Abstract
BackgroundResearch aiming to improve the hospital experience for patients with dementia and their informal carers is strongly recommended. The present review aimed to describe the research on interventions to meet the needs of people with dementia in acute hospital settings regarding physical environment, organization of care, and staff knowledge of dementia and competence in person-centred care. An integrative review design was applied. We searched for studies in PubMed, Ovid Medline, Cinahl, Embase, Swemed+, and Cochrane databases using the Mixed Methods Appraisal Tool (MMAT) for quality evaluation. Twenty-seven articles were included, describing the perspectives of people with dementia, informal carers, and professional carers. The MMAT score ranged from two to four. Twelve studies described needs and experiences, mostly using a qualitative design. Common themes and results were synthesized. The studies identified a need to enhance staff competence regarding dementia and person-centred care. Fifteen studies described interventions: two were qualitative; three used mixed method, and 10 were quantitative, of which two were randomized controlled trials and eight were observational studies. Five types of interventions were identified. Three types could positively impact staff knowledge about dementia and person-centred care. One type was experienced as positive regarding organisation of care for patients with dementia. None of the intervention studies found evidence for effects on the identified needs regarding physical environment.ConclusionThe included studies suggest that staff need more knowledge regarding dementia and person-centred dementia care and that training interventions implemented to enhance staff competence had promising results. However, there is a need for research on the needs of patients with dementia in acute hospital settings regarding physical environment and effect of design elements. There is also a scarcity of intervention studies focusing on the effect of models of care that support the psychosocial needs of patients with dementia.
Highlights
Research aiming to improve the hospital experience for patients with dementia and their informal carers is strongly recommended
Discharge No significant differences Treatment of selected 4 disposition, mortality, were found between nursing home residents cause of hospitalization, groups in length of stay, in an acute-care geriatric chronic medical mortality, or discharge unit is feasible, medically condition, cognitive disposition effective, results in a safe state, change of discharge, and provides functional status during an alternative to transfer the hospital stays to an emergency room
The present review found limited research regarding the needs of people with dementia in acute hospital settings and of the effect of interventions implemented to meet these needs
Summary
Research aiming to improve the hospital experience for patients with dementia and their informal carers is strongly recommended. The present review aimed to describe the research on interventions to meet the needs of people with dementia in acute hospital settings regarding physical environment, organization of care, and staff knowledge of dementia and competence in person-centred care. Consequences for people with dementia admitted to hospital include higher mortality rates, increased likelihood of falls, functional decline, spatial disorientation, possible malnutrition and dehydration, increased reliance on caregivers, depression, and delirium [1]. They may experience more pain, thirst, fear, and over-stimulation than people without a cognitive impairment while in hospital, partly due to their impaired ability to communicate [6]. In acute hospitals the level of activity is high, monitoring and managing patients’ acute needs is a first priority for staff [7]
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