Nurses' experiences of caring for persons with dementia experiencing responsive behaviours in an acute hospital: A qualitative descriptive study

Abstract

Objective: To explore nurses' experiences of caring for persons with dementia experiencing responsive behaviours in an acute hospital.

Background: Caring for persons with dementia who have an acute medical illness and are experiencing responsive behaviours in acute hospitals can be challenging for nurses. While existing research has explored the experiences of nurses in providing dementia care in this setting, there is limited knowledge about the specific care experiences of nurses when working to meet the needs of persons with dementia who experience responsive behaviours alongside an admitting diagnosis.

Method: A qualitative descriptive design was implemented. Semi-structured interviews were carried out with nine nurses working in medical and surgical wards. A thematic analysis approach was used to analyse the data. Ethical approval to conduct the study was received from the writers' university.

Results: Three themes were found: (a) challenges encountered, (b) a person-centred response and (c) dementia preparedness. Key findings about challenges encountered by nurses included: the acute hospital environment; increased need for enhanced knowledge; and emotional challenges. Person-centred responses such as working in partnership with others and reminiscence were identified as strategies to address the challenges. Finally, nurses identified particular interventions that were supportive to them in enhancing their preparedness to meet the needs of persons with dementia who experience responsive behaviours.

Conclusions: Persons with dementia who are acutely unwell and are experiencing responsive behaviours, within acute hospitals, have specific and individualised care needs. Nurses working in these settings must therefore be supported in developing competence in managing these frequently complex clinical cases, while also providing person-centred care.

Implication for practice: Nurses' narratives demonstrate that they continue to experience challenges in the presence of responsive behaviours. There is a consequent need for dementia-specific education on person-centred ways to address responsive behaviours within acute hospital settings.

Keywords: acute hospital; dementia; non cognitive symptoms of dementia; nurses' caring experiences; person living with dementia; person-centred practice; responsive behaviours.