Supporting person-centred care for people with dementia in hospitals

Research project: Supporting person-centred care for people with dementia in hospital settings: co-designing and testing the feasibility of an intervention for use during constant observation activities.

Lead Investigator: Dr Melanie Handley

  • Institution: University of Hertfordshire
  • Grant type: Project grant
  • Duration: 24 months 
  • Amount: ÂŁ316,381.60

Why did we fund this research?

Comments from our Research Network volunteers:

People with dementia who need to stay in hospital must be treated with dignity and with an understanding that they can’t necessarily articulate important information about their symptoms, or how they feel.

Project summary

Hospital’s need to carefully manage risk of harm to people with dementia, such as falls. One strategy used is constant observation. The team plan to design an intervention to make constant observation in hospitals more person-centred. They will then test the intervention in two hospitals to see how it works in practice. 

The background 

Approximately 40% of older people admitted to hospital have dementia. There has been considerable work to develop dementia awareness amongst hospital staff.

However, delivering person-centred care in busy hospital wards is difficult and staff may not see it as important as other types of patient care.

Despite training and specialist advice in dementia care, the use of person-centred practices in hospitals is inconsistent.

When people with dementia are assessed to be a risk to themselves, they are likely to receive close supervision from staff. Constant observation is used in hospitals where a member of staff is allocated to closely watch a person for all or part of their shift.

Constant observation provides opportunities for providing person-centred care. However, often these opportunities are missed and staff may instead focus on protection and restriction of patient movement. 

What does this project involve?

The team will look at three hospital trusts in England which all use constant observation.

The project will: 

  • look at how constant observation is currently used for people with dementia in the three hospitals; 
  • build on this information to develop an intervention to make constant observation more person-centred; 
  • pilot the intervention on two wards in each hospital; 
  • present findings from the study to participants, hospital staff, people with dementia, family carers, representatives from NHS England and the Royal College of Nursing and researchers in dementia care in hospitals. 

How will this project help people with dementia?

Being in hospital can be a difficult experience for people with dementia and their families. This research team believe a person-centred approach to care during constant observation could improve the experience of people living with dementia in hospital.

It could also help staff to understand that challenging behaviour may be due to an unmet medical, physical or social need.