Understanding Disruption: Enhancing Dementia Care in Hospitals
The experience of hospitalization for individuals with dementia can be profoundly disruptive, not only for the patients themselves but also for their family caregivers and co-patients. A recent qualitative study titled "Disruption, Control, and Coping: Responses of and to the Person with Dementia in Hospital" provides valuable insights into these dynamics. By understanding the core issues of disruption and control, practitioners can enhance their care strategies to improve outcomes for individuals with dementia in hospital settings.
The Core Problem: Disruption from Normal Routine
Hospitalization often disrupts the normal routine of individuals with dementia, leading to a loss of personhood and increased vulnerability. The study identifies this disruption as a core problem, affecting not only the patients but also their family caregivers and co-patients. This disruption begins before admission and can continue beyond discharge, impacting the patient's ability to readjust to their environment.
Gaining Control: A Core Process
To cope with the disruption, all involved parties attempt to gain or give a sense of control. This process is crucial for minimizing the impact of the disruption. The study highlights several behaviors exhibited by patients with dementia as attempts to regain control, such as sociability, inquisitiveness, and purposeful activity. These behaviors can be constructive, disengaged, distressed, or neutral, each impacting the care environment differently.
Family Caregivers: Advocates and Supporters
Family caregivers play a vital role in managing the disruption by advocating for the patient and filling gaps in care. They use their detailed knowledge of the patient to influence nursing care and maintain the personhood of their loved ones. Additionally, they often support co-patients and staff by helping manage the patient's behavior and providing emotional support.
Co-Patients: Navigating Shared Spaces
Co-patients, sharing the hospital environment with individuals with dementia, also experience disruption. They may feel vulnerable or afraid but often attempt to gain control by helping the patient or family caregivers. Their interactions can either alleviate or exacerbate the disruption, depending on the dynamics of the situation.
Implications for Practitioners
For practitioners, understanding these dynamics is crucial for providing effective care. By recognizing the importance of routine and the need for control, healthcare professionals can tailor their approaches to support both patients and their families. Training in person-centered care and strategies to manage disruption can enhance the hospital experience for individuals with dementia.
Conclusion
The study underscores the complexity of hospital care for individuals with dementia, emphasizing the need for a nuanced understanding of disruption and control. By implementing person-centered care strategies and fostering supportive environments, practitioners can improve outcomes for this vulnerable population.
To read the original research paper, please follow this link: Disruption, control and coping: responses of and to the person with dementia in hospital.
