Method In preparation for a refurbishment, intended to improve the care environment for patients with end stage dementia, a paper questionnaire survey of healthcare assistants, domestics and catering staff was devised to explore the staff's understanding Their views about meeting their needs. Changes the organisation needed to make Each staff member was given the questionnaire at work by their line manager with a period of two weeks to return it to a collection point in the hospice reception.

Results 20 out of a possible 43 staff replied (46.5%)

Knowledge Most were aware of the number of people with dementia in UK but overestimated life expectancy and under estimated the length of their dependency on others for activities of daily living. The majority indicated a prognosis of 10 years or more from diagnosis (81%)

Training needs Whilst well informed about symptoms a significant number of staff felt they would need training around meeting patient needs and particularly how to communicate effectively.

Physical environment and impact on caring for other patients Staff were concerned about the impact of patients with dementia on other patients and the fear of the patient “wandering off” Concern was also expressed by the majority that staffing levels would need to be increased to accommodate these patients.

Conclusions The response rate to the questionnaire was disappointing but other literature suggests that the findings are in line with the views of qualified members of staff. Staff appeared to underestimate the palliative care needs of people affected by the disease. These staff members regularly encounter confused and disorientated patients, yet the label of dementia appeared to raise additional concerns. This needs further exploration.