IDEAS home Printed from https://ideas.repec.org/a/wly/jocnur/v27y2018i1-2pe70-e79.html
   My bibliography  Save this article

The liminality of the patient with dementia in hospital

Author

Listed:
  • Robin Digby
  • Susan Lee
  • Allison Williams

Abstract

Aims and objectives The aim was to explore the experiences of people with dementia in subacute geriatric rehabilitation hospitals to critically evaluate the care received by such patients. Background Globally, the number of people with dementia is growing and is expected to impact progressively more on health systems. People with dementia can become deconditioned and deteriorate in cognitive function while in hospital. The unfamiliar environment and people can cause the person to become disorientated, which then leads to behavioural symptoms which complicate care. Design Critical ethnography. Methods Methods included observation with field notes and 30 audio‐recorded conversational interviews with patients with dementia in an Australian subacute care setting. Data were collected in May–December 2014, transcribed verbatim and analysed using thematic analysis. Results The central theme identified that patients with dementia described a liminal experience and felt like outsiders in the hospital environment. This was supported by the subthemes of not understanding why they were being kept in hospital, feeling lost in the space, bored, anxious about discharge plans and lacking intersubjective relationships. Many felt imprisoned by the locked wards. There was little evidence of nursing care delivered in an empathetic person‐centred way. Nurses were busy and engaged with the patients only superficially. Conclusions People with dementia can have a liminal experience and feel like outsiders in this environment, which does not cater for the specific needs of this patient group. It should be acknowledged that people with dementia require additional resources. A caring nurse–patient relationship is fundamental to the patient experience. Nurses require further support and education about dementia in order to deliver quality care to this patient group. Relevance to clinical practice These findings will influence nurse leaders to advocate for improved resources for nurses to provide appropriate care for patients with dementia in subacute geriatric hospitals. The clinical practice of nurses needs to be supported with education, pyschological and material support to improve the therapeutic environment for patients with cognitive impairment resulting from dementia.

Suggested Citation

  • Robin Digby & Susan Lee & Allison Williams, 2018. "The liminality of the patient with dementia in hospital," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(1-2), pages 70-79, January.
    • Handle: RePEc:wly:jocnur:v:27:y:2018:i:1-2:p:e70-e79
    DOI: 10.1111/jocn.13869
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/jocn.13869
    Download Restriction: no
    File URL: https://libkey.io/10.1111/jocn.13869?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Wendy Moyle & Sally Borbasi & Marianne Wallis & Rachel Olorenshaw & Natalie Gracia, 2011. "Acute care management of older people with dementia: a qualitative perspective," Journal of Clinical Nursing, John Wiley & Sons, vol. 20(3‐4), pages 420-428, February.
    2. Little, Miles & Jordens, Christopher FC & Paul, Kim & Montgomery, Kathleen & Philipson, Bertil, 1998. "Liminality: a major category of the experience of cancer illness," Social Science & Medicine, Elsevier, vol. 47(10), pages 1485-1494, November.
    3. Helen Ross & Angela Mary Tod & Amanda Clarke, 2015. "Understanding and achieving person‐centred care: the nurse perspective," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(9-10), pages 1223-1233, May.
    4. Murphy, Robert F. & Scheer, Jessica & Murphy, Yolanda & Mack, Richard, 1988. "Physical disability and social liminality: A study in the rituals of adversity," Social Science & Medicine, Elsevier, vol. 26(2), pages 235-242, January.
    5. Robin Digby & Susan Lee & Allison Williams, 2017. "The experience of people with dementia and nurses in hospital: an integrative review," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(9-10), pages 1152-1171, May.
    6. Anita Nilsson & Birgit H Rasmussen & David Edvardsson, 2013. "Falling behind: a substantive theory of care for older people with cognitive impairment in acute settings," Journal of Clinical Nursing, John Wiley & Sons, vol. 22(11-12), pages 1682-1691, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Anita Nilsson & David Edvardsson & Carole Rushton, 2019. "Nurses’ descriptions of person‐centred care for older people in an acute medical ward—On the individual, team and organisational levels’," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(7-8), pages 1251-1259, April.
    2. Robin Digby & Susan Lee & Allison Williams, 2017. "The experience of people with dementia and nurses in hospital: an integrative review," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(9-10), pages 1152-1171, May.
    3. Paul Stenner & Raffaele De Luca Picione, 2023. "A Theoretically Informed Critical Review of Research Applying the Concept of Liminality to Understand Experiences with Cancer: Implications for a New Oncological Agenda in Health Psychology," IJERPH, MDPI, vol. 20(11), pages 1-21, May.
    4. Greenhalgh, Trisha & Wherton, Joe & Sugarhood, Paul & Hinder, Sue & Procter, Rob & Stones, Rob, 2013. "What matters to older people with assisted living needs? A phenomenological analysis of the use and non-use of telehealth and telecare," Social Science & Medicine, Elsevier, vol. 93(C), pages 86-94.
    5. MacDonald, Chelsea & Theurer, Julie A. & Doyle, Philip C., 2021. "“Cured” but not “healed”: The application of principles of palliative care to cancer survivorship," Social Science & Medicine, Elsevier, vol. 275(C).
    6. Werner-Lin, Allison & Forbes Shepherd, Rowan & Young, Jennifer L. & Wilsnack, Catherine & Merrill, Shana L. & Greene, Mark H. & Khincha, Payal P., 2022. "Embodied risk for families with Li-Fraumeni syndrome: Like electricity through my body," Social Science & Medicine, Elsevier, vol. 301(C).
    7. Kristin Turney, 2013. "Liminal Men: Incarceration and Family Instability," Working Papers 1478, Princeton University, School of Public and International Affairs, Center for Research on Child Wellbeing..
    8. Standing, Holly C. & Rapley, Tim & MacGowan, Guy A. & Exley, Catherine, 2017. "‘Being’ a ventricular assist device recipient: A liminal existence," Social Science & Medicine, Elsevier, vol. 190(C), pages 141-148.
    9. Ana Patrícia Hilário & Fábio Rafael Augusto, 2022. "Pathways for a ‘Good Death’: Understanding End-of-Life Practices Through An Ethnographic Study in Two Portuguese Palliative Care Units," Sociological Research Online, , vol. 27(2), pages 219-235, June.
    10. Elisabeth Dahlborg Lyckhage & Anna Gardvik & Helena Karlsson & Jenny Törner Mulari & Ina Berndtsson, 2015. "Young Women With Anorexia Nervosa," SAGE Open, , vol. 5(1), pages 21582440155, March.
    11. Helen Ross & Angela Mary Tod & Amanda Clarke, 2015. "Understanding and achieving person‐centred care: the nurse perspective," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(9-10), pages 1223-1233, May.
    12. Dumit, Joseph, 2006. "Illnesses you have to fight to get: Facts as forces in uncertain, emergent illnesses," Social Science & Medicine, Elsevier, vol. 62(3), pages 577-590, February.
    13. Gentry, James W. & Kennedy, Patricia F. & Paul, Catherine & Hill, Ronald Paul, 1995. "Family transitions during grief: Discontinuities in household consumption patterns," Journal of Business Research, Elsevier, vol. 34(1), pages 67-79, September.
    14. Elaine Haycock‐Stuart & Eddie Donaghy & Chris Darbyshire, 2016. "Involving users and carers in the assessment of preregistration nursing students' clinical nursing practice: a strategy for patient empowerment and quality improvement?," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(13-14), pages 2052-2065, July.
    15. Kaisa Kinnunen‐Luovi & Reetta Saarnio & Arja Isola, 2014. "Safety incidents involving confused and forgetful older patients in a specialised care setting – analysis of the safety incidents reported to the HaiPro reporting system," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(17-18), pages 2442-2450, September.
    16. Vindrola-Padros, Cecilia & Brage, Eugenia, 2017. "What is not, but might be: The disnarrated in parents' stories of their child's cancer treatment," Social Science & Medicine, Elsevier, vol. 193(C), pages 16-22.
    17. Philip Clissett & Davina Porock & Rowan H Harwood & John RF Gladman, 2014. "The responses of healthcare professionals to the admission of people with cognitive impairment to acute hospital settings: an observational and interview study," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(13-14), pages 1820-1829, July.
    18. Boardman, Felicity & Clark, Corinna, 2022. "‘We're kind of like genetic nomads': Parents' experiences of biographical disruption and uncertainty following in/conclusive results from newborn cystic fibrosis screening," Social Science & Medicine, Elsevier, vol. 301(C).
    19. Menkes, David B. & Davison, Mary P. & Costello, Shaun A. & Jaye, Chrystal, 2005. "Stereotactic radiosurgery: the patient's experience," Social Science & Medicine, Elsevier, vol. 60(11), pages 2561-2573, June.
    20. Denise Wilson & Vanessa Heaslip & Debra Jackson, 2018. "Improving equity and cultural responsiveness with marginalised communities: Understanding competing worldviews," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(19-20), pages 3810-3819, October.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:jocnur:v:27:y:2018:i:1-2:p:e70-e79. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: https://doi.org/10.1111/(ISSN)1365-2702 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.