Involving the Person with Dementia in Crisis Planning: Focus Groups with Crisis Intervention Teams

Abstract

Dementia leads to progressive critical situations that can escalate to a crisis episode if not adequately managed. A crisis may also resolve spontaneously, or not resolve after receiving professional support. Because of the intensity of the crisis, the extent to which the person engages in decision making for their own care is often decreased. In UK mental health services, ‘crisis teams’ work to avert the breakdown of support arrangements and to avoid admissions to hospital or long-term care where possible. This study aimed to explore the views of crisis teams about promoting the involvement of the person with dementia in decision-making at all points in the care pathway, here defined as co-production. The staff of crisis teams from three NHS Trusts in the UK were interviewed through focus groups. Data were analysed using framework analysis. Three focus groups were run with 22 staff members. Data clustered around strategies used to promote the active involvement of the person with dementia, and the challenges experienced when delivering the care. Staff members reported that achieving a therapeutic relationship was fundamental to successful co-production. Miscommunication and/or lack of proper contact between the team and the individuals and carers receiving support adversely affected the quality of care. Making service users aware of the support provided by crisis teams before they need this may help promote a positive therapeutic relationship and effective care management.