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Palliative & Supportive Care Palliative & Supportive Care

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Professional caregivers' experiences with the Liverpool Care Pathway in dementia: An ethnographic study in a Dutch nursing home

Published online by Cambridge University Press:  11 July 2017

Natashe Lemos Dekker ,
Marjolein Gysels  and
Jenny T. van der Steen Open the ORCID record for Jenny T. van der Steen[Opens in a new window]
Natashe Lemos Dekker*
Affiliation:
Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
Marjolein Gysels
Affiliation:
Centre for Social Science and Global Health, University of Amsterdam, Amsterdam, The Netherlands
Jenny T. van der Steen
Affiliation:
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
*
Address correspondence and reprint requests to: Natashe Lemos Dekker, Amsterdam Institute for Social Science Research, Nieuwe Achtergracht 166, 1018 WV Amsterdam, The Netherlands. E-mail: N.lemosdekker@uva.nl.
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Abstract

Objective:

There are few studies on how professional caregivers apply the Liverpool Care Pathway (LCP) in nursing home care for people with dementia. Further, despite critiques in the United Kingdom, the LCP continues to be used in the Netherlands, while, to the best of our knowledge, no studies have been conducted since its implementation. The purpose of the present study was to analyze professional caregivers' experiences with the LCP in this context.

Method:

This article draws on an ethnographic study. Data collection was based on 4 months of ethnographic fieldwork in 2015 in 11 psychogeriatric units of a nursing home in a rural area of the Netherlands. Data collection included participant observation and 25 semistructured audiotaped interviews with specialist elderly care physicians, nursing staff, and a nurse practitioner.

Results:

We found that professional caregivers appreciate the LCP as a communication tool and as a reminder of care goals. However, the document was deemed too complicated and to cause duplication of work. It was also reported that the LCP did not cover the complexity of care needs that emerge in practice. Actual care needs were prioritized over the LCP, which calls its contribution into question.

Significance of Results:

Overall, the LCP does not match the context of dementia care in the nursing home. While it could be argued that the LCP does not intend to replace good care, its benefits as a reminder and a communication tool need continued consideration in relation to the amount of work it requires as a bureaucratic obligation.

Keywords

Liverpool Care PathwayDementiaNursing homeProfessional caregiversEthnography
Type
Original Article
Information
Palliative & Supportive Care , Volume 16 , Special Issue 4: Topics in Bereavement , August 2018 , pp. 479 - 486
Copyright
Copyright © Cambridge University Press 2017 

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