Improving the Short-term Management of Patients with Dementia Admitted to Hospital

This doctoral project aims to contribute to academic and practice knowledge about how to improve the short-term management of people with dementia admitted to hospital, through the development and initial feasibility testing of an education and management support bundle.

Rationale: Two thirds of medical beds in general hospitals are occupied by people over 65 and around 30% have dementia (Alzheimer Society 2014). During their time in hospital, people with dementia are at higher risk of developing major complications such as pressure sores, falls and incontinence. Half of people with moderate dementia who are admitted to hospital with an acute illness, such as hip fracture or pneumonia, die within six months compared to around 13% in other patients (Lawlor 2002). While interventions have been piloted to reduce the risk of morbidity and mortality in acute hospital settings (Morrison and Siu 2000) there is a dearth of evidence as to effective treatment. There is a pressing need for research enabling hospital staff to best to provide services to people with dementia in a general hospital setting (Royal College of Nursing 2013).

Methods Phase 1: What adverse events are associated with the inpatient stay of patients with dementia? This will be a cohort observational study using established and validated methods to measure the prevalence of falls, fear of falling, injury, incontinence, delirium, poor nutrition, pressure sores, disturbed sleep, and psychotropic use among inpatients with dementia.

Phase 2: Perceptions of ward environment Some wards at RBCH have been refurbished into ‘dementia friendly’ wards according to Kings Fund criteria while others have not. The environment is therefore diverse and lends itself to comparison. This phase of work will explore perceptions about environment, perceptions about treatment, rationale for being in-hospital use of free time, boredom and sleep. This study is intended to leave space for expression of individual likes and dislikes and will explore perceptions of living in a community of patients on the ward.

Phase 3: Knowledge translation - Improving outcomes in patients with Dementia. Synthesis of findings from phases 1 and 2 will be used as the basis for focus group discussion with hospital staff. The support ‘bundle’ will be developed and feasibility tested in one hospital ward.

Outcomes: A feasibility test of a care bundle developed in consultation with patients with dementia and their carers and nursing staff to improve knowledge and provide benefit to those affected by dementia when visiting hospital on key outcomes relating to morbidity and mortality.

This research will lead to academic impact via:
• A recognition of the scale and range of outcomes associated with the inpatient stay of people with dementia. This includes areas where there is very little literature for e.g. sleep and its impact on outcomes such as recovery.
• A shared learning of different approaches and techniques to support the management of patients with dementia in hospital
The study will enable collaborative work between the university and local hospital in line with both government policy directives and Bournemouth University’s emphasis on cross-disciplinary and cross-faculty collaboration.

How to apply: Applications are made via our website using the Apply Online button below. If you have an enquiry about this project please contact us via the Email NOW button below, however your application will only be processed once you have submitted an application form as opposed to emailing your CV to us.

Candidates for funded PhD studentship must demonstrate outstanding qualities and be motivated to complete a PhD in 3 years.

All candidates must satisfy the University’s minimum doctoral entry criteria for studentships of an honours degree at Upper Second Class (2.1) and/or an appropriate Master’s degree. An IELTS (Academic) score of 6.5 minimum (or equivalent) is essential for candidates for whom English is not their first language.