Self-management-support in dementia care: A mixed methods study among nursing staff

Background: Self-management in patients and family caregivers confronted with dementia is not self-evident. Self-management skills may be limited because of the progressive cognitive decline of the patient and because family caregivers are often also very aged. Self-management support by nursing staff is therefore of paramount importance. Objectives: To gain insight into how nursing staff perceive their self-management support tasks, and how they put them into practice. Research questions are: ‘What are the opinions and experiences of Dutch nursing staff working in home care or residential elderly care regarding self-management support for people with dementia and their family caregivers?' and ‘Do nursing staff feel sufficiently trained and skilled for self-management support?’. Methods: A mixed methods approach was used, combining cross-sectional quantitative survey data from 206 Dutch nursing professionals with qualitative interviews among 12 nursing staff working in home care or residential elderly care in The Netherlands. Results: Nursing staff working in home care experienced self-management support of people with dementia as a part of their job and as an attractive task. They consider ‘helping people with dementia to maintain control over their lives by involving them in decisions in daily care’ the essence of self-management support. Nursing staff saw family caregivers as their main partners in providing self-management support to the patient. They were less aware that family caregivers themselves might also need self-management support. Nursing staff often felt insufficiently trained to give adequate self-management support. RN’s and CNA’s did not differ in their opinions, experiences and training needs. Conclusions: Nursing staff in home care do consider self-management support an important and attractive task in dementia care. Their skills for providing self-management support to patients with dementia and family caregivers need improvement. Recommendations: Nursing staff need sufficient training to enable the proper provision of self-management support for people with dementia. More attention should also be given to the support of self-management for family caregivers.