The problem

People living with dementia may be unable to communicate their needs. Previous research had developed evidence-based guidance to help staff in residential care facilities meet the palliative care needs of people with dementia. The researchers wanted to help put this palliative-care guidance into practice.

The project

Research by the Departments of Nursing and Midwifery at UL and University College Cork, in partnership with the Irish Hospice Foundation, introduced guidance documents on managing pain, medicines, hydration and nutrition into three Health Service Executive (HSE) long-term care facilities. The researchers examined current practices in each facility and tailored the training to suit that environment. Staff took part in work-based learning groups to introduce the guidance over the course of six months. The researchers then examined the changes that had occurred in practice and asked staff about their experience.

The outcomes

  • Staff in three HSE long-term care facilities received training on evidence-based guidance for aspects of palliative care for people with dementia
  • Staff reported enjoying the work-based learning, particularly as it was tailored to their learning needs and the clinical environment. The training used a participatory problem-solving approach
  • The research found that knowing the practice environment and how best to engage staff are important first steps to practice change. In addition, time and timing was an important factor for staff to be able to take part in the training
  • Three published journal articles shared the findings about how strategies are needed to implement guidance and how a ‘participatory action’ framework that tailors learning and engages staff as participants helps make sustainable change.

Alice Coffey, Professor of Nursing at UL, says:

“We learned that facilitation, engagement and participation were key factors required to translate new guidance into changed clinical practice. We need to first assess the needs of a facility, deliver training at times that suits staff and patients and have champions to lead changes on site. We could see there was a real appetite for this kind of engagement with staff.”

“Participatory research helps put dementia-palliative care guidance into practice” is part of a wider collection of success stories across four themes from this year’s annual Health Research in Action. Download the full report.