Designing and Developing a Clinical Practice Guideline for Palliative Home Health Care of the Elderly with Dementia

Introduction: The progressive deterioration of cognitive function in dementia causes self-care disorders Home is a common place providing care for most patients with dementia. Hence, world health organization suggests home-based palliative care to improve patients’ quality of life with dementia and their caregivers. This study aimed to design and develop a clinical practice guideline for home care of the elderly with dementia. The developed guideline may facilitate the decision-making process and nursing evidence-based practice at home care services.Material and Methods: Adapting the clinical practice guideline was done according to the model of the international guideline network. The set-up phase included examining the possibility of adaptation, forming the committee, and planning the adaptation process. Clinical practice guidelines were searched, screened, and selected after setting the research in the adaptation phase. Also, the data were analyzed using qualitative content analysis to determine people's need who have dementia. After drafting guideline, experts reviewed recommendations in the RAND/UCLA Appropriateness Methodology (RAM) panels. Developing the latest guideline version was done in the finalizing phase. Target users confirmed this version.Result: Designed clinical guideline was developed based on recommendations of mains and supplements guidelines and identified cared needs. Adapted guideline according to the Nursing Process theoretical framework, included ۱۸۶ recommendations in five domains (assessment, diagnosis, Planning, implementation and, evaluation). Caring for a patient with dementia based on the needs identified in the qualitative part of the research covers different construct including ،physical, psychological, safety and security, interpersonal relationships, and caregiver support.Conclusion: The developed clinical guideline can be provided to nurses as a guide to improve the quality of care services to dementia patient. Using a holistic and person-oriented approach to patient care, while adapting to the service delivery platform, can increase the applicability of the guide in Iranian society.

Keywords:

Dementia , Palliative care , Home Health Care , Guidelines , Islamic Republic of Iran.