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Preparation to care for confused older patients in general hospitals: a study of UK health professionals

Griffiths, Amanda; Knight, Alec; Harwood, Rowan H.; Gladman, John R.F.

Authors

Amanda Griffiths amanda.griffiths@nottingham.ac.uk

Alec Knight

Rowan H. Harwood

John R.F. Gladman john.gladman@nottingham.ac.uk



Abstract

Background and Objective: in the UK, two-thirds of patients in general hospitals are older than 70, of whom half have dementia or delirium or both. Our objective was to explore doctors, nurses and allied health professionals' perceptions of their preparation to care for confused older patients on general hospital wards.

Methods: using a quota sampling strategy across 11 medical, geriatric and orthopaedic wards in a British teaching hospital, we conducted 60 semi-structured interviews with doctors, nurses and allied healthcare professionals and analysed the data using the Consensual Qualitative Research approach.

Results: there was consensus among participants that education, induction and in-service training left them inadequately prepared and under-confident to care for confused older patients. Many doctors reported initial assessments of confused older patients as difficult. They admitted inadequate knowledge of mental health disorders, including the diagnostic features of delirium and dementia. Handling agitation and aggression were considered top priorities for training, particularly for nurses. Multidisciplinary team meetings were highly valued but were reported as too infrequent. Participants valued specialist input but reported difficulties gaining such support. Communication with confused patients was regarded as particularly challenging, both in terms of patients making their needs known, and staff conveying information to patients. Participants reported emotional and behavioural responses including frustration, stress, empathy, avoidance and low job satisfaction.

Conclusion: our findings indicate that a revision of training across healthcare professions in the UK is required, and that increased specialist support should be provided, so that the workforce is properly prepared to care for older patients with cognitive problems.

Journal Article Type Article
Publication Date Jul 1, 2014
Journal Age and Ageing
Print ISSN 0002-0729
Electronic ISSN 0002-0729
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
APA6 Citation Griffiths, A., Knight, A., Harwood, R. H., & Gladman, J. R. (2014). Preparation to care for confused older patients in general hospitals: a study of UK health professionals. Age and Ageing, doi:10.1093/ageing/aft171
DOI https://doi.org/10.1093/ageing/aft171
Publisher URL http://ageing.oxfordjournals.org/content/early/2013/10/27/ageing.aft171.full?sid=26214dcd-0703-4059-89d1-3273d52e8f48
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc/4.0





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