Kelley, R orcid.org/0000-0002-8838-0313, Godfrey, M orcid.org/0000-0002-2408-534X and Young, J (2021) Knowledge Exchanges and Decision-Making Within Hospital Dementia Care Triads: An Ethnographic Study. The Gerontologist, 61 (6). gnaa216. pp. 954-964. ISSN 0016-9013
Abstract
Background and Objectives
Important decisions about the future care of people living with dementia are routinely made in hospitals. Very little is known about how the care needs of hospitalized people with dementia are understood, or how the perspectives of the person, families, and staff intersect to inform decision-making. This study explores how the care needs of people with dementia are understood by the person, their family, and hospital staff (the care triad), and how these perspectives shape decision-making.
Research Design and Methods
Ethnographic data were collected from 2 care-of-older-people general hospital wards via observations, conversations, and interviews with people with dementia, families, and staff. In total, 400 hr of observation and 46 interviews were conducted across two 7- to 9-month periods.
Results
The person’s care needs were often understood differently between and within arms of the care triad. A lack of consistent engagement with families and people with dementia reduced opportunities to recognize and integrate this range of views, leading to delays or difficulties in decision-making. People with dementia, particularly those lacking capacity, were most likely to have their perspectives overlooked.
Discussion and Implications
Early engagement with people with dementia and their families is required to ensure that all perspectives on the person’s current and future care needs are understood and represented during decision-making. Particular attention should be paid to involving people living with dementia in discussions and decisions about their care, and to the assessment and involvement of people who may lack capacity.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. This is an open access article under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0) (https://creativecommons.org/licenses/by/4.0/) |
Keywords: | Decision-making, Dementia, Ethnography, Family caregivers, General hospitals |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Elderly Care and Rehabilitation (Leeds) |
Funding Information: | Funder Grant number National Co-ordinating Centre for Research Capacity Development DRF-2009-02-85 |
Depositing User: | Symplectic Publications |
Date Deposited: | 26 Feb 2021 13:08 |
Last Modified: | 25 Jun 2023 22:35 |
Status: | Published |
Publisher: | Oxford University Press |
Identification Number: | 10.1093/geront/gnaa216 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:171591 |