Communication between the multidisciplinary team and families regarding nutrition and hydration for people with severe dementia in acute hospitals: a qualitative study

Author:

Anantapong Kanthee1234ORCID,Davies Nathan1256ORCID,Sampson Elizabeth L127ORCID

Affiliation:

1. Marie Curie Palliative Care Research Department , Division of Psychiatry, , London , UK

2. University College London , Division of Psychiatry, , London , UK

3. Department of Psychiatry , Faculty of Medicine, , Hat Yai , Thailand

4. Prince of Songkla University , Faculty of Medicine, , Hat Yai , Thailand

5. Centre for Ageing Population Studies , Research Department of Primary Care and Population Health, , London , UK

6. University College London , Research Department of Primary Care and Population Health, , London , UK

7. Department of Psychological Medicine, Royal London Hospital, East London NHS Foundation Trust , London , UK

Abstract

Abstract Background When a person with severe dementia is in hospital and has eating and drinking difficulties, communication between the multidisciplinary team and families can be challenging and lead to suboptimal care. Objective To gain in-depth understanding about the experiences, views and needs of family carers and hospital staff, regarding communication and conversations about nutrition and hydration, for hospital patients with severe dementia. Design Qualitative semi-structured interview study. Setting Acute hospital in England. Methods From January to May 2021, semi-structured interviews were conducted with 29 family carers and hospital staff. Interviews were transcribed verbatim and analysed using reflexive thematic methods. Results Four overarching themes were developed: (i) prerequisites to initiating communication about eating and drinking; (ii) communication aiming to develop agreed care plans; (iii) difficulty discussing palliative and end-of-life care; and (iv) needs of information and plans about future eating and drinking difficulties. Families tended to wait for hospital staff to initiate discussions but usually experienced frustration with delays and repeated conversations with different staff. Some staff felt unprepared to manage these conversations and found it challenging to work across the multidisciplinary team. During discharge processes, key information and care plans about eating and drinking were not regularly passed on to people involved to avoid unnecessary readmissions. Conclusions In acute hospitals, family carers and hospital staff can have disjointed communications and conversations about nutrition and hydration for persons with severe dementia. Timely reassurance, ongoing discussions and clear information sharing will support communication between those involved.

Funder

Prince of Songkla University

Faculty of Medicine

Publisher

Oxford University Press (OUP)

Subject

Geriatrics and Gerontology,Aging,General Medicine

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