In brief
A funded qualitative study protocol that will interview about 16 hospital dementia care triads (nurse, patient, caregiver), guided by an implementation framework, to describe dementia friendly care and identify what helps or hinders including family caregivers; no results are reported yet.
What this article is about
Quick Answer
A funded qualitative study protocol that will interview about 16 hospital dementia care triads (nurse, patient, caregiver), guided by an implementation framework, to describe dementia friendly care and identify what helps or hinders including family caregivers; no results are reported yet.
Student takeaways
Key Takeaways
- This is a funded NRSA training-grant qualitative study protocol, so it reports aims and rationale rather than findings; no results are presented.
- The abstract states that people living with dementia experience adverse outcomes from hospitalization at higher rates than older adults without dementia.
- 'Dementia friendly' in hospitalization is described as a developing concept covering initiatives to reduce adverse events and improve the hospital experience for people with dementia and their caregivers.
- Including family caregivers during hospitalization is presented as a tenet of dementia friendly care and a best practice, yet stakeholder perspectives and implementation strategies are said to be lacking, especially in the US.
- The plan uses a descriptive qualitative design with semi-structured interviews of about 16 dementia care triads (hospital nurse, person living with dementia, family caregiver), guided by the Consolidated Framework for Implementation Research, to describe the concept, examine caregiver inclusion, and identify facilitators and barriers.
Student summary
Why This Research Matters
This abstract describes a funded research training project, meaning a study plan carried out as part of a researcher's training rather than a completed study with findings. The project focuses on making hospital care better for people living with dementia and for their family caregivers. The award is a National Research Service Award, which supports an emerging researcher, and the applicant brings first-hand experience as an acute care nurse and clinical nurse specialist. That clinical background shapes the project's focus on improving the outcomes and experiences of hospitalization for people living with dementia, often abbreviated as PLwD, and their families. The abstract explains an important clinical problem. People living with dementia experience adverse outcomes from hospitalization at higher rates than older adults without dementia. Being in the hospital can be disorienting and stressful, and the unfamiliar environment, routines, and procedures can worsen confusion and lead to complications. To address this, a developing concept called dementia friendly has emerged. In the hospital setting, dementia friendly describes initiatives designed to reduce these adverse events and improve the experience of hospitalization for patients with dementia and their caregivers. A central part of the dementia friendly idea is including family caregivers during hospitalization, which is considered a best practice in dementia care because families know the person, can provide comfort, and can share vital information. The authors note a gap in knowledge: there is limited understanding of what key stakeholders think about dementia friendly practices, and of the concrete strategies needed to include family caregivers, especially in the United States. To fill this gap, the study proposes qualitative, semi-structured interviews with about 16 hospital dementia care triads. Each triad includes three perspectives: a hospital nurse who cares for people with dementia, the hospitalized person living with dementia, and their family caregiver. Gathering all three viewpoints allows the researchers to compare and combine perspectives within and across these roles. The study has three aims. The first is to describe the concept of dementia friendly in the context of hospitalization. The second is to describe how family caregivers of people with dementia are currently included, and how they could be included, during hospitalization. The third is to identify facilitators and barriers to putting dementia friendly practices into place, including the effective inclusion of family caregivers. The research uses a descriptive, qualitative approach and is guided by the Consolidated Framework for Implementation Research, a well-known framework that helps researchers understand what influences whether a practice is successfully adopted. By triangulating the perspectives of the different people involved, the study hopes to produce new knowledge that advances the dementia friendly concept and clarifies what helps or hinders including families. For nursing students, this abstract offers several lessons. First, because it is a study protocol, there are no results yet; it does not tell us which strategies work, only that the researcher plans to explore them. It should be read as a plan and a rationale. Second, it highlights qualitative research, which seeks to understand experiences and meanings rather than to measure numbers, and which is well suited to exploring a developing concept like dementia friendly care. Third, it centers family-centered and person-centered care, reinforcing that caregivers are partners, not visitors, and that their inclusion can improve safety and comfort. Some cautions are worth noting. This is a small qualitative study with about 16 triads, so its future findings will offer rich description and hypotheses rather than broad statistical generalizations. People living with dementia are a vulnerable population, and interviewing them requires careful attention to consent, capacity, comfort, and dignity, often with caregiver involvement and appropriate safeguards. The dementia friendly concept is still developing, so definitions may vary. In practice, nurses can already apply the spirit of this work by welcoming and involving family caregivers, communicating clearly, reducing disorientation, and advocating for a calm, familiar environment. Overall, this is a thoughtfully framed plan to understand and improve how hospitals include families in the care of people living with dementia.
Source abstract
Study Overview
Project Summary/Abstract The purpose of this individual National Research Service Award (NRSA) is to provide research training that will enable the applicant to become an independent researcher focusing on interventions for improving outcomes and experiences of hospitalized persons living with dementia (PLwD) and their family caregivers. This NRSA will ensure that the applicant achieves competence in establishing an understanding of the care of PLwD and their family caregivers, develops foundational skills to commence a program of research with this vulnerable population, and gains professional development skills to advance in a rigorous academic setting. This training will occur in a resource rich environment with support from a world-renowned advising team ideally suited to the applicant's topic and training plan. Informed by her work as an acute care nurse and a clinical nurse specialist, the applicant has first-hand knowledge of the importance of improving the outcomes and experiences of hospitalization for PLwD and their family caregivers. PLwD experience adverse outcomes resulting from hospitalization at greater rates than older adults without dementia. The term “dementia friendly” in the context of hospitalization, is a developing concept that describes initiatives aimed at addressing these adverse events and improving the experience of hospitalization for PLwD and their family caregivers. The inclusion of family caregivers during hospitalization is a tenet of the dementia friendly concept and is considered a best practice in dementia care. Key stakeholder perspectives about dementia friendly practices, as well as strategies for implementing the inclusion of family caregivers, are lacking, especially in the United States. This study proposes to fill this gap in knowledge through the following aims: Using qualitative, semi-structured interviews, the perspectives of approximately 16 hospital dementia care triads, including hospital nurses who care for PLwD, hospitalized PLwD, and their family caregivers, will be gathered and analyzed to 1) describe the concept of dementia friendly in the context of hospitalization, 2) describe how family caregivers of PLwD are currently and could be included during hospitalization, and 3) identify facilitators and barriers to the implementation of dementia friendly practices, including the effective inclusion of family caregivers of PLwD during hospitalization. The study will use a descriptive, qualitative approach, guided by the Consolidated Framework for Implementation Research, to describe the triangulated perspectives of these affected individuals within and across the various role types. This study has the potential to provide new knowledge that will 1) advance the concept of dementia friendly in the context of hospitalization and 2) identify facilitators and barriers to the implementation of dementia friendly practices and the effective inclusion of family caregivers for PLwD during hospitalization.
Evidence appraisal
Main Findings
- This is a funded NRSA training-grant qualitative study protocol, so it reports aims and rationale rather than findings; no results are presented.
- The abstract states that people living with dementia experience adverse outcomes from hospitalization at higher rates than older adults without dementia.
- 'Dementia friendly' in hospitalization is described as a developing concept covering initiatives to reduce adverse events and improve the hospital experience for people with dementia and their caregivers.
- Including family caregivers during hospitalization is presented as a tenet of dementia friendly care and a best practice, yet stakeholder perspectives and implementation strategies are said to be lacking, especially in the US.
- The plan uses a descriptive qualitative design with semi-structured interviews of about 16 dementia care triads (hospital nurse, person living with dementia, family caregiver), guided by the Consolidated Framework for Implementation Research, to describe the concept, examine caregiver inclusion, and identify facilitators and barriers.
Practice transfer
Clinical Relevance
- Nurses can treat family caregivers as care partners rather than visitors, since their inclusion is considered best practice and can support the safety and comfort of hospitalized people with dementia.
- Because people with dementia face higher rates of adverse hospital outcomes, nurses should minimize disorientation through clear communication, familiar routines, and a calm environment, applying the spirit of dementia friendly care now.
- Gathering information from family caregivers about the person's baseline, preferences, and triggers can help nurses individualize care and recognize changes such as delirium early.
- Interviewing or involving people with dementia requires attention to consent, capacity, comfort, and dignity, often with caregiver support and appropriate safeguards.
- Since this is a protocol without results, nurses should not assume any specific dementia friendly strategy is proven; the study aims to identify what helps and hinders, not yet to demonstrate effectiveness.
Faculty notes
Educational Relevance
This NRSA training-grant abstract is a qualitative study protocol, useful for teaching qualitative appraisal and the distinction between a plan and evidence. Because it reports aims and rationale but no findings, students should practice reading it as a proposal. The clinical anchor, that people living with dementia (PLwD) suffer adverse hospitalization outcomes at higher rates than peers, opens discussion of delirium risk, environmental stressors, and the developing 'dementia friendly' concept. The design offers concrete qualitative vocabulary: a descriptive qualitative approach, purposive sampling of roughly 16 dementia care triads (nurse, PLwD, family caregiver), semi-structured interviews, triangulation across role types, and use of the Consolidated Framework for Implementation Research to organize facilitators and barriers. This is a strong prompt for discussing family-centered and person-centered care, the difference between visitors and care partners, and the ethics of interviewing a vulnerable population, including consent, capacity, and assent. Ask students what trustworthiness criteria (credibility, transferability, dependability, confirmability) they would expect, why a small sample is appropriate for depth over generalization, and how a nurse can operationalize caregiver inclusion now, independent of study results.
Critical appraisal
Limitations
- The abstract is a study proposal with no results, so it cannot show which dementia friendly practices are effective.
- The planned sample is small (about 16 triads), and as qualitative research it is designed for depth and description rather than statistical generalization.
- The dementia friendly concept is still developing, so definitions and practices may vary across settings.
Classroom use
Discussion Questions
- Why might people living with dementia experience worse outcomes during hospitalization than other older adults?
- What does dementia friendly care mean in a hospital, and what practices might it include?
- Why is including family caregivers considered a best practice in dementia care?
- What is a care triad, and why is it valuable to interview nurse, patient, and caregiver together?
- How does qualitative research differ from quantitative research, and when is each most useful?
- What is the purpose of using an implementation framework like the Consolidated Framework for Implementation Research?
- What ethical issues arise when interviewing people living with dementia, and how can they be addressed?
- What might be some facilitators and barriers to including family caregivers during hospitalization?
- How can a nurse apply the spirit of dementia friendly care even before this study produces results?
- Why is a small, in-depth sample appropriate for this kind of study?
Search-ready answers
Frequently asked questions
Does this study show how to make hospitals dementia friendly?
Not yet. It is a study plan (protocol) that describes aims and methods but reports no findings. It aims to explore the concept and identify facilitators and barriers.
What does dementia friendly mean in a hospital?
It is a developing concept describing initiatives that reduce adverse events and improve the hospital experience for people living with dementia and their family caregivers.
Why include family caregivers during hospitalization?
Caregivers know the person, can provide comfort, and can share important information about baseline function, preferences, and triggers. Their inclusion is considered a best practice.
What is a care triad?
In this study, a triad is a set of three linked perspectives: a hospital nurse, the hospitalized person living with dementia, and their family caregiver.
Why use a qualitative approach?
Qualitative interviews are well suited to exploring a developing concept and understanding people's experiences and meanings, which is the goal here rather than measuring numbers.
What is the Consolidated Framework for Implementation Research?
It is a widely used framework that helps researchers understand the factors that influence whether a practice is successfully adopted. It guides this study's analysis of facilitators and barriers.
Why is the sample only about 16 triads?
Qualitative studies favor depth and rich description over large numbers. A small, focused sample can yield detailed insight, though findings are not meant to be statistically generalized.
What ethical issues arise in this research?
People living with dementia are a vulnerable population, so the study must carefully address consent, capacity, comfort, and dignity, often involving caregivers and appropriate safeguards.
How can nurses help hospitalized patients with dementia right now?
By welcoming and involving family caregivers, communicating clearly and calmly, maintaining familiar routines, reducing disorientation, and watching for changes such as delirium.
Where can families of people with dementia find support?
This summary is educational only. Families should speak with the care team and seek local dementia and caregiver support services for practical and emotional help.