Background: Approximately 56,000 persons with dementia are admitted to hospitals annually and 75% of them experience responsive behaviours. Responsive behaviours are words/actions used to make one's needs known (e.g. wandering, yelling, hitting, and restlessness) and are perceived by healthcare professionals to be a challenging aspect of dementia care. Aims: This study explores the perceptions of nurses about: (a) caring for older adults with dementia experiencing responsive behaviours in acute medical settings and (b) an educational intervention in dementia care called P.I.E.C.E.S. (Physical, Intellectual, Emotional, Capabilities, Environmental, and Social assessment). Methods: Thorne's interpretive description approach was used. In-person, semi-structured interviews were conducted with 15 nurses and allied health professionals from acute medical settings in a hospital in Ontario. Data were analyzed using experiential thematic analysis. Findings: Themes related to caring for individuals with responsive behaviours included the following: (a) providing nursing care for older adults with responsive behaviours of dementia is a complex experience, (b) there are many barriers to dementia care within acute medical settings, (c) nurses use a combination of pharmacological and non-pharmacological strategies to care for older adults with dementia, (d) there is limited continued use of P.I.E.C.E.S. education although the program and its approaches were seen as relevant for dementia care, and (e) participants viewed organizations as responsible for improving dementia care in acute medical settings. Conclusions: Findings provide guidance for improved support for nurses who provide care to persons experiencing responsive behaviours in acute medical settings such as increasing staffing. Strategies should be implemented to provide continuous educational reinforcements to help staff apply P.I.E.C.E.S such as interdisciplinary rounds focusing on responsive behaviours. / Thesis / Master of Science (MSc)

<p><strong>Objectives</strong>: Research shows that Montessori-based activities can help address responsive behaviours experienced by persons with dementia by increasing their participation in and enjoyment of daily life. The purpose of this study was to investigate staff perceptions of factors that affect the implementation of Montessori Methods for Dementia™ (MMD) in Ontario long-term care (LTC) homes.</p> <p><strong>Methods</strong>: Qualitative data was obtained during semi-structured telephone interviews with 17 participants who were putting MMD into practice in Ontario LTC homes. The study was guided by a political economy of aging perspective using thematic analysis to elucidate the various factors that affected the implementation of MMD.</p> <p><strong>Results</strong>: Several themes emerged from the data: Regulating and Funding Medical Practices; Shifting Practice Amidst Resistance to Change; Educating and Understanding; Seeing Results is Believing; Being Supported; (Re-)Connecting People and Passions; and Improving Residents’ Quality of Life. Barriers such as insufficient funding and negative attitudes toward activities and MMD reinforced a task-oriented biomedical model of care, whereas various forms of support and understanding helped put MMD into practice as a person-centred program, which improved the quality of life of residents with dementia, staff and family members.</p> <p><strong>Conclusions</strong>:<strong> </strong>The results from this research can help ensure that MMD are as practical and easy to implement as possible despite perceived barriers so that persons with dementia in LTC and their partners in care can have a good quality of life. The findings include suggestions for future research, reducing staff hierarchies and ensuring there is sufficient organizational, financial, educational, and personal support. <strong><br /> </strong></p> / Master of Arts (MA)