Leeds Beckett University - City Campus,
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For example, we know that around a quarter of people in hospital in the UK have dementia and the most people with dementia have one or more co-morbid health problems, making them regular users of hospital outpatient services too. The range of care needs people living with dementia may have can mean that hospital staff and services sometimes struggle to meet their needs. We also know that outcomes of hospital care are less positive for people living with dementia than for similar groups of patients without dementia.
Our acute hospital-focused research responds to the need to improve experiences and outcomes of hospital care for people living with dementia and their families. Our research ranges from exploratory work to identify current care experiences and how these might be improved through to the development and evaluation of interventions to improve general hospital care (including inpatient and outpatient services) for people living with dementia. We use inclusive methods (such as the use of ‘ethnography’ - observing and spending time with people in hospital settings) to ensure the experiences and views of people with dementia are included in our research. We also work with NHS Trusts to share the findings of our research and develop ideas for improving care based on the findings.
Our portfolio of research in this area is predominantly funded by the National Institute for Health and Care Research (NIHR) but also by other funders such as the Alzheimer’s Society.
Hospital staff report difficulty using person-centred care during routine care activities despite increased access to training and resources. Managing patient safety, such as reducing a person’s risk of harm from falls, is a priority for hospitals and staff. A common activity used to address risk of harm in people with dementia is constant observation. This involves allocating a member of staff to one patient, or a small group of patients, in one area of a hospital ward. The quality of care during this activity varies. This study will design and test the acceptability and feasibility of an intervention that supports person-centred care for people with dementia during constant observation. It will map the use of constant observation for people with dementia, co-design an intervention with hospital staff and people affected by dementia and then test its acceptability and feasibility.
Chief Investigator: Dr Melanie Handley, University of Hertfordshire
Leeds Beckett Investigators: Prof Claire Surr, Dr Nicky Taylor
Funder: Alzheimer’s Society
Funding amount: £316,381
The difficulties of being in hospital for some people living with dementia can mean they experience higher levels of distress, agitation, acute confusion and falls than other patient groups. Responses to this can vary and may include the use of ‘restrictive’ practices – responses that are designed to keep the person safe but can restrict the person’s movement or self-expression (such as the use of falls sensors, raised sides on beds, removal of walking aids, relocation of patients to side-rooms or supervised bays). At other times, alternative less-restrictive approaches may be used, such as engagement with activities, social interaction or attempts to identify and respond to unmet needs (such as pain or fear).
The use of ‘restrictive’ practices has been linked to adverse outcomes such as physical deterioration, increased distress and longer lengths of hospital stay. This study will use ethnographic methods (observations, conversations, interviews and documents) to explore the use, experiences and impacts of restrictive practices, and their alternatives, during hospital admissions for people with dementia. Data will be collected from, and with, people living with dementia, their families, and hospital staff. The study will focus on identifying strategies for supporting people with dementia who are distressed or at risk during a hospital admission in ways that are as unrestrictive and person-centred as possible.
Chief Investigator: Professor Katie Featherstone, University of West London
Leeds Beckett Investigators: Dr Rachael Kelley
Funder: National Institute for Health and Care Research (NIHR), Health and Social Care Delivery Research programme (HS&DR)
Funding amount: £1,053,221
People who have dementia often get distressed when they are in hospital. Distress can be shown by agitation, aggression or calling out. How healthcare practitioners say things can calm or inflame a difficult situation, but this has not been studied in detail in this setting. ‘Conversation Analysis’ is a research method which looks at the fine detail of the language we use, including ‘body language’, and the responses to it. This study will use conversation analysis to identify approaches that work in reducing distress in video recording of interactions between staff and patients with dementia in acute hospitals. It will develop a training programme on communication approaches to help prevent and support distress and deliver this to staff in two acute hospitals. It will use in-depth case studies on two wards at each hospital site to assess the impact of the training.
Chief Investigator: Prof Rowan Harwood, University of Nottingham
Leeds Beckett Investigators: Prof Claire Surr
Funder: National Institute for Health and Care Research (NIHR), Health and Social Care Delivery Research programme (HS&DR)
Funding amount: £828,827
Identifying best practice and testing interventions to improve hospital care for people living with dementia can be challenging for multiple reasons. These challenges include the complexity, costs and time involved as well as the difficulties of implementing changes on busy hospital wards and effectively measuring their impact. Computer simulation is used in other areas of research (such as business management) to create computer simulation models, based on real data, of how people behave and of how changes to systems and environments impact on people’s behaviour and/or outcomes. This project aims to explore whether data from multiple hospital wards about the characteristics, care and outcomes of people with dementia can be used to build a simulation model through which different approaches to care delivery (such as different staffing and skill mixes or changes in visiting times) can be tested to identify approaches which may be more beneficial to people with dementia and worth testing further in clinical practice.
Chief Investigators: Dr Helen Hughes & Dr Matthew Davis, University of Leeds
Leeds Beckett Investigators: Dr Rachael Kelley
Funder: Leeds University Business School
Funding Amount: £26,000
We recently completed the CanDem Study – an NIHR-funded ethnographic study of the hospital outpatient cancer care needs and experiences of people with comorbid dementia and cancer. More information about this study can be found under our Dementia and Comorbidity page.
