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

Abstract

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. To explore the perspectives of emergency department health care professionals about end-of-life care for patients with dementia in the emergency department. Qualitative study using semi-structured focus groups interviews (<i>n</i> = 23). Interviews took place in-person after recruitment via a contact person and were transcribed verbatim. Reflexive thematic analysis was used. Physicians, nurses, and health care assistants who regularly work at the emergency department of a tertiary hospital. 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. 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.