%0 Journal Article
%T Out-of-hospital paramedic interactions with people living with dementia: a scoping review.
%A Han MX
%A Ross L
%A Hemingway L
%A Anderson D
%A Gosling C
%J Age Ageing
%V 53
%N 7
%D 2024 Jul 2
%M 38994589
%F 12.782
%R 10.1093/ageing/afae143
%X <B>BACKGROUND: </B>Dementia encompasses neurodegenerative disorders that account for a global estimated healthcare expenditure of 1.3 trillion US dollars. In Australia, one in 12 people aged ≥65 has a diagnosis of dementia and it is the second leading cause of death. Paramedics play a crucial role in person-centred dementia care, particularly in the community. While consensus has been established on paramedicine's integration into interdisciplinary care teams, there remains a lack of clarity regarding the paramedic role in dementia care.<BR><B>OBJECTIVE: </B>This study aimed to examine and report paramedic interactions with people living with dementia in the out-of-hospital setting.<BR><B>METHODS: </B>This was a scoping review study of paramedics and people living with dementia within the out-of-hospital setting.<BR><B>METHODS: </B>This study was guided by the Joanna Briggs Institute (JBI) scoping review framework. Databases were searched without date limits, up to 4 April 2023. These encompassed OVID Medline, CINAHL, Scopus, APA PsycInfo and OVID Embase. Articles were included if they were primary, peer-reviewed studies in English and reporting on paramedic-specific interactions with people living with dementia in the out-of-hospital setting. Data extraction was performed based on study setting, design, population and key findings.<BR><B>RESULTS: </B>Twenty-nine articles were included in the thematic analysis. Four themes emerged: need for training, patterns of attendances, patterns of documentation and the integrative potential of paramedicine. Paramedics reported feeling ill-equipped and unprepared in caring for patients living with dementia due to challenges in assessment and management of caregiver tensions. They were often called as a last resort due to poor service integration and a lack of alternative care pathways. Despite high conveyance rates, there was low incidence of paramedic interventions initiated. Underdocumentation of dementia and pain was found.<BR><B>CONCLUSIONS: </B>Emergency ambulance conveyance of people living with dementia is a surface reaction compounded by a lack of direction for paramedics in the provision of out-of-hospital care. There is a pressing need for establishment of research and educational priorities to improve paramedic training in dementia-specific skillsets.