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Disruption, control and coping: responses of and to the person with dementia in hospital.

Porock D, Clissett P, Harwood RH, Gladman JR - Ageing Soc (2013)

Bottom Line: Family care-givers' lives and experiences both inside and outside the hospital were disrupted by the hospitalisation.They too attempted to gain a sense of control over the experience and to give a sense of control to the patient, co-patients and staff.They too attempted to gain a sense of control over their situation and give some control by helping the person with dementia, the family care-giver and the staff.

View Article: PubMed Central - PubMed

Affiliation: Institute for Person-Centered Care , State University of New York at Buffalo , USA . ; School of Nursing, Midwifery and Physiotherapy , University of Nottingham , UK .

ABSTRACT

This qualitative study aimed to gain insight into the experience of hospitalisation from the perspectives of the older person with dementia, their family care-giver and other patients sharing the ward (co-patients). Non-participant observation of care on 11 acute hospital wards was supplemented by 39 semi-structured interviews with 35 family care-givers and four co-patients following discharge. Constant comparative analysis produced the core problem facing all those involved: disruption from normal routine meaning that the experience of hospitalisation was disrupted by the presence and behaviour of the person with dementia. Disruption adversely affected the person with dementia, triggering constructive, disengaged, distressed and neutral behaviours. Using Kitwood's model of person-centred care, these behaviours were interpreted as attempts by the person with dementia at gaining a sense of control over the unfamiliar environment and experience. Family care-givers' lives and experiences both inside and outside the hospital were disrupted by the hospitalisation. They too attempted to gain a sense of control over the experience and to give a sense of control to the patient, co-patients and staff. Co-patients experienced disruption from sharing space with the person with dementia and were left feeling vulnerable and sometimes afraid. They too attempted to gain a sense of control over their situation and give some control by helping the person with dementia, the family care-giver and the staff.

No MeSH data available.


Related in: MedlinePlus

Flow chart of the hypothesised impact of person with dementia (PWD) disruption on the family carer (FC) and co-patients.
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fig02: Flow chart of the hypothesised impact of person with dementia (PWD) disruption on the family carer (FC) and co-patients.

Mentions: The patients with dementia appeared to seek a feeling of control by constructive, disengaged, distressed or neutral behaviours. Each behaviour type has an impact on the disruption experienced by family carers and co-patients. For co-patients, this included feeling a sense of responsibility for the patients with dementia who were in nearby beds, which resulted in their intervention on occasions and being the eyes and ears for the family carer on a 24-hour basis. There were other less positive responses by co-patients that had the potential to increase the sense of disruption experienced by the person with dementia. This is illustrated in Figure 2.Figure 2.


Disruption, control and coping: responses of and to the person with dementia in hospital.

Porock D, Clissett P, Harwood RH, Gladman JR - Ageing Soc (2013)

Flow chart of the hypothesised impact of person with dementia (PWD) disruption on the family carer (FC) and co-patients.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4301214&req=5

fig02: Flow chart of the hypothesised impact of person with dementia (PWD) disruption on the family carer (FC) and co-patients.
Mentions: The patients with dementia appeared to seek a feeling of control by constructive, disengaged, distressed or neutral behaviours. Each behaviour type has an impact on the disruption experienced by family carers and co-patients. For co-patients, this included feeling a sense of responsibility for the patients with dementia who were in nearby beds, which resulted in their intervention on occasions and being the eyes and ears for the family carer on a 24-hour basis. There were other less positive responses by co-patients that had the potential to increase the sense of disruption experienced by the person with dementia. This is illustrated in Figure 2.Figure 2.

Bottom Line: Family care-givers' lives and experiences both inside and outside the hospital were disrupted by the hospitalisation.They too attempted to gain a sense of control over the experience and to give a sense of control to the patient, co-patients and staff.They too attempted to gain a sense of control over their situation and give some control by helping the person with dementia, the family care-giver and the staff.

View Article: PubMed Central - PubMed

Affiliation: Institute for Person-Centered Care , State University of New York at Buffalo , USA . ; School of Nursing, Midwifery and Physiotherapy , University of Nottingham , UK .

ABSTRACT

This qualitative study aimed to gain insight into the experience of hospitalisation from the perspectives of the older person with dementia, their family care-giver and other patients sharing the ward (co-patients). Non-participant observation of care on 11 acute hospital wards was supplemented by 39 semi-structured interviews with 35 family care-givers and four co-patients following discharge. Constant comparative analysis produced the core problem facing all those involved: disruption from normal routine meaning that the experience of hospitalisation was disrupted by the presence and behaviour of the person with dementia. Disruption adversely affected the person with dementia, triggering constructive, disengaged, distressed and neutral behaviours. Using Kitwood's model of person-centred care, these behaviours were interpreted as attempts by the person with dementia at gaining a sense of control over the unfamiliar environment and experience. Family care-givers' lives and experiences both inside and outside the hospital were disrupted by the hospitalisation. They too attempted to gain a sense of control over the experience and to give a sense of control to the patient, co-patients and staff. Co-patients experienced disruption from sharing space with the person with dementia and were left feeling vulnerable and sometimes afraid. They too attempted to gain a sense of control over their situation and give some control by helping the person with dementia, the family care-giver and the staff.

No MeSH data available.


Related in: MedlinePlus