Exploring nurses' difficulties and strategies when caring for patients with dementia in a neurological ward.

Nurses in neurological wards face numerous challenges when caring for patients with dementia, particularly those who also present other acute illnesses. However, studies focusing on this area are limited. This study aimed to explore the difficulties and strategies in caring for patients with dementia among nurses working in a neurological ward. A qualitative descriptive design was adopted. Twelve nurses from a neurology ward participated in individual semi-structured interviews. The data collected through these interviews were subjected to qualitative content analysis. Two main themes emerged from the analysis: (i) various shortcomings and concerns, which include subthemes: insufficient support, worry about patient safety, inadequate care ability of the caregiver, and insufficient self-competence, and (ii) unique clinical strategies, which include subthemes: cooperate with the caregiver, improve self-competence in dementia care, and employ meticulous resorts. The findings highlighted the nurses' dedication to minimizing patient risks and utilizing available resources as well as stakeholders to provide optimal care. To enhance patient care quality, it is essential to support nurses by addressing care-related barriers, offering continuous education, and establishing care pathways.

Exploring the Difficulties and Strategies of Family Caregivers in Caring for Patients With Dementia in Acute Care Wards.

BACKGROUND: Providing appropriate care to patients with dementia in acute care settings can be a challenge for healthcare professionals. A key factor is working closely with family caregivers. PURPOSE: This study aims to explore the difficulties and strategies involved in caring for patients with dementia who have been admitted to an acute care ward from the perspective of family caregivers. METHODS: Exploratory research was conducted using a qualitative data collection approach. Data were collected by means of in-depth interviews carried out with participants. Semistructured interviews were conducted with nine participants. Content analysis was performed to analyze the data. RESULTS: A number of themes and subthemes were identified based on the primary research purposes. The first theme is "vicious cycle due to multiple factors," with the following subthemes: (a) communication disturbance, (b) endless worries, (c) inadequate care skills of paid caregivers, and (d) physical and psychological exhaustion. The second theme is "do everything," with the following subthemes: (a) management of the behavioral and psychological symptoms of dementia, (b) constant accompaniment of the patient, and (c) seeking sources of support. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results may be used to help healthcare professionals better anticipate the difficulties faced by family caregivers while providing assistance to patients with dementia and understand the related strategies they use. Acute care wards should consider the specific needs of family caregivers to ensure patients with dementia receive adequate care from the relevant parties in the ecological care chain during the care process.

[Getting Lost in People With Dementia: A Scoping Review].

BACKGROUND: Many people with dementia suffer from getting lost, which not only impacts their daily lives but also affects their caregivers and the general public. The concept of getting lost in dementia has not been clarified in the literature. PURPOSE: This scoping review was designed to provide a deeper understanding of the overall phenomenon of getting lost in people with dementia, with the results intended to provide caregivers with more complete information and enlightening research and practice related to dementia getting lost. METHODS: A systematic review method was used, and articles were retrieved from electronic databases including PubMed, Embase, Airiti Library, Cochrane Library, and Gray literature. Specific keywords, MeSH terms, and Emtree terms were used to search for articles on dementia and getting lost. A total of 10,523 articles published from 2011-2020 that matched the search criteria were extracted. After screening the topics and deleting repetitions, 64 articles were selected for further analysis. These articles were classified and integrated based on the six-step literature review method proposed by Arksey and O'Malley. RESULTS: The key findings of the review included: (1) The concept of getting lost in dementia is diverse and inseparable from wandering; (2) More than half of the assessment tools related to getting lost in dementia include the concept of wandering; (3) The factors identified as affecting getting lost in dementia include the patient's personal traits, disease factors, care factors, and environmental factors; (4) Getting lost in dementia negatively affects patients as well as their caregivers and the general public; (5) Most of the articles in this review were quantitative studies and were conducted in Western countries. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The scoping review approach may assist care providers to fully understand the phenomenon of getting lost in dementia, clarify its causes and consequences, and identify the limitations in the literature. The findings may be referenced in the creation of healthcare policies promoting related preventive measures and care plans as well as used to guide future academic research.

[Factors Influencing "Face" in People With Dementia: A Systematic Review of the Literature].

BACKGROUND: Face (self-esteem) is an issue that involves socially endowed status, identity roles, and self-image management and maintenance. People with dementia and their family members often experience social isolation due to diminished self-image, which affects disease progression. Better understanding the factors that influence the self-image of people with dementia may promote the ability of caregivers to maintain self-image and promote public understanding and empathy toward people with dementia. PURPOSE: The aim of this study was to explore the factors influencing self-image in people with dementia using a systematic review of the literature. METHODS: A systematic review was used. Articles were retrieved from electronic databases including PubMed, CINAHL, Airiti Library, and Cochrane Library. The following keywords and MeSH terms were used to search for articles on dementia, face, self-esteem, respect, and self-concept. A total of 3,050 articles published prior to September 2018 that matched the search criteria were extracted. After screening the topics, deleting repetitions, and doing critical appraisals, eight articles were selected for analysis. Research quality was appraised using the Joanna Briggs Institute and the Melnyk and Fineout-Overholt for Evidence-Based Medicine Level of Evidence. RESULTS: Two themes related to the factors influencing self-image in people with dementia were extracted from the selected articles. The first theme was "loss of self-identity". As people with dementia gradually lose their cognitive function and memory ability, they are increasingly incapable of handling and managing their current role tasks. The second theme was "negative public perception". The public believes that people with dementia are at risk to others and that their behaviors are unpredictable, resulting in the deprivation of the rights to which people with dementia are entitled. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Because of disease progression, people with dementia gradually lose their self-identity and become unable to perform their life-role tasks. This is accompanied by negative perceptions of the disease among the public, which, in turn, damages the self-image of people with dementia and their families. The results of this review may provide a reference for caregivers planning future person-centered care approaches for people with dementia. In addition, these results may help facilitate the establishment of a more friendly environment for people with dementia in both public and private spaces.

[The Relationship Between Diet Nutrition Knowledge and Demographic Characteristics in Family Caregivers of Patients With Dementia].

BACKGROUND: Although the general-care knowledge of family caregivers related to dementia had been studied, little attention has been given to understanding the knowledge of caregivers related to dementia diet nutrition. This knowledge is important to help caregivers handle the eating and nutrition problems of people with dementia (PwD). PURPOSE: The purpose of this study was to explore the dementia diet nutrition knowledge of family primary caregivers and to analyze whether demographic characteristics of caregivers and/or the dementia stages of PwD have a relationship with dementia diet nutrition knowledge. METHODS: A descriptive and cross-sectional study using a questionnaire survey was conducted. A total of 220 primary family caregivers of people with dementia were recruited. RESULTS: Results showed that the average total score for the 13 questions on diet nutrition knowledge was 71.85%. Moreover, only 28.2% of the participants answered the question "Malnutrition is a significant risk during the early stage of dementia" correctly. In addition, the findings showed significant differences in the diet nutrition knowledge of participants based on education level (F = 3.989, p < .05) and the use of foreign (non-Taiwanese) caregivers (t = -2.919, p < .01). CONCLUSIONS: The participants had sufficient overall diet nutrition knowledge of dementia. However, they lacked knowledge in specific areas. Family caregivers with higher levels of education and those who hired foreign caregivers had better knowledge scores. The results may be used as a reference for nurses providing dementia dietary education. It is recommended that special attention be given to dietary education when patients are at the early onset phase of the disease and when caregivers have a lower level of education in order to improve the overall quality of dementia dietary care in the community.