TY - JOUR

T1 - The use of the truth and deception in dementia care amongst general hospital staff

AU - Turner, Alex

AU - Eccles, Fiona Juliet Rosalind

AU - Keady, John

AU - Simpson, Jane

AU - Elvish, Ruth

N1 - This is an Accepted Manuscript of an article published by Taylor & Francis in Aging and Mental Health on 04/05/2016, available online: http://www.tandfonline.com/10.1080/13607863.2016.1179261

PY - 2017/8

Y1 - 2017/8

N2 - Objectives: Deceptive practice has been shown to be endemic in long-term care settings. However, little is known about the use of deception in dementia care within general hospitals and staff attitudes towards this practice. This study aimed to develop understanding of the experiences of general hospital staff and explore their decision-making processes when choosing whether to tell the truth or deceive a patient with dementia. Method: This qualitative study drew upon a constructivist grounded theory approach (Charmaz, 2006) to analyse data gathered from semi-structured interviews with a range of hospital staff. A model, grounded in participant experiences, was developed to describe their decision-making processes. Findings: Participants identified particular triggers that set in motion the need for a response. Various mediating factors influenced how staff chose to respond to these triggers. Overall, hospital staff were reluctant to either tell the truth or to lie to patients. Instead, ‘distracting’ or ‘passing the buck’ to another member of staff were preferred strategies. The issue of how truth and deception are defined was identified. Conclusion: The study adds to the growing research regarding the use of lies in dementia care by considering the decision-making processes for staff in general hospitals. Various factors influence how staff choose to respond to patients with dementia and whether deception is used. Similarities and differences with long-term dementia care settings are discussed. Clinical and research implications include: opening up the topic for further debate, implementing staff training about communication, and evaluating the impact of these processes.

AB - Objectives: Deceptive practice has been shown to be endemic in long-term care settings. However, little is known about the use of deception in dementia care within general hospitals and staff attitudes towards this practice. This study aimed to develop understanding of the experiences of general hospital staff and explore their decision-making processes when choosing whether to tell the truth or deceive a patient with dementia. Method: This qualitative study drew upon a constructivist grounded theory approach (Charmaz, 2006) to analyse data gathered from semi-structured interviews with a range of hospital staff. A model, grounded in participant experiences, was developed to describe their decision-making processes. Findings: Participants identified particular triggers that set in motion the need for a response. Various mediating factors influenced how staff chose to respond to these triggers. Overall, hospital staff were reluctant to either tell the truth or to lie to patients. Instead, ‘distracting’ or ‘passing the buck’ to another member of staff were preferred strategies. The issue of how truth and deception are defined was identified. Conclusion: The study adds to the growing research regarding the use of lies in dementia care by considering the decision-making processes for staff in general hospitals. Various factors influence how staff choose to respond to patients with dementia and whether deception is used. Similarities and differences with long-term dementia care settings are discussed. Clinical and research implications include: opening up the topic for further debate, implementing staff training about communication, and evaluating the impact of these processes.

KW - Demential

KW - deception

KW - truth-telling

KW - general hospital

KW - staff

U2 - 10.1080/13607863.2016.1179261

DO - 10.1080/13607863.2016.1179261

M3 - Journal article

VL - 21

SP - 862

EP - 869

JO - Aging and Mental Health

JF - Aging and Mental Health

SN - 1360-7863

IS - 8

ER -