Balancing the needs of individuals and services in cancer treatment for people with dementia: A focused ethnographic study.
Alys Wyn Griffiths, Laura Ashley, Rachael Kelley and 7 others
PMID 34271462WHAT IT FOUND
Staff often adjusted appointments, communication and continuity to help patients with cancer and dementia, but targets and unclear conversations caused distress.
Ask about dementia, document needs, and plan familiar, flexible care before treatment.
Key findings
01Staff said knowing a patient's dementia-related needs helped them provide person-centred care, while missing information made examinations and distress management harder.
02Strict cancer targets made flexible care difficult, so adaptations often happened reactively when problems arose.
03Speaking directly to the person with dementia was key to relationships, while being spoken over or about caused upset and withdrawal.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in a limited area of the UK across NHS Trusts, so it may not apply elsewhere. Only people receiving hospital cancer treatment were included, so experiences of those who do not receive treatment are missing. Participants were mostly White British, and almost all patient participants had a family member attending appointments, so it may not reflect people without family support or from minority ethnic backgrounds. Some participants did not have a formal dementia diagnosis, and many were in earlier stages of dementia, so experiences of later-stage dementia are less clear. Data were collected before the COVID-19 pandemic, and some experiences were reported retrospectively.
Declared interests
The authors declared no competing interests.
The easy way to misread this
Do not read these themes as proof that flexible appointments, familiar staff or communication changes improve cancer outcomes. The study describes what staff, patients and relatives reported and observed, not a tested intervention.