Perspectives About Health Care Provision in Dementia Care in Spain

Risco, Ester; Cabrera, Esther; Farré, Marta; Alvira, Carme; Miguel, Susana; Zabalegui, Adelaida

doi:10.1177/1533317515603818

Cited by 14 publications

(44 citation statements)

References 34 publications

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“…We all seem to do a little bit of dementia each, but we don't have perfectly dedicated people and if we do they're very secondary care positioned. -GP (Newton et al, 2016) But while having multiple professionals involved could complicate expectations and responsibilities of the professionals (Gilmour et al, 2003;Risco et al, 2015), one study observed that:…”

Section: Expectations Of Care and Of The Role In The Triadmentioning

confidence: 99%

“…Carers and people living with dementia reported that if there were too many professionals offering advice and getting involved it could lead to confusion over tasks and professional involvement (Gilmour et al, 2003;Risco et al, 2015). Continuity was reduced when there was a lack of services, which resulted in increased risk of harm, and carers finding themselves stretched in order to provide more care (Stephan et al, 2018;Toot et al, 2013).…”

Section: Continuity Of Carementioning

confidence: 99%

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Exploring how triads of people living with dementia, carers and health care professionals function in dementia health care: A systematic qualitative review and thematic synthesis

Tuijt¹,

Rees²,

Frost³

et al. 2020

Dementia

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Background Many qualitative studies report the post-diagnostic care experiences of carers and people living with dementia; however, this is not often accompanied by opportunities to hear the corresponding views of their health care professionals and how this triadic relationship functions. The aim of this review was to identify and thematically synthesize the experiences of health care services reported by people living with dementia, their carers and health care professionals. Methods Medline, PsycINFO, Embase and CINAHL were searched from inception to 31 July 2019 for qualitative research including people living with dementia, carers and health care professionals. Data were coded and thematically synthesised using NVivo. Results Of 10,045 search results, 29 papers relating to 27 studies were included in the final synthesis, including 261 people living with dementia, 444 carers and 530 health care professionals. Six themes emerged related to the functioning of a dementia care triad: (1) involving the person living with dementia, (2) establishing expectations of care and the roles of the members of the triad, (3) building trust, (4) effective communication, (5) continuity of care and (6) understanding the unique relationship dynamics within each triad. Discussion The interactions and complexity of triadic dementia care relationships further our understanding of how to improve dementia care. Awareness of possible diverging attitudes highlights areas of necessary improvement and further research into facilitating engagement, such as when multiple professionals are involved or where there are mismatched expectations of the roles of triad members. In order to operate efficiently as a triad member, professionals should be aware of how pre-existing relations can influence the composition of a triad, encourage the involvement of the person living with dementia, clarify the expectations of all parties, establish trusting relationships and enable communication within the direct triad and beyond.

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Section: Expectations Of Care and Of The Role In The Triadmentioning

confidence: 99%

Section: Continuity Of Carementioning

confidence: 99%

Exploring how triads of people living with dementia, carers and health care professionals function in dementia health care: A systematic qualitative review and thematic synthesis

Tuijt¹,

Rees²,

Frost³

et al. 2020

Dementia

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“…The articles comprised three reviews of dementia care and four primary studies. Two of the primary studies explored views of people living with dementia and health and social care staff in the UK (Dening, Greenish, Jones, Mandal, & Sampson, 2012) and in Spain (Risco et al, 2016). Melin Emilsson (2009) employed a comparative approach to investigating views of health and social care staff in long-term care facilities in France, Portugal, and Sweden, while Gotts et al (2016) conducted a survey of commissioners of end-of-life care in the UK.…”

Section: Characteristics Of Items Selected For Synthesismentioning

confidence: 99%

“…The findings highlight that most healthcare systems in Europe are designed to tackle distinct illnesses without much scope for interaction between different parts of systems. Delayed diagnoses, care in inappropriate and distressing settings, and unnecessary early transfers to long-term care facilities embody dementia care provided within disjointed care systems (Houghton et al, 2016;Risco et al, 2016;Turner et al, 2017). Fragmentation is apparent not only in the system-based approaches to providing care but also in the hegemony of biomedical diagnoses, which focus on the condition and its management with little or no concern for social health of the person with dementia (de Vugt & Dr€ oes, 2017).…”

Section: Implications For Policy Research and Practicementioning

confidence: 99%

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

2018

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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.

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“…Mediterranean cultures tend to place similar emphasis on the importance of the family and older people are still helped and cared for by the youngest offspring at home. Consequently, admission of a family member to a long-term care institution can even cause feelings of failure and disappointment within the family (Risco et al 2015). Many international studies have been conducted on the risk factors associated with admission to a long-term care institution (Rongve et al 2014; Tam-Tham et al 2013).…”

Section: Introductionmentioning

confidence: 99%

Risk factors related to the admission of people with dementia into a long-term care institution in Spain: an explorative study

et al. 2016

Self Cite

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Risk factors associated with admission of people with dementia to long-term care institutions need to be identified to support health-care professionals in dementia care at home. An explorative study, combining quantitative and qualitative data collection methods, was performed in people with dementia in Spain. The sample, consisting of people with dementia receiving formal care from health-care professionals but at risk of institutionalisation, and their informal care-givers; and people with dementia recently admitted to a long-term care institution, and their informal care-givers, was interviewed between November 2010 and April 2012. Perceived reasons for admission were determined through an open-ended question put to both groups. Presumed risk factors were collected with validated questionnaires and analysed using bivariate analysis. A total of 287 people with dementia and informal care-givers were studied. Reasons given by the institutionalised group were mostly related to the level of dependency of the person with dementia. People recently admitted to a long-term care institution had more cognitive impairment, a greater degree of dependency and poorer quality of life than those still living at home. Home-care services in Spain need to develop or improve interventions based on the risk factors identified in this study: informal care-giver profile, high cognitive impairment, high level of dependency and the poor quality of life of the person with dementia.

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Perspectives About Health Care Provision in Dementia Care in Spain

Abstract: The family is a key element in successful care coordination during dementia care provision. New effective strategies including self-management and emergent roles, such as case managers, could bring great benefits to people with dementia, caregivers, and health care providers.

Cited by 14 publications

References 34 publications

Exploring how triads of people living with dementia, carers and health care professionals function in dementia health care: A systematic qualitative review and thematic synthesis

Exploring how triads of people living with dementia, carers and health care professionals function in dementia health care: A systematic qualitative review and thematic synthesis

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

Risk factors related to the admission of people with dementia into a long-term care institution in Spain: an explorative study

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