Abstract
Quality of dementia care improves with a personalized approach to aged care, and knowledge of the disease process and unique care needs of residents with dementia. A personalized model of care can have a significant impact on the overall organizational culture in aged care homes. However, the dimensions of personalized aged care relating to dementia often remain under-managed. We aim to explore the factors that shape the dimensions of personalized dementia care in rural nursing homes using qualitative data of a mixed-method 'Harmony in the Bush' dementia study. The study participants included clinical managers, registered nurses, enrolled nurses and care workers from five rural aged care homes in Queensland and South Australia. One hundred and four staff participated in 65 semi-structured interviews and 20 focus groups at three phases: post-intervention, one-month follow-up and three-months follow-up. A multidimensional model of nursing home care quality developed by Rantz et al. (1998) was used in data coding and analysis of the factors. Three key themes including seven dimensions emerged from the findings: resident and family [resident and family centeredness, and assessment and care planning]; staff [staff education and training, staff-resident interaction and work-life balance]; and organization [leadership and organizational culture, and physical environment and safety]. A lack of consideration of family members views by management and staff, together with poorly integrated, holistic care plan, limited resources and absence of ongoing education for staff, resulted in an ineffective implementation of personalized dementia care. Understanding the dimensions and associated factors may assist in interpreting the multidimensional aspects of personalized approach in dementia care. Staff training on person-centered approach, assessment and plan, and building relationships among and between staff and residents are essential to improve the quality of care residents receive.
Highlights
Personalized care is integral to the quality of residential dementia care [1, 2]
We aim to provide an insight into the dimensions including factors and issues that influence personalized dementia care in rural aged care homes, using qualitative data from ‘Harmony in the Bush’ project
This qualitative study is a part of a large project, ‘Harmony in the Bush’ (2017–2019)–funded by the Australian Department of Health, that seeks to understand the personalized care support for residents with dementia (RwD) in Australian rural aged care homes and trials a personalized dementia care program
Summary
Personalized care is integral to the quality of residential dementia care [1, 2]. Standard dementia care is generally provided by a multidisciplinary team of nurses, allied health and care support workers, and related to the routine clinical assessment and maintenance of a holistic care plan [5]. The literature indicates a personalized approach, based on active listening, recognition, compassion, attentiveness and sensitivity to the resident’s needs and preferences in providing care, promotes quality of life for residents with dementia (RwD) [1, 6]. A lack of understanding of the dimensions of personalized aged care relating to dementia restricts the integration of person-centered approach into dementia care assessment and plan, especially in rural aged care homes [7, 8]
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