Prioritizing problems in and solutions to homecare safety of people with dementia: supporting carers, streamlining care

BMC Geriatrics

Research Article

Igor Rudan¹  Josip Car²  Charles Vincent³  Rifat Atun⁴  Mona El-Khatib⁵  Nikolaos Papachristou⁵  Azeem Majeed⁵  Lorainne Tudor Car⁶  Robert Perneczky⁷ 

[1] Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh Medical School, Edinburg, UK;Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore;Department of Experimental Psychology, Medical Sciences Division, University of Oxford, Oxford, UK;Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, UK;Department of Primary Care and Public Health, School of Public Health, Faculty of Medicine, Imperial College London, London, UK;Department of Primary Care and Public Health, School of Public Health, Faculty of Medicine, Imperial College London, London, UK;Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA;Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore;Neuroepidemiology and Ageing Research Unit, School of Public Health, Faculty of Medicine, Imperial College London, London, UK;Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany;

关键词: Dementia care;    Homecare;    Priority-setting;    Patient safety;    Clinicians;    Collective wisdom;   

DOI  :  10.1186/s12877-017-0415-6

 received in 2016-08-17, accepted in 2017-01-05,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundDementia care is predominantly provided by carers in home settings. We aimed to identify the priorities for homecare safety of people with dementia according to dementia health and social care professionals using a novel priority-setting method.MethodsThe project steering group determined the scope, the context and the criteria for prioritization. We then invited 185 North-West London clinicians via an open-ended questionnaire to identify three main problems and solutions relating to homecare safety of people with dementia. 76 clinicians submitted their suggestions which were thematically synthesized into a composite list of 27 distinct problems and 30 solutions. A group of 49 clinicians arbitrarily selected from the initial cohort ranked the composite list of suggestions using predetermined criteria.ResultsInadequate education of carers of people with dementia (both family and professional) is seen as a key problem that needs addressing in addition to challenges of self-neglect, social isolation, medication nonadherence. Seven out of top 10 problems related to patients and/or carers signalling clearly where help and support are needed. The top ranked solutions focused on involvement and education of family carers, their supervision and continuing support. Several suggestions highlighted a need for improvement of recruitment, oversight and working conditions of professional carers and for different home safety-proofing strategies.ConclusionsClinicians identified a range of suggestions for improving homecare safety of people with dementia. Better equipping carers was seen as fundamental for ensuring homecare safety. Many of the identified suggestions are highly challenging and not easily changeable, yet there are also many that are feasible, affordable and could contribute to substantial improvements to dementia homecare safety.

【 授权许可】

CC BY   
© The Author(s). 2017