People With Dementia as Active Agents in Nursing Homes: A Scoping Review

Abstract

People with dementia (PWD) are fragile and need aid and care in their daily lives. This scoping review explores the extent to which PWD can be involved in society and their daily lives. Publications were selected according to PRISMA guidelines. We graded the level of participation/involvement in daily life and research using a five-level participation model developed by Shier. A higher grade means a greater ambition to involve PWD in decisions. Of the 11 included studies, three reached level three according to Shier’s model. The studies describe ways of and potentials for participation, capabilities of PWD, caregivers’ opportunities to foster involvement, and cooperation between PWD caregivers and relatives. Caregivers and managers must have the attitude that PWD can be involved in decisions and caregivers need opportunities to actively promote such involvement. Shier’s model can be a tool with which organizations strive to involve PWD.

Moral Distress and Moral Agency: Staff Experience of Supporting Self-Determination for People with Dementia

“…However, there should be more discussion in these documents about supporting staff when endeavoring to promote resident autonomy (Lindmark et al 2022). According to Ingard et al (2023), nursing homes have not managed to facilitate self-determination for persons with dementia to any great degree, and staff must apply the approach that self-determination is essential. In our study, some of the staff mentioned that the policy documents have unrealistic ambitions given the resources allotted (e.g., staffing limits).…”

“…Sci. 2024, 13, 237 2 of 15 individuals with dementia (Ingard et al 2023). When staff members cannot deliver care in line with policy guidelines and their own perception of quality care, they may experience moral distress.…”

“…Adequate skills are crucial for staff to involve residents in decision-making (Strøm and Slettebø 2021). Broad self-determination for persons with dementia in nursing homes is uncommon; it requires that the staff and managers prioritize efforts to promote it (Ingard et al 2023). Staff perceptions of self-determination for the residents are intertwined with their perceptions of what constitutes reasonable care.…”