14 Identifying and Addressing Challenges Experienced by Nurses when Caring for Persons with Dementia Experiencing Responsive Behaviours in Acute Hospitals

Abstract Background Due to the increasing number of persons with dementia being hospitalised (Timmons et al., 2015), nurses working in acute hospitals need to be competent in caring for this patient population. Amongst other dementia-care specific competencies, nurses require competence in caring for those with dementia who experience responsive behaviours, a common phenomenon in acute hospitals. The aims of this study were to explore challenges encountered by nurses in caring for persons with dementia experiencing responsive behaviours in an acute hospital and to explore strategies used by nurses to address the encountered challenges. Methods A qualitative descriptive study, involving semi-structured interviews with nine nurses was conducted. Ethical approval was received from the School of Nursing & Midwifery Research Ethics Committee in the participating University. Data was collected in 2018 and was analysed using a thematic analysis approach. Results An analysis identified three challenging components for nurses, namely: emotional, environmental and organisational challenges. These challenges in turn contributed to barriers to the provision of nursing care and management of responsive behaviours in the setting. To address these challenges, nurses implemented therapeutic interventions, for example reminiscence, and engaged with other healthcare professionals and caregivers. Conclusion This study explored how various emotional, environmental and organisational challenges are experienced and addressed by nurses when managing responsive behaviours in the acute hospital. The increasing number of persons with dementia attending acute hospitals necessitates an urgency for service development to enhance the specific dementia-care competency levels of nurses. Changes at an organisational level, to support competency development in dementia-care in acute hospitals, must also be adopted.