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Questionable practices despite good intentions: coping with risk and impact from dementia-related behaviours in care homes

Published online by Cambridge University Press:  17 April 2017

TAMARA BACKHOUSE ,
BRIDGET PENHALE ,
RICHARD GRAY  and
ANNE KILLETT
TAMARA BACKHOUSE*
Affiliation:
School of Health Sciences, University of East Anglia, Norwich, UK.
BRIDGET PENHALE
Affiliation:
School of Health Sciences, University of East Anglia, Norwich, UK.
RICHARD GRAY
Affiliation:
Department of Nursing, LaTrobe University, Melbourne, Australia.
ANNE KILLETT
Affiliation:
School of Health Sciences, University of East Anglia, Norwich, UK.
*
Address for correspondence: Tamara Backhouse, School of Health Sciences, University of East Anglia, Queen's Building, Norwich Research Park, Norwich NR4 7TJ, UK E-mail: [email protected]
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Abstract

Care-home residents with dementia can experience behavioural and psychological symptoms such as aggression, agitation, anxiety, wandering, calling out and sexual disinhibition. Care-home staff have a duty to keep residents safe. However, residents with dementia can pose particular challenges in this area. In this paper, we draw on a study which explored how care-home staff manage dementia-related behaviours. In-depth ethnographic case studies at four separate care homes were conducted in England. These involved interviews with 40 care-home staff and 384 hours of participant observation. Our analysis showed that some residents with dementia experience behaviours which can either create risks for, or negatively impact on, themselves and/or other residents or staff members. It emerged that the consequences of the behaviours, rather than the behaviours themselves, created difficulties for staff. To cope with the risk and impact of behaviours, staff employed multiple strategies such as surveillance, resident placement, restrictions and forced care. Using the data, we explore how actions taken by staff to manage the risk and impact of behaviours in these communal settings relate to residents’ human rights. Our findings have particular relevance for care-home staff who need support and guidance in this area, for service development worldwide and for the global ageing population whose valued human rights may become under threat, if they require long-term care.

Keywords

older peoplecare homehuman rightsriskimpactdementia behavioursbehavioural and psychological symptoms of dementia (BPSD)
Type
Article
Information
Ageing & Society , Volume 38 , Issue 9 , September 2018 , pp. 1933 - 1958
Copyright
Copyright © Cambridge University Press 2017 

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