Table 2

Initial theoretical propositions developed from phase 1

Dementia-friendly interventions in hospitals improve outcomes for people living with dementia and their carers if…Evidence from stakeholders and preliminary scoping and supporting references
… a change agent supports staff to reframe their understanding of dementia and respond appropriately to people living with dementia through learning and resources that address patient needs in an individual way. Then staff will have increased awareness of dementia and the impact dementia has on a person, and build confidence in their ability to recognise and address distress.Emphasis on training and education that improve staff confidence in working with people living with dementia; breaking down negative assumptions and supporting staff to see the person rather than the diagnosis; use of resources to get to know the person
References 9 10 28 39 40 46 51 70 72 76 77
Stakeholders (SK01, SK02, SK03, SK04, SK05, SK06, SK07, SK09, SK10, SK11, SK12, SK13, SK14)
Example quote: “we’re starting to do some training with our staff as well just to try and help everyone to know how to approach and how to feel empathy towards these patients who have dementia.” (SK12)
… a change agent with organisational and clinical authority communicates the priorities for dementia care and addresses staff concerns around managing risk and workplace disruption in person-centred ways. Staff are supported by training and resources that improve the involvement in decision-making and safety of people living with dementia, then staff will understand they have the permission and encouragement to adapt practices in ways that are beneficial for people living with dementia.Strategic planning, prioritising good dementia care, providing resources that support staff to work in new ways, changes to systems and processes
References 15 40 41 45 46 52 55 58 75
Stakeholders (SK05, SK06, SK07, SK08, SK10, SK11, SK14, SK15)
Example quote: “…however good people’s ideas are, if they don’t have some kind of sign-off at a fairly senior level then they’re not really going to have it ‘cos they’ll never be a priority and because there are so many targets to be met in general, unless there’s some kind of strategy or policy in writing I don’t think it can change much really.” (SK08)
… a change agent with clinical expertise in dementia and dementia care supports staff with assessments and care planning, then staff will identify and resolve the care needs of people living with dementia.Assessments of cognition, mental health and psychosocial needs; role-modelling good dementia care; supporting staff to perform care in a person-centred way, direct care planning and address complex issues such as decisions of best interest, access to mental and social care information
References 45 55 58 59 62 74 78
Stakeholders (SK04, SK09, SK11, SK14, SK15)
Example quote: “we had mental health nurses came to work with us and they had a really important part in role-modelling how it looked, how to approach things.” (SK14)