Communication and interaction within dementia care triads

Adams, Trevor; Gardiner, Paula

doi:10.1177/1471301205051092

Cited by 133 publications

(32 citation statements)

References 48 publications

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“…49 Individuals' families are acknowledged to be a vital source of support for people with dementia, and care for people with dementia has evolved to recognise that relationships often involve triads including service users, their family carers and health and social care professionals. 50,51 Management continuity…”

Section: Relationship Continuitymentioning

confidence: 99%

Comorbidity and dementia: a mixed-method study on improving health care for people with dementia (CoDem)

Bunn

Burn

Goodman

et al. 2016

Health Serv Deliv Res

116

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BackgroundAmong people living with dementia (PLWD) there is a high prevalence of comorbid medical conditions but little is known about the effects of comorbidity on processes and quality of care and patient needs or how services are adapting to address the particular needs of this population.ObjectivesTo explore the impact of dementia on access to non-dementia services and identify ways of improving the integration of services for this population.DesignWe undertook a scoping review, cross-sectional analysis of a population cohort database, interviews with PLWD and comorbidity and their family carers and focus groups or interviews with health-care professionals (HCPs). We focused specifically on three conditions: diabetes, stroke and vision impairment (VI). The analysis was informed by theories of continuity of care and access to care.ParticipantsThe study included 28 community-dwelling PLWD with one of our target comorbidities, 33 family carers and 56 HCPs specialising in diabetes, stroke, VI or primary care.ResultsThe scoping review (n = 76 studies or reports) found a lack of continuity in health-care systems for PLWD and comorbidity, with little integration or communication between different teams and specialities. PLWD had poorer access to services than those without dementia. Analysis of a population cohort database found that 17% of PLWD had diabetes, 18% had had a stroke and 17% had some form of VI. There has been an increase in the use of unpaid care for PLWD and comorbidity over the last decade. Our qualitative data supported the findings of the scoping review: communication was often poor, with an absence of a standardised approach to sharing information about a person’s dementia and how it might affect the management of other conditions. Although HCPs acknowledged the vital role that family carers play in managing health-care conditions of PLWD and facilitating continuity and access to care, this recognition did not translate into their routine involvement in appointments or decision-making about their family member. Although we found examples of good practice, these tended to be about the behaviour of individual practitioners rather than system-based approaches; current systems may unintentionally block access to care for PLWD. Pathways and guidelines for our three target conditions do not address the possibility of a dementia diagnosis or provide decision-making support for practitioners trying to weigh up the risks and benefits of treatment for PLWD.ConclusionsSignificant numbers of PLWD have comorbid conditions such as stroke, diabetes and VI. The presence of dementia complicates the delivery of health and social care and magnifies the difficulties that people with long-term conditions experience. Key elements of good care for PLWD and comorbidity include having the PLWD and family carer at the centre, flexibility around processes and good communication which ensures that all services are aware when someone has a diagnosis of dementia. The impact of a diagnosis of dementia on pre-existing conditions should be incorporated into guidelines and care planning. Future work needs to focus on the development and evaluation of interventions to improve continuity of care and access to services for PLWD with comorbidity.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Relationship Continuitymentioning

confidence: 99%

Comorbidity and dementia: a mixed-method study on improving health care for people with dementia (CoDem)

Bunn

Burn

Goodman

et al. 2016

Health Serv Deliv Res

116

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“…Generally, supporting relationships benefits wellbeing in dementia (McGovern, 2010), and there are arguments for extending the concept of person-centred care to relationship-focused care (Adams & Gardiner, 2005). It is important steps are taken to reduce any invisibility through staff training in inclusive practice and not making assumptions about relationships.…”

Section: Discussionmentioning

confidence: 99%

How do lesbian and gay people experience dementia?

McParland

Camic

2016

Dementia

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“…Finally, the issue of having carers or family members present during an examination was of key concern to the participants -this explicitly relates to the communicative 'triad' around professionals, carers and the individual with dementia in situ described by Adams and Gardiner (2005). In this particular regard, participant experiences and broad perceptions of effective practice provided both convergences and contrasts with extant literature.…”

mentioning

confidence: 97%

“…In this particular regard, participant experiences and broad perceptions of effective practice provided both convergences and contrasts with extant literature. It is relatively clear within recent allied healthcare research that carer/family presence is widely taken to be a positive, particularly in fields such as nursing and social work (Adams & Gardiner, 2005;Livingston et al, 2014;Veselinova, 2014).…”

mentioning

confidence: 99%

Dementia and Clinical Interaction in Frontline Radiography: Mapping the Practical Experiences of Junior Clinicians in the UK

2017

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Usage of any items from the University of Cumbria's institutional repository 'Insight' must conform to the following fair usage guidelines.Any item and its associated metadata held in the University of Cumbria's institutional repository Insight (unless stated otherwise on the metadata record) may be copied, displayed or performed, and stored in line with the JISC fair dealing guidelines (available here) for educational and not-for-profit activities provided that• the authors, title and full bibliographic details of the item are cited clearly when any part of the work is referred to verbally or in the written form AbstractThis paper reports findings from a study of the practical experiences of junior diagnostic radiographers in the UK when managing patients with dementia. Extended semi-structured interviews with six participants (mean experience in diagnostic radiography = 3.5 years) were analysed using Interpretative Phenomenological Analysis (IPA). Findings highlight that participants' recurrently-cited lack of confidence around their knowledge of dementia, and regular treatment of the condition as a 'generic' thing in practice, had sometimes damaged clinical interaction, particularly when the participant was feeling institutional time pressures.Education for new professionals was seen as lacking in both quantity and context-relevance, with implications for professional confidence and ethical practice. Carers and family members were viewed by participants as potentially positive and negative forces within an examination context, and technological advances in radiography were taken to be clinically advantageous, but also actively detrimental to the effective interpersonal care of their patients.

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Communication and interaction within dementia care triads

Cited by 133 publications

References 48 publications

Comorbidity and dementia: a mixed-method study on improving health care for people with dementia (CoDem)

Comorbidity and dementia: a mixed-method study on improving health care for people with dementia (CoDem)

How do lesbian and gay people experience dementia?

Dementia and Clinical Interaction in Frontline Radiography: Mapping the Practical Experiences of Junior Clinicians in the UK

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