Caring for people with dementia at end of life: The clinical decision making process of healthcare professionals within primary care

Smith, Cathryn, Baillie, Jessica ORCID: https://orcid.org/0000-0002-4592-7286 and Fry, Sarah 2024. Caring for people with dementia at end of life: The clinical decision making process of healthcare professionals within primary care. Presented at: RCN International Nursing Research Conference 2024, Newcastle, UK, 10-12 September 2024.

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Abstract

Background: Dementia is one of the primary causes of ill health worldwide (World Health Organisation 2023) and has no known cure; therefore, at some point, end of life care (EoLC) is required. Decision making on EoLC is diverse and dynamic in nature and specific to the person, particularly in dementia care due to the unpredictable nature of the disease (Murali 2019). There is a gap in the literature exploring healthcare professionals’ EoLC decision making for people with dementia within primary care. Aim: To determine what factors inform healthcare professionals’ decision making when providing EoLC for people with dementia in primary care. Method: This ethnographic study purposively sampled healthcare professionals (n=21) from one health board in Wales, covering three demographic settings. Fieldwork included non-participatory observations of clinical meetings and semi-structured interviews, undertaken in 2023. Data analyses was iterative, utilizing a thematic approach (Braun and Clark 2021), and data were managed using NVivo 12. Ethical and governance approvals were gained, and all participants gave written informed consent. Results: Three themes were developed: (1) missed opportunities; (2) services and care delivery; (3) collaboration, and the EoL process. Participants identified missed opportunities in care for this patient group compared to other life-limiting conditions, which indicated challenges and barriers in the care process linked to crises management, referrals, and education. Geographical location and availability of services affected EoLC decision making, alongside interprofessional relationships and the challenges and issues associated in the EoLC process specifically for people living with dementia. Discussion: The study findings highlight the need for specific dementia related EoLC for patients during the last year of life. The many challenges and facilitators in EoLC decision making for this patient group are evident. Conclusion: The study will subsequently influence the development of an EoLC decision making intervention within primary care in the UK.

Item Type:	Conference or Workshop Item (Other)
Status:	Unpublished
Schools:	Healthcare Sciences
Funders:	RCBC Wales
Date of Acceptance:	September 2024
Last Modified:	26 Nov 2024 10:24
URI:	https://orca.cardiff.ac.uk/id/eprint/174168

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