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Challenges for professional care of advanced dementia
Author(s) -
Chang Esther,
Daly John,
Johnson Amanda,
Harrison Kathleen,
Easterbrook Sally,
Bidewell John,
Stewart Heather,
Noel Michael,
Hancock Karen
Publication year - 2009
Publication title -
international journal of nursing practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.62
H-Index - 55
eISSN - 1440-172X
pISSN - 1322-7114
DOI - 10.1111/j.1440-172x.2008.01723.x
Subject(s) - dementia , palliative care , nursing , medicine , aged care , focus group , qualitative research , psychology , disease , social science , pathology , marketing , sociology , business
Qualitative methodology based on action research identified challenges when caring for persons with advanced dementia, as perceived by key professional providers. Data collection was via five focus groups (total n = 24) and 20 follow‐up individual interviews. Participants included palliative care, aged care and dementia specialist nurses, medical specialists from an area health service, residential aged care staff and general medical practitioners. Responses emphasized the need for improved knowledge and skills, and clearer policy. Concerns included accurate assessment, especially of pain, owing to the inability of people with advanced dementia to communicate their symptoms. Assessment, managing physical and behavioural symptoms, and communicating with family presented as further challenges. Conclusions are that the need for a palliative approach to care in advanced dementia should be recognized. Aged care staff can deliver palliative care to people with advanced dementia only if the staff receive relevant education and training beyond their generalist competencies.