Insights into the system of care of the elderly with mental disorders from the perspective of informal caregivers in Lithuania

Abstract

Background Changes in the demographics and respective growth of life expectancy and social needs make informal caregiving crucial component of comprehensive health and social care network, which substantially contributes to the health and well-being of the elderly. The purpose of this paper is to understand the system of care of elderly patients with mental disorders from the perspective of informal caregivers in Lithuania. Methods We conducted five semi-structured focus group discussions with 31 informal caregivers attending to elderly patients with mental disorders. The data were audiotaped and transcribed verbatim. A thematic analysis was subsequently performed. Results Five thematic categories were established: (1) the current state of care-receivers: representation of the complexity of patients’ physical and mental condition. (2) The current state of caregivers: lack of formal caregivers’ integration as a team; inadequate formal involvement of informal caregivers. (3) Basic care needs: the reflection of the group needs relating directly to the patient, care organisation and the caretaker. (4) The (non-) Readiness of the existing system to respond to the needs for care: long-term care reliance on institutional services, lack of distinction between acute/immediate care and nursing, lack of integration between the medical sector and the social care sector. (5) Potential trends for further improvement of long-term care for the elderly with mental disorders. Conclusions Strengthening of the care network for elderly patients with mental disorders should cover more than a personalised and comprehensive assessment of the needs of patients and their caregivers. Comprehensive approaches, such as formalization of informal caregivers’ role in the patient care management and planning, a more extensive range of available services and programs supported by diverse sources of funding, systemic developments and better integration of health and social care systems are essential for making the system of care more balanced.

Qualitative research of informal caregivers’ personal experiences caring for older adults with mental disorders in Lithuania: A phenomenological approach

“…The scope of the present paper concerns comprehensive in-depth research into the personal experiences of informal caregivers for older adults with mental disorders, as well as the impact their caregiving role has on certain aspects of their own lives. A previous study has analyzed informal caregivers' experiences regarding the Lithuanian system of care for older adults with mental disorders [23].…”

Partnership between primary health and social care services in the long-term care of older people with dementia: a vignette study

“…The aim of the project is to develop a better understanding of the primary health care and social care collaboration and management of older people with mental disorders and their informal caregivers, and to nd pathways for improvement in care. The views regarding the care system held by the informal caregivers attending to elderly patients with mental disorders have been discussed elsewhere [31]. The focus of this study was to understand the system of care for older patients with dementia in Lithuania from the perspectives of family physicians (FPs), community nurses (CNs), psychiatrists (PPs), psychiatric nurses (PNs), and social workers (SWs).…”

“…A vignette situation involving two ctitious patients (spouses) with dementia and their daughter was created by our group of researchers based on a previous research with informal caregivers [26] and the opinions of experts. The vignette was piloted with a group of experts, which included all the professions to be included later in the study, that is, family physicians, community nurses, psychiatrists, psychiatric nurse, and social worker.…”

“…Lack of partnership and coordination of care activities between health and social care sectors could negatively affect the well-being and safety of older patients with dementia and impose an additional burden on their informal caregivers [24,25]. Various efforts have been made to address the Lithuanian situation of care for older patients with complex needs including dementia, mainly focusing on the experience of informal caregivers [26,27], piloting the integrated care delivery project [28,29]. However, research on long term care for older patients with complex needs is missing not only in Lithuania, but also in other Eastern European countries [21,30].…”

Partnership between Primary Health and Social Care Services in the Long-Term Care of Older People with Dementia: A Vignette Study

“…Lack of partnership and coordination of care activities between health and social care sectors could negatively affect the well-being and safety of older patients with dementia and impose an additional burden on their informal caregivers [24,25]. Various efforts have been made to address the Lithuanian situation of care for older patients with complex needs including dementia, mainly focusing on the experience of informal caregivers [26,27], piloting the integrated care delivery project [28,29]. However, research on long term care for older patients with complex needs is missing not only in Lithuania, but also in other Eastern European countries [21,30].…”