King's College London, London, UK.
Int Psychogeriatr. 2012 Jun;24(6):902-10. doi: 10.1017/S1041610211002882. Epub 2012 Feb 3.
Little is known about the impact of caring experience on the practice of dementia care professionals. Few research studies covering dementia practice ask about personal experiences of providing care or having a family member with dementia. In England and Wales, the Mental Capacity Act (MCA) 2005 provided a new legal framework for planning and decision-making in the event of possible loss of capacity. Professional activities in this area include advice and assistance with arranging proxy decision-making, establishing wishes, and advance decisions. The aim of this paper is to present interview data from dementia care professionals with family experiences of dementia and their reflections on decision-making frameworks.
A total of 123 dementia care professionals working in community and care home settings were interviewed (2007-2010) about their experiences and expectations of the MCA 2005. Additional questions covered experiences of being family members or carers of a person with dementia and any use of the planning and decision-making provisions of the MCA in personal and family contexts. Data were analyzed thematically.
Seventy practitioners had experience of family members with dementia and family caring. Decision-making and planning were viewed as easier under the MCA but tensions could arise around loss of decision-making capacity or family dispute. Empathy for caregiving situations and how things could have been different were reflected upon.
Trainers, clinical supervisors, and researchers in dementia care may build upon personal experience of some practitioners to promote empathy with other family carers and the provision of timely information and advice.
对于照顾经验对痴呆症护理专业人员实践的影响知之甚少。很少有研究涵盖痴呆症实践,询问提供护理或有家庭成员患有痴呆症的个人经历。在英格兰和威尔士,《2005 年精神能力法》(MCA)为可能丧失能力的情况下的规划和决策提供了新的法律框架。该领域的专业活动包括为代理决策、确立意愿和预先决策提供建议和协助。本文旨在介绍具有痴呆症家庭经验的痴呆症护理专业人员的访谈数据,以及他们对决策框架的反思。
2007 年至 2010 年期间,共有 123 名在社区和养老院工作的痴呆症护理专业人员接受了关于他们对 2005 年 MCA 的经验和期望的访谈。附加问题涵盖了作为痴呆症患者的家庭成员或照顾者的经验,以及在个人和家庭背景下对 MCA 规划和决策条款的任何使用。数据进行了主题分析。
70 名从业者有家庭成员患有痴呆症和家庭护理的经验。在 MCA 下,决策和规划被认为更容易,但可能会出现丧失决策能力或家庭纠纷的紧张局面。人们对照顾情况和事情可能有所不同进行了反思。
痴呆症护理方面的培训师、临床主管和研究人员可以借鉴一些从业者的个人经验,促进与其他家庭照顾者的同理心,并及时提供信息和建议。