Experience of Paramedics Providing Care to People Living with Dementia: The Working with Uncertainty

Paramedics are key to the provision of emergency care in the community. Those living with dementia use paramedic services at a high rate, due to a range of issues related to comorbid conditions and other acute events which mean care cannot continue in the home. There is a paucity of literature related to care provided in such instances. Anecdotally, a perception exists that providing care to this group of people is challenging for paramedics in situations where high level assessment and emergency care are paramount. Paramedics in one Australian state were sought to participate in an exploratory study to enhance understanding of how they currently worked with people who lived in the community and had dementia. Sixteen participants were recruited to the study, and they worked in a number of areas, including urban and rural. Experience was broad, ranging from one to 36 years in the paramedic role. Inductive thematic analysis of interviews revealed key themes that framed the paramedic role and permeated interactions, assessment and decision-making. Paramedics participating in this study recognised people living with dementia who had high level impacts of the condition, suggesting those with less visible symptoms may remain hidden. With the projected increase of people diagnosed with dementia it is imperative that paramedics are aware of, and integrate dementia knowledge, skills and confidence into their practice. Deeper exploration of the area that includes volunteer ambulance personnel and further inquiry of the role of paramedics in relation to those living with dementia is needed. A focus on education and professional development to equip paramedics to work with people living with dementia is recommended. The findings suggest that greater work in this area is required.