Provision of dementia-specific care in nursing homes in North Rhine-Westphalia (Germany) – analysis of person-centered practices and related problems within a holistic multiple case study
Abstract Background To ensure high-quality care for residents living with dementia, recommendations for dementia-specific care do exist internationally as well as in Germany. Nevertheless, it remains unclear how dementia-specific care is currently provided and what can be derived from this for the i...
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| Format: | Article |
| Language: | English |
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BMC
2025-02-01
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| Series: | BMC Nursing |
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| Online Access: | https://doi.org/10.1186/s12912-025-02726-5 |
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| author | Kathrin Schmüdderich Anne Fahsold Jonas Dörner Martina Roes Rebecca Palm Bernhard Holle |
| author_facet | Kathrin Schmüdderich Anne Fahsold Jonas Dörner Martina Roes Rebecca Palm Bernhard Holle |
| author_sort | Kathrin Schmüdderich |
| collection | DOAJ |
| description | Abstract Background To ensure high-quality care for residents living with dementia, recommendations for dementia-specific care do exist internationally as well as in Germany. Nevertheless, it remains unclear how dementia-specific care is currently provided and what can be derived from this for the improvement of dementia-specific care. Therefore, this study aimed to investigate the provision of dementia-specific care and related problems in German nursing homes. Methods We used a holistic multiple case design with a total of four cases. The cases were defined as care units in which residents living with dementia were cared for. For data collection, we used problem-centered face-to-face interviews, document analysis, and context questionnaires and analyzed all qualitative data inductively and deductively using content structuring qualitative analysis. To identify case-specific and cross-case patterns and themes, we focused on similarities and differences between the cases. The reporting followed the EQUATOR reporting guideline for organizational case studies. Results We interviewed 21 professionals, 14 relatives and 8 residents living with dementia. Despite context-specific differences, we identified a variation of care practices and problems in applying person-centered, dementia-specific care in German nursing homes. In all cases, these belong to the following topics: 1) handling neuropsychiatric symptoms, 2) dealing with communication difficulties, 3) providing person-centered interaction and communication, 4) dealing with stress caused by experiencing dementia-specific symptoms and 5) using and sharing knowledge. Even though the problems were identified in all cases, we also found differences in the extent and perception of these problems across the analyzed cases. Discussion Despite existing conceptual recommendations and described care practices in our study, the identified problems showed that current care practices are perceived as problematic and partly are not person-centered. This highlights that person-centered requirements in dementia-specific care are not yet adequately addressed and that there is a need to give greater consideration to the identified problems when developing interventions to improve quality of care. Furthermore, the identified context-specific differences in the extent and perception of these problems show that the designs of new care models should allow for more flexibility, so that written recommendations can be implemented in practice and adapted to given contexts. |
| format | Article |
| id | doaj-art-f11978f8b5f44a1ab3ad856279dae9a4 |
| institution | Kabale University |
| issn | 1472-6955 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nursing |
| spelling | doaj-art-f11978f8b5f44a1ab3ad856279dae9a42025-02-02T12:15:00ZengBMCBMC Nursing1472-69552025-02-0124111710.1186/s12912-025-02726-5Provision of dementia-specific care in nursing homes in North Rhine-Westphalia (Germany) – analysis of person-centered practices and related problems within a holistic multiple case studyKathrin Schmüdderich0Anne Fahsold1Jonas Dörner2Martina Roes3Rebecca Palm4Bernhard Holle5German Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE)Faculty of Health, School of Nursing Science, Witten/Herdecke UniversityGerman Center for Neurodegenerative Diseases (DZNE)Abstract Background To ensure high-quality care for residents living with dementia, recommendations for dementia-specific care do exist internationally as well as in Germany. Nevertheless, it remains unclear how dementia-specific care is currently provided and what can be derived from this for the improvement of dementia-specific care. Therefore, this study aimed to investigate the provision of dementia-specific care and related problems in German nursing homes. Methods We used a holistic multiple case design with a total of four cases. The cases were defined as care units in which residents living with dementia were cared for. For data collection, we used problem-centered face-to-face interviews, document analysis, and context questionnaires and analyzed all qualitative data inductively and deductively using content structuring qualitative analysis. To identify case-specific and cross-case patterns and themes, we focused on similarities and differences between the cases. The reporting followed the EQUATOR reporting guideline for organizational case studies. Results We interviewed 21 professionals, 14 relatives and 8 residents living with dementia. Despite context-specific differences, we identified a variation of care practices and problems in applying person-centered, dementia-specific care in German nursing homes. In all cases, these belong to the following topics: 1) handling neuropsychiatric symptoms, 2) dealing with communication difficulties, 3) providing person-centered interaction and communication, 4) dealing with stress caused by experiencing dementia-specific symptoms and 5) using and sharing knowledge. Even though the problems were identified in all cases, we also found differences in the extent and perception of these problems across the analyzed cases. Discussion Despite existing conceptual recommendations and described care practices in our study, the identified problems showed that current care practices are perceived as problematic and partly are not person-centered. This highlights that person-centered requirements in dementia-specific care are not yet adequately addressed and that there is a need to give greater consideration to the identified problems when developing interventions to improve quality of care. Furthermore, the identified context-specific differences in the extent and perception of these problems show that the designs of new care models should allow for more flexibility, so that written recommendations can be implemented in practice and adapted to given contexts.https://doi.org/10.1186/s12912-025-02726-5Dementia-specific carePerson-centered careDelivery of healthcareAdvancing nursing careResidential facilitiesQualitative research |
| spellingShingle | Kathrin Schmüdderich Anne Fahsold Jonas Dörner Martina Roes Rebecca Palm Bernhard Holle Provision of dementia-specific care in nursing homes in North Rhine-Westphalia (Germany) – analysis of person-centered practices and related problems within a holistic multiple case study BMC Nursing Dementia-specific care Person-centered care Delivery of healthcare Advancing nursing care Residential facilities Qualitative research |
| title | Provision of dementia-specific care in nursing homes in North Rhine-Westphalia (Germany) – analysis of person-centered practices and related problems within a holistic multiple case study |
| title_full | Provision of dementia-specific care in nursing homes in North Rhine-Westphalia (Germany) – analysis of person-centered practices and related problems within a holistic multiple case study |
| title_fullStr | Provision of dementia-specific care in nursing homes in North Rhine-Westphalia (Germany) – analysis of person-centered practices and related problems within a holistic multiple case study |
| title_full_unstemmed | Provision of dementia-specific care in nursing homes in North Rhine-Westphalia (Germany) – analysis of person-centered practices and related problems within a holistic multiple case study |
| title_short | Provision of dementia-specific care in nursing homes in North Rhine-Westphalia (Germany) – analysis of person-centered practices and related problems within a holistic multiple case study |
| title_sort | provision of dementia specific care in nursing homes in north rhine westphalia germany analysis of person centered practices and related problems within a holistic multiple case study |
| topic | Dementia-specific care Person-centered care Delivery of healthcare Advancing nursing care Residential facilities Qualitative research |
| url | https://doi.org/10.1186/s12912-025-02726-5 |
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