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Realizing a palliative approach in dementia care: strategies to facilitate aged care staff engagement in evidence-based practice

Published online by Cambridge University Press:  01 April 2009

Sharon Andrews ,
Fran McInerney  and
Andrew Robinson
Sharon Andrews*
Affiliation:
School of Nursing and Midwifery and Wicking Dementia Research and Education Centre, Menzies Research Institute, University of Tasmania, Australia
Fran McInerney
Affiliation:
School of Nursing and Midwifery, Australian Catholic University/Catholic Homes Inc.
Andrew Robinson
Affiliation:
School of Nursing and Midwifery, University of Tasmania, Australia
*
Correspondence should be addressed to: Sharon Andrews, Private Bag 121 Hobart, Tasmania, 7001, Australia. Phone: + 61 3 62264750; Fax: +61 3 62149742. Email: [email protected].
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Abstract

Background: There is growing evidence that a palliative approach to care provision for people with dementia in residential aged care facilities improves their quality of life and provides support for family members. Despite the development of Guidelines for a Palliative Approach in Residential Aged Care (hereafter the Guidelines), there is limited evidence that these have been adopted. To date, little research has been undertaken to explore processes which could assist aged care staff to develop their practice consistent with the intent of the Guidelines.

Methods: This project utilized an action research method, through which staff members from a residential dementia special care unit (SCU) undertook an investigation into their practice to explore how they could develop strategies to support a palliative approach to care provision. A key focus was related to addressing the information needs of family members of residents on the SCU.

Results: Aged care staff involved in this project had little understanding of available evidence that could assist them to better support family members, including the existence of the Guidelines. Through their engagement in successive action research cycles, these staff accessed evidence-based resources and developed strategies to address the information needs of family members.

Conclusions: When provided with an opportunity to reflect on and critique their practice, aged care staff were better positioned to engage with evidence concerning a palliative approach and to execute change in their practice to improve care provision for family members.

Keywords

Action researchevidence-based practiceGuidelinesaged carenursing homes
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Supplement S1: International perspectives on dementia education, training and knowledge transfer , April 2009 , pp. S64 - S68
Copyright
Copyright © International Psychogeriatric Association 2009

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References

Allen, S., O'Connor, M., Chapman, Y. and Francis, K. (2008). The implications on delivering a palliative approach in residential aged care: rhetoric or reality? Contemporary Nurse, 28, 174–183.Google Scholar
Andrews-Hall, S., Howe, A. and Robinson, A. (2007). The dynamics of residential aged care in Australia: 8-year trends in admissions, separations and dependency. Australian Health Review, 31, 611–622.Google Scholar
Australian Department of Health and Ageing (ADoHA). (2006). Guidelines for a Palliative Approach in Residential Aged Care (enhanced version). Canberra: Rural Health and Palliative Care Branch, Government Department of Health and Ageing.Google Scholar
AIHW (2006). Dementia in Australia: National Data Analysis and Development. AIHW cat. no. AGE 53. Canberra: Australian Institute of Health and Welfare.Google Scholar
Blue Mountains Division of General Practice, University of West Sydney, & Sydney West Area Health Service (2006). Information for Families and Friends of People with Severe and End Stage Dementia. University of Western Sydney. Available at: http://www.uws.edu.au/__data/assets/pdf_file/0008/7100/INFORMATION_Dementia__Web_Ready.pdfGoogle Scholar
Cheek, J., Gilbert, A., Ballantyne, A. and Penhall, R. (2004). Factors influencing the implementation of quality use of medicines in residential aged care. Drugs and Aging, 21, 813–824.Google Scholar
Hansen, E. (2006). Successful Qualitative Health Research: A Practical Introduction. NSW: Allen & Unwin.Google Scholar
Kemmis, S. (2007). Action research as a practice-changing practice. Paper presented at the Spanish Collaborative Action Research Network (CARN) Conference, University of Valladolid, Spain, 18–20 October, 2007.Google Scholar
Kemmis, S. and McTaggart, R. (1986). The Action Research Planner, 3rd edition. Geelong, Australia: Deakin University Press.Google Scholar
Kim, H. S. (1999). Critical reflective inquiry for knowledge development in nursing practice. Journal of Advanced Nursing, 29, 1205–1212.Google Scholar
Lather, P. (1991). Getting Smart: Feminist Research and Pedagogy with/in the Postmodern. New York: Routledge.CrossRefGoogle Scholar
Lloyd-Williams, M. (1996). An audit of palliative care in dementia. European Journal of Cancer Care, 5, 53–55.Google Scholar
Lloyd-Williams, M. and Payne, S. (2002). Can multidisciplinary guidelines improve the palliation of symptoms in the terminal phase of dementia? International Journal of Palliative Nursing, 8, 370–375.Google Scholar
Mitchell, S. L., Kiely, D. K. and Hamel, M. B. (2004). Dying with advanced dementia in the nursing home. Archives of Internal Medicine, 164, 321–326.CrossRefGoogle ScholarPubMed
Moore, K. and Haralambous, B. (2007). Barriers to reducing the use of restraints in residential elder care facilities. Journal of Advanced Nursing, 58, 532–540.CrossRefGoogle ScholarPubMed
Panke, J. and Volicer, L. (2002). Caring for persons with dementia: a palliative approach. Journal of Hospice and Palliative Nursing, 4, 143–149.Google Scholar
Parker, D., Grbich, C., Brown, M., Maddocks, I., Willis, E. and Roe, P. (2005). A palliative approach or specialist palliative care? What happens in aged care facilities for residents with a noncancer diagnosis? Journal of Palliative Care, 21, 80–87.Google Scholar
Robinson, A., Andrews-Hall, S. and Fassett, M. (2007). Living on the edge: issues that undermine the capacity of residential aged care providers to support student nurses on clinical placement. Australian Health Review, 31, 368–378.Google Scholar
Sachs, G. A., Shega, W. and Cox-Hayley, D. (2004). Barriers to excellent end-of-life care for people with dementia. Journal of Geriatric Internal Medicine, 19, 1057–1063.Google Scholar
Shuster, J. J. (2000). Palliative care for advanced dementia. Clinics in Geriatric Medicine, 16, 373–386.CrossRefGoogle ScholarPubMed
Street, A. (1995). Nursing Replay: Researching Nursing Culture Together. Melbourne: Churchill Livingstone.Google Scholar
Street, A. and Robinson, A. (1995). Advanced clinical roles: investigating dilemmas and changing practice through action research. Journal of Clinical Nursing, 4, 349–357.Google Scholar
Warelow, P. J. (1997). A nursing journey through discursive praxis. Journal of Advanced Nursing, 26, 1020–1027.CrossRefGoogle ScholarPubMed