gms | German Medical Science

Background and status of (inter)national research: Although the implementation of nurse-led care models that require highly qualified nurses and promote interprofessional care is recommended, there are so far no nurse-led care models in residential long-term care in Germany that meet these requirements. To develop a suitable new care model, it is, according to the PEPPA-framework [1], important to describe the current care model and to determine the need for a new care model. A case study design provides an in-depth insight into the care situation of residents with dementia in care units, taking into account the general conditions of the care unit and the respective nursing home.

Research question and objective: The case study follows two research questions: How is dementia-specific and interprofessional care of residents with dementia organized in care units of German nursing homes? What do residents with dementia, their relatives, and internal and external staff expect from the care provided in the care unit? Accordingly, the objectives of the case study are to describe the current care situation as well as care problems in the care units and to identify goals for improving care from the perspectives of residents with dementia, their relatives and internal and external staff of the care unit.

Method or hypothesis: This study is based on an embedded multiple-case design. In total four cases will be investigated. The individual care units in which residents with dementia are cared for are defined as cases. The context is the respective nursing home and the regional affiliation to the federal state of North Rhine-Westphalia. Interdisciplinary collaboration and dementia-specific care in the care unit will be the main focus of the analysis. Embedded units of analysis form the perspectives of residents with dementia, their relatives and internal and external staff of the care unit. Qualitative face-to-face interviews, document analyses and a quantitative survey will be used for data collection. The different sources of evidence serve to capture complementary perspectives and to validate the findings. The embedded units of analysis will be used to be able to distinguish between different perspectives of the participant groups. In the first step, the collected data will be combined on a case-specific basis (within-case analysis). In the second step, similarities and differences between the cases will be identified to elaborate cross-case patterns and themes (cross-case analysis).

Discussion: Through the case study, we expect to gain a comprehensive understanding of current care problems and the need for a new care model, taking into account the context and the perspectives of relevant practice stakeholders. The in-depth investigation of four different cases (four care units) will help to identify case-specific as well as cross-case problems and goals. In the end, this shall lead to the definition of central and context-specific elements of a dementia-specific, nurse-led care model.