Determinants of multiple admission to acute hospital wards for older people with dementia.

Applications are invited for a 3-year fully funded PhD studentship based at the Centre for Dementia Studies, Neuroscience Division, Brighton and Sussex Medical School (BSMS) at the University of Sussex Campus. The project closely maps onto the dementia theme of the NIHR Applied Research Collaboration Kent, Sussex and Surrey (ARC KSS) and is co-funded by the NIHR. The NIHR is the nation’s largest funder of health and care research and provides the people, facilities and technology that enables research to thrive. The 15 NIHR ARCs, part of a £135 million investment by the NIHR to improve health and care, support applied health and care research that meets the needs of local populations and local health and care systems. The regional challenges of the ARC KSS include coastal town social deprivation, high GP to patient ratio, large proportion of older people and the highest concentration of people living with dementia in the UK (https://www.sussexpartnership.nhs.uk/research-arc-kss).

The project:
There is a strong association between dementia and multimorbidity. The high prevalence of multiple chronic conditions especially among moderate to severe dementia patients presents with diagnostic, treatment and hospital admission challenges. A host of factors, not all clearly understood, are likely to make repeated admission to acute hospitals a rather common experience for those with dementia. What is known, however, is that hospital admission for dementia patients, especially when it is not critical, can be harmful as it is likely to increase disorientation and delirium (half of all diagnosed with delirium have dementia), worsen cognitive prognosis further and increase post-discharge institutional placements. Repeated admissions are likely to make all these worse.
This timely PhD project will aim to increase our knowledge of the determinants for multiple admission to acute hospitals for dementia patients and the likely negative consequences of these on the overall well-being of patpatients. A fuller appreciation of the reasons/factors behind multiple admissions will better inform strategies directed at decreasing, whenever possible, such admissions. The studentship will also add to the study of the resultant “burdensome” transition from hospitals back to own homes or care homes. These understandings will likely lead to better discharge planning and proper interaction between health and social care staff in acute hospital settings.
This studentship will comprise two distinct components: 1) Quantitative phase: Routinely collected data from the notes and hospital records of 150-200 patients with either single or multiple admissions to acute hospital wards will be included for analysis by the student to compare patients in relation to demographics, patients’ characteristics, admission factors, case management and transition/other outcomes; 2) Qualitative phase: This will include purposive sampling of 20 hospital staff (including social services) and 20 carers to allow the student to carry out face to face interviews to obtain an in dept understanding of staff and carers’ views and attitudes and the factors contributing to multiple admissions and subsequent transition from hospitals back to homes or care homes.
Supervision and training:
This PhD studentship will provide the student with experience and transferable skills in many aspects of dementia research, especially those anchored in clinical practice. The PhD student will gain experience in mixed methodology research combining traditional data analysis with targeted qualitative techniques. The student will lead on all aspects of the PhD project under close supervision leading to publications. Lead supervision will be provided by Dr Naji Tabet, NIHR ARC KSS Dementia theme Lead and Director of Centre for Dementia Studies, BSMS. An excellent record exists of successful PhD studies completion and relevant post-doc placements. The student will also benefit from a strong co-supervisory team from NIHR ARC KSS academics: Dr Khalid Ali, Dr Catherine Evans, Prof Julien Forder and Prof Heather Gage. The student will be placed in a supportive and academically rewarding research environment working alongside other PhD students and post-doctoral fellows.
Entry Requirements
Applicants should possess or expect to be awarded a minimum of a First or Upper Second Class Honours degree (or equivalent) in psychology, neuroscience, social care, occupational therapy, nursing, physiotherapy, or a related biomedical sciences subject.

Enquiries and applying
Please address informal enquiries to Dr Naji Tabet, Dementia Theme Lead, NIHR ARC KSS ([Email Address Removed]) or BSMS Doctoral and Research Office ([Email Address Removed]).