Caring for patients with dementia in acute physical health settings

There are approximately 800,000 people in the UK with a diagnosis of dementia (Alzheimer’s Society, 2007). The ageing population is leading to increased pressures on dementia care facilities and acute hospital settings. As a result the care of patients with dementia is often suboptimal and staff tend to experience high levels of distress. Review of the literature examined the quantitative evidence base regarding the predictors of distress in staff working in 24 hour dementia care facilities. A narrative synthesis of 12 articles was carried out and identified three areas of predictors, these reflected intrapersonal, interpersonal and environmental predictors of distress. It was found that little attention was paid to environmental predictors of distress, most studies explored individual and relational factors, environmental predictors were often found to be linked to distress when research questions were broad and often investigating predictors of distress generally. Distress as a concept is ill defined, leading to many theories being applied and many tools being used, making synthesis of the results difficult. The findings are discussed in line with the existing evidence base on distress research. The research consisted of interviews with 21 acute care staff to explore how they experienced caring for those with dementia in acute medical units (AMU). Thematic analysis (TA) was used to develop four main themes and twelve subthemes, allowing for identification of the main concerns for staff caring for patients with dementia in their general practice. Findings inform changes that AMU could make to allow for staff to care for patients with dementia in a more effective way. The critical appraisal offers a reflective description of the experience of completing the research and its limitations.