Moore, K;
Goodison, H;
Sampson, EL;
(2019)
The role of the memory service in helping carers to prepare for end of life: A mixed methods study.
International Journal of Geriatric Psychiatry
, 34
(2)
pp. 360-368.
10.1002/gps.5034.
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Abstract
OBJECTIVES: To explore current practice and the role taken by UK memory services in helping carers of people with dementia prepare for the end of life. METHODS: Mixed methods including a survey (48 responses/51% response rate) and semi-structured interviews (n=12) with clinicians working in UK memory services accredited by the Memory Services National Accreditation Programme. We used descriptive statistics to report survey findings and thematically analysed interview and survey qualitative data. RESULTS: Surveys: services routinely discussed with carers the progressive nature of dementia (89%), legal arrangements (health: 72%; finances: 74%), advance care planning (63%) and implications of loss of capacity (61%). Fewer services routinely discussed the terminal nature of dementia (41%) and meaning of death (11%) with carers. Most (89%) agreed these conversations were in line with their role. Interview findings corresponded with survey findings. Themes included: diagnosis considered too early to discuss end of life; discussions being inconsistent with a 'living well' approach; people with dementia being resistant to conversations; and discussions of spirituality crossing professional boundaries. Services' capacity for follow-up with carers impacted on ability to broach these topics. CONCLUSIONS: More in-depth and distressing topics such as end of life and advance care planning require longer follow-up to establish relationships to broach difficult topics. Variability in follow-up practices between services created inequity in the extent to which memory services could address these topics. More research is required to investigate the best method for broaching these topics with carers and the person with mild dementia within different healthcare contexts.
| Type: | Article |
|---|---|
| Title: | The role of the memory service in helping carers to prepare for end of life: A mixed methods study |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/gps.5034 |
| Publisher version: | https://doi.org/10.1002/gps.5034 |
| Language: | English |
| Additional information: | Copyright © 2018 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
| Keywords: | Dementia, Family Carers, Preparation for end of life, advance care planning, memory services, progressive, terminal |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10062030 |
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