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Caring for people living with dementia in their own homes: A qualitative study exploring the role and experiences of registered nurses within a district nursing service in the UK

Hoe, J. ORCID: 0000-0003-4647-8950, Trickey, A. & Mcgraw, C. ORCID: 0000-0001-6661-9808 (2022). Caring for people living with dementia in their own homes: A qualitative study exploring the role and experiences of registered nurses within a district nursing service in the UK. International Journal of Older People Nursing, e12491. doi: 10.1111/opn.12491

Abstract

Background
In the UK, district nursing services (DNS) deliver care to people intheir own homes and have regular contact with people with dementia. Research conducted with nurses working in similar roles outside the UK suggests their contribution to high quality dementia care is limited by compassion fatigue, lack of dementia training and low levels of confidence. However, there is a paucity of research exploring the role and learning and support needs of nurses within DNS.

Objectives
The aim was to gain insight into the role and experiences of nurses caring for people living with dementia at home.

Methods
The study was informed by a descriptive phenomenological approach. Semi-structured interviews were conducted with a purposive sample of ten nurses working in DNS. Data were analysed thematically.

Results
Five main themes were identified: ‘Home as a care setting’ reflected how delivering home-based care shaped participants experiences of caring for people with dementia; ‘Taking it in their stride’ revealed how participants adapted and responded to the complexity of care needs for people with dementia; ‘Complexity and unpredictability’ related to the unpredictable nature of people with dementia's care needs and the impact this had on participants' workloads; ‘Expertise and support within the wider team’ detailed which networks nurses used for advice and support to manage the complex needs of people living with dementia at home; ‘Specialist support’ identified the need for structural changes and resources to enable the nurses to deliver the care needed.

Conclusions
This study enables better understanding of the role of DNS in supporting people with dementia to live at home. This is important for defining how dementia care can become effectively integrated into primary care. Recommendations include improved models of care, which factor in specialist nurses, additional time for home visits and greater emphasis on education and training.

Implications for practice
Improved models of working that factor in additional time and staffing such as specialist nurses in dementia and palliative care would allow DNS to meet the needs of people with dementia more effectively.

Publication Type: Article
Additional Information: This is the peer reviewed version of the following article: Hoe, J. , Trickey, A. & Mcgraw, C. (2022). Caring for people living with dementia in their own homes: A qualitative study exploring the role and experiences of registered nurses within a district nursing service in the UK. International Journal of Older People Nursing, e12491, which has been published in final form at 10.1111/opn.12491. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Publisher Keywords: community health nursing, dementia, primary health care, qualitative research
Subjects: R Medicine > RT Nursing
Departments: School of Health & Psychological Sciences > Healthcare Services Research & Management
School of Health & Psychological Sciences > Nursing
[img] Text - Accepted Version
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