User, carer and staff perspectives on anxiety in dementia: A qualitative study

Background: Anxiety is extremely common in dementia and can lead to social exclusion, excess disability and associated problems including high physical dependency, problems in the patient/carer relationship, and increased cognitive and behavioural difficulties. Despite this, there is little research on the detection or management of anxiety in dementia, and nothing from the perspective of people with dementia or their carers. Methods: This study aimed to conceptualize users', carers' and staff views on the causes and management of anxiety in dementia. Eighty-one participants (users, carers and staff) participated in nine focus groups. Results were analysed using a mind-map technique and the 'long table approach'. Results: Themes related to the causes of anxiety included coming to terms with the diagnosis, loss of skills, physical and environmental factors and relationships with others. Themes related to the management of anxiety included coming to terms with the diagnosis, person-centred care, memory aids, enjoyable and distracting activities, management of physical and environmental problems and medication as a last resort. Conclusions: Support around diagnosis, person-centred care, fostering good relationships and engagement in meaningful activity are of great importance to people with dementia and those who care for them. Yet in clinical practice, people with dementia suffering from anxiety may receive no help or else be given medication due to a lack of understanding of what else might help. Developing evidence-based psychological treatments for anxiety in dementia, to improve care and quality of life, should be a priority. (C) 2010 Elsevier BM. All rights reserved.