Implementing a new approach to enhance palliative care for people with dementia in Aruba, Bonaire, and Curaçao: a mixed-methods study

IntroductionThe Caribbean islands Aruba, Bonaire, and Cura & ccedil;ao (ABC islands) face challenges in providing palliative care for people with dementia. The Desired Dementia Care Towards End of Life (DEDICATED) approach empowers healthcare professionals to provide person-centered palliative care to individuals with dementia. This study examines healthcare professionals' needs for improving palliative care and their experiences with implementing the DEDICATED approach, as well as its impact on palliative care for people with dementia on the ABC islands.MethodologyA consortium was established with stakeholders from the ABC islands to facilitate the training of 72 healthcare professionals in implementing the DEDICATED approach in these locations. A needs assessment questionnaire, referred to as the 'DEDICATED questionnaire', was completed to explore the needs for palliative care improvement on the ABC islands. For each island, a focus group was organized to gather feedback from healthcare professionals about their experiences with implementing the DEDICATED approach. A descriptive thematic analysis was performed.ResultsIn total, 49 healthcare professionals completed the DEDICATED questionnaire, which indicated high needs for improvement in aspects such as familiarization with a person with dementia and conducting advance care planning. Twenty healthcare professionals participated in the focus groups. Five main themes were identified, related to the implementation of the DEDICATED approach in the islands' sociocultural and organizational aspects, the approach's impact on palliative dementia care, and the necessity of adapting the DEDICATED approach to local contexts. The results revealed that talking about death and palliative care is considered taboo in ABC island culture. Healthcare professionals expressed a need for further refinements to stimulate the implementation of the approach. The DEDICATED approach increased awareness about providing person-centered care and stimulated healthcare professionals to more proactively discuss the palliative care needs of people with dementia and their family caregivers.ConclusionThe DEDICATED approach showed added value for healthcare professionals in the context of the ABC islands. The approach encouraged proactive discussions about palliative and end-of-life care. However, cultural and contextual aspects, such as religion, could pose barriers to the implementation of the approach. Further refinements are needed to align the DEDICATED approach with the context of the ABC islands, thereby stimulating its implementation.Trial registrationNot applicable.