Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 8;50(1):233-241.
doi: 10.1093/ageing/afaa210.

Understanding and identifying ways to improve hospital-based cancer care and treatment for people with dementia: an ethnographic study

Laura Ashley  1 , Rachael Kelley  2 , Alys Griffiths  2 , Fiona Cowdell  3 , Ann Henry  4   5 , Hayley Inman  6 , June Hennell, Margaret Ogden, Maria Walsh, Liz Jones, Ellen Mason  7 , Michelle Collinson  7 , Amanda Farrin  7 , Claire Surr  2
Affiliations

Understanding and identifying ways to improve hospital-based cancer care and treatment for people with dementia: an ethnographic study

Laura Ashley et al. Age Ageing. .

Abstract

Background: Providing cancer care and treatment for ageing populations with complicating comorbidities like dementia is a growing global challenge. This study aimed to examine the hospital-based cancer care and treatment challenges and support needs of people with dementia, and identify potential ways to address these.

Methods: A two-site ethnographic study in England involving semi-structured interviews, observations and accompanying conversations, and medical record review. Participants (N = 58) were people with dementia and comorbid cancer (n = 17), informal caregivers (n = 22) and hospital staff (n = 19). Ethnographically informed thematic analysis was conducted.

Results: There was an accumulated complexity of living with both illnesses simultaneously. People with dementia and families could feel confused and uninformed due to difficulties understanding, retaining and using cancer information, which impacted their informed treatment decision-making. Dementia increased the complexity and burden of travelling to and navigating unfamiliar hospital environments, frequent lengthy periods of waiting in hospital, and self-managing symptoms and side-effects at home. Oncology staff were often working without the full picture, due to variable documenting of dementia in medical records, dementia training was limited, and time and resource pressures impeded the highly individualised, flexible cancer care required by people with dementia. Supportive family carers were crucial in enabling people with dementia to access, navigate and undergo cancer treatment and care.

Conclusions: Dementia complicates cancer care in a range of ways accumulating across the cancer pathway. Our findings suggest there are several strategies and interventions, which we list here, with potential to improve cancer care and treatment for people with dementia and their families.

Keywords: Older people; cancer; dementia; hospital; multimorbidity; qualitative research.

PubMed Disclaimer

References

    1. Nguyen H, Manolova G, Daskalopoulou C, Vitoratou S, Prince M, Prina AM. Prevalence of multimorbidity in community settings: a systematic review and meta-analysis of observational studies. J Comorb 2019; 9: 2235042X19870934. - PMC - PubMed
    1. Pilleron S, Sarfati D, Janssen-Heijnen M et al. Global cancer incidence in older adults, 2012 and 2035: a population-based study. Int J Cancer 2019; 144: 49–58. - PubMed
    1. Cancer Research UK Cancer Incidence by Age Statistics. www.cancerresearchuk.org/health-professional/cancer-statistics/incidence... (30 September 2020, date last accessed).
    1. Prince M, Wimo A, Guerchet M, Ali G-C, Wu Y-T, Prina M. World Alzheimer Report 2015. The Global Impact of Dementia: an Analysis of Prevalence, Incidence, Cost and Trends. London: Alzheimer’s Disease International, 2015.
    1. Smith GE, Farias ST, eds. APA Handbooks in Psychology: APA Handbook of Dementia. Washington DC: American Psychological Association, 2018.

Publication types