Dementia and Spirituality Study

AIMS To ascertain how the spiritual needs of patients living with Dementia are addressed within the Care and Treatment Plans (CTPs). OBJECTIVES 1. To analyse dementia patients’ CTPs, from community mental health teams (CMHT) and in-patient wards. 2. To compare Domain 7 with the other domains of the CTP. 3. To conduct focus groups with staff to explore their views on completing Domain 7; this will be compared with the written CTP. METHODOLOGY/APPROACH Research study completed from: January 2016 – December 2016. Ethically approved. Research Centres were: Aneurin Bevan University Health Board (ABUHB), Cwm Taf University Health Board (CTUHB) and Abertawe Bro Morgannwg University Health Board (ABMULHB) Phase 1. Literature review of spiritual care in dementia. Phase 2. Thematic analysis of Domain 7 of a purposive sample of 150 CTPs (with Domain 7 completed) collected from older persons CMHTs and wards in 3 Health Boards to identify how spiritual needs were addressed, how often CTPs were updated (if they are) and by whom. The content of Domain 7 was compared with the other domains (for content, volume, and frequency/method of evaluation). Phase 3. Focus groups with health care professionals to explore emerging themes identified in Phase 2. Collected 150 CTPs: 50 from each Health Board. CTUHB 25 Community, 25 Hospital ABMULHB 25 Community, 25 Hospital ABUHB 11 Community, 39 Hospital All CTPs retrieved had Domain 7 completed. Analysis primarily conducted on Domain 7 (Social, Cultural. Spiritual). Social aspects of care were well documented. Staff encouraged patients to engage in meaningful activities and maintain social connections with family and staff. Eight themes emerged. These were: 1. Religion/ Religious beliefs; 2. Social connections with family, friends and neighbours; 3. Social connections with staff/paid workers and volunteers; 4. Meaningful activities (e.g. photos, memory books, watching TV, hobbies, and work-related activities); 5. Support for family and carers; 6. Culture; 7 Person centred care and 8. Considered but no detail given (e.g. to have social, cultural, spiritual needs met). CONCLUSIONS/RECOMMENDATIONS Staff recognised that spirituality was broader than a person’s religious affiliation, but capturing this on the CTP was difficult. Staff agreed that training in completing the CTP would be beneficial, but especially to complete domain 7, as staff expressed in focus groups, that this was the least completed of all the 8 domains. The entire CTP needs to be analysed because this documented what person-centred care is and was not specific to one domain. IMPACT TO PATIENT/CLIENT CARE & OUTCOMES Domain 7 and especially spiritual needs were seen as important by staff and care coordinators in focus group interviews. Providing good spiritual care will impact on the well-being of persons living with dementia and will enable person-centred care to be delivered. For good spiritual care to be documented in the CTPs and delivered staff expressed that further training would be helpful especially given some guidance on what questions to ask around spiritual needs or prompts they could use.