Supporting Independent Living Among Individuals With Dementia Who Live Alone: A Qualitative Study With Home-Visit Nurses.

AIMS: To elucidate the essential strategies used by home-visit nurses to support the independence of individuals with dementia who live alone.

DESIGN: Qualitative interview study employing the Interpretive Description methodology.

METHODS: Purposive sampling was conducted across three home-visit nursing offices in Tokyo. Individual semi-structured interviews were conducted with 14 home-visit nurses between June and August 2022. The interviews explored the strategies the participants employed while caring for individuals with dementia living alone. The transcribed data were analysed using reflexive thematic analysis.

RESULTS: Four strategies were identified: Strategy 1. Cultivating a relationship of trust to manage client refusal, Strategy 2. Fostering a balance between client and practical realities, Strategy 3. Optimising limited support resources and Strategy 4. Educating and advocating for a lack of understanding among supporters.

CONCLUSION: Home-visit nurses incorporate their standard practices into four strategies at both the direct care and support network levels to support independent living of individuals with dementia living alone. These strategies address the challenge of balancing autonomy with safety and health protection, which is a key consideration in supporting this population.

IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: The findings provide guidance for home-visit nursing practice and inform the development of educational programmes to enhance their training.

IMPACT: This study advances understanding of how home-visit nurses navigate the challenges of autonomy, safety and health for people with dementia living alone, offering insights to inform future research and educational initiatives.

REPORTING METHOD: This study adhered to the Consolidated Criteria for Reporting Qualitative Research.

PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct, or reporting.