Abstract
Objectives: to report on acute hospital care experiences for persons with dementia and family/carers in a pilot study (PiP) of person-centred care compared with usual care. Methods: participants were recruited from one acute aged care ward and one mixed medical/surgical ward. One-on-one interviews occurred soon after discharge using a semi-structured interview guide framed by person-centred principles whereby the person is: V—valued; I—treated as an individual; P—perceived as having a unique identity; and S—supported socially and psychologically. Data were analysed deductively with reference to these a priori principles. Results: 11 consented persons with dementia and 36 family/carers participated. A total of eight core VIPS concepts were derived from the data. While many occasions of person-centred care occurred, there was variability in staff expertise, interest and aptitude for dementia care work. Neglect of person-centred principles more frequently occurred for the usual care group, where staff failed to place the person and their family/carer at the centre of service. Conclusions: person-centred services for persons with dementia requires that hospital executive equip staff with the relevant knowledge, skills and support to adhere to person-centred care guidelines. Hospitals must address workplace cultures and procedures that favour organisational systems over person-centred services.
Highlights
Persons living with dementia need extra care and supervision to stay safe and well during a hospital stay [1,2,3]
This paper reports on the methods and results of follow-up interviews held with a volunteer sample of PiP study participants with dementia and family/carers who regularly visited them in hospital
The VIPS principles [13] provided a useful structure for interpreting the acute hospital experience for persons with dementia and their family/carers from Kitwood’s person-centred lens [12], in respect of: V—how they are valued; I—how they are treated as individuals; P—how they are perceived as persons with unique identities; and S—how they are supported within the acute hospital service [30]
Summary
Persons living with dementia need extra care and supervision to stay safe and well during a hospital stay [1,2,3]. Unfamiliar surroundings, unknown staff, frequent staff changes and interruptions in daily routines can cause delirium and increased behavioural and psychological symptoms of dementia [8], which further complicate the person’s treatment and care [9]. These risks demand the readiness of hospitals to ensure a dementia-friendly environment and dementia-specific delivery of care [10]. When armed with PCC knowledge and skills, staff are more likely to understand how dementia can impact the person’s behaviour, for example, which often occurs as a response to the healthcare environment [14] and know how to accommodate changed behaviour in routine care [15]
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