# Identifying Challenges Related to the Management of Comorbidities in People with Dementia in Residential Care: Expert Delphi Consensus Exercise

## TL;DR

This study identifies the most challenging comorbidities and issues in managing dementia in residential care through expert consensus.

## Contribution

A novel expert Delphi consensus approach to prioritize dementia comorbidities and management challenges in residential care.

## Key findings

- Mental illnesses, delirium, and sensory impairments are the most difficult dementia comorbidities to manage.
- Medication and symptom management are major challenges due to staff shortages and lack of training.
- Limited healthcare resources hinder effective dementia comorbidity management in residential settings.

## Abstract

Improving early detection, management, and treatment of comorbid conditions to dementia in residential care could slow down cognitive and functional decline, and increase residents’ quality of life. We conducted a Delphi study comprising three rounds (two surveys and an interview) to identify the most difficult dementia comorbidities to deal with in residential care and related issues. Participants were 15 UK-based experts including academics, residential care workers, geriatricians, and neuropsychologists. In the first-round of the Delphi, experts mentioned 15 comorbid health conditions to dementia and 19 issues. In the following rounds of the Delphi mental illnesses, delirium, and sensory impairments were identified as the most difficult comorbidities to dementia to deal with. Medication management, symptom management, shortage of staff, lack of training among staff, and limited resources from the broader healthcare system were identified as the most difficult issues when dealing with dementia comorbidities.