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Professional caregivers’ knowledge, beliefs and attitudes about awareness in advanced dementia: a systematic review of qualitative studies

Published online by Cambridge University Press:  21 February 2019

H. Rice ,
R. Howard  and
J. Huntley
H. Rice
Affiliation:
Imperial College NHS Foundation Trust, London, UK
R. Howard
Affiliation:
Division of Psychiatry, University College London, London, UK
J. Huntley*
Affiliation:
Division of Psychiatry, University College London, London, UK
*
Correspondence should be addressed to: Jonathan Huntley, Division of Psychiatry, University College London, London, UK. Email: j.huntley@ucl.ac.uk.
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Abstract

Objectives:

Awareness can be defined as a response to, or evaluation of, an aspect of one’s situation or internal state. Awareness becomes impaired as dementia progresses; however, the exact nature and degree of impairment in advanced dementia remains unclear. The extent to which caregivers understand or make assumptions about the level and nature of awareness in advanced dementia may have a significant impact on their ability to appropriately respond to and care for the person with dementia. This systematic review examines the literature regarding professional caregiver perceptions about awareness in advanced dementia.

Design:

A systematic search of online literature databases (PsychInfo, Medline, Embase, CINAHL) was conducted up to January 15, 2018, using a range of search terms related to dementia, awareness and caregiver attitudes.

Results:

The systematic review included a total of 10 qualitative studies that were heterogeneous in aspects of design, including analyses. Narrative synthesis was used to integrate results. Four major themes were identified from review of the papers: how professional caregivers defined awareness; professional caregiver beliefs about what influences the expression of awareness; professional caregiver beliefs around how to assess awareness in advanced dementia; and the perceived impact of episodes of increased awareness on the person with dementia and caregiver. Sub-themes were identified within each of these areas.

Conclusion:

This review highlights the importance of professional caregiver perceptions of awareness in advanced dementia. Supporting professional caregivers to assess and understand the nature of awareness in advanced dementia would improve their approach to care and outcomes for people with dementia.

Keywords

awarenessadvanced dementiacaregiver
Type
Review Article
Information
International Psychogeriatrics , Volume 31 , Issue 11: Issue Theme: Psychiatric Morbidity in Exceptionally Old People , November 2019 , pp. 1599 - 1609
Copyright
© International Psychogeriatric Association 2019 

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