Dementia care in remote northern communities : perceptions of registered nurses

Abstract

Little is known about Registered Nurses (RNs) and their work in northern Canada and the care of older adults with dementia in this setting. As the prevalence of dementia is predicted to increase over the next 30 years, the purpose of this project was to discover key concepts that depicted salient issues in dementia care in northern Saskatchewan from the perspective of RNs working in northern health care facilities. A sequential exploratory mixed method design was chosen for this study with a qualitative lead complemented by a secondary analysis of quantitative data. Interviews were conducted with 14 RNs, employed in small northern Saskatchewan communities, about their experiences with dementia caregiving and their perceptions of dementia care resources. The grounded theory method used in analysis of the interview data resulted in the construction of the theory, Insulating and Expanding the Awareness of Dementia in Northern Nursing. The study identified three categories of conditions that influenced awareness of dementia: Dementia Care and Community Caregiving, Characteristics of the Northern RN, and Northern Nursing Worklife. The quantitative secondary analysis, using a north-south comparison of data from the national survey (Stewart et al., 2005) in the multi-method study “The Nature of Nursing Practice in Rural and Remote Canada” (MacLeod et al., 2004), was used to explore contextual elements identified in the grounded theory analysis. The comparison of nursing practice in northern (n = 597) and southern (n = 2154) rural and small town communities found that fewer RNs in northern Canada reported dementia as a client characteristic, worked in long-term care, or in home care nursing positions, compared to RNs in southern Canada. Findings from both the qualitative and quantitative studies contribute to an understanding of the RNs’ awareness of dementia. Recommendations for increasing the awareness of dementia in northern nursing practice include enhancing the resources and services available to older adults with dementia in small northern communities. It is hoped that further exploration of dementia within northern communities will result in improved care for individuals with dementia and their families.