4. Discussion and conclusion
The results provide relevant knowledge about the difficulties faced by DCWs when caring for people with
dementia. These were related to the lack of ability to perform the ideal care given the time-pressure, lack of
emotional support and absence of information and preparation to deal with dementia. Additionally, feelings of
emotional and physical exhaustion that emerge from residents’ behaviours were emphasised. These findings are of
great significance as they provide important insights to design effective training interventions.
Providing DCWs with information about dementia and competences to deal with BPSD, as well as ways to cope
with frustration, stress and burnout might be an important lever to deliver better care. Psycho-educational
interventions, albeit underdeveloped in the context of formal care, can be helpful for DCWs as they add to the
traditional training programmes (training alone) a supportive component that addresses their emotional needs.
Supporting DCWs to cope effectively with stress and burnout is of paramount importance, as it has been shown that
staff strain is associated with less willingness to help residents, low optimism and negative emotional responses to
residents’ behaviour [4]. Organisationally, the present study suggests that the availability of adequate support
managers is a key factor in improving the quality of care to residents with dementia. Managers can, for example,
hold open channels of communication (e.g., by maintaining DCWs informed about residents’ biography), certify
that DCWs have enough time to maximize the use of residents’ abilities during personal care tasks or encourage and
give feedback on care practice. The findings reflect the hierarchical management structure of LTC facilities and the
emphasis placed on organisational needs rather than on emotional issues. This kind of ‘culture’ had determined a
dearth of adequate training and support for DCWs. Thus, extending the focus of interventions to all levels of staff
might be necessary in order to raise awareness across the entire organization.