Triangles of Care: Pessary Care for Women With Pelvic Organ Prolapse and Dementia

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Abstract
Background: Pelvic organ prolapse and dementia are both common conditions which increase in prevalence with age. Women who have prolapse and dementia may have a different clinical presentation from those with prolapse alone. This development study aimed to understand: Which services currently deliver pessary care for women with dementia and how those services manage/support the women and their family supporters, and what women with prolapse and dementia and/or their family supporters would like from services to alleviate the women’s symptoms. Methods: Multimethod development study. An anonymous online survey for Health and Social Care Professionals (HSCPs) was circulated via various professional networks. Semistructured interviews were conducted with HSCP, women with a dual diagnosis of prolapse and dementia and their family supporters. Results: Survey results ( n = 336) indicated that care was delivered predominantly in secondary care and that HSCPs encounter some challenges in providing best care to women with a dual diagnosis. Two women with prolapse and dementia, two family supporters and six HSCPs were interviewed. Interview data suggested the need for further information about features of prolapse and pessary care directly aimed at family supporters and that care experiences vary for women with a dual diagnosis, especially regarding decision‐making. Conclusions: The study demonstrates that the care for women with prolapse and dementia may be different from care for those who do not have a dual diagnosis. Further research is needed to inform clinical practice.

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