Patient safety in community dementia services: what can we learn from the experiences of caregivers and healthcare professionals?

Abstract

Objectives: this study aims to explore how patient safety in community dementia services is understood by caregivers, and healthcare professionals.

Methods: cross-sectional analysis of guided one-to-one interviews with 10 caregivers, and 10 healthcare professionals.

Results: caregivers and healthcare professionals identified a range of issues including medication errors, mis-communication between professionals, unclear service pathways and the effects of stress on caregivers' behaviour. Caregivers and professionals differed in their attitudes to balancing safety with patient autonomy and who is responsible for managing safety.

Conclusions: this article helps to define the nature of safety issues in the context of community care for people with dementia. In contrast to hospital medicine, where the ideal treatment world is safe with all risks managed or minimised, in dementia some risks are actively taken in the interests of promoting autonomy. Caregivers' views differ from those of health professionals but both parties see potential for collaborative working to manage risk in this context, balancing the promotion of autonomy with the minimisation of potential harm.

Keywords: caregivers; dementia services; older people; patient safety; qualitative; risk.