The acute care ward experience for persons with dementia and their caregivers

Mrs Linda Hollis (2011). The acute care ward experience for persons with dementia and their caregivers Professional Doctorate, School of Psychology, The University of Queensland.

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Author Mrs Linda Hollis
Thesis Title The acute care ward experience for persons with dementia and their caregivers
School, Centre or Institute School of Psychology
Institution The University of Queensland
Publication date 2011-03
Thesis type Professional Doctorate
Supervisor Professor Nancy Pachana
Total pages 162
Total colour pages 9
Total black and white pages 153
Language eng
Subjects 1701 Psychology
Abstract/Summary Acute hospitalisation of persons with dementia can be a distressing experience for both the person with dementia and their caregiver, and is frequently a catalyst for the transition to residential care. Schözel-Dorenbos, Meeuwsen, and Olde Rikkert’s (2010) Hierarchy Model of Needs in Dementia, relating to the unmet needs of persons with dementia and their caregivers, was used to guide this study. All persons aged 70 years and over presenting to four acute care wards in and around Brisbane, and their caregivers, were approached to participate in this study. A qualitative analysis was conducted of pre and post-hospital stay survey data obtained from caregivers of persons with dementia (n = 25) and caregivers of persons without dementia (n = 80). Quantitative analysis was performed on data from assessment measures for persons with dementia (n = 96) and persons without dementia (n = 386) admitted to the acute care ward. The results for the qualitative analysis showed that caregivers’ most prominent concern was to maintain the dignity of their care recipient, and that many caregivers found the attitude of staff to be inappropriate. Issues surrounding discharge and the transition to residential care were also highlighted. The quantitative results revealed that persons with dementia scored more highly than persons without dementia on measures relating to cognitive decline, behavioural and psychological symptoms of dementia, and depression, and were more likely to have a longer hospital stay. Unexpectedly, they did not score more highly than persons without dementia in relation to decline in activities of daily living from admission to discharge, on a measure relating to vulnerable elders, or in the number of falls experienced during the hospital stay. Delirium was less likely to be resolved on discharge in persons with dementia, but persons with dementia were no more likely to have delirium on admission or during the hospital stay than persons without dementia. Documentation of the results of assessment measures was higher than expected for the Mini-Mental State Examination and the Confusion Assessment Method, but results for measures requiring caregivers’ input, that is, The Informant Questionnaire on Cognitive Decline in the Elderly and the Neuropsychiatric Inventory Questionnaire, were more likely to be absent from patients’ records. Assessment of depression was performed significantly less frequently in persons with dementia than in persons without dementia. Findings are considered with reference to the needs of persons with dementia and their caregivers, and also the potential role for geropsychologists in ensuring that these needs are met. Geropsychologists may contribute by providing education and training to staff, as well as support to staff, caregivers, and the person with dementia. Accuracy of diagnoses may also be enhanced by geropsychologists skilled in differential diagnoses of older adults.
Keyword Dementia
Acute care

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Created: Tue, 16 Aug 2011, 09:07:56 EST by Mrs Linda Hollis on behalf of Faculty of Social & Behavioural Sciences