Abstract
ABSTRACT Objective: to understand nursing workers' experiences with the nursing care provided to elderly individuals with dementia living in a long-term care facility. Method: comprehensive qualitative study conducted in a long-term care facility located in Joinville, Santa Catarina, Brazil, from July to September 2018. Thirteen nursing technicians and one nurse participated. Data were collected using questionnaires, field diaries, individual interviews, and participatory observation. Thematic content analysis was used to interpret content. Results: three themes emerged from data analysis: "Knowledge acquired with practice and gap existing in the care provided to institutionalized elderly individuals with dementia"; "Individualized care provided to elderly individuals and bonding"; and "Conflicts the nursing staff faces when reconciling care needs, the time available, and the facility's routines". These themes originated the central theme: Meanings assigned to the nursing care provided to institutionalized elderly individuals with dementia. By sharing information regarding care actions that obtained positive results, the staff perceived the importance of an individualized approach and of establishing bonds as a therapeutic process. Gaps were identified in the professionals' knowledge regarding how to provide hygiene care when individuals become aggressive, agitated, or resist care. Conclusion: health workers' experience is a source of evidence for evidence-based practice and is also essential to fill in existing gaps between knowledge and care delivery.
Highlights
More than 46 million people live with dementia worldwide
Given the importance of the role of nursing in the care provided to institutionalized elderly individuals and the need to improve the quantity and quality of scientific evidence concerning nursing care provided to institutionalized individuals with dementia, this study proposes the following question: how does the nursing staff experiences the care provided to elderly individuals with dementia living in a long-term facility? this study’s objective was to understand nursing professionals’ experience regarding the nursing care provided to elderly individuals with dementia living in longterm care facilities
Three themes emerged from the individual interviews, field diaries, and participatory observation regarding nursing care provided to institutionalized elderly individuals with dementia: 1) knowledge acquired with practice and the gap existing in the care provided to institutionalized elderly individuals with dementia; 2) individualized care provided to elderly individuals and bonding; and 3) conflicts the nursing staff faces when reconciling care needs, the time available, and the facility’s routines
Summary
More than 46 million people live with dementia worldwide. Dementia became a public health problem because it is the leading cause of dependency among the elderly globally, with considerable emotional and financial impact on families. Given difficulties to continually provide care to elderly individuals at home, many families opt to place them in a long-term care facility (LTCF). This new context became relevant for nursing care. One study addressing Brazilian LTCF identified that 66.1% of the facilities provided medical services, while the percentage of nurses, nursing technicians, and aids is higher than that of caregivers in the facilities located in the northeast and southeast[5]. One study conducted in Rio de Janeiro verified that 88.02% of these facilities maintain technical nursing activities[6]
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