Prof Joyce Kenkre
University of South Wales
Caring for people who have dementia in Community Hospitals: A longtitudal ethographic study of healthcare workers everyday decision making
Health and Care Research Wales
Historically, the community hospital was viewed as a healthcare venue for intermediate or step down care, rehabilitation for those who were patients in the acute service and were intending to return to their community. This demographic of patient has changed over the past decade with the community hospital now accommodating a significantly increasing number of older people, with greater acuity, who may also have dementia and who are staying for longer periods in such healthcare institutional environments. Recent concerns have been raised for example by the Francis report (2013) about fundamental issues related to older people in society who as patients in the National Health Service are experiencing poor care. Moreover, as people who have dementia are particularly vulnerable when making a transition from the acute sector of service, their social needs are as much of a priority as their clinical needs. For this reason, the healthcare workers involved in caring for these people in the community hospital are facing a significant challenge in responding to change in the way they practice.
This research will explore and describe community hospital healthcare workers everyday decision-making in relation to people with dementia. By producing an account of practice in a community hospital, apparent influences on decision-making can be revealed. As the care of people with dementia often involves workers from various disciplinary backgrounds, this study intends to gather a wide range of perspectives with a view of developing a shared model of decision-making. The research will involve conducting interviews comprising three groups of lay and professional people who have experience of making decisions that have direct impact on this vulnerable group of people. The focus of the investigation is to make explicit, social/professional paradigms of influence on decision-making by exploring the context of normal everyday activity and the use of language.