Abstract
[Purpose]
The purpose of this study is to identify what healthcare professionals engaged in dementia care (e.g. nurses, care-workers) focus on when they interact with people with dementia, their families and physicians, in each (i.e. mild, moderate, or severe) stage of dementia.
[Methods]
Data were collected at medical institutions, healthcare service facilities for the elderly, nursing homes, and group homes. For this study, 13 nurses and 9 healthcare workers were interviewed. The interviews were analyzed using content analysis.
[Results and Discussion]
The results showed that in the period from the onset of dementia to mild stage, healthcare professionals engaged in dementia care focused on basic care, involving listening carefully to dementia patients and their families to understand their situations and watchful waiting until intervention is necessary. However, professionals seemed to pay little attention to interventions that could have a meaningful therapeutic effect on dementia. In the moderate stage, professionals focused on discovering the hidden “true personality” of dementia patients, by collecting and analyzing information on behaviors displayed, i.e. behavioral and psychological symptoms of dementia (BPSD) assessment. Regarding efforts to create a comfortable therapeutic environment for patients, professionals made adjustments to the care environment, focusing on the “human environment,” to ensure that family and physician involvement in dementia care is not interrupted. In the moderate to severe stage of dementia, professionals focused their efforts on understanding dementia patients’ intentions and worked with physicians to help dementia patients experience a peaceful end of life, and their families to spend a peaceful time with them. However, the results were unclear concerning preventive care for complications and concrete support for decision-making about care.
These results show that professionals engaged in dementia care are required not only to possess the ability to act and the management capability so that they can deliver necessary care for dementia patients and their families in cooperation with multi-professional team members, but also to comprehensively assess dementia patients so as not to deteriorate their quality of life (QOL).
