Knowledge Exchanges and Decision-Making Within Hospital Dementia Care Triads: An Ethnographic Study

Area of Science:

• Gerontology
• Healthcare Management
• Patient Experience

Background:

• Hospitalized individuals with dementia face critical future care decisions.
• Understanding care needs and decision-making involving the person with dementia, their family, and staff is limited.
• This study investigates the intersection of perspectives within the care triad for hospitalized dementia patients.

Purpose of the Study:

• To explore how care needs of hospitalized people with dementia are understood by the individual, family, and hospital staff.
• To examine how these intersecting perspectives shape decision-making processes.
• To identify barriers and facilitators in understanding and integrating diverse care needs.

Main Methods:

• Ethnographic data collection on two general hospital wards.
• Involved 400 hours of observation and 46 interviews with people with dementia, families, and staff.
• Focused on the 'care triad' dynamic over two extended periods.

Main Results:

• Significant discrepancies exist in understanding care needs between and within the care triad.
• Limited engagement with people with dementia and their families hinders the integration of diverse perspectives.
• Individuals with dementia, especially those lacking capacity, are frequently overlooked in decision-making.

Conclusions:

• Early and consistent engagement with people with dementia and their families is essential for comprehensive care planning.
• Ensuring all perspectives are understood and represented is critical for effective decision-making.
• Specific attention must be given to involving individuals with dementia in care discussions and decisions, including those lacking capacity.