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    Crisis management for people with dementia at home: Mixed‐methods case study research to identify critical factors for successful home treatment

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    Name:
    Crisis management research ...
    Embargo:
    2021-08-27
    Size:
    123.0Kb
    Format:
    Microsoft Word 2007
    Description:
    Word doc of accepted manuscript ...
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    Authors
    Hopkinson, Jane
    King, Amanda
    Young, Lucy
    McEwan, Kirsten
    Elliot, Fiona
    Hydon, Kate
    Muthukrishnan, Sabarigirivasan
    Tope, Rosie
    Veitch, Anne
    Howells, Cristie
    Hoskins, Mathew
    Show allShow less
    Affiliation
    Cardiff University, Cardiff, UK
    Elysium Healthcare, Ty Gwyn Hall, Abergavenny, UK
    University of Derby
    Aneurin Bevin University Health Board, Serennu Children’s Centre, Newport, UK
    Avon and Wiltshire Mental Health, Bristol, UK
    Trustee, Carers UK, London, UK
    Mental Health Services for Older People, Cardiff & Vale University Health Board, Cardiff, UK
    Issue Date
    2020-08-27
    
    Metadata
    Show full item record
    Abstract
    Best practice in dementia care is support in the home. Yet, crisis is common and can often result in hospital admission with adverse consequences. The objective of this mixed‐methods case study research was to identify the critical factors for resolving crisis for a person with dementia living at home. The research was an in‐depth investigation of what happens during crisis for people with dementia and how it is managed by a Home Treatment Crisis Team to resolution and outcome at 6 weeks and 6 months. The methods were; observation of crisis management for 15 patients with dementia (max three observations per patient, total 41), interviews with patients with dementia (n = 5), carers (n = 13) and professionals (n = 14, range one to six interviews per person, total 29), focus group (nine professionals), and extraction of demographics and medical history from medical records. Analysis focused on the identification of factors important for crisis resolution and avoidance of hospital admission. Critical factors for the Home Treatment Crisis Team to enable successful crisis resolution were: immediate action to reduce risk of harm, expertise in dementia care and carer education, communication skills to establish trust and promote benefits of home treatment, shared decision‐making, medication management, addressing the needs of carers independently of the person with dementia and, local availability of respite and other community services. The Home Treatment Crisis Team integrated the seven factors to deploy a biopsychosocial systems approach with embedded respect for personhood. This approach enabled crisis resolution for a person with dementia by creating a system of services, treatments, resources and relationships, ‘Safe Dementia Space’, in the community with avoidance of hospital admission in more than 80% of referrals. The identified critical factors for crisis resolution are important considerations in the design and delivery of home treatment services for people with dementia.
    Citation
    Hopkinson, J., King, A., Young, L., McEwan, K., Elliott, F., Hydon, K., Muthukrishnan, S., Tope, R., Veitch, A.M., Howells, C. and Hoskins, M., (2020). 'Crisis management for people with dementia at home: Mixed‐methods case study research to identify critical factors for successful home treatment'. Health & Social Care in the Community, pp. 1-28.
    Publisher
    Wiley
    Journal
    Health and Social Care in the Community
    URI
    http://hdl.handle.net/10545/625178
    DOI
    10.1111/hsc.13141
    Additional Links
    https://onlinelibrary.wiley.com/doi/abs/10.1111/hsc.13141
    Type
    Article
    Language
    en
    ISSN
    0966-0410
    EISSN
    1365-2524
    ae974a485f413a2113503eed53cd6c53
    10.1111/hsc.13141
    Scopus Count
    Collections
    School of Allied Health and Social Care

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