A scoping review of gaps and priorities in dementia care in Europe

Abstract

Dementia is a widely recognized public health priority due to the increasing number of people living with the condition and its attendant health, social, and economic costs. Delivering appropriate care is a challenge in many countries in Europe contributing to unmet needs of people living with dementia. Acute hospital settings are often the default route in pursuit for dementia care due to the lack of or limited knowledge of local service provisions. The care environment and the skillsets in acute hospitals do not fully embrace the personhood necessary in dementia care. Predictions of an exponential increase in people living with dementia in the coming 30 years require evidencebased strategies for advancing dementia care and maximizing independent living. However, the evidence required to inform priorities for enabling improvements in dementia care is rarely presented in a way that stimulates and sustains political interests. This scoping review of the literature drew on principles of meta-ethnography to clarify the gaps and priorities in dementia care in Europe. The review constituted eight papers (n ¼ 8) and a stakeholder consultation involving three organizations implementing dementia care programs in Europe comprising Emmaus Elderly Care in Belgium, Residential Care Holy Heart in Belgium, and ZorgSaam in the Netherlands. Overarching concepts of gaps identified include fragmented non-person-centered care pathways, the culture of dementia care, limited knowledge and skills, poor communication and information sharing, and ineffective healthcare policies. Key areas distinguished from the literature for narrowing the gaps to improve care experiences and the support for people living with dementia care encompass person-centered care, integrated care pathways, and healthcare workforce development. Action for advancing care and maximizing independent living needs to go beyond mere inclusions on political agendas to incorporate a shift in health and social care policies to address the needs of people living with dementia.

Urgent care for patients with dementia: a scoping review of associated factors and stakeholder experiences

“… 74 75 However, a lack of communication between existing services was also detrimental to appropriate care, which has also been identified in other studies of dementia services. 4 There is much recent research highlighting the benefits of integrated care for people with dementia, especially regarding patient-specific information being easily shared across different services, both between health and social care services and between community and hospital based services. 74 The use of dementia specialists has also been highlighted as key to higher quality care, which was also identified in the review.…”

“… 3 People with dementia are an at-risk patient group when accessing healthcare services in urgent situations due to their cognitive frailty. 4 They may also be vulnerable to important changes being made when unplanned, urgent care is required, such as introducing or increasing social care support, institutionalisation, prescribing, deprescribing and hospital admission. 1 However, the impact of dementia on a patient’s communication can lead to less involvement in treatment.…”

What next? Experiences of social support and signposting after a diagnosis of dementia

“…Person‐centred care for people with dementia should respect individual preferences and include flexible programmes of support following diagnosis (Martin, O’Connor, & Jackson, ). However, the diagnostic process may prioritise the needs of carers over those being diagnosed (Manthorpe et al, ; Tanner, ).…”

Designing Dementia Care Pathways to Transform Non Dementia-Friendly Hospitals: Scoping Review

“…This stage of care may increase stress in healthcare staff. Debriefing sessions may help them confront and discuss the lived situation to perform new strategies as a process of continuous improvement [37][38][39][40]. As it has been mentioned before, it is necessary to evaluate PwD from a multidisciplinary perspective and take decisions based on PwD wishes and last evidence.…”