Identification and Management of Comorbidities in Nursing Home Residents With Dementia: A UK-based Case Study

Background This case study sought the opinions of 15 stakeholders from a family-run UK nursing home about comorbidities in residents with dementia. Methods Stakeholders comprised four care assistants; three well-being companions; two nurses; the manager of the nursing home; the owner of the nursing home; a general practitioner (GP); two informal caregivers; and a chaplain. Semi structured interviews were conducted online via Microsoft Teams in 2024. Data was analyzed using thematic analysis. Five difficulties related to identification and management of comorbidities in residents with dementia were identified: dealing with the consequences of dementia; providing geriatric knowledge to nursing home staff; providing services and activities that are inclusive towards residents with dementia; interacting with and compensating for an under-sourced healthcare system; and being aware of one’s responsibility. Results Eight factors that may facilitate identification and management of comorbid conditions in residents with dementia were also identified: undertaking a holistic approach of care; ensuring continuity of care; providing personalized care; effective interdisciplinary collaboration; securing the trust of residents; investing in psychosocial care; welcoming criticism and striving for improvement; and fostering wellbeing among staff. Among the identified factors, the role of the GP was key in ensuring continuity of care. Conclusions To better identify and manage the complex healthcare needs of residents with dementia and additional comorbidities, nurses, care assistants, and wellbeing specialists would benefit from psycho-educational interventions imparting them with greater clinical and geriatric knowledge. Moreover, equipping staff with basic psychological skills would facilitate understanding the feelings of residents’ families, leading to more positive interactions between them.