Dementia in Long-term Care Homes: Direct Care Workers’ Difficulties

Abstract

Increasing numbers of people with dementia are being admitted to long-term care facilities. Behavioural and psychological symptoms of dementia (BPSD) are particularly challenging to care homes which are commonly characterised by a low-skilled workforce. The increasing demand for higher quality dementia care emphasizes the need to address the Direct Care Workers’ (DCWs) difficulties, as this can inform the development of effective training interventions. This study aimed to explore the difficulties faced by DCWs caring for people with dementia in long term care homes. A qualitative cross-sectional study was conducted with 58 DCWs (female; mean age 44.63 ± 2.32). Eight focus-group interviews were performed to collect data. All interviews were video-recorded, transcribed and submitted to thematic analysis by two independent judges. Main difficulties faced by DCWs were related to: i) lack of time to provide personalised care and interact with residents, particularly during morning care; ii) management of the BPSD (e.g., agitation); iii) lack of knowledge about dementia and its symptoms, evolution and available treatments; iv) communication with residents; and v) stress and burnout related to BPSD. The findings underline the importance of training programmes for DCWs that provide both information and skills for dementia care that can be implemented during personal care tasks, and support to deal with stress and burnout. This is essential as training interventions are usually targeted on DCWs’ care knowledge and skills, neglecting the psychological pressure experienced by these workers.