End-of-Life Care for Patients with Dementia in the Emergency Department—Reflexive Thematic Analysis of the Perspective of Health Care Professionals

Abstract

Background:

Patients with dementia at the end-of-life frequently visit the emergency department. These visits can be distressing for patients and families and challenging for staff.

Aim:

To explore the perspectives of emergency department health care professionals about end-of-life care for patients with dementia in the emergency department.

Design:

Qualitative study using semi-structured focus groups interviews (n = 23). Interviews took place in-person after recruitment via a contact person and were transcribed verbatim. Reflexive thematic analysis was used.

Setting/Participants:

Physicians, nurses, and health care assistants who regularly work at the emergency department of a tertiary hospital.

Results:

Participants’ views on end-of-life care for patients with dementia in the emergency department produced five main themes: (1) the cultural context and perceived place of patients with dementia in the emergency department and in society; (2) the person with dementia—their dignity and multidimensional needs; (3) end-of-life care in the emergency department—managing uncertainty, setting goals, and meeting specific care needs; (4) conditions for supporting the palliative care needs of patients with dementia at the end of life in the emergency department; and (5) ethics and moral distress of health professionals in caring for patients with dementia at the end of life in the emergency department.

Conclusions:

Health care professionals identify strengthening dementia awareness, implementing structured training programs, and improving the physical environment and care models within emergency departments as key priorities for practice.