Nurses' Experiences in Caring for Older Adults With Responsive Behaviors of Dementia in Acute Care

Abstract

wandering, yelling, hitting, and restlessness). Health-care professionals perceive these behaviors to be a challenging aspect in providing care for persons with dementia. Aims: This study explores the perceptions of nurses about (a) caring for older adults with dementia experiencing responsive behaviors in acute medical settings and (b) recommendations to improve dementia care. Methods: Thorne's interpretive description approach was used. In-person, semistructured interviews were conducted with 10 nurses and 5 allied health professionals from acute medical settings in an urban hospital in Ontario. Interviews were conducted with allied health professionals to understand their perspectives regarding care delivery for persons with responsive behaviors of dementia. Data were analyzed using Braun and Clarke's experiential thematic analysis. Findings: Themes related to caring for individuals with responsive behaviors included (a) delivering care is a complex experience, (b) using pharmacological strategies and low investment nonpharmacological strategies to support older adults with responsive behaviors, (c) acute medical settings conflicted with principles of dementia care due to a focus on acute care priorities and limited time, and (d) strong interprofessional collaboration and good continuity of care were facilitators for care. Conclusions: Findings provide guidance for improved support for nurses who provide care for individuals experiencing responsive behaviors in acute medical settings such as increasing staffing and providing educational reinforcements (e.g., annual review of dementia care education and in-services).

Low investment non-pharmacological approaches implemented for older people experiencing responsive behaviours of dementia

“…This study used secondary analysis of qualitative data from a primary study (Yous et al, 2019) using Thorne's (2016) interpretive description approach to explore a clinical practice issue (i.e., nursing care delivery for older people experiencing responsive behaviours). Thorne (2016) indicates that a secondary analysis is appropriate to revisit data guided by a new or extended research question and further elaborate on findings within an expanded clinical context, if the new question aligns with the data.…”

“…The primary study was conducted in four acute medical units (i.e., three clinical teaching units and a cardiology unit) in a hospital in Ontario, Canada housing approximately 130 acute medical beds (Yous et al, 2019). Participants were registered nurses, registered practical nurses, a nurse educator, and allied health professionals (e.g., occupational therapists, a social worker, a physiotherapist).…”

“…The first author conducted individual face-to-face semistructured interviews from December 2017 to March 2018 and audio-recorded and transcribed interviews (Yous et al, 2019). Participants were asked about their day-to-day experiences in supporting older people experiencing responsive behaviours.…”

“…In an acute care environment, which is fast paced with increasing demands placed on nurses, low investment non-pharmacological approaches are often implemented rather than high investment ones (Yous, Ploeg, Kaasalainen, Schindel Martin, & 2019). At present, the types of low investment non-pharmacological approaches implemented by nurses in acute medical settings are not well understood.…”

“…and (b) What are the influencing factors that inform the decisions of nurses to implement low investment non-pharmacological approaches? We present findings from a qualitative secondary data analysis of a primary study that explored nursing perceptions in caring for older people experiencing responsive behaviours of dementia in acute medical settings (Yous et al, 2019).…”