I conducted an interview with Maureen, BSN, RN, ACM, who has had an abundance of jobs in the healthcare field, but is currently a care coordinator at Hartford Hospital. I asked her, if there was one topic that she could research if times and funds were unlimited, and she mentioned dementia. She stated, "What are the best ways to care for these patients if the family cannot manage them? Research could focus on putting funds toward alternate, smaller homelike care settings with more caregivers and see how these patients react over time. Or is it best to provide funds for continuous care in their own home? Would agitated patients be able to live happier, calmer lives, as they would feel safe and “at home”?" From this interview, I created my research question.
Dementia is a chronic brain disorder typically associated with the aging process. It brings along impaired thought, personality modifications, and memory disorders. Dementia is in fact not a disease, but instead a syndrome. Individuals with dementia can either live at home with the help of a caregiver, live within a hospital ward, or live within a skilled facility such as an assisted living facility or a nursing home.
Most people think that living in their own home is the smartest route for the best quality of life. However a study conducted by Black (2013), shows that safety is an issue if the house doesn’t have updated accessible qualities, 99% of individuals with dementia and 97% of their caregivers have one or more unmet need, more than 60% of the individuals needed medical attention, and more than half of the patients had inadequate meaningful daily activities at home or at a senior center. Moreover, caregivers such as family members working within the home have limited access to resources, recommendations to support services, and little education on the best way to take care of someone with dementia.
Jennifer Albrecht and colleagues (2013) conducted a cross-sectional analysis of data to find the differences between quality of care of hospice patients with and without dementia. They concluded that there were only two quality of care measures that were different for hospice patients with dementia, which included feeding tubes and pain assessment (Albrecht et al., 2013). These measures indicated a slightly poorer quality of care for hospice patients with dementia.
Skilled nursing facilities, such as nursing homes, allow individuals with dementia to participate in meaningful activities. These activities, specifically for people with mild to moderate dementia, include work-related activities, social gatherings, leisure activities, and household chores. These activities leave individuals with a sense of satisfaction, connection to one’s world, and a sense of self, despite the changes from dementia (Finni & Bottomley, 2013). Long-term care facilities improve the quality of life of these individuals because professionals are able to independently assess each person’s abilities and decline from their stage in dementia and create a program that specifically caters to their abilities. These facilities offer the best quality of care because they include full time professional caretakers, occupational therapists, and rehabilitation specialists.
Utilization of Findings in Clinical Practices
The findings from these studies can be used in clinical practice because they give insight on which correlations change the quality of life of those with dementia, they provide evidence that urge caregivers to focus on tense behavior and depressive systems, and they make it possible to develop strategies that can be used to improve the quality of care offered to patients with dementia living within hospital and nursing homes.
Albrecht J.S., Gruber-Baldini A.L., Fromme E.K., McGregor J.C., Lee D.S.H., & Furuno J.P. (2013). Quality of hospice care for individuals with dementia. The American Geriatrics Society, 61(7), 1060-1065. doi: 10.1111/jgs.12316
Finni, R., & Bottomley. (2013). Promoting client quality of life: Characteristics of successful dementia care. Geri Notes, 20(4), 14-19. Retrieved from: http://content.ebscohost.com/ContentServer.asp?T=P&P=AN&K=104056894&S=R&D=ccm&EbscoContent=dGJyMNXb4kSeqLc4y9fwOLCmr0%2Bep7ZSs6u4Sa%2BWxWXS&ContentCustomer=dGJyMPGus0quq7RJuePfgeyx44Dt6fIA
Living at home with dementia. (2013). John Hopkins Medicine. Retrieved from: http://www.hopkinsmedicine.org/news/media/releases/living_at_home_with_dementia