Improving verbal communication between older adults with dementia, care givers and the inter-professional team within the hospital setting: a literature review and qualitative analysis

Lewis, Lucy Anne, Bartlett, Ruth and Patel, Harnish (2016) Improving verbal communication between older adults with dementia, care givers and the inter-professional team within the hospital setting: a literature review and qualitative analysis. Age and Ageing, 45 (1), 7. (doi:10.1093/ageing/afw024.31).

Abstract

Topic Patients with dementia may account for 25% of patients within the hospital setting, can have impaired abilities to understand and express information, plan and solve problems that may hinder their involvement in care decisions. Identifying methods that enhance relationships between the inter-professional team and patients with dementia and their caregivers during hospital admission by improved verbal communication, to support decision making, is essential. It is important for patients and their caregivers to have clarity regarding which senior clinician has overall clinical responsibility and whom to contact to discuss ongoing care.

Intervention The aim of this review was to determine evidence that underpins best practice for improving verbal communication with patients who have dementia and inform the process of implementing best practice within the acute setting. A systematic search of the databases CINAHL, MEDLINE, Web of Science and Psyche Info of literature published between 2004 and 2014 identified eight qualitative studies meeting inclusion criteria. Thematic analysis approach was used to ascertain common or recurring concepts amongst the studies identified.

Improvement The main themes that associated with improved outcomes were partnership working between the inter-professional team, patients and caregivers; frequent communication between the team, caregivers and patients; and structured caregiver/family meetings.

Discussion Caregivers wish to engage collaboratively with the inter-professional team and be viewed as partners in planning care. Poor patient and carer outcomes were associated with a lack of recognition of the significance of the caregiver's relationship with patients. Promoting good relationships between the caregivers and the inter-professional team reduced anxiety, frustration and likelihood of complaints, whilst increasing trust. Interventions that improve verbal communication between caregivers, patients and the inter-professional team can be transferable to older adults with or without dementia. Based on evidence, a feasibility study of improved communication through dedicated communication clinics was set up within our department.

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Contributors

Author: Lucy Anne Lewis

Author: Ruth Bartlett

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