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Title: Medication-related challenges in the management and care of people with dementia
Author: De Witt Jansen, Bannin
ISNI:       0000 0004 5369 6611
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2014
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Research evidence indicates that people with dementia are at increased risk of potentially inappropriate and inconsistent medication use in both healthcare and community settings. However, there are few available data to indicate why this might be so. This thesis explored the way in which medications are discussed, decided upon, managed and administered to people with dementia and includes the perspectives of both healthcare professionals and informal caregivers. Respondent interviews were conducted with healthcare professionals (n=18) and bereaved caregivers (n=10) to explore decision-making for pharmacological management of people with dementia and its impact on carer satisfaction with end-of-life care. Two studies explored the administration of and adherence to, medications for people with dementia. Respondent interviews were conducted with nurses (n= 15) to identify barriers and facilitators to administration and adherence for nursing home residents. A self-report structured questionnaire was used to investigate informal carers' (n=20) beliefs about medications and to identify through proxy report, adherence for patients with dementia. An online structured questionnaire was used with final-year undergraduate students (n=281) of Pharmacy, Medicine and Nursing to explore attitudes towards dementia and students' self reported perceived competence and confidence in providing palliative care to people with dementia. Decision-making about medication use was challenging for healthcare professionals and carers alike. Carer satisfaction and good clinical outcomes for patients were associated with positive healthcare professional-carer relationships. Medicine administration to residents with dementia was challenging and required the use of personal, professional and psychosocial skills. Interdisciplinary collaboration was perceived by healthcare professionals to support appropriate pharmacological management of people with dementia. Informal carers held positive attitudes towards medication use and were largely adherent to prescribed regimens; however, a low response rate and skewed responses for adherence limited these findings. I I Final year undergraduate students reported positive attitudes towards people with dementia. Medicine and nursing students indicated low confidence regarding pain management whilst pharmacy students reported high confidence in assisting other healthcare professionals in this task. The findings identified some challenges and facilitators in the provision of pharmacological care for people with dementia. Further training, education and support at undergraduate and professional level are required to support healthcare professionals, particularly in regard to the optimal use of medications. Interdisciplinary collaboration should be encouraged to support better use of medicines in those with dementia.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available