioperative areas experience when caring for people with dementia.

Methods: Participants from four hospitals at the Oxford University Hospitals NHS Trust were recruited. Data was collected using semi-structured face to face interviews. Five participants have been interviewed from a total of sixteen planned participants. Preliminary data was analysed using thematic analysis by Braun and Clarke (2006), with the use of the NVivo 12 software.

Results: Analysis on this preliminary data suggests that perioperative care for people who have dementia could be improved. From the nursing point of view, healthcare professionals reported that their knowledge and training about dementia is very scarce and the majority of them have learned through their clinical experiences. Main issues reported were lack of communication between departments, problems related to pain assessment and difficulties ensuring patient safety while preserving their dignity. From the anaesthetic point of view, issues reported included concerns regarding informed consent for surgery and selecting the most appropriate form of anaesthesia.

Conclusion: Although this research is still in process, these initial results show that current practice needs to evolve to ensure that healthcare professionals are providing the best care for people with dementia during their surgical trajectory. More training is needed for healthcare professionals working in perioperative environments regarding dementia care.

PO2.3. Investigating the association between ward and discharge discussions regarding support needs for people with dementia

BOURKE Lori, MORRIS Aimee

Royal College of Psychiatrists, London, United Kingdom

The National Audit of Dementia (NAD) collects information from general hospitals in England and Wales to evaluate the quality of care provided to people with dementia. For Round 4 of audit (published 2019) hospitals submitted information from the casenotes of 50-100 patients. 9782 casenotes were submitted across 192 hospitals. The team aimed to investigate the association between the ward on which the patient spent the most time and the documentation of discussions with the person with dementia, carer/family member and medical staff regarding support needs at discharge. The audit tool included 4 questions asking about recorded discussions of support needs with: the person with dementia, a carer or family member, a consultant, and members of the multidisciplinary team (MDT). In 28% of casenotes discharge plans were discussed with all 4 groups. This was most commonly discussed with the MDT (85%) and least likely to be discussed with the person with dementia (57%).We calculated a combined average across all four questions which revealed that patients on the care of the elderly ward (COE) were most likely to have involvement (80%) followed by stroke (76%) and orthopaedic (76%). A multiple regression revealed that ward had a significant impact on the presence of these discharge discussions. COE had the largest effect (P< .000) accounting for 73% of the variance. Although the number of casenotes present (R2 = .024) and LOS (R2 = 0.10) had a significant influence on discharge discussions, this only accounted for a very small amount of variance. These findings highlight initial evidence that the ward on which a patient spent the most time influences whether discussions of support needs are likely to take place at discharge.

PO2.4.

PO2.6. Improving Impact of Learning on Practice

BARTLE Caroline

3 Spirit UK, Buckinghamshire, United Kingdom

A highly regulated industry drives tick-box approaches to learning in dementia care. Resources can be deployed ineffectively, at a high cost without meaningful impact. Barriers such as negative media representations of care work ‘unskilled’ limit opportunities for creative approaches to learning. A different approach is required to deliver sustainable changes in practice, one that recognises the central role the care worker has in designing and leading their own learning journey.

The technological explosion driven by the pandemic has opened up new possibilities for utilising technology to deliver programmes which drive behavioural changes front line. Examples of barriers removed by the pandemic are greater digital capability, opportunities for collaboration and more control for the learning to navigate and contribute to their own learning journey.

My organisation has been developing infographics in dementia care for the past ten years, as part of a broader strategy to utilise creative approaches to learning. During this time testing and measuring different approaches to dementia education to identify those that are most impactful. This has led to important insights around effective practice and highlighted the role of training services bring to bridging academia and practice. Our infographics are designed to start conversations in busy environments, make complex research findings accessible to front line practice that act as important memory aids at the point of practice.

However, infographics are only part of the strategy, specific activities before, during and after training are required to improve dementia care practice. Two years ago, I started by a professional doctorate at Stirling University where I am hoping to explore these possibilities, now with the aid of a community that is much more digitally able and aware. In my research, I am hoping to explore the factors that support the development of compassionate, capable and confident workforces 

 

 
 

Last Updated: Tuesday 01 September 2020

 

 
  • Acknowledgements

    The 30th AE Conference received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe gratefully acknowledges the support of all conference sponsors.
  • European Union
  • Roche
 
 

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