Staff perspectives on getting to know an individual with dementia

Background: Previously, a diagnosis of dementia was associated with decline, with little hope for positive intervention, having implications on care practice. This has meant little focus on individuals’ needs in care homes. Over the past 20 years there has been a gradual shift towards emphasising the importance of the environment on individuals’ psychological wellbeing, with relationships being central to this. Objectives: This study aimed to explore staff’s perspectives on getting to know a person with dementia in a care home environment, bearing in mind the recent literature on the positive benefits of knowing a person’s life history, and what helps or gets in the way of getting to know a person in a care home setting. Design: This was an exploratory study using thematic analysis, taking an inductive approach. A critical realist position was taken which allowed both the content and the context of staff’s experiences to be considered. Method: Semi-structured interviews were used with nine members of staff across three care home settings. Data was analysed using thematic analysis, based on Braun and Clarke (2006). Results: Three themes conceptualising staff’s experiences of getting to know a person with dementia are proposed: i) The development of a ’risk’ lens? ii) challenges in what is valued by staff and organisations: a need for congruency? and iii) creating fertile ground for building trusting relationships. Conclusions: This study suggests that psychological safety for everyone in the system is paramount to enable trusting relationships to be built. Knowing a person with dementia’s life history and spending time ‘being with’ them creates opportunities to enhance identity and increase wellbeing for clients and staff. The importance of the impact of historical and current social and political influences is highlighted and recommendations made on how to help staff provide high quality care to clients and families.