Factors Impacting The Experiences of Dementia Patients & Carers when Accessing Emergency Department Care in Northern Ireland

Introduction

It is acknowledged that older people with a background of dementia are frequent attenders of Emergency Departments (EDs), where overcrowding, long waits and an unfamiliar environment can create a distressing experience for these patients and their carers. By identifying and understanding modifiable factors that shape these patient’s experiences, healthcare systems and professionals can aim to improve experiences for both this patient group and their carers. This qualitative analysis aims to identify and explore the factors that can impact the experiences of patients with dementia and their carers when accessing ED care within Northern Ireland. By identifying and understanding these factors, strategies and interventions can be developed in order to improve experiences for this patient group.

Methodology

A secondary qualitative analysis was carried out using anonymised feedback from the website Care Opinion relating to patient and carer experience when accessing ED care across all Health and Social Care Trusts in Northern Ireland. Feedback tagged with relevant terms were screened by researchers and 17 out of 30 stories were included in the final analysis. Data was analysed using Braun & Clarke’s Thematic Analysis framework to generate codes and themes.

Results

Three key themes were identified: kindness and compassion from staff, ED waiting times and dementia awareness. It was determined that compassionate communication from ED staff enhanced experiences, whereas perceived lack of empathy caused significant dissatisfaction. Prolonged wait times contributed to distress and behavioural deterioration, whereas staff dementia awareness, including awareness of delirium risk was associated with positive experiences.

Conclusions

This analysis can conclude that experiences in ED in Northern Ireland can be strongly influenced by simple intervention such as dementia-focused training for staff, priority triage for dementia patients and maximising use of cubicle space for this patient group. It also acknowledges the need for staff support to reduce burnout and compassion fatigue.